What's the difference between perseveration and hyperfocus?

Question

Dr. Russell Barkley says hyperfocus goes with autism while perseveration goes with ADHD.

I read that perseveration is the same as hyperfocus or that hyperfocus goes with ADHD.

So what's the difference? Is Dr. Russell Barkley right?

Answer 1

I myself have never found evidence to suggest a difference between perseveration and hyperfocus when referring to ADHD. However, while 'hyperfocus' can be a psychiatric or non-psychiatric condition, perseveration is typically considered a psychiatric condition in all instances.

The wikipedia page for hyperfocus has an entire section dedicated to the confusion between hyperfocus and perseveration, particularly as it pertains to ADHD.

Hyperfocus may in some cases also be symptomatic of a psychiatric condition. In these cases it is more commonly and accurately referred to as perseveration (or perseverance) - the inability to, or impairment in, switching tasks or activities ("set shifting"), or desisting from mental or physical response repetition (gestures, words, thoughts) despite absence or cessation of a stimulus, and which is not excessive in terms of quantity but are apparently both functionless and involve a narrow range of behaviours, and are not better described as stereotypy (a highly repetitive idiosyncratic behaviour).

It is typical for individuals with ADHD to say they 1), can not focus on boring things and 2), can only focus on stimulating things, and that focus is often extreme. Thus it is both a concentration deficit and over-concentration, or generically: "hyperfocus.

Answer 2

Actually,if you saw a few of Dr. Barkley's presentations. He referred to people with autism spectrum disorder as hyperfocus because they focused immensely on fine details of their sensations and their environments. While this hyperfocus, lacks the big picture perception. For instance, the child with autism might focus on the car wheel, while not attending to the car itself.

While perseveration was well defined by the "upstairs" author.

EDIT: Scientists would agree that they have what the ADHD community defines hyperfocus, but some (not all) psychologist/psychiatrist would not appreciate the use of this term based on the definition alone. They would disagree on the word used to define it. They would agree that people with ADHD have perseveration, but not hyperfocus (based on the definition alone). There is science to backup issues related to perseveration. While positive aspects of perseveration is probably lacking in the literature (since that's harder to look for). Hyperfocus would be kept for the autistic symptoms of focusing far too much on one element or detail and not perceiving the remaining of the item for instance.

To make things more complicated, I know there is one psychiatrist who uses the term hyperfocus (although probably not in thescientific literature). His name is Edward Hallowell. He's more of a clinicians and a book writer than a scientist from what I remember.

Answer 3

NOTE: This response is based on my own personal experiences with these kinds of things and also on the information I've gathered online from people who claim to know about the subject (experts). I do not recall specifics, so as to be able to cite every source. Thus, your mileage may vary. :-)

I like words, especially in higher reading levels. However a lot of this quibbling over technical definitions of one condition or another seems to be missing out on what caused the question to arise in the first place.

Perseveration and hyper-focus both can FEEL similar to the casual observer on account of the effects of either symptom making a person behave similarly.

Splitting hairs about what to call it might come from a concern over clearly and consistently identifying the source of what's causing each issue.

So- If I understand correctly:

PERSEVERATION is a general difficulty regulating one's ability to persevere, either for eventually starting or in having trouble with stopping. It is affected or enhanced when the task involves a subject that is particularly stimulating in it's interactions.

It can often feel like a strong motivational inertia regarding task management. Specific stimulating interests can make it easier to start and also harder to stop. This can both work for and against timely task completion, until sufficient supports and accommodations are permitted in order to put that within the reach of the person.

But it sure makes a 12 hour video game marathon easier to do, if a person finds that sufficiently stimulating. Over all, they WANT to try to function, but they can have a tough time making themselves functional on a consistent basis.

HYPER-FOCUS is fixating on a detail or subject specifically. The subject itself is stimulating, even if the activities relating to it might not ordinarily be that engaging to other people.

It doesn't matter if the subject relates to the task at hand, it will definitely, definitely draw the person's attention in a compulsive manner. That's what they want to talk about, study and/or do. If the behavior resulting from the fixation produces something useful, such as an exceedingly niche position of employment, then great! At least they managed to find work, finally.

In extreme cases, until their subject of interest presents itself, they (like the honey-badger) just don't care.

Comorbidity between the two conditions is not entirely uncommon, (overlapping effects from both conditions). The way professional smart people try to argue that both are completely different and there can be no other way might be losing sight of this point.

TO ANSWER YOUR QUESTION: the cause of either condition may be different enough to warrant distinct labels when discussed in a professional medical setting. So I wouldn't be surprised if Dr. Russel Barkley is technically correct. When it comes to fixing a problem, it helps to classify it accurately, rather than just generalize for convenience.

There may even be some people who possess a measure of both conditions, on account of being affected by the separate causes of those conditions at the same time.

Whatever the case, the day-to-day experience is a pension for extreme focus.

Thus the casual inclination of people who are NOT Dr. Russell Barkley is to just call it "hyper-focus" and be done with it. :-)

Hopefully that helps.