cpCST: A New Continuous Performance Test for High-Precision Assessment of Attention Across the Lifespan

Abstract

Assessing sustained attention presents methodological challenges, particularly when spanning diverse populations whose baseline sensorimotor functioning may vary significantly. This study introduces the Continuous Performance Critical Stability Task (cpCST), a novel paradigm combining high-density sampling of behavior (30Hz), individualized calibration, and fixed-difficulty assessment to measure attentional control. In a sample of 166 adults (ages 18-76), we evaluated the psychometric properties of the cpCSTs instantaneous reaction time (iRT) metric derived through dynamic time warping. Results demonstrated exceptional reliability (bootstrap split-half r = .999), age invariance, and predictive validity for cognitive performance (flanker and Woodcock-Johnson) and cardiorespiratory fitness (est. VO2max). The cpCST achieved high temporal efficiency, with just two minutes of data correlating at r = .94 with full-task performance, outperforming a standard arrow-based flanker task. The cpCSTs individualized calibration effectively isolated attentional control processes from baseline sensorimotor function, eliminating age-related slowing effects typically observed in reaction time tasks. This approach offers methodological advantages for lifespan studies, clinical populations, integration with neurophysiological measures, and computational modeling approaches while addressing limitations of existing attention assessment paradigms.