Hyperfocus: the forgotten frontier of attention

Abstract

‘Hyperfocus’ is a phenomenon that reflects one’s complete absorption in a task, to a point where a person appears to completely ignore or ‘tune out’ everything else. Hyperfocus is most often mentioned in the context of autism, schizophrenia, and attention deficit hyperactivity disorder, but research into its effect on cognitive and neural functioning is limited. We propose that hyperfocus is a critically important aspect of cognition, particularly with regard to clinical populations, and that it warrants significant investigation. Hyperfocus, though ostensibly self-explanatory, is poorly defined within the literature. In many cases, hyperfocus goes undefined, relying on the assumption that the reader inherently knows what it entails. Thus, there is no single consensus to what constitutes hyperfocus. Moreover, some studies do not refer to hyperfocus by name, but describe processes that may be related. In this paper, we review how hyperfocus (as well as possibly related phenomena) has been defined and measured, the challenges associated with hyperfocus research, and assess how hyperfocus affects both neurotypical and clinical populations. Using this foundation, we provide constructive criticism about previously used methods and analyses. We also propose an operational definition of hyperfocus for researchers to use moving forward.

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Psychological Research (2021) 85:1–19
https://doi.org/10.1007/s00426-019-01245-8
REVIEW
Hyperfocus: theforgotten frontier ofattention
BrandonK.Ashino1,3 · AhmadAbu‑Akel2
Received: 24 January 2019 / Accepted: 9 September 2019 / Published online: 20 September 2019
© The Author(s) 2019
Abstract
‘Hyperfocus’ is a phenomenon that reflects one’s complete absorption in a task, to a point where a person appears to com-
pletely ignore or ‘tune out’ everything else. Hyperfocus is most often mentioned in the context of autism, schizophrenia,
and attention deficit hyperactivity disorder, but research into its effect on cognitive and neural functioning is limited. We
propose that hyperfocus is a critically important aspect of cognition, particularly with regard to clinical populations, and that
it warrants significant investigation. Hyperfocus, though ostensibly self-explanatory, is poorly defined within the literature.
In many cases, hyperfocus goes undefined, relying on the assumption that the reader inherently knows what it entails. Thus,
there is no single consensus to what constitutes hyperfocus. Moreover, some studies do not refer to hyperfocus by name, but
describe processes that may be related. In this paper, we review how hyperfocus (as well as possibly related phenomena)
has been defined and measured, the challenges associated with hyperfocus research, and assess how hyperfocus affects both
neurotypical and clinical populations. Using this foundation, we provide constructive criticism about previously used methods
and analyses. We also propose an operational definition of hyperfocus for researchers to use moving forward.
What ishyperfocus?
Hyperfocus, broadly and anecdotally speaking, is a phenom-
enon that reflects one’s complete absorption in a task, to a
point where a person appears to completely ignore or ‘tune
out’ everything else. It is generally reported to occur when
a person is engaged in an activity that is particularly fun
or interesting. An example of hyperfocus is when a child
becomes engrossed in a video game to a point where they
do not hear a parent calling their name. Although most
neurotypical people would likely report experiencing a
hyperfocus-like state at some point in their life, it is most
often mentioned in the context of autism, schizophrenia, and
attention deficit hyperactivity disorder—conditions that have
consequences on attentional abilities. Despite the experi-
ence of hyperfocus being ubiquitous, in both neurotypical
and psychiatric populations, there is very limited explicit
academic research into its effect on cognitive and neural
functioning. A Google Scholar search (excluding citations)
for hyperfocus and variations of the term, namely “hyper-
focus”, “hyper focus”, “hyperfocusing”, “hyper-focusing”,
and “hyper focusing” in the title, returned 6 results. A
PubMed search for the same terms in the title or abstract
returned 19 results. Of these, 7 are empirical studies explic-
itly focused on assessing cognitive and neural states associ-
ated with hyperfocus (in ADHD: Sklar, 2013; Ozel-Kizil
etal., 2013, 2016; in schizophrenia: Luck etal., 2014;
Sawaki etal., 2017; Kreither etal., 2017; Hahn etal., 2016;
Gray etal., 2014). An additional result is a paper that has
developed a new questionnaire to assess hyperfocus experi-
ences (Hupfeld, Abagis, & Shah, 2019).We also found 1
study that did not appear in our searches, but was cited in
a couple of the papers cited above (Ozel-Kizil, 2013). This
naturally leads to a simple question: why is there limited
explicit research on an ostensibly common human cognitive
and perceptual experience?
In this review, we will attempt to explain why hyperfocus
research has been so limited and we will assess if other phe-
nomena in the literature may essentially be hyperfocus going
by another name. Based on this, we will propose a clear and
testable operational definition of hyperfocus. Finally, we will
assess if the definitions of hyperfocus used in the psychiatric
literature match our proposed operational definition.
* Brandon K. Ashinoff
bka2115@cumc.columbia.edu
1 Department ofPsychiatry, Columbia University, 1051
Riverside Dr, NewYork, NY10032, USA
2 Institute ofPsychology, University ofLausanne, Quartier
UNIL-Mouline, Geopolis, Lausanne1015, Switzerland
3 Centre forHuman Brain Health (CHBH), School
ofPsychology, University ofBirmingham, Edgbaston,
BirminghamB152TT, UK
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2 Psychological Research (2021) 85:1–19
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Why hashyperfocus been forgotten?
There are three major issues to consider. First, there is no
clear general or operational definition of hyperfocus in the
literature, which usually assumes that the reader inherently
knows what it is. As there is limited explicit literature on the
topic, references to and descriptions of hyperfocus are typi-
cally anecdotal and can differ from paper to paper. Table1
reflects a comprehensive collection of how the few studies
that have explicitly studied hyperfocus have defined it, as
well as a representative sample of references to hyperfocus
in the ADHD, autism, and schizophrenia literature where
it was not the explicit focus of research. For example, Kahl
and Wahl (2006) reported that adults with ADHD could
“hyperfocus” on activities in which they have special inter-
est but did not define what cognitive or subjective experi-
ences are associated with hyperfocusing. It is important to
note that in most of these papers, these are the only refer-
ences or descriptions of hyperfocus at any point throughout
(with some exceptions; See Sklar, 2013), and they rarely
provide an operational definition that can be tested. When
it is defined, it is rarely operationally defined in a way that
can be used for quantitative research. Ozel-Kizil etal. (2013;
also see Ozel-Kizil etal., 2014) defined hyperfocusing as
being “characterized by intensive concentration on interest-
ing and non-routine activities accompanied by temporar-
ily diminished perception of the environment”. However,
this definition raises several questions, such as what defines
something as interesting? Does it have to produce enjoy-
ment, like a video game, or is an important homework
assignment enough? And how is the perception of the envi-
ronment diminished? The exceptions to this are the papers in
the schizophrenia section of Table1 (all of which come from
the same lab group and use the same operational definition
of hyperfocus), but we will discuss these in further detail
later in the paper and assess if they provide an appropriate
operational definition.
Despite these issues, there appear to be four general
features or criteria of hyperfocus that are consistently
reported (Table1):
1. Hyperfocus is characterized by an intense state of con-
centration/focus.
2. When engaged in hyperfocus, unrelated external stimuli
do not appear to be consciously perceived; sometimes
reported as a diminished perception of the environment.
3. To engage in hyperfocus, the task has to be fun or inter-
esting.
4. During a hyperfocus state, task performance improves.
Second, it is very difficult to experimentally manipu-
late a subject into a hyperfocus state (Sklar, 2013). The
nature of hyperfocus is such that a person must be com-
pletely absorbed in a task that is interesting or fun. How-
ever, most cognitive psychology experiments do not meet
this requirement. Even if subjects are able to enter into
a hyperfocus state with some interesting activity, having
them respond to a non-task relevant stimulus will break
them out of the hyperfocus state. This prevents monitor-
ing of cognitive functioning while the hyperfocus state is
occurring, or at least makes it very difficult to do.
Third, some studies do not refer to hyperfocus by name,
but describe processes that appear to be related, such as
“in the zone” and “flow”. For example, several research-
ers (e.g., Esterman, Noonan, Rosenberg, & DeGutis 2012,
Esterman, Rosenberg & Noonan 2014; Fortenbaugh etal.,
2015; Kucyi, Hove, Esterman, Hutchison, & Valera, 2017)
measured performance during a sustained attention task
while participants were “in the zone”, a state defined by
reduced variability in task performance. Dietrich (2004),
on the other hand, assessed the neural correlates of “flow”,
defined subjectively as a state of intense concentration
with the loss of reflective self-consciousness. However, it
is unclear if “in the zone” states, “flow” states, and “hyper-
focus” states reflect the same or distinct processes.
