What They Did
The researchers recruited participants to complete an online
questionnaire about four areas of visual hypersensitivity: brightness,
strobing, pattern (such as stripes), and intense visual environments (such as
supermarkets). Participants were also asked to indicate any neurodivergent,
medical, or mental health conditions. Nearly 2600 participants were included in
the final data set.
Using the Hierarchical Taxonomy of Psychopathology, some
conditions were combined for analysis: binge eating disorder, anorexia, and
bulimia were combined into eating pathologies; social anxiety, OCD, panic
disorder, and agoraphobia were considered as fear-based conditions; and
depression, generalized anxiety disorder, PTSD, and borderline personality
disorder were combined into distress-based conditions. ADHD, autism, dyslexia,
dyspraxia, fibromyalgia, migraine, persistent postural-perceptual dizziness (PPPD),
and synesthesia were also included. The researchers found that all 11
conditions or categories of conditions were associated with all for types of
visual hypersensitivity.
Sensitivity to intense visual environments (IVE) was the
most increased factor for people with ADHD, autism, dyslexia, fibromyalgia, and
PPPD. People with dyspraxia also showed the largest increase in IVE
sensitivity, as well as a greater sensitivity to pattern compared to brightness
or strobing. People with migraines, synesthesia, eating pathologies, and
conditions based on fear or distress had relatively little difference in the
four types of sensitivity. Of these, people with migraines or synesthesia were
most sensitive to pattern and the others were most sensitive to IVE. The
researchers note that the lack of distinctive patterns may indicate that all
these conditions share a broad visual hypersensitivity in addition to their
widely varying symptoms.
Further Exploration
Since comorbidities are common, many of the participants had
more than one condition and were included in the analysis for each. The
researchers also statistically isolated the conditions to determine which
visual hypersensitivities were the most predictive of each condition. For
example, none of the hypersensitivities were significantly predictive of
dyspraxia, while all four were predictive of autism. Therefore, the
sensitivities to IVE and pattern among people with dyspraxia might result from
the fact that many of those people are also autistic.
The researchers caution, however, that while isolating the
conditions in this way may have benefits for better understanding the effect of
each condition, it also risks erasing the lived experience of people with
comorbidities. The point I found particularly interesting is that the
researchers can only isolate the collections of symptoms that have their own
names. Our understanding of many of these conditions is still very new, and we
don’t really know how well our current conceptualizations actually reflect the
underlying physiology.
Less than 100 years ago, autism was understood as a form of
schizophrenia that manifested in childhood (see https://azaunited.org/blog/how-the-autism-diagnosis-has-evolved-over-time).
By contrast, insulin for management of diabetes has been known since the 1920s
(see https://origins.osu.edu/read/first-insulin-injection-treatment-diabetes).
Fibromyalgia, meanwhile, was only officially recognized as a distinct medical
condition in 1981 (see https://www.swing.care/blog/what-is-fibromyalgia/).
It’s easy sometimes to forget how little we actually know. It would be really
interesting to do a factor analysis on neurodivergence like the one used to
develop the five-factor personality model, but that’s a rabbit hole for another
day!
Image credit: Frankie Fouganthin
https://commons.wikimedia.org/wiki/File:Supermarket_shelves.jpg