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Journal of Abnormal Child Psychology

, Volume 42, Issue 1, pp 49–62 | Cite as

Sluggish Cognitive Tempo in Psychiatrically Hospitalized Children: Factor Structure and Relations to Internalizing Symptoms, Social Problems, and Observed Behavioral Dysregulation

  • Stephen P. Becker
  • Aaron M. Luebbe
  • Paula J. Fite
  • Laura Stoppelbein
  • Leilani Greening
Article

Abstract

As research examining sluggish cognitive tempo (SCT) advances, it is important to examine the structure and validity of SCT in a variety of samples, including samples of children who are clinically-distressed but not referred specifically for attention-deficit/hyperactivity disorder (ADHD). The present study used a large sample of psychiatrically hospitalized children (N = 680; 73 % male; 66 % African American) between the ages of 6 and 12 to examine the latent structure of SCT, ADHD, oppositional defiant disorder (ODD), depression, and anxiety using confirmatory factor analysis (CFA). Results of the CFA analyses demonstrated that SCT is distinct from these other dimensions of child psychopathology, including ADHD inattention, depression, and anxiety. Regression analyses indicated that SCT symptoms were positively associated with depression and, to a lesser degree, anxiety. SCT symptoms were also positively associated with children’s general social problems, whereas SCT symptoms were negatively associated with an observational measure of behavioral dysregulation (i.e., frequency of time-outs received as a part of a manualized behavior modification program). These associations were significant above and beyond relevant child demographic variables (i.e., age, sex, race), children’s other mental health symptoms (i.e., ADHD, ODD, depression, anxiety symptoms), and, for all relations except child anxiety, parents’ own anxiety and depression symptoms.

Keywords

ADHD Anxiety Attention deficit disorder Attention-deficit/hyperactivity disorder Comorbidity Depression SCT Sluggish cognitive tempo Social functioning 

