The subtypes of visual hypersensitivity are transdiagnostic across neurodivergence, neurology and mental health

Abstract

Many areas of neurodivergence are associated with heightened sensitivity, discomfort, and aversion to certain visual stimuli (e.g., bright lights, patterns, movement, flicker, complex scenes). This hypersensitivity also associates with mental health and some areas of neurology. However, it remains unclear whether this is a transdiagnostic phenomenon, implying a common underlying mechanism of shared vulnerability, or whether the forms of visual discomfort differ instructively across the wide range of associated conditions and areas of neurodivergence. We compared the four recently clarified subtypes of visual hypersensitivity (Brightness, Pattern, Strobing, Intense Visual Environments) self-reported by 2582 participants across 11 areas of neurodivergence, neurology, and mental health: Autism, ADHD, Dyslexia, Dyspraxia, Fibromyalgia, Migraine, PPPD, synaesthesia, Distress, Eating Pathology, and Fear (HiTOP System). Enhanced sensitivity in all four factors was reported for every area. Sensitivity to Intense Visual Environments was especially pronounced across Autism, ADHD, Dyslexia, and Dyspraxia, forming a shared pattern. The same pattern was shared with fibromyalgia and PPPD, and to some extent with Eating Pathology and Fear, while migraine and synaesthesia showed a different pattern. Regression analyses controlling for comorbidities showed significant unique prediction by 9 out of 11 neurodivergence/condition labels, the strongest predictors being autism, fibromyalgia, migraine, and PPPD. In conclusion, the four factors of visual hypersensitivity are all transdiagnostic, and the relative emphasis on each factor also forms transdiagnostic patterns that transcend traditional discipline boundaries. This implies there are common underlying vulnerabilities in the development of perceptual systems that can be associated with a wide range of other symptomologies.