This review was motivated by the lack of clarity and
consistency across the academic literature with respect
to hyperfocus. As such, we intend this paper to address
the following issues. First, has hyperfocus been explic-
itly studied, just under a different name? Therefore, in
the next section of this paper, we examine the literature
on related phenomena, namely “in the zone” and “flow”
states—which at face value appear to instantiate the same
subjective experiences and behavioral effects—to evaluate
if they reflect a similar or distinct process from hyperfo-
cus. It is important to note here that the notion of “in the
zone” reported in this review is distinct from the notion of
“in the zone” used in the flow literature—often to describe
the flow experience. Here, when we refer to “in the zone”,
we are referring to it as defined by Esterman etal. (2012,
2014)—performance characterized by relatively low
variability in response times. Notably, this highlights the
importance of clarity, specificity, and operational defini-
tions in research. Second, we will propose an operational
definition of hyperfocus. And third, as hyperfocus is most
often referenced in relation to psychiatric disorders, we
will then assess if patients with ADHD, autism, or schizo-
phrenia exhibit hyperfocus-related symptoms relative to
our proposed operational definition and if these symptoms
are consistent across disorders. The ultimate purpose is to
provide a common baseline for researchers of the hyper-
focus phenomenon.
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Table 1 Various descriptions of hyperfocus from the ADHD, autism and schizophrenia literature
Clinical
population
Author(s) Description of hyperfocus
ADHD Hupfeld etal.
(2019)*
“While the estimated 8 million adults in the USA affected by attention-deficit/hyperactivity disorder (ADHD)
might find it nearly impossible to sit still in a lecture hall or excruciatingly challenging to focus on writing a
term paper, these same individuals might find themselves spending hours at a time composing a new song,
tinkering with their car, writing computer code, or watching television (Kessler etal., 2006). The term
“hyperfocus” (HF) has been used to characterize this state of heightened, focused attention that individuals
with ADHD frequently report (Brown, 2005; Conner, 1994; Ozel-Kizil etal., 2016).”
Ozel-Kizil etal.
(2016)*
“ ‘Hyperfocusing’ is defined as a clinical phenomenon of “locking on” to a task in patients with ADHD who
have a difficulty of shifting their attention from one subject to another, especially if the subject is about
their interests (Conner, 1994). Hyperfocusing was mentioned as a state resembling a “hypnotic spell”,
according to the subjective experiences of the cases with ADHD (Brown, 2005)… Moreover, hyperfo-
cused individuals neglect things other than the condition they are already focused on. Patients with ADHD
are reported to be stuck in the activities that they are interested and they keep on doing these things for
hours while they lose interest in their surroundings…The patients with ADHD usually report that they
cannot understand how the time passes. During hyperfocusing, the individuals state that they are aware of
the things that they ignore, however they cannot give up what they are doing (Brown, 2005; Conner, 1994).
Hyperfocusing is thought to occur on the basis of attention disorder; patients with ADHD have difficulties
of focusing and sustaining, as well as shifting their attention.”
Ozel-Kizil etal.
(2013)*
“Hyperfocusing, which is characterized by intensive concentration on interesting and non-routine activities
accompanied by temporarily diminished perception of the environment, is a clinically well-known phenom-
enon in patients with attention deficit and hyperactivity disorder. It is also described as ‘locking on’ to some
task.”
Sklar (2013)* “…hyperfocus appears to refer to a more specific (and perhaps extreme) type of sustained attention in which
the individual’s behaviour is controlled for a long period of time by a task which is ‘non-routine’ or of
interest to him/her, to the point that his/her awareness of the environment is considerably diminished.”
Goodwin and
Oberacker (2011)
“Many children with ADHD have the ability to hyperfocus on certain tasks. This trait can confuse parents,
as they see their highly distractible child engrossed in a video game, for example. They call his name but he
has tuned them out, along with every other stimulus in the room.”
Schecklmann etal.
(2008)
“Hyperfocusing is not mentioned in DSM-IV [with respect to ADHD], but it is known from clinical work
and can be described as intensive concentration on interesting and non-routine activities accompanied by
temporarily diminished perception of the environment.”
Carver (2009) “Both research and clinical experience tells us that ADHD Children [sic] can exhibit a type of “hyperfo-
cus”—intense concentration and single-minded focus when the activity is very interesting.”
Kahl and Wahl
(2006)
“The researchers noted that “interest” probably the most frequently experience positive emotion, “is an
extremely important motivation in the development of skills, competencies and intelligence”. The motivat-
ing power of such “interest” may be most apparent when it is absent, as described in the chronic complaints
of many adults with ADDs who report that although they can “hyperfocus” on activities in which they
have special interest, they chronically find themselves unable to mobilize effort for tasks in which they do
not feel any special immediate interest, even when they are fully aware that their failure to do that uninter-
esting task may cause significant problems later.”
Autism Isomura, Ogawa,
Shibasaki, &
Masataka, (2015)
“Typically, children with autism are known to… pay abnormal and obsessive attention to detail, and to note
and record their environment with exquisite clarity (Casey etal., 2008). They are capable of becoming
hyper-focused and locked-in on apparently arbitrary subjects of interest, and of sustaining their attention
on these subjects for unusually long periods of time…as a result of this internal hyper-focus, it would
be more difficult for another person to command the attention of the child with autism, and it would also
be more difficult for the child himself/herself to command his/her own attention voluntarily (Posner and
Dehaene, 1994).”
Fein (2015) “The co-existence of strength and vulnerability encapsulated in these narratives captured essential features
of the experience of living with Asperger’s Syndrome—a condition that itself brought valued strengths
(the ability to hyperfocus on a topic of interest, strengths in systematic thinking, an occasionally exquisite
sensitivity to sensory input) as well as disabilities.”
Mayes (2014) “Unlike most children with ADHD who have difficulty sustaining their focus on anything, children with
autism can hyperfocus on activities of interest to them (e.g., spending hours twirling a string, assembling
puzzles, drawing the same picture over and over, or reading a book).”
Meilleur, Jelenic,
and Mottron,
(2014)
“Alternatively, improvements in adaptive abilities may accompany loss of skills involving hyperfocus, as
autistic people learn and adapt.” (No description of hyperfocus is provided and there is no further mention
of it in the paper)
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4 Psychological Research (2021) 85:1–19
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Table 1 (continued)
Clinical
population
Author(s) Description of hyperfocus
Bombaci (2012) “Besides associational thinking and mindblindness, autistic subjects also tend to display extreme concentra-
tion when gazing on or thinking about objects that interest them. Other terms for autistic hyper-focus are
‘stimming’ and ‘perseveration’. Interestingly, over-selective attention, the clinical term for this form of
perceptual difference, echoes William James’s notion of selective attention—a perceptual ability that he
associated with masculine power.”
Mayes, Calhoun,
Murray, Ahuja,
and Smith,
(2011)
“Attention deficit, hyperactivity, and impulsivity are common in children with autism, but, unlike children
with ADHD, children with autism have the ability to hyperfocus on activities of interest to them, such
as spending hours twirling a string or reading a book (Mayes & Calhoun, 1999). Repetitive behaviors in
autism (e.g., spinning wheels on a car or drawing the same pictures over and over) are often driven by
pleasure…”
Geurts etal. (2009) “Difficulties in shifting attention, disengaging attention from details (i.e., hyperfocus)”
Schizophre-
nia
Luck etal. (2019)* “This new hypothesis states that schizophrenia involves an aberranthyperfocusingof processing resources
on a small number of representations. In other words, even when the task requires perceiving or remember-
ing multiple objects or locations, PSZ [patients with schizophrenia] tend to focus intensely but narrowly.”
Sawaki etal.
(2017)*
“…the hyperfocusing hypothesis, which proposes that PSZ [patients with schizophrenia] tend to focus their
processing resources more intensely but more narrowly than HCS [healthy controls] as a result of disrupted
attractor dynamics that tend to create deeper basins of attraction and produce exaggerated winner-take-all
processing (Luck etal., 2014)”
Luck etal. (2014)* “… processing resources are focused more intensely but more narrowly in PSZ [patients with schizophrenia]
than in healthy control subjects (HCS [healthy controls]). In other words, PSZ [patients with schizophre-
nia] focus unusually strongly on some sources of information to the exclusion of others. We call this the
hyperfocusing hypothesis.”
Gray etal. (2014)* “We speculate that impairments in the Divided Attention subtest, and in part also reduced WM [working
memory] capacity, reflect an underlying abnormality in the dynamics of local cortical circuits in PSZ
[patients with schizophrenia]. Briefly, we propose that an imbalance between excitatory and inhibitory
function tends to cause exaggerated local inhibition and an increase in winner-take-all processing. This
winner-take-all processing mode is suggested to cause a ‘hyperfocusing’ of resources onto a small number
of locations or objects, whether they are currently visible (as in the Divided Attention subtest) or being held
in memory (as in our WM [working memory] task). When applied to external representations, the tendency
to hyperfocus may lead to deficits in dividing attention among multiple targets or spreading attention
among multiple locations or a broad area in space. When hyperfocusing is applied to internal representa-
tions, this would lead to a reduction in the number of items, rules, or response alternatives that can be
simultaneously active, which could compromise more complex cognitive operations.”
