Price, A., Sumner, P., & Powell, G. (2025). The subtypes of visual hypersensitivity are transdiagnostic across neurodivergence, neurology and mental health. Vision Research, 234, 108640.

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

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