Tag Archives: Idea of New Attention Disorder Spurs Research and Debate

An ADHD related disorder: ‘Sluggish Cognitive Tempo’

12 Apr

Tania Tirraoro posted the article, It’s not ADHD, it’s Sluggish Cognitive Tempo at Special Needs jungle:

Have you heard of “Sluggish Cognitive Tempo” (SCT)? It’s apparently regarded by psychiatric professionals as a subtype of attention-deficit/hyperactivity disorder (ADHD). Until now, that is.
Medscape has reported some research that concludes it is most likely to be a distinct attention disorder, although there is notable overlap with ADHD.
The researchers, Dr Catherine Saxbe and Dr Russell A. Barkley from the Medical University of South Carolina in the US, have based their findings on reviewing nearly three decades’ worth of research on SCT and their own clinical experience. They’re predicting that, given the evidence, SCT may “eventually be accepted as an identifiable attention disorder with its own diagnostic criteria that distinguish it from ADHD.”. Writing in the Journal of Psychiatric Practice they claim that SCT may represent an exciting new frontier in psychiatry.
Characteristics of Sluggish Cognitive Tempo
• Like ADHD, SCT typically presents in childhood.
• Being daydreamy, mentally foggy, and easily confused.
• Staring frequently.
• May have symptoms of hypoactivity, lethargy, slow movement, possibly sleepiness.
• Children with SCT also appear to have slow processing speed and reaction times.
There are no officially endorsed criteria for SCT but the researchers believe that may change in the “foreseeable future,” and that most doctors who see children with ADHD have probably come across someone who falls within the parameters of SCT.
First, there needs to be more research on the cognitive deficits, such as which areas of the brain are most active when the patient appears the most distracted ― in other words the researchers say, “where does the mind go?” http://www.specialneedsjungle.com/adhd-sluggish-cognitive-tempo/

See, Slow Cognitive Tempo (SCT): The Second Attention Disorder http://www.youtube.com/watch?v=1t7X6uhgB4E

Alan Schwartz reported in the New York Times article, Idea of New Attention Disorder Spurs Research, and Debate:

With more than six million American children having received a diagnosis of attention deficit hyperactivity disorder, concern has been rising that the condition is being significantly misdiagnosed and overtreated with prescription medications.
Yet now some powerful figures in mental health are claiming to have identified a new disorder that could vastly expand the ranks of young people treated for attention problems. Called sluggish cognitive tempo, the condition is said to be characterized by lethargy, daydreaming and slow mental processing. By some researchers’ estimates, it is present in perhaps two million children.
Experts pushing for more research into sluggish cognitive tempo say it is gaining momentum toward recognition as a legitimate disorder — and, as such, a candidate for pharmacological treatment. Some of the condition’s researchers have helped Eli Lilly investigate how its flagship A.D.H.D. drug might treat it.
The Journal of Abnormal Child Psychology devoted 136 pages of its January issue to papers describing the illness, with the lead paper claiming that the question of its existence “seems to be laid to rest as of this issue.” The psychologist Russell Barkley of the Medical University of South Carolina, for 30 years one of A.D.H.D.’s most influential and visible proponents, has claimed in research papers and lectures that sluggish cognitive tempo “has become the new attention disorder.”
In an interview, Keith McBurnett, a professor of psychiatry at the University of California, San Francisco, and co-author of several papers on sluggish cognitive tempo, said: “When you start talking about things like daydreaming, mind-wandering, those types of behaviors, someone who has a son or daughter who does this excessively says, ‘I know about this from my own experience.’ They know what you’re talking about.”
Yet some experts, including Dr. McBurnett and some members of the journal’s editorial board, say that there is no consensus on the new disorder’s specific symptoms, let alone scientific validity. They warn that the concept’s promotion without vastly more scientific rigor could expose children to unwarranted diagnoses and prescription medications — problems that A.D.H.D. already faces.
“We’re seeing a fad in evolution: Just as A.D.H.D. has been the diagnosis du jour for 15 years or so, this is the beginning of another,” said Dr. Allen Frances, an emeritus professor of psychiatry at Duke University. “This is a public health experiment on millions of kids.”
Though the concept of sluggish cognitive tempo, or S.C.T., has been researched sporadically since the 1980s, it has never been recognized in the Diagnostic and Statistical Manual of Mental Disorders, which codifies conditions recognized by the American Psychiatric Association. The editor in chief of The Journal of Abnormal Child Psychology, Charlotte Johnston, said in an email that recent renewed interest in the condition is what led the journal to devote most of one issue to “highlight areas in which further study is needed…” http://www.nytimes.com/2014/04/12/health/idea-of-new-attention-disorder-spurs-research-and-debate.html?ref=education&_r=0