Leonard etal.
(2012)*
“Recent work has instead found that schizophrenia is associated with a ‘failure’ to attend broadly (Elahipanah
etal. 2011; Hahn etal. 2012), suggesting that impaired WM [working memory] capacity estimates in PSZ
[patients with schizophrenia] may reflect a tendency to hyperfocus on a subset of the relevant information
rather than an inability to filter irrelevant information.”
Hahn etal. (2016)* “…it has been suggested that PSZ [patients with schizophrenia] have a narrowed “attentional spotlight” and
difficulty maintaining a wide visual span
We followed up on these findings with a visuospatial Allocation Task (SARAT), in which a central cue
predicts the location of a peripheral target stimulus… One, 2, or all 4 possible target locations could be
cued simultaneously, manipulating the degree to which attention had to be focused narrowly or distributed
broadly. Both HCS [healthy controls] and PSZ [patients with schizophrenia] displayed step-wise faster RT
with more precise cueing. However, this effect was substantially larger in PSZ [patients with schizophre-
nia] than in HCS [healthy controls]. Potential explanations for this finding are that (1) PSZ [patients with
schizophrenia] “hyperfocused” the location to which a predictive cue directed their attention, resulting in
disproportionate RT benefits in predictive cue trials, or (2) PSZ [patients with schizophrenia] had difficulty
distributing attention broadly, resulting in greater RT costs when there was no advance information about
the target location.”
Prentky (2001) “Positive symptoms, as Gruzelier and Raine (1994) reported, are associated with higher left than right hemi-
spheric activity, supporting the hypothesis that general overactivation of the left hemisphere or underacti-
vation of the right hemisphere characterizes the C-type. Thus, there is a hypothetical optimal hemispheric
imbalance that promotes a constructive, task-specific hyperfocus on detail and facilitates problem solving
but does not seriously incapacitate or debilitate the individual.”
Entries with an asterisk are papers which explicitly studied hyperfocus
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5Psychological Research (2021) 85:1–19
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Hyperfocus andpossibly related
phenomena
Hyperfocus andflow
Flow was one of the first concepts introduced as part of the
field of ‘Positive Psychology,’ which focuses on the “science
of positive subjective experience, positive individual traits, and
positive institutions” (Seligman and Csikszentmihalyi, 2000,
p. 5; also see Seligman, Steen, Park, & Peterson, 2005; Rich,
2013; Lopez and Snyder, 2009). According to Nakamura and
Csikszentmihalyi (2009, p. 195–196; also see Nakamura and
Csikszentmihalyi, 2002; Csikszentmihalyi 1975, 1997, 2000),
The conditions for entering flow include:
• perceived challenges, or opportunities for action,
that stretch but do not overmatch existing skills;
• clear proximal goals and immediate feedback about
the progress being made.
Under these conditions, experience seamlessly unfolds
from moment to moment and one enters a subjective
state with the following characteristics:
• intense and focused concentration on the present
moment;
• merging of action and awareness;
• loss of reflective self-consciousness (i.e., loss of
awareness of oneself as a social actor);
• a sense that one can control one’s actions; that is,
a sense that one can in principle deal with the situ-
ation because one knows how to respond to what-
ever happens next;
• distortion of temporal experience (typically a sense
that time has passed faster than normal);
• experience of the activity as intrinsically reward-
ing, such that often the end goal is just an excuse
for the process.
The conditions for entering flow and the subjective expe-
riences associated with it appear to map onto the most com-
monly reported features of hyperfocus (Table2). Therefore,
we propose that flow and hyperfocus are the same phenom-
enon. Although we are mindful that just because two phe-
nomena are descriptively similar, they are not necessarily
mechanistically identical, there is no evidence to suggest that
either flow or hyperfocus are distinct. From our reading of
the literature, we note that the psychiatric literature is more
likely to use the word hyperfocus and positive psychology
literature is more likely to use the word flow, despite the
phenomenology being almost identical. With this in mind,
the flow literature can be used as a framework to understand
hyperfocus. Here, we review the literature on flow in con-
junction with cognitive psychology literature on attention
with an emphasis on assessing if these literatures can pro-
vide insight into hyperfocus, specifically with respect to the
common features we identified earlier. We will also review
the limited research on the neural correlates of flow to assess
the possible neural correlates mediating hyperfocus. Fur-
thermore, if the flow literature provides sufficient evidence
of the phenomenology associated with hyperfocus, then we
can be more confident that these are the same processes. If
not, then we would have to re-evaluate this claim.
Table 2 Common descriptive features of hyperfocus and flow, based on the most commonly reported features of hyperfocus and Nakamura and
Csikszentmihalyi’s (2009) criteria for flow
Hyperfocus criteria Corresponding flow criteria/experiences
Hyperfocus is characterized by an intense state of concentration/focus Intense and focused concentration on the present moment
When engaged in hyperfocus, unrelated external stimuli do not
appear to be consciously perceived; sometimes reported as a dimin-
ished perception of the environment
Merging of action and awareness
Loss of reflective self-consciousness (i.e., loss of awareness of oneself as
a social actor)
Distortion of temporal experience (typically a sense that time has passed
faster than normal)
To engage in hyperfocus, the task has to be fun or interesting Experience of the activity as intrinsically rewarding, such that often the
end goal is just an excuse for the process
Perceived challenges, or opportunities for action, that stretch but do not
overmatch existing skills
During a hyperfocus state, task performance improves A sense that one can control one’s actions; that is, a sense that one can in
principle deal with the situation because one knows how to respond to
whatever happens next
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6 Psychological Research (2021) 85:1–19
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Criterion 1: toengage ahyperfocus, thetask hastobe fun
orinteresting
Linnell and Caparos (2013; Linnell, Caparos, de Fockert,
& Davidoff, 2013, Linnell, Bremner, Caparos, Davidoff,
& de Fockert, 2018) have suggested attentional/cognitive
engagement, rather than task difficulty (such as in perceptual
load theory; Murphy, Groeger, & Greene. 2016; Makovski,
Hommel, & Humphreys 2014; Lavie, 1995; Lavie and Tsal,
1994), to be the critical factor in determining the scope of
attentional function during a task. Engeser and Rheinberg
(2008) examined the effect of perceived importance on flow.
Flow was measured with the Flow Short Scale (Rheinberg,
Engeser, & Vollmeyer 2002), a ten-item questionnaire
designed to assess flow experiences. During a low impor-
tance task (playing the video game pac-man), flow was high-
est when there was equal perceived difficulty of the task and
perceived skill at the task by the subjects (termed skills-
demand compatibility), compared to when the task was easy
or hard. For a high importance task (studying for a university
level statistics test that required a passing grade to continue
on with the degree program), they found that flow was high
when the task was easy and when there was a skills-demand
compatibility, compared to when the task was hard. Simi-
larly, Schüler (2007) measured subjects’ achievement motive
before and after an academic lecture (with a 1-week interval
in between testing sessions) and it was found that those who
were motivated by their ‘hope of success,’ as compared to
‘fear of failure,’ experienced flow during the lecture. In both
of these studies, increased perceived importance of the task
arguably increased the subject’s motivation to engage in it
and subsequently moderated the conditions under which
flow was achieved. In terms of flow, this suggests that the
“experience of the activity as intrinsically rewarding”, may
in fact be one of the criteria for entering a flow state, rather
than an effect of these states. In terms of hyperfocus, it sug-
gests that engaging hyperfocus requires task engagement,
which would simply be more common during fun or inter-
esting tasks.
Criteria 2 and3: intense state ofconcentration; external
stimuli donotappear tobe consciously perceived/
diminished perception oftheenvironment
In terms of cognitive psychology, we could phrase “intense
concentration” as the intense engagement of sustained and
selective attention mechanisms. Unfortunately, there are lim-
ited cognitive studies of attentional processes in the flow
literature. As with the hyperfocus literature, this is largely
due to the reasons discussed at the beginning of this review.
Although mostly speculative, this section highlights atten-
tional processes that may contribute to flow and hyperfocus.