References

  1. Achenbach, T. M. (2001). Child behavior checklist for ages 6 to 18. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
  2. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASEBA school-age forms and profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.Google Scholar
  3. Adams, Z. W., Milich, R., & Fillmore, M. T. (2010). A case for the return of attention-deficit disorder in DSM-5. The ADHD Report, 18, 1–6.CrossRefGoogle Scholar
  4. American Psychiatric Association. (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: Author.Google Scholar
  5. Barkley, R. A. (2012). 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.
  6. Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martínez, 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.PubMedCrossRefGoogle Scholar
  7. 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.
  8. Becker, S. P., Langberg, J. M., Vaughn, A. J., & Epstein, J. N. (2012a). Clinical utility of the vanderbilt ADHD diagnostic parent rating scale comorbidity screening scales. Journal of Developmental and Behavioral Pediatrics, 33, 221–228.CrossRefGoogle Scholar
  9. Becker, S. P., Luebbe, A. M., Greening, L., Fite, P. J., & Stoppelbein, L. (2012b). A preliminary investigation of the relation between thyroid functioning and sluggish cognitive tempo in children. Journal of Attention Disorders. doi: 10.1177/1087054712466917. Advance online publication.
  10. Becker, S. P., Luebbe, A. M., & Langberg, J. M. (2012c). Co-occurring mental health problems and peer functioning among youth with attention-deficit/hyperactivity disorder: a review and recommendations for future research. Clinical Child and Family Psychology Review, 15, 279–302.CrossRefGoogle Scholar
  11. Becker, S. P., Luebbe, A. M., Stoppelbein, L., Greening, L., & Fite, P. J. (2012d). Aggression among children with ADHD, anxiety, or co-occurring symptoms: competing exacerbation and attenuation hypotheses. Journal of Abnormal Child Psychology, 40, 527–542.CrossRefGoogle Scholar
  12. Brady, E. U., & Kendall, P. C. (1992). Comorbidity of anxiety and depression in children and adolescents. Psychological Bulletin, 111, 244–255.PubMedCrossRefGoogle Scholar
  13. Briggs-Gowan, M. J., Carter, A. S., & Schwab-Stone, M. (1996). Discrepancies among mother, child, and teacher reports: examining the contributions of maternal depression and anxiety. Journal of Abnormal Child Psychology, 24, 749–765.PubMedCrossRefGoogle Scholar
  14. Bryne, B. M., Shavelson, R. J., & Muthén, B. (1989). Testing for the equivalence of factor covariance and mean structures: the issue of partial measurement invariance. Psychological Bulletin, 105, 456–466.CrossRefGoogle Scholar
  15. Carlson, C. L., & Mann, M. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominantly inattentive type. Journal of Clinical Child and Adolescent Psychology, 31, 123–129.PubMedGoogle Scholar
  16. Derogatis, L. R., Lipman, R. S., Rickels, K., Uhlenhuth, E. H., & Covi, L. (1974). The Hopkins symptom checklist (HSCL): a self-report symptom inventory. Behavioral Science, 19, 1–15.PubMedCrossRefGoogle Scholar
  17. Diamond, A. (2005). Attention-deficit disorder (attention-deficit/hyperactivity disorder without hyperactivity): a neurobiologically and behaviorally distinct disorder from attention-deficit/hyperactivity disorder (with hyperactivity). Development and Psychopathology, 17, 807–825.PubMedCentralPubMedCrossRefGoogle Scholar
  18. Fergusson, D. M., Lynskey, M. T., & Horwood, L. J. (1993). The effect of maternal depression on maternal ratings of child behavior. Journal of Abnormal Child Psychology, 21, 245–269.PubMedCrossRefGoogle Scholar
  19. Frick, P. J., Lahey, B. B., Applegate, B., Kerdyck, L., Ollendick, T., Hynd, G. W., et al. (1994). DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates. Journal of the American Academy of Child and Adolescent Psychiatry, 33, 529–539.PubMedCrossRefGoogle Scholar
  20. Garber, J., & Weersing, V. R. (2010). Comorbidity of anxiety and depression in youth: implications for treatment and prevention. Clinical Psychology: Science and Practice, 17, 293–306.Google Scholar
  21. 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.PubMedCentralPubMedCrossRefGoogle Scholar
  22. Garner, A. A., Mrug, S., Hodgens, B., & Patterson, C. (2011). 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.
  23. Hartman, C. A., Willcutt, E. G., Rhee, S. H., & Pennington, B. F. (2004). The relation between sluggish cognitive tempo and DSM-IV ADHD. Journal of Abnormal Child Psychology, 32, 491–503.PubMedCrossRefGoogle Scholar
  24. 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.PubMedCrossRefGoogle Scholar
  25. Kline, R. B. (1998). Principles and practice of structural equation modeling. New York: Guilford.Google Scholar
  26. Lahey, B. B., Schaughency, E. A., Hynd, G. W., Carlson, C. L., & Nieves, N. (1987). Attention deficit disorder with and without hyperactivity: comparison of behavioral characteristics of clinic-referred children. Journal of the American Academy of Child and Adolescent Psychiatry, 26, 718–723.PubMedCrossRefGoogle Scholar
  27. Lahey, B. B., Carlson, C. L., & Frick, P. J. (1997). Attention-deficit disorder without hyperactivity. In T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, & W. Davis (Eds.), DSM-IV sourcebook, Vol. 3 (pp. 163–188). Washington, DC: American Psychiatric Association.Google Scholar
  28. Lahey, B. B., Applegate, B., Waldman, I. D., Loft, J. D., Hankin, B. L., & Rick, J. (2004). The structure of child and adolescent psychopathology: generating new hypotheses. Journal of Abnormal Psychology, 113, 358–385.PubMedCrossRefGoogle Scholar
  29. McBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001). Symptom properties as a function of ADHD type: an argument for continued study of sluggish cognitive tempo. Journal of Abnormal Child Psychology, 29, 207–213.PubMedCrossRefGoogle Scholar
  30. Mikami, A. Y., Huang-Pollock, 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.PubMedCrossRefGoogle Scholar
  31. Muris, P., Roelofs, J., Rassin, E., Franken, I., & Mayer, B. (2005). Mediating effects of rumination and worry on the links between neuroticism, anxiety and depression. Personality and Individual Differences, 39, 1105–1111.CrossRefGoogle Scholar
  32. Muthén, L. K., & Muthén, B. O. (1998–2007). Mplus user’s guide (5th ed). Los Angeles, CA: Muthén & Muthén.Google Scholar
  33. Nakamura, B. J., Ebesutani, C., Bernstein, A., & Chorpita, B. F. (2009). A psychometric analysis of the child behavior checklist DSM-oriented scales. Journal of Psychopathology and Behavioral Assessment, 31, 178–189.CrossRefGoogle Scholar
  34. Penny, A. M., Waschbusch, D. A., Klein, R. M., Corkum, P., & Eskes, G. (2009). Developing a measure of sluggish cognitive tempo for children: content validity, factor structure, and reliability. Psychological Assessment, 21, 380–389.PubMedCrossRefGoogle Scholar
  35. Pillow, D. R., Pelham, W. E., Hoza, B., Molina, B. S. G., & Stultz, C. H. (1998). Confirmatory factor analyses examining attention deficit hyperactivity disorder and other childhood disruptive behaviors. Journal of Abnormal Child Psychology, 26, 293–309.PubMedCrossRefGoogle Scholar
  36. 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.PubMedCrossRefGoogle Scholar
  37. Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R.,… Lahey, B. B. (2012). Validity of DSM-IV attention-deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Stephen P. Becker
    • 1
  • Aaron M. Luebbe
    • 1
  • Paula J. Fite
    • 2
  • Laura Stoppelbein
    • 3
    • 4
  • Leilani Greening
    • 5
  1. 1.Department of PsychologyMiami UniversityOxfordUSA
  2. 2.Clinical Child Psychology ProgramUniversity of KansasLawrenceUSA
  3. 3.Department of PsychologyUniversity of Alabama at BirminghamBirminghamUSA
  4. 4.Glenwood Autism and Behavioral Health CenterBirminghamUSA
  5. 5.Department of Psychiatry and Human BehaviorUniversity of Mississippi Medical CenterJacksonUSA

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