Validity of the Sluggish Cognitive Tempo Symptom Dimension in Children: Sluggish Cognitive Tempo and ADHD-Inattention as Distinct Symptom Dimensions
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This study examined the validity of the sluggish cognitive tempo (SCT) symptom dimension in children. Ten symptom domains were used to define SCT (i.e., (1) daydreams; (2) attention fluctuates; (3) absent-minded; (4) loses train of thought; (5) easily confused; (6) seems drowsy; (7) thinking is slow; (8) slow-moving; (9) low initiative; and (10) easily bored, needs stimulation). Teacher ratings of 366 children (ages 5 to 13 with 56 % girls) along with parent ratings of 703 children (ages 5 to 13 with 55 % girls) indicated that SCT symptom domains one to eight showed convergent validity (i.e., substantial loadings on the SCT factor) and discriminant validity with the ADHD-IN dimension (i.e., higher loadings on the SCT factor than the ADHD-IN factor). Higher scores on this eight-symptom measure of SCT predicted lower levels of academic and social competence even after controlling for ADHD-IN and ADHD-HI. In addition, higher SCT scores still predicted higher anxiety/depression scores after controlling for ADHD-IN and ADHD-HI. Higher SCT scores also predicted lower ADHD-HI scores after controlling for ADHD-IN and anxiety/depression while higher ADHD-IN and anxiety/depression scores predicted higher ADHD-HI scores after controlling for SCT and anxiety/depression or ADHD-IN. SCT also showed a unique negative relationship with ODD while ADHD-IN and anxiety/depression showed unique positive relationships with ODD. This new measure of the SCT dimension was meaningfully independent from the ADHD-IN and anxiety/depression dimensions and suggests that such an SCT dimension may signify a distinct presentation of ADHD or a different (if highly comorbid) disorder altogether.
KeywordsSluggish cognitive tempo Attention deficit disorder Attention deficit hyperactivity disorder
- Barkley, R. A. (2012b). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of Clinical Child and Adolescent Psychology. doi: 10.1080/15374416.2012.734259. Advance online publication.
- Bauermeister, J. J., Matos, M., Reina, G., Salas, C. C., Martínez, J. V., Cumba, E., & Barkley, R. A. (2005). Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children. Journal of Child Psychology and Psychiatry, 46, 166–179. doi: 10.1111/j.1469-7610.2004.00343.x.PubMedCrossRefGoogle Scholar
- Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martinez, J. V., & McBurnett, K. (2012). Validity of the sluggish cognitive tempo, inattention, and hyperactivity symptom dimensions: neuropsychological and psychosocial correlates. Journal of Abnormal Child Psychology, 40, 683–697. doi: 10.1007/s10802-011-9602-7.PubMedCrossRefGoogle Scholar
- Becker, S. P., & Langberg, J. M. (2012). Sluggish cognitive tempo among young adolescents with ADHD: relations to mental health, academic and social functioning. Journal of Attention Disorders. doi: 10.1177/1087054711435411. Advance online publication.
- Burns, G. L., & Lee, S. (2010). Child and Adolescent Disruptive Behavior Inventory–Teacher Version 5.0. Pullman, WA: Author.Google Scholar
- Burns, G. L., & Lee, S. (2011). Child and Adolescent Disruptive Behavior Inventory–Parent Version 5.0. Pullman, WA: Author.Google Scholar
- Burns, G. L., Moura, M. A., Walsh, J. A., Desmul, C., Silpakit, C., & Sommers-Flanagan, J. (2008). Invariance and convergent and discriminant validity between mothers’ and fathers’ ratings of oppositional defiant disorder toward adults, ADHD-HI, ADHD-IN, and academic competence factors within Brazilian, Thai, and American children. Psychological Assessment, 20, 121–130. doi: 10.1037/1040-35184.108.40.206.PubMedCrossRefGoogle Scholar
- Burns, G. L., Desmul, C., Walsh, J. A., Silpakit, C., & Ussahawanitchakit, P. (2009). A multitrait (ADHD-IN, ADHD-HI, ODD toward adults, academic and social competence) by multisource (mothers and fathers) evaluation of the invariance and convergent/discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with Thai Adolescents. Psychological Assessment, 21, 635–641. doi: 10.1037/a0016953.PubMedCrossRefGoogle Scholar
- Burns, G. L., Walsh, J. A., Servera, M., Lorenzo-Seva, U., Cardo, E., & Rodríguez-Fornells, A. (2012). Construct validity of ADHD/ODD rating scales. Recommendations for the evaluation of the forthcoming DSM-V ADHD/ODD scales. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-012-9660-5. Advance online publication.
- Capdevila-Brophy, C., Artigas-Pallarés, J., Navarro-Pastor, J. B., García-Nonell, K., Rigau-Ratera, E., & Obiols, J. E. (2012). ADHD predominantly inattentive subtype with high sluggish cognitive tempo: a new clinical entity? Journal of Attention Disorders. doi: 10.1177/1087054712445483. Advance online publication.
- Garner, A. A., Marceaux, J. C., Mrug, S., Patterson, C., & Hodgens, B. (2010). Dimensions and correlates of attention deficit/hyperactivity disorder and sluggish cognitive tempo. Journal of Abnormal Child Psychology, 38, 1097–1107. doi: 10.1007/s10802-010-9436-8.PubMedCentralPubMedCrossRefGoogle Scholar
- Garner, A. A., Mrug, S., Hodgens, B., & Patterson, C. (2012). Do symptoms of sluggish cognitive tempo in children with ADHD symptoms represent comorbid internalizing difficulties? Journal of Attention Disorders. doi: 10.1177/1087054711431456. Advance online publication.