As attention is a limited resource, if a significant amount of
those resources are focused on a particular task, peripheral
and task irrelevant information may be lost (such as in per-
ceptual load: see references above; and inattentional blind-
ness: Simons and Chabris, 1999; Simons, 2000; Stothart,
Wright, Simons, & Boot, 2017). In this case, subjects in a
flow state will not pay attention to their own actions beyond
what is required for the task, resulting in a ‘loss of reflec-
tive self-consciousness’, nor will they be paying attention
to the time passing, resulting in ‘the distortion of temporal
experience.’ In fact, there is ample evidence that attention
is required for conscious awareness (Taylor, 2002; Cohen,
Cavanagh, Chun, & Nakayama 2012; Dehaene, Changeux,
Naccache, Sackur, & Sergent 2006; but see Lamme, 2003
and Koch & Tsuchiya, 2007 for a dissenting viewpoint) and
for accurate time perception (Brown, 1985). When refer-
encing hyperfocus, the literature refers to the “diminished
perception of the environment” (Sklar, 2013; Schecklmann
etal., 2008), which one could argue may be due to similar
mechanisms and result in similar experiences as the effects
of flow that were just described. That being said, efficient
engagement of attentional resources could also produce an
apparent diminished perception of the environment. Cru-
cially, these explanations may not be mutually exclusive. For
example, it is possible that attention is efficiently engaged
such that external distractors could be processed and sup-
pressed, but time perception is still impaired due to a lack of
available resources. A corresponding set of effects could also
occur with respect to information that is relevant to the task.
In fact, the well-known phenomenon of the attentional blink
(Raymond, Shapiro, & Arnell, 1992; Dux and Marois, 2009;
Shapiro, Hanslmayr, Enns, & Lleras 2017) shows that under
conditions of significant attentional engagement even cen-
trally presented, task relevant information may be ignored.
Unfortunately, this way of thinking about flow has rarely
been applied in an experimental context. In a notable excep-
tion, Castellar, Antons, Marinazzo, and Looy (2019; also
see Allison and Polich (2008) had participants engage in an
auditory novelty oddball task while simultaneously play-
ing a video game under three conditions (manipulated by
adjusting the difficulty of the game): boredom, frustration,
and flow. The results showed that the participants made more
errors in the oddball task during the flow condition, than
boredom or frustration, suggesting they were focused more
intently on the video game during the flow state (measured
with a questionnaire given after the task) and that they did
not perceive “external” stimuli (relative to the video game)
as efficiently. This study also included EEG measurements,
but that will be discussed further in the next section. Future
research will have to continue to investigate the relationship
between flow and cognitive functioning with sophisticated
cognitive paradigms like this.
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7Psychological Research (2021) 85:1–19
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Criterion 4: task performance improves
It is critical to ask ‘Does flow/hyperfocus actually improve
performance?’ Csikszentmihalyi and colleagues (Csiksze-
ntmihalyi, 1997; 2000; Nakamura and Csikszentmihalyi,
2009) have consistently described flow as a state that pro-
duces inherently high performance, yet there is limited evi-
dence to support this statement. Keller, Bless, Blomann, and
Kleinböhl (2011); Keller, Ringelhan, and Blomann (2011)
conducted a study in which subjects were presented with
a computerized knowledge task; they were presented with
a question and had to select an answer from four response
options. There were three separate experimental conditions:
boredom, fit, and overload. In the boredom condition, the
questions were consistently very easy throughout the blocks.
In the fit (or adaptive) condition, the difficulty of the ques-
tions was adapted based on performance (when they got a
question right, the next one was harder; when they got one
wrong, the next one was easier). It was predicted that the
fit condition would produce a flow state. In the overload
condition, the difficulty of the questions was consistently
too hard for the subjects throughout the blocks.1 After the
knowledge task, subjects filled out a questionnaire indicating
if they experienced flow or felt that skills-demand compat-
ibility was met. Throughout this study, heart rate variabil-
ity (HRV) was measured as a dependent variable, with the
logic that a low HRV was indicative of mental involvement
and/or strain. Subjects reported being ‘more involved’ with
the fit condition than the boredom and overload conditions.
Additionally, it was reported that HRV was significantly
decreased in the fit and overload condition compared to the
boredom condition. The difference in HRV between fit and
overload conditions was not significant.2 A second experi-
ment following a similar procedure, but measuring salivary
cortisol (an indicator of stress), found that subjects pro-
duced more cortisol in the fit and overload conditions com-
pared to the boredom conditions. There was no difference
between the overload and fit conditions. It was reasoned that
increased stress would be expected in the overload condition,
as subjects would be struggling to succeed, but that the same
levels of stress in the fit condition is surprising. Keller etal.,
(2011) argued that despite the generally positive subjective
experience associated with flow, “flow experiences can be
considered as involving straining tension and mental load
from a physiological perspective”. This can be interpreted
that the brain is in fact ‘working harder’ than normal, lend-
ing credence to the idea that people might perform better
during a flow state. However, these studies only provide
indirect and speculative evidence that performance might
increase during a flow state because one’s brain appears to
be working harder.
Other studies have also provided more, albeit still indirect,
evidence of increased performance in flow states (Schüler
2007; Jin, 2012; Engeser and Rheinberg, 2008; Keller and
Bless, 2008). Keller and Bless (2008) had subjects play
the video game Tetris under varying difficulty conditions
(Adaptive, Boredom, and Overload) and found that subjects
in the adaptive condition (where subjects purportedly were
in a flow state) had higher top scores than subjects in the
other conditions. This was interpreted as evidence that flow
experiences result in improved performance. Additionally,
Schüler (2007; experiment 2) reported that flow experience3
was a significant predictor of exam performance, such that
more intense flow experiences were associated with higher
grades. However, as all of this evidence is correlational,
causal relationships cannot be inferred. In fact, Jin (2012)
has suggested that the direction of the relationship between
performance and flow may be the opposite; her study found
that high performance while playing a video game was a
predictor of experiencing flow.
Based on this, it is unclear if task performance actually
improves during flow or hyperfocus states. One possibility
is that flow states simply make people feel as if they were
doing better than usual, rather than actually improving per-
formance. The flow experiences of the ‘merging of action
and awareness’ and having ‘a sense that one can control
one’s actions’ may be explained by the fact that more atten-
tional resources are deployed towards the relevant informa-
tion than is typical, resulting in faster processing of infor-
mation (Carrasco & McElree, 2001; Carrasco, Giordano, &
McElree, 2006; Noguchi, Tanabe, Sadato, Hoshiyama, &
Kakigi 2007). According to the ease-of-processing heuristic
(Kornell, Rhodes, Castel, & Tauber, 2011), information that
is processed quickly is judged to be learned better than more
slowly processed information. In addition, Winkleman and
Cacioppo (2001; see also Reber, Schwarz, & Winkielman
2004) showed that faster processing of information results
in higher positive affect. This could give subjects the impres-
sion that they always know what to do because they are mak-
ing quick judgments that they feel good about, regardless if
they are correct. Of course, this will require explicit testing
in the future.
1 Some details of the study were not reported by the authors. For
example, the threshold criterion in the staircase procedure was
not reported nor was if the overload condition adapted to subjects
responses.
2 The authors reported that HRV for overload and fit differed at
‘trend level’ significance (p < .10), which is an invalid interpretation
that is reported properly here. However, because of this, they inter-
preted HRV as being uniquely low in the fit condition and do not
address the serious theoretical implications of there being no signifi-
cant difference between the fit and overload conditions.
3 It is unclear from the paper if the ‘flow experience’ that influenced
exam performance occurred over the class lectures or during the
exam itself.
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8 Psychological Research (2021) 85:1–19
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The neural correlates offlow
Research into the neural correlates of flow is limited.
Dietrich (2004) proposed a theoretical framework based on
the idea that information processing consists of an explicit
(i.e., conscious, voluntary) and implicit (i.e., unconscious,
automatic) system. In this framework, flow is associated
with suppression of activity in the explicit system, specifi-
cally the frontal and prefrontal cortex—referred to as “tran-
sient hypofrontality”. According to Dietrich (2004), this
allows the implicit network to be engaged without inter-
ruption, producing flow states. However, Weber, Tamborini,
Westcott-Baker, and Kantor (2009) point out that Dietrich’s
(2004) framework does not account for flow as an attentional
phenomenon (see below for an alternative framework). To
our knowledge, only one study has explicitly investigated
the neural correlates of flow in a healthy population. As
described in an earlier section. Castellar etal. (2019) had
participants engage in an auditory novelty oddball task while
simultaneously playing a video game during a flow state and,
based on the behavioural data from the oddball task, ostensi-
bly less intense attentional states (boredom and frustration).
During the task, EEG measurements were recorded, and they
found a delayed (by 24ms on average) midfrontal negativity
during the flow condition, which was interpreted as “a neu-
ral correlate of executive attentional processes involved in
top-down cognitive control operations… reflecting executive
processes as defined in the three-network view of attention…
(p. 9)”. Moreover, Raz and Buhle (2006) reviewed fMRI
research on the three attention networks (alerting, orienting,
and executive) and reported that the alerting and executive
function networks were both independently associated with
increased frontal cortex activity, notably in the dorsolateral
prefrontal cortex and the anterior cingulate cortex. Other
non-frontal brain regions have also been associated with
attentional processes and executive control, such as the pari-
etal cortex and subcortical regions, but we focus on fron-
tal regions here in response to the transient hypofrontality
framework. Therefore, if we posit that flow (or hyperfocus)
is first and foremost an attentional phenomenon, then these
results may contrast Dietrich’s (2004) notion of “transient
hypofrontality” as the trigger for flow states.