Journal of Abnormal Child Psychology
January 2014, Volume 42, Issue 1, pp 1-6
Sluggish Cognitive Tempo in Abnormal Child Psychology: An Historical Overview and Introduction to the Special Section
• Stephen P. Becker,
• Stephen A. Marshall,
• Keith McBurnett
• …show all 3hide
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
There has recently been a resurgence of interest in Sluggish Cognitive Tempo (SCT) as an important construct in the field of abnormal child psychology. Characterized by drowsiness, daydreaming, lethargy, mental confusion, and slowed thinking/behavior, SCT has primarily been studied as a feature of Attention-Deficit/Hyperactivity Disorder (ADHD), and namely the predominately inattentive subtype/presentation. Although SCT is strongly associated with ADHD inattention, research increasingly supports the possibility that SCT is distinct from ADHD or perhaps a different mental health condition altogether, with unique relations to child and adolescent psychosocial adjustment. This introductory article to the Special Section on SCT provides an historical overview of the SCT construct and briefly describes the contributions of the eight empirical papers included in the Special Section. Given the emerging importance of SCT for abnormal psychology and clinical science, there is a clear need for additional studies that examine (1) the measurement, structure, and multidimensional nature of SCT, (2) SCT as statistically distinct from not only ADHD-inattention but also other psychopathologies (particularly depression and anxiety), (3) genetic and environmental contributions to the development of SCT symptoms, and (4) functional impairments associated with SCT. This Special Section brings together papers to advance the current knowledge related to these issues as well as to spur research in this exciting and expanding area of abnormal psychology.
Within this Article
1. An Historical Overview of SCT
2. Special Section Studies
3. Conclusion
4. References
5. References
References (46)
1. Achenbach, T. M., & Edelbrock, C. (1983). Manual for the child behavior checklist and revised child behavior profile. Burlington: University of Vermont.
2. 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.CrossRef
3. American Psychiatric Association. (1968). Diagnostic and statistical manual of mental disorders (2nd ed.). Washington, DC: Author.
4. American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.
5. American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., revised). Washington, DC: Author.
6. American Psychiatric Association. (1991). DSM-IV options book: work in progress. Washington, DC: Author.
7. American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
8. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
9. Barkley, R. A. (2006). Attention-deficit/hyperactivity disorder: a handbook for diagnosis and treatment (3rd ed.). New York: Guilford.
10. Barkley, R. A. (2012). Distinguishing sluggish cognitive tempo from attention deficit hyperactivity disorder in adults. Journal of Abnormal Psychology, 121, 978–990.CrossRef
11. Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1990). Comprehensive evaluation of attention deficit disorder with and without hyperactivity as defined by research criteria. Journal of Consulting and Clinical Psychology, 58, 775–789.CrossRef
12. Barkley, R. A., DuPaul, G. J., & McMurray, M. B. (1991). Attention deficit disorder with and without hyperactivity: clinical response to three dose levels of methylphenidate. Pediatrics, 87, 519–531.
13. Becker, S. P. (2013). Topical review: Sluggish cognitive tempo: research findings and relevance for pediatric psychology. Journal of Pediatric Psychology, 38, 1051–1057. doi:10.1093/jpepsy/jst058.CrossRef
14. Becker, S. P., Langberg, J. M., Luebbe, A. M., Dvorsky, M. R., & Flannery, A. J. (2013). Sluggish cognitive tempo is associated with academic functioning and internalizing symptoms in college students with and without attention-deficit/hyperactivity disorder. Journal of Clinical Psychology. doi:10.1002/jclp.22046. Advance online publication.
15. *Becker, S. P., Luebbe, A. M., Fite, P. J., Stoppelbein, L., & Greening, L. (2014). Sluggish cognitive tempo in psychiatrically hospitalized children: Factor structure and relations to internalizing symptoms, social problems, and observed behavioral dysregulation. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9719-y.
16. Carlson, C. L. (1986). Attention deficit disorder with and without hyperactivity: A review of preliminary experimental evidence. In B. B. Lahey & A. E. Kazdin (Eds.), Advances in clinical child psychology (Vol. 9) (pp. 153–175). New York: Plenum.
17. 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. doi:10.1207/153744202753441738.
18. Conners, C. K. (1969). A teacher rating scale for use in drug studies with children. American Journal of Psychiatry, 126, 884–888.