- Hinshaw, S. P., Carte, E. T., Sami, N., Treuting, J. J., & Zupan, B. A. (2002). Preadolescent girls with attention-deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification. Journal of Consulting and Clinical Psychology, 70, 1099–1111.PubMedCrossRefGoogle Scholar
- Jacobson, L. A., Murphy-Bowman, S. C., Pritchard, A. E., Tart-Zelvin, A., Zabel, T. A., & Mahone, E. M. (2012). Factor structure of a sluggish cognitive tempo scale in clinically referred children. Journal of Abnormal Child Psychology, 40, 1327–1337. doi: 10.1007/s10802-012-9643-6.PubMedCrossRefGoogle Scholar
- Khadka, G., & Burns, G. L. (2012). A measurement framework to determine the construct validity of ADHD/ODD rating scales: additional evaluations of the child and adolescent disruptive behavior inventory. Journal of Psychopathology and Behavioral Assessment. doi: 10.1007/s10862-012-9336-z. Advance online publication.
- Lahey, B. B., & Willcutt, E. G. (2010). Predictive validity of a continuous alternative to nominal subtypes of attention-deficit/hyperactivity disorder for DSM-V. Journal of Clinical Child and Adolescent Psychology, 39, 761–775. doi: 10.1080/15374416.2010.517173.PubMedCentralPubMedCrossRefGoogle Scholar
- Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, H. A., Hynd, G., Russo, M. A., Hartdagen, S., & Lorys-vernon, A. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 330–335.PubMedCrossRefGoogle Scholar
- McBurnett, K. (2010). Kiddie-Sluggish Cognitive Tempo Diagnostic Interview Module for Children and Adolescents. San Francisco: Author.Google Scholar
- McBurnett, K., & Pfiffner, L. J. (2005). Sluggish Cognitive Tempo (SCT Scale). San Francisco: Author.Google Scholar
- Moura, M. A., & Burns, G. L. (2010). Oppositional defiant behavior toward adults and oppositional defiant behavior toward other children: evidence for two separate constructs with mothers’ and fathers’ ratings of Brazilian children. Journal of Child Psychology and Psychiatry, 51, 23–30. doi: 10.111/j.1469-7610.2009.02130.x.PubMedCrossRefGoogle Scholar
- Mikami, A. Y., Huang-Pollck, C. L., Pfiffner, L. J., McBurnett, K., & Hangai, D. (2007). Social skills differences among attention-deficit/hyperactivity disorder types in a chat room assessment task. Journal of Abnormal Child Psychology, 35, 509–521. doi: 10.1007/s10802-007-9108-5.PubMedCrossRefGoogle Scholar
- Milich, R., Ballentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive types are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463–488.Google Scholar
- Muthén, L. K., & Muthén, B. O. (1998). Mplus User’s Guide (7 th Edition). Los Angeles: Muthén and Muthén.Google Scholar
- Nigg, J. T., Tannock, R., & Rohde, L. A. (2010). What is to be the fate of ADHD subtypes? An introduction to the special section on research on the ADHD subtypes and implications for the DSM–V. Journal of Clinical Child and Adolescent Psychology, 39, 723–725. doi: 10.1080/15374416.2010.517171.PubMedCrossRefGoogle Scholar
- Pfiffner, L. J., Mikami, A. Y., Huang-Pollock, C., Easterlin, B., Zalecki, C., & McBurnett, K. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child and Adolescent Psychiatry, 46, 1041–1050. doi: 10.1097/chi.0b013e318064675f.PubMedCrossRefGoogle Scholar
- Shipp, F., Burns, G. L., & Desmul, C. (2010). Construct validity of ADHD-IN, ADHD-HI, ODD toward adults, academic and social competence dimensions with teacher ratings of Thai adolescents: additional validity for the child and adolescent disruptive behavior inventory. Journal of Psychopathology and Behavioral Assessment, 32, 557–564. doi: 10.1007/s10862-010-9185-6.CrossRefGoogle Scholar
- Skansgaard, E. P., & Burns, G. L. (1998). Comparison of DSM-IV ADHD combined and predominantly inattention types: Correspondence between teacher ratings and direct observations of inattentive, hyperactivity/impulsivity, slow cognitive tempo, oppositional defiant and overt conduct disorder symptoms. Child & Family Behavior Therapy, 20, 1–14.CrossRefGoogle Scholar
- Skirbekk, B., Hansen, B. H., Oerbeck, B., & Kristensen, H. (2011). The relationship between sluggish cognitive tempo, subtypes of attention-deficit/hyperactivity disorder, and anxiety disorders. Journal of Abnormal Child Psychology, 39, 513–525. doi: 10.1007/s10802-011-9488-4.PubMedCrossRefGoogle Scholar
- Solanto, M. V., Gilbert, S. N., Raj, A., Zhu, J., Pope-Boyd, S., Stepak, B., Vail, L., & Newcorn, J. H. (2007). Neurocognitive functioning in AD/HD, predominantly inattentive and combined subtypes. Journal of Abnormal Child Psychology, 35, 729–744. doi: 10.1007/S10802-007-91236.PubMedCentralPubMedCrossRefGoogle Scholar
- Todd, R. D., Rasmussen, E. R., Wood, C., Levy, F., & Hay, D. A. (2004). Should sluggish cognitive tempo symptoms be included in the diagnosis of attention-deficit/hyperactivity disorder? Journal of the American Academy of Child and Adolescent Psychiatry, 43, 588–597. doi: 10.1097/01.chi.0000117309.94712.a4.PubMedCrossRefGoogle Scholar