That being said, we urge caution in inferring attentional
processes based on increased or decreased frontal activation,
a rationale known as reverse inference. There is some debate
on the value of both formal and informal reverse inference
in neuroimaging data (Sprooten etal., 2017; Poldrack 2011;
Yarkoni, Poldrack, Nichols, Van Essen, & Wager, 2011; Pol-
drack, 2006) and a full treatment of this is beyond the scope
of this paper. However, most relevant to our purposes is that
Poldrack (2011) has argued that reverse inference is useful
as a method to generate novel hypotheses. In other words,
we cannot say based on the current literature that increased
frontal activation in alerting and executive functions con-
tradicts transient hypofrontality during flow states, because
frontal activity does not inherently imply the engagement of
attentional control, but the literature does provide enough
evidence to justify the development of a study designed to
test this possibility. And we would encourage readers to do
just that!
Another theoretical framework was proposed by Weber
etal. (2009), suggesting that flow states are the result of syn-
chronization between attentional (particularly alerting and
orienting) and reward networks—states that can be induced
when there is a balance between skill and challenge in a
task. They argue that synchronization has fewer metabolic
demands than non-synchronous brain activity, that it is a
particularly efficient method of information processing, that
it is a mechanism for conscious awareness, and that it mani-
fests subjectively as a pleasurable experience. It should be
noted that Weber etal. (2009) provided this definition spe-
cifically in the context of media, such as video games. The
available empirical data relating to this theory is both limited
and mixed. Only one study we found attempts to explic-
itly test this theory. Klasen, Weber, Kircher, Mathiak, and
Mathiak (2012) showed activation in the reward and alerting
network in response to the skill/challenge balance during
a video game, arguing that it supported the notion of syn-
chronization between reward and attention areas. Although
critically, this is indirect evidence as they did not obtain any
explicit measures of functional connectivity or synchroniza-
tion. However, other studies that were not explicitly designed
to test the synchronization theory, nevertheless provide con-
tradictory evidence. For example, Kucyi etal. (2017) found
that, during a rhythmic tapping task, increased functional
connectivity between and within the default mode network
(DMN) and the salience network was associated with “out
of the zone” attention. To the extent that “out of the zone”
contrasts “the flow state” (see discussion in following sec-
tion), this interpretation contradicts the notion that increased
synchronization is associated with more efficient informa-
tion processing. Future research will have to resolve these
conflicting results.
Hyperfocus andbeing “In theZone”
In an effort to assess moment to moment fluctuations in
sustained attention performance, Esterman etal. (2012)
developed the gradual continuous performance task (grad
CPT). During the grad CPT, participants were presented
with images of either a city scene or a mountain scene that
would gradually transition from one to the next over the
course of the 800ms presentation time. Participants had to
respond to city scenes and withhold responses during moun-
tain scenes. To assess behavioral variation in performance
over time, Esterman etal. (2012) employed a variance time
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9Psychological Research (2021) 85:1–19
1 3
course analysis, which assessed within-subject performance.
They found that high variability epochs were associated with
increased errors, faster RTs prior to commission errors, and
slower RTs prior to correct responses relative to low vari-
ability epochs. As such, the low variability epochs were
termed “in the zone” and the high variability epochs were
termed “out of the zone”. One significant advantage of the
variance time course analysis was that it allowed for the
measurement of attentional states without having to directly
probe the subjects to find out if they were “in the zone”.
Esterman etal. (2014) conducted a similar study using
the grad CPT paradigm, but also included irrelevant dis-
tractors. In this study, participants had to respond to male
faces, while withholding responses to female face. These
faces were superimposed on top of mountain or city scenes
which independently transitioned out-of-sync with the faces.
On some trials, the background image was the same as the
previous trial (repeat trials) and on others it changed (novel
trials). Behaviorally, they reported that “in the zone” states
were associated with fewer errors, suggesting improved task
performance. Moreover, using a cortical-scene network ROI,
regions that are selectively activated by scene images, they
found a larger difference in the BOLD % signal change
between novel and repeat trials (with more activity during
novel trials) during “in the zone” epochs relative to “out of
the zone” epochs. Because scenes were the distractors in
their study, they argued that this was evidence of increased
distractor processing, which was possible because of a con-
comitant reduction in perceptual load associated with the
primary face identification task. Essentially, they argue that
“in the zone” epochs are characterized by efficient atten-
tional engagement, while “out of the zone” epochs are char-
acterized by over engagement.
Based on these data, there do seem to be similarities
between hyperfocus and “in the zone” epochs. Notably, the
evidence suggests that “in the zone” states reflect intense
engagement of sustained attention and reduced distraction.
Critically, although numerous studies have described hyper-
focus as being associated with a temporarily diminished per-
ception of the environment (Table1; Sklar, 2013; Ozel-Kizil
etal., 2013; Schecklmann etal., 2008) resulting in fewer
distractions, Esterman etal. (2014) would suggest that it may
be associated with an enhanced perception of the environ-
ment leading to more efficient distractor suppression. How-
ever, despite the apparent similarities, “in the zone” states
do not meet the criteria to be classified as the same process
as hyperfocus. First, the task is not especially fun or interest-
ing beyond a traditional psychology experiment. And sec-
ond, the nature of the variance time course analysis is such
that there is no baseline condition, so it is unclear if perfor-
mance during the “in the zone” epochs reflects enhanced
performance or simply unimpaired performance, relative to
impaired performance during the “out of the zone” epochs.
An operational denition ofhyperfocus
Based on the above review, we propose the following
operational definition for four distinct and testable features
of hyperfocus: (1) hyperfocus is induced by task engage-
ment; (2) hyperfocus is characterized by an intense state
of sustained or selective attention; (3) During a hyper-
focus state, there is a diminished perception of non-task
relevant stimuli; and (4) During a hyperfocus state, task
performance improves.
Flow states do show evidence that they are induced
by at least interesting, if not fun tasks. In particular, they
are induced by engaging tasks, irrespective of the source
of motivation. Although the specific language is different
from what has been typically used to describe hyperfocus
(engagement vs fun/interesting), it is arguable that in context
they mean the same thing. There is no explicit evidence that
flow induces intense states of sustained and selective atten-
tion. However, based the reported effects of flow, it is rea-
sonable to hypothesize that sustained and selective attention
likely play a significant role. Moreover, applying a cognitive
framework can provide a reasonable account of how intense
states of attention could lead to the reported effects of flow.
There is ample evidence that flow states induce a “dimin-
ished perception of non-task related stimuli”, though this
has been only reported in subjective questionnaires, after the
flow state had ended. To date, there have been no explicit
cognitive or psychometric measurements taken during a flow
state. Regardless, the subjective reports match the anecdotal
reports of hyperfocus closely. Finally, there is some limited
evidence that flow states improve task performance, but
this is all correlational and indirect. Overall, the evidence
suggests that flow states and hyperfocus appear to be the
same phenomena, just with different names and initially
reported in different fields of psychology. That being said,
more research will be necessary to confirm and strengthen
this claim (Table3).
“In the zone” states show no evidence that they are
induced by fun or interesting tasks. They do show some
evidence that they are characterized by intense states of sus-
tained attention, but it is unclear how “intense” these states
really are. “In the zone” states seem to reflect the upper
range of normal fluctuations in attentional performance,
rather than a distinct state of attention. “In the zone” states
also show clear evidence of increased distractor suppression,
resulting in a diminished perception of non-task relevant
stimuli. Finally, there is no evidence that “in the zone” states
result in improved task performance. Overall, the evidence
leads us to conjecture that while “in the zone” states may
still be mediated by similar mechanisms to hyperfocus, they
are nevertheless distinct phenomena. More research will be
needed to investigate this possibility (Table3).
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10 Psychological Research (2021) 85:1–19
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Hyperfocus inpsychiatric disorders
References to hyperfocus most frequently arise in research
on ADHD, schizophrenia, and autism. Each disorder is
reported to increase the frequency and/or magnitude of
hyperfocus states, sometimes in different contexts. This phe-
notypic overlap may not be surprising given evidence for a
genetic overlap across the three conditions (Cross-Disorder
Group of the Psychiatric Genomics Consortium, 2013). For
each population, we will review how hyperfocus has been
measured, the general consensus on how hyperfocus affects
these populations, and we will provide constructive criticism
about the methods and analyses used in each. There will also
be a discussion about whether the measures of hyperfocus
used across populations reflect the same process or not.