19. Crichton, A. (1798). An inquiry into the nature and origin of mental derangement: Comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. London: T. Cadell, Jr. and W. Davies. (Reprinted by AMS Press, New York, 1976).
20. Douglas, V. I. (1972). Stop, look, and listen: The problem of sustained attention and impulse control in hyperactive and normal children. Canadian Journal of Behavioural Science, 4, 259–282.CrossRef
21. Frick, P. J., Lahey, B. B., Applegate, B., Kerdyck, L., Ollendick, T., & Hynd, G. W. (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.
22. Hinshaw, S. P. (1987). On the distinction between attentional deficits/hyperactivity and conduct problems/aggression in child psychopathology. Psychological Bulletin, 101(3), 443–463.CrossRef
23. Hynd, G. W., Lorys, A. R., Semrud-Clikeman, M., Nieves, N., Huettner, M. I. S., & Lahey, B. B. (1991). Attention deficit disorder without hyperactivity: A distinct behavioral and neurocognitive syndrome. Journal of Child Neurology, 6, 37–43.
24. Lahey, B. B., Schaughency, E. A., Frame, C. L., & Strauss, C. C. (1985). Teacher ratings of attention problems in children experimentally classifies as exhibiting attention deficit disorder with and without hyperactivity. Journal of the American Academy of Child Psychiatry, 24, 613–616.CrossRef
25. 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 Psychiatry, 26(5), 718–723.CrossRef
26. Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, A., & Hynd, G. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 330–335.
27. *Langberg, J. M., Becker, S. P., & Dvorsky, M. R. (2014). The association between sluggish cognitive tempo and academic functioning in youth with attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9722-3.
28. Laufer, M., Denhoff, E., & Solomons, G. (1957). Hyperkinetic impulse disorder in children’s behavioral problems. Psychosomatic Medicine, 19, 38–49.
29. *Lee, S., Burns, G. L., Snell, J., & McBurnett, K. (2014). Validity of the sluggish cognitive tempo symptom dimension in children: Sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9714-3.
30. *Marshall, S. A., Evans, S. W., Eiraldi, R. B., Becker, S. P., & Power, T. J. (2014). Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9758-4.
31. 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. doi:10.1023/A:1010377530749.CrossRef
32. *McBurnett, K., Villodas, M., Burns, L. G., Hinshaw, S. P., Beaulieu, A., & Pfiffner, L. J. (2014). Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology.
33. Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463–488. doi:10.1093/clipsy.8.4.463.
34. *Moruzzi, S., Rijsdijk, F., & Battaglia, M. (2014). A twin study of the relationships among inattention, hyperactivity/impulsivity and sluggish cognitive tempo problems. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9725-0.
35. Neeper, R., & Lahey, B. B. (1986). The children’s behavior rating scale: a factor analytic developmental study. School Psychology Review, 15, 277–288.
36. Palmer, E. D., & Finger, S. (2001). An early description of ADHD (inattentive subtype): Dr. Alexander Crichton and “Mental Restlessness” (1798). Child Psychology and Psychiatry Review, 6, 66–73.CrossRef
37. Peterson, D. R. (1961). Behavior problems of middle childhood. Journal of Consulting Psychology, 25, 205–209.CrossRef
38. Quay, H. C. (1983). A dimensional approach to behavior disorder: the revised behavior problem checklist. School Psychology Review, 12, 244–249.
39. Quay, H. C., & Quay, L. C. (1965). Behavior problems in early adolescence. Child Development, 36, 215–220.CrossRef
40. Smallwood, J., & Schooler, J. (2006). The restless mind. Psychological Bulletin, 132, 946–958.CrossRef
41. Stewart, M. A. (1970). Hyperactive children. Scientific American, 222, 94–98.CrossRef
42. Still, G. F. (1902). Some abnormal psychical conditions in children. Lancet, 1, 1008-1012, 1077-1082, 1163-1168.
43. *Watabe, Y., Owens, J. S., Evans, S. W., & Brandt, N. E. (2014). The relationship between sluggish cognitive tempo and impairment in children with and without ADHD. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9767-3.
44. Weinberg, W. A., & Brumback, R. A. (1990). Primary disorder of vigilance: a novel explanation of inattentiveness, daydreaming, boredom, restlessness, and sleepiness. Journal of Pediatrics, 116, 720–725.CrossRef
45. Willcutt, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., & Tannock, R. (2012). Validity of DSM-IV attention-deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010.
46. *Willcutt, E. G., Chhabildas, N., Kinnear, M., DeFries, J. C., Olson, R. K., & Leopold, D. R. (2014). The internal and external validity of sluggish cognitive tempo and its relation with DSM-IV ADHD. Journal of Abnormal Child Psychology. doi: 10.1007/s10802-013-9800-6.
About this Article
Sluggish Cognitive Tempo in Abnormal Child Psychology: An Historical Overview and Introduction to the Special Section
Journal of Abnormal Child Psychology
Volume 42, Issue 1 , pp 1-6
Cover Date
Print ISSN
Online ISSN
Springer US

