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Ergül B, Ersöz Alan B. The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder. Early Interv Psychiatry 2024. [PMID: 38698721 DOI: 10.1111/eip.13535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 03/16/2024] [Accepted: 04/08/2024] [Indexed: 05/05/2024]
Abstract
AIMS We aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) and non-suicidal self injury (NSSI) in adolescents with attention deficit hyperactivity disorder (ADHD). METHODS A semi-structured psychiatric interview and an NSSI screening questionnaire were conducted. Questionnaires assessing CDS (with daydreamer, sleepy, and slow subdimensions), depression, anxiety, self-esteem, emotion regulation, coping strategies, and loneliness were administered. RESULTS Among 104 participants (n: 63, 60.6% girls), the combined type of ADHD was the most common (66.3%), and 35 adolescents (27 girls) were in the NSSI+ group. Although only depression and ADHD were found to be predictors of NSSI in ADHD, CDS was associated with many risk factors of NSSI in ADHD: depression, anxiety, emotion dysregulation, low self-esteem, and emotion-oriented coping ways. After controlling for the effects of cognitive problems/inattentiveness, depression, and anxiety, CDS still correlated with low self-esteem and emotion dysregulation. The daydreamer and slow sub-dimensions of CSD differed between NSSI+ and NSSI- groups, while sleepy did not. CONCLUSIONS CDS is associated with several relevant factors, indirectly relating it to self-harm in ADHD. CDS increases the vulnerability to mental health changes that could lead to NSSI in adolescence with ADHD.
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Affiliation(s)
- Beyza Ergül
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
| | - Burcu Ersöz Alan
- Faculty of Medicine, Department of Child and Adolescent Psychiatry, Hacettepe University, Ankara, Turkey
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Luedke JC, Vargas G, Jashar DT, Morrow A, Malone LA, Ng R. [Formula: see text] Cognitive disengagement syndrome in pediatric patients with long COVID: associations with mood, anxiety, and functional impairment. Child Neuropsychol 2024; 30:652-672. [PMID: 37667487 DOI: 10.1080/09297049.2023.2252967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023]
Abstract
Children with long COVID often report symptoms that overlap with cognitive disengagement syndrome (CDS, previously sluggish cognitive tempo (SCT)), a set of behaviors distinct from attention-deficit/hyperactivity disorder (ADHD) including excessive daydreaming, mental fogginess, and slowed behavior and thinking. Those with long COVID also frequently report low mood and anxiety, which are linked to CDS. The relationships between cognitive difficulties, mood, and functional impairment have yet to be explored in pediatric long COVID. Specifically, it is unclear how much cognitive difficulties (CDS, inattention) contribute to functional impairment, when accounting for mood/anxiety symptoms in this population. Retrospective parent-reported data was collected from 34 patients with long COVID (22 females, Mage = 14.