Hyperfocus andADHD
Attention deficit hyperactivity disorder (ADHD) is character-
ized by clinically significant (i.e., it interferes with daily life)
hyperactivity, impulsivity, and inattention. It should be noted
that, despite its seemingly self-descriptive name, ADHD is
not solely a disorder of attention, but also executive func-
tions (Roberts, Martel, & Nigg, 2017; Castellanos, Xavier,
Sonuga-Barke, Milham, & Tannock 2006; Willcutt, Doyle,
Nigg, Faraone, & Pennington 2005). Moreover, there are
three subtypes of ADHD (inattentive, hyperactive, and com-
bined), which may even be distinct disorders (Milich, Balen-
tine, & Lynam 2001; Roberts and Milich, 2013). According
to the DSM-V (APA, 2013), one of the symptoms of ADHD
is that the child “often does not seem to listen when spo-
ken to directly”. While the DSM-V does not explicitly refer
to this symptom (or any other symptom for that matter) as
hyperfocus, references to it as a symptom of ADHD are per-
vasive in academic literature (Goodwin and Oberacker, 2011;
Travis, 2010; Carver, 2009; Kahl and Whal, 2006; Ozel-Kizil
etal., 2013; Schecklmann etal., 2008; Sklar, 2013; see also
Table1). Indeed, Hupfeld etal. (2019) found that patients
with ADHD experience hyperfocus more often than healthy,
neurotypical controls both in general and across a range of
specific settings (in school, during hobbies, during “screen
time”, and in the “real world”). In addition, although hyperfo-
cus is seemingly antithetical to the association of ADHD with
inattention and impulsivity, it is often reported as a positive
state in individuals with ADHD because they actually engage
in tasks for longer periods of time than is typical (Goodwin
and Oberacker, 2011; Travis, 2010).
Research into hyperfocus and ADHD is extremely lim-
ited. We were only able to find one study that explicitly
attempted to measure cognitive and neural differences in
hyperfocus between ADHD and neurotypical populations.
In this study, Sklar (2013) took EEG measurements while
ADHD and neurotypical participants played a first-person
shooter game, ostensibly measuring brain activity during a
hyperfocus state. In this study, hyperfocus was essentially
defined to be identical to flow, as described by Csikszent-
mihalyi (1997, 2000). There were a few important findings.
First, patients with ADHD showed reduced alpha and beta
levels in the frontal lobe relative to controls while playing
the game; and although not significant (but mentioned in
light of small sample sizes) alpha and beta levels decreased
over the course of the game for the ADHD patients, but
increased for the controls. This was interpreted as evidence
that ADHD patients required less cognitive effort to play the
game, in line with the reported experiences of hyperfocus.
Second, in the frontal midline, delta wave activity increased
significantly over the course of the game (and it was reported
that theta wave activity increased at a trend level; p < .10).
It was speculated that this might reflect the “experience of
the activity as intrinsically rewarding” element of hyper-
focus. Third, in the parietal lobe, the mean absolute power
was higher in the ADHD patients than the controls. This
was notable because typically ADHD patients show lower
parietal activation than controls, which is thought to reflect
impaired attentional process in ADHD. Sklar (2013) argued
that these results supported the notion that impairments to
attention may be context-specific in patients with ADHD.
In other words, it is possible that patients with ADHD are
not impaired when in a hyperfocus state and may even have
enhanced attentional control. And fourth, a post-experiment
questionnaire revealed that patients with ADHD experienced
a more distorted perception of time, possibly supporting the
notion that they did in fact experience hyperfocus during
the task.
However, some methodological aspects need to be con-
sidered for a better understanding of the results. First, there
is a question of whether or not the participants (both ADHD
and neurotypical) experienced hyperfocus while playing
the games. Sklar (2013), like Weber etal. (2009), argued
that media, such as video games, provided the appropriate
environment to induce hyperfocus/flow states. Noteworthy,
Weber etal.’s (2009) framework is predicated on the notion
that hyperfocus is the result of enhanced neural synchroniza-
tion between attentional and reward networks in the brain.
However, Hoekzema etal. (2014)showed that patients with
ADHD exhibited reduced functional connectivity between
the dorsolateral pre-frontal cortex and various brain net-
works, and notably the DMN, during attention demanding
tasks. Additionally, Querne etal. (2014; see also Fassbender,
Scangos, Lesh, & Carter 2014) reported that, in contrast to
neurotypical participants, children with ADHD did not show
significant anti-phase synchronization (a form of inhibitory
synchronization) between the DMN and task positive net-
works (TPN; brain regions that activate during “externally
oriented” task—including the dorsal and ventral fronto-
parietal attention networks). This was interpreted as an
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11Psychological Research (2021) 85:1–19
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impairment in the ability of the TPN to suppress the DMN
due to immaturity in ADHD-related brain development, even
in adult ADHD (Castellanos and Elmaghrabi, 2017; Catel-
lanos etal., 2006; Kelly, Margulies, & Castellanos 2007;
Scheres, Milham, Knutson, & Castellanos, Scheres etal.,
2007). Based on this evidence, it is questionable whether
Weber etal.’s (2009) synchronization-based theory of hyper-
focus is likely, and by extension if simply playing games is
enough to consistently induce hyperfocus across subjects.
That being said, if attention deficits are contextual, as sug-
gested by Sklar (2013), then perhaps the connectivity defi-
cits identified by Hoekzema etal. (2014) and Querne etal.
(2014) would not be found if the task induced hyperfocus.
Second, Sklar (2013) did not assess behavioral measures
that might correspond with neurological measurements.
Although this was an understandable methodological choice,
the use of a video game provides a unique opportunity because
performance over the course of the game can theoretically be
measured (for example, most games have some kind of scoring
mechanism) without having to probe the subject (admittedly,
this is easier said than done). In general, it is good practice
to include behavioral measurements to compare to neurologi-
cal measurements, so as to be able to establish a relationship
between brain activity and behavior (i.e., linking hypotheses;
Teller, 1984; Morgan, Melmoth, & Solomon, 2013).
ADHD is synonymous with a high degree of distract-
ibility and having a short attention span. However, the oft
reported hyperfocusing states in this condition suggest that
individuals with ADHD can, paradoxically, sustain atten-
tion excessively. In fact, attentional control may not be as
impaired in patients with ADHD as once thought. For exam-
ple, Roberts, Ashinoff, Castellanos, and Carrasco (2018)
have shown that spatial covert attention is functionally intact
in adults with ADHD. Therefore, sophisticated investigation
of the nature of hyperfocus in ADHD is critically important
as it may provide important etiological clues that have been
previously overlooked due to a focus on “distractibility”.
Moreover, despite the ubiquity of reports of hyperfocus in
patients with ADHD, it is not reflected in the DSM criteria
for a diagnosis. Perhaps this should be reconsidered since,
based on anecdotal evidence, hyperfocus appears to be a
core symptom.
Hyperfocus andautism
Autism spectrum disorders (ASD) are neurodevelopmental
disorders associated with impairments in social develop-
ment, language, and repetitive, circumscribed behaviors/
interests. Two defining symptoms of ASD are “(B1) Ste-
reotyped or repetitive motor movements, use of objects,
or speech (e.g., simple motor stereotypies, lining up toys
or flipping objects, echolalia, idiosyncratic phrases)” and
“(B3) Highly restricted, fixated interests that are abnormal
in intensity or focus (e.g., strong attachment to or preoccu-
pation with unusual objects, excessively circumscribed or
perseverative interest)” (APA, 2013). Of particular interest
here are the cases where individuals with autism exhibit an
intense focus on a particular behavior or topic, which are
sometimes explicitly referred to as hyperfocus (although
usually anecdotally; Mayes, 2014; Clark, 2016; Fein, 2015;
Bombaci, 2012). The term hyperfocus is also sometimes
used to refer to stereotypic behavior or stimming (short for
self-stimulatory behavior; Bombaci, 2012—see Table1).
However, these are distinct phenomena that co-occur in ASD
and need to be treated as such, with hyperfocus referring to
symptom B3 and not B1, although we recognize that the
two sets of symptoms may be difficult to tease apart from a
phenomenological and clinical perspective. Here, we focus
on studies that appear to get at the phenomenon of hyperfo-
cus in ASD, rather than stereotyped behaviors or stimming.