Reference Links:

Edge Foundation ADHD Coaching Study Executive Summary http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

Edge Foundation ADHD Coaching Study Full Report http://edgefoundation.org/wp-content/uploads/2011/01/Edge-Foundation-ADHD-Coaching-Research-Report.pdf

ADHD and College Success: A free guide http://www.edgefoundation.org/howedgehelps/add-2.html

ADHD and ExecutiveFunctioning http://edgefoundation.org/blog/2010/10/08/the-role-of-adhd-and-your-brains-executive-functions/

Executive Function, ADHD and Academic Outcomes http://www.helpforld.com/efacoutcomes.pdf

If you suspect that your child might have ADHD, you should seek an evaluation from a competent professional who has knowledge of this specialized area of medical practice.


Studies: ADHD drugs don’t necessarily improve academic performance https://drwilda.com/2013/07/14/studies-adhd-drugs-dont-necessarily-improve-academic-performance/

ADHD coaching to improve a child’s education outcome https://drwilda.com/2012/03/31/adhd-coaching-to-improve-a-childs-education-outcome/

Where information leads to Hope. © Dr. Wilda.com

Dr. Wilda says this about that ©

Blogs by Dr. Wilda:
COMMENTS FROM AN OLD FART© http://drwildaoldfart.wordpress.com

Dr. Wilda Reviews © http://drwildareviews.wordpress.com/

Dr. Wilda © https://drwilda.com/