To our knowledge, there are no studies that specifically
attempt to measure behavior or cognitive performance
Table 3 Evidence for the phenomenology of hyperfocus during “in the zone” or “flow” states (color figure online)
Features of Hyperfocus In the Zone Flow
Fun/Interesng None Good
Intense Concentraon Limited Speculave
Reduced Percepon of Irrelevant/
Non-Task Related Smuli Good Good
Improved Task Performance None Limited
The colored boxes indicate the quality and quantity of the evidence relating to different features of hyperfocus. In the online version, green indi-
cates good evidence, yellow indicates limited or speculative evidence, and red indicates no evidence. In the print version, white indicates good
evidence, light grey indicates limited or speculative evidence, and dark grey indicates no evidence
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12 Psychological Research (2021) 85:1–19
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during hyperfocus or flow states in ASD. In a review paper,
Geurts etal. (2009) defined hyperfocus in the context of
ASDs as “difficulties in shifting attention, disengaging
from details”. So, it might be surprising to learn that some
fundamental attentional processes appear to be intact in
patients with ASD, including exogenous and endogenous
spatial attention (Grubb etal., 2013a, b) and attentional
disengagement (Fischer, Plessow, Dreisbach, & Goschke
2014), although other aspects of attention have been shown
to be deficient. For example, Keehn, Westerfield, Müller,
& Townsend, (2017) found that children with ASD, unlike
typically developing children, showed no behavioral or elec-
trophysiological evidence of attentional capture.
Geurts, Corbett, and Solomon (2009) also proposed that
hyperfocus in ASD was associated with cognitive flexibil-
ity (the ability to re-allocate cognitive resources based on
the situation; Brady etal., 2017; South, Ozonoff, & Mcma-
hon, 2007; Hill and Bird, 2006; Lopez, Lincoln, Ozonoff, &
Lai, 2005). The neural correlates of cognitive flexibility in
ASD are usually assessed using attention or task switching
paradigms, such as the Wisconsin card sorting test (WCST;
Yeung, Han, Sze, & Chan 2016) or reversal learning tasks
(D’Cruz, Mosconi, Ragozzino, Cook, & Sweeney, 2016).
In these tasks, individuals with ASD have exhibited hypo-
activation in the prefrontal cortex, striatum, and parietal
cortex (Shafritz, Dichter, Baranek, & Belger, 2008; Gilbert,
Bird, Brindley, Frith, & Burgess 2008; Yeung etal., 2016;
D’Cruz etal., 2016; Gomot etal., 2006), which is thought
to reflect impairments in the ability to shift between differ-
ent behaviors. Important to our purposes, this hypoactiva-
tion has been associated with stereotyped behaviors, which
may be confounded with hyperfocus. However, D’Cruz etal.
(2016) noted that hypoactivation in a reinforcement learning
task was specifically associated with unpredictable task out-
comes. They suggested that uncertainty may induce anxiety
in patients with ASD, motivating them to maintain behav-
iors with predictable outcomes and resist novelty. Thus, it
is unclear if ASD-related deficits in cognitive flexibility
are related to hyperfocus, stereotyped behaviors, or other
processes.
Overall, it appears as if hyperfocus is a real phenomenon
that occurs in ASD, but care must be taken to distinguish
it from other symptoms such as stereotypic behaviors.
Research into hyperfocus in ASD is important because, as
of now, it is unclear if hyperfocus is a primary symptom or
a secondary symptom that is merely induced by other ASD-
related behaviors. It is possible that mechanisms underlying
hyperfocus behaviors are not autism-specific, but rather that
ASD behaviors happen to trigger the same kind of hyper-
focus seen in the general population more frequently or
strongly.
Hyperfocus andschizophrenia
Schizophrenia is a disorder characterized by abnormal social
behavior, deficits in emotional processing, and psychosis.
Symptoms of schizophrenia are divided into three catego-
ries: positive symptoms, negative symptoms, and cognitive
dysfunction (APA, 2013). Positive symptoms are those that
individuals with schizophrenia can experience that are not
present in the healthy population. These include hallucina-
tions, delusions, and other forms of psychosis. Negative
symptoms are deficits in cognition or emotion in individu-
als with schizophrenia that are not impaired in the healthy
population. These include, but are not limited to, anhedonia,
flat affect, and lack of motivation. Cognitive dysfunction
refers to deficits across a wide range of cognitive abilities.
In the last few years, a hyperfocusing hypothesis of schizo-
phrenia has been developed (see Luck, Hahn, Leonard, &
Gold, 2019 for a review of this hypothesis; Luck etal., 2014;
Gray etal., 2014; Hahn etal., 2016; Sawaki etal., 2017;
Kreither etal., 2017). Here, hyperfocus is defined as the use
of processing resources more intensely (i.e., stronger work-
ing memory representation), but more narrowly compared
to healthy control subjects.
Luck etal. (2014; Gray etal., 2014) showed that a colored
distractor that matched a color held in working memory had
a greater distracting effect during saccadic eye movements
in individuals with schizophrenia than in healthy controls.
They argued that the individuals with schizophrenia had
generated a more intense working memory representation
of the color because they had focused more intensely (i.e.,
hyperfocused) on it. Additionally, Leonard etal. (2013)
showed that the neural mechanisms underlying the work-
ing memory differences between individuals with schizo-
phrenia and healthy controls are not the same as those that
underlie general individual differences in working memory.
They argued this reflected a deficit in the ability of individu-
als with schizophrenia to distribute their attention broadly.
Though the authors are careful to note that attributing these
results to hyperfocusing is a conjecture, they do suggest that
it provides converging evidence for such a theory.
More recent studies have also supported the hyperfocus-
ing theory of schizophrenia. Sawaki etal. (2017) found that
individuals with schizophrenia showed electrophysiological
evidence of abnormal attentional focus towards goal-relevant
stimulus features. Participants had to respond when a cen-
trally located circle matched a pre-defined target color, while
ignoring two colored distractor circles that horizontally
flanked the central circle. On some trials, when the central
circle was a non-target color, one of the distractor circles
could match the target color (i.e., a goal-relevant feature
embedded in a distractor). To account for frequently reported
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13Psychological Research (2021) 85:1–19
1 3
deficits in goal maintenance, the target color was presented
constantly between trials throughout the experiment. They
found that on these trials, neurotypical controls exhibited
a significant distractor positivity event related potential
(ERP) component, a measure of attentional suppression.
This suggested that attention was not directed towards the
distractor containing goal-relevant information. However,
the individuals with schizophrenia exhibited a significant
N2pc (N2 posterior-contralateral) ERP component, a meas-
ure of spatial attention shifts and focus towards a lateralized
stimulus. This suggested that they actually focused their
attention (or hyperfocused) on the distractor containing goal-
relevant information. The authors argued that this was evi-
dence that individuals with schizophrenia hyperfocused on
goal-relevant information when maintaining a task set. This
is consistent with some of the most commonly reported fea-
tures of hyperfocus, particularly improved task performance.
In fact, Beck etal. (2016) reported that, as a consequence
of hyperfocusing on goal-related information, people with
schizophrenia showed significantly better performance on a
probabilistic visual search task.
Kreither etal. (2017) addressed another prediction of the
hyperfocus hypothesis, namely that individuals with schizo-
phrenia would focus attention more narrowly, in addition to
more intensely. They interpreted this to mean that hyper-
focus would be strongest for stimuli in central vision, but
weak in peripheral vision. Participants had to discriminate
between standard and oddball stimuli at either central or
peripheral locations. They found, based on an abnormal
P3b ERP component (a measure of higher-level process-
ing resources), individuals with schizophrenia were able
to suppress peripheral stimuli when they were responding
to centrally located stimuli, but could not suppress central
stimuli when they were responding to peripheral stimuli. The
healthy controls exhibited the opposite pattern of results.
Moreover, they showed that the P3b results correlated with
performance in the useful field of view task (UFOV), which
measures distributed attention. Individuals with schizophre-
nia showed worse performance than controls.
Considering the symptom variability associated with
schizophrenia, a natural question is whether hyperfocus is
associated with negative symptoms, positive symptoms, or
cognitive dysfunction. Luck etal. (2014) tested for, but did
not find, a correlation between hyperfocusing and the sever-
ity of positive (BPRS; Faustman and Overall, 1999) or nega-
tive (SANS; Andreasen, 1989) symptoms in their individuals
with schizophrenia. However, they obtained a single sub-
scale score for each symptom type (positive and negative)
and did not assess if individual symptoms were associated
with hyperfocus. If only a subset of positive (like delusions)
or negative symptoms are associated with hyperfocus or
hypersalience, then a generalized subscale score may not be
sensitive enough to reflect these effects. Luck etal. (2019)
reported that there is an association across several studies
between cognitive dysfunction and the intensity of hyperfo-
cus. Furthermore, they proposed that hyperfocus may be a
cause of cognitive dysfunction, rather than a consequence,
but are careful to note that this is speculative. They further
note that it is unclear, due to a lack of research in unmedi-
cated patients and patients with current psychotic symptoms,
if hyperfocus is associated with the positive and/or nega-
tive symptoms of schizophrenia. Prentky (2001) argued that
patients that exhibit positive symptoms show “higher left
than right hemispheric activity. Thus, there is a hypothetical
optimal hemispheric imbalance that promotes a constructive,
task-specific hyperfocus on detail”. There is also evidence
that patients with schizophrenia show a greater preoccu-
pation with delusional beliefs than healthy controls (Sisti
etal., 2012), which could be interpreted as hyperfocusing
on the belief. In fact, many descriptions of individuals with
schizophrenia report the experience of hallucinations being
distracting and engrossing, even to the point of exhaustion
(Walsh, Hochbrueckner, Corcoran & Spence, 2016; Flana-
gan etal., 2012). This suggests that individuals with positive
symptoms are more likely to experience hyperfocus, or at
least that positive symptoms may induce hyperfocus.
More generally, although we do not doubt the results or
value of the “hyperfocusing theory of schizophrenia”, it is
debateable if its operational definition of hyperfocusing
reflects the same process that is typically described in anec-
dotal reports of hyperfocusing. The hyperfocusing theory
does appear to reflect intense concentration and improved
task performance. And, although it is generally consistent
with reports that people who hyperfocus “tune everything
else out”, it is not clear if, in anecdotal reports, people were
always focused on stimuli at the center of vision. A future
study will need to assess if hyperfocus can only occur at the
center of vision or the loci of hyperfocus can move, such as
with the spotlight of attention. Moreover, there was noth-
ing particularly fun or interesting about the tasks. A further
consideration was that the effect of “hyperfocus” was rela-
tively consistent over time in these studies, which is incon-
sistent with the notion that hyperfocus reflects an irregular,
inconsistent state of attention that is difficult to induce. One
possibility is that the “hyperfocus theory” studies were tap-
ping into a visual attention counterpart of hypersalience
(rather than hyperfocus) that has been previously reported
in individuals with schizophrenia in decision-making tasks.
Speechley, Whitman, and Woodward (2010) showed that
individuals with delusions exhibited a bias for evidence that
matched their expectations, which may explain the results
of Luck etal. (2014).
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14 Psychological Research (2021) 85:1–19
1 3
Is hyperfocus thesame phenomenon
acrosspsychiatric conditions?
Does hyperfocus, reported in the ADHD, autism, and schizo-
phrenia literature, refer to the same phenomenon in all three
conditions? Before we can address this, we must first con-
sider more generally if these disorders present with similar
symptoms.
ADHD and autism Panagiotidi, Overton, and Stafford
(2017; also see Kern, Geier, Sykes, Geier, & Deth, 2015;
Banaschewski etal., 2005) investigated co-occurring traits in
autism spectrum disorder (ASD) and ADHD. They assessed
334 healthy, neurotypical participants with two ADHD
questionnaires and two ASD questionnaires. Their most
relevant finding for our purposes was a moderate positive
correlation between the attention switching subscale of the
autism quotient (AQ; Baron-Cohen, Wheelwright, Skinner,
Martin, & Clubley 2001) and the inattention subscales from
both ADHD questionnaires (The Wender Utah Rating Scale
and the Adult ADHD Self-Report Scale; Ward, Wender, &
Reimherr 1993; Kessler etal., 2005). They defined hyperfo-
cus as “difficulties in diverting attention between tasks” and
inattention as “difficulty in sustaining attention”, suggesting
that these phenomena were reflected in the questionnaire
results. They suggested that ADHD and ASD may share a
common etiology, and that hyperfocus and inattention may
be related to a common mechanism. Therefore, ADHD and
autism present with similar symptoms, possibly including a
similar form of hyperfocus.
ADHD and schizophrenia Research has shown that
ADHD and schizophrenia present with similar cognitive
deficits in executive functions and attentional function
(Banaschewski etal., 2005). In fact, ADHD and schizo-
phrenia cohorts are frequently used as psychiatric control
groups for each other. However, there has been no explicit
comparison of hyperfocus in these groups. That being said,
it is possible that both ADHD and schizophrenia present
with a similar form of hyperfocus.
Autism and schizophrenia According to Crespi and Bad-
cock (2008), “psychosis and autism represent two extremes
on a cognitive spectrum with normality at its center. Social
cognition is thus underdeveloped in autism, but hyper-
developed to dysfunction in psychosis”. Recent studies
have provided support for this spectrum account showing
opposite attentional effects based on the relative expression
of autism and psychosis in healthy participants (Abu-Akel
etal., 2016a, b, c, 2018) and in patient populations (Abu-
Akel etal., 2018). In comparing attentional set shifting,
Abu-Akel etal. (2018) showed that children with autism had
difficulties with extra-dimensional shifts, and children with
schizotypal disorders had difficulties with intra-dimensional
shifts. Based on this, it seems unlikely that patients with
autism and schizophrenia would exhibit a similar form of
hyperfocus, since their attentional control patterns seems to
reflect a diametric relationship.
However, an alternative interpretation is that patients
with these disorders simply hyperfocus on different types
of stimuli, making it difficult to see a direct comparison.
Crespi and Backcock (2008) conceptualized symptoms of
ASD and schizophrenia related to under- and over-mentaliz-
ing (i.e., capacity for theory of mind), respectively (see also
Abu-Akel and Bailey, 2000; Frith, 2004). In this conception,
patients with ASD under-interpret social cues, leading to
social withdrawal which would arguably result in focusing
on things rather than people, and patients with schizophrenia
over-interpret social cues, leading to symptoms like paranoid
delusions, which is interpretable as a focus on people and
their intentions. Langdon and Brock (2008), however, argued
that this interpretation is incomplete as patients with schizo-
phrenia in particular exhibit both over- and under-mentaliz-
ing. Furthermore, using a social judgement task, Stanfield
etal. (2017) showed that deficits in social cognition in ASD
and schizophrenia are mediated by distinct neural correlates.
Thus, although additional research is needed to confirm if
phenomenon like hyperfocus is expressed via similar mecha-
nisms in these disorders, it does not appear likely.
Are they the same? Based on the evidence, we propose
that the version of hyperfocus described in this review and
more generally in anecdotal reports, occurs in both ADHD
and autism, although in autism the term is often incorrectly
used to refer to stereotypic and self-stimulatory behavior.
The evidence for hyperfocus in schizophrenia is less clear.
Although there is a so-called “hyperfocus theory of schizo-
phrenia”, we propose that the effects they have identified
reflect hypersalience rather than hyperfocus. Aside from
these studies, references to hyperfocus in the schizophrenia
literature are few.
Conclusions
This review discussed the well-known, but poorly investi-
gated phenomenon of hyperfocus, which is referenced in
the ADHD, autism, and schizophrenia literature. Until now,
there has been no clear operational definition of hyperfo-
cus, leading to a wide range of behaviors being referred
to as hyperfocus. To eliminate confusion in the future, we
provided a clear and testable definition of hyperfocus that
comprised four criteria: (1) to engage in hyperfocus, the task
has to be engaging (i.e. fun, interesting, important, etc.).
(2) Hyperfocus is characterized by an intense state of sus-
tained or selective attention. (3) When engaged in hyperfo-
cus, there is a diminished perception of non-task relevant
stimuli. (4) During a hyperfocus state, task performance
improves. Although this definition may change in light of
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15Psychological Research (2021) 85:1–19
1 3
future research, it provides a reasonable starting point for the
investigation of this phenomenon. Moreover, we proposed
and provided supporting evidence for the notion that the
phenomenon of flow is synonymous with hyperfocus. Last,
we reviewed the references to hyperfocus in the psychiatric
literature to determine if they fit with our newly established
definition. We propose that the hyperfocus referenced in the
ADHD and autism literature does fit with our definition,
but the hyperfocus referred to in the schizophrenia literature
does not.
In all, the purpose of this review was to bring attention
to an important, but generally forgotten or ignored phenom-
enon that may be a critical element in several psychiatric
disorders. We hope that our operational definition of hyper-
focus will facilitate the development of new research para-
digms that are specifically tailored to assess the hyperfocus
state and underlying mechanisms in both healthy and psy-
chiatric populations. One possibly fruitful avenue for future
research is to explore the potential of gamification of cogni-
tive psychology paradigms combined with assessments of
performance over the course of the task (like in Esterman
etal., 2012, 2014). This may allow researchers to meet the
necessary criteria to both induce hyperfocus states, assess
when a hyperfocus state is occurring in time, and measure
cognitive performance during these time periods.
Acknowledgements The authors would like to thank Carmel Mevorach
who provided helpful comments on an early draft of this manuscript.
Brandon K. Ashinoff is currently supported by a T32 Postdoctoral Fel-
lowship (T32-MH018870) at Columbia University.
Compliance with ethical standards
Conflict of interest Authors B.K.A. and A.A. declare that they have no
conflict of interest.
Ethical approval This article does not contain any studies with human
participants or animals performed by any of the authors.
Open Access This article is distributed under the terms of the Crea-
tive Commons Attribution 4.0 International License (http://creat iveco
mmons .org/licen ses/by/4.0/), which permits unrestricted use, distribu-
tion, and reproduction in any medium, provided you give appropriate
credit to the original author(s) and the source, provide a link to the
Creative Commons license, and indicate if changes were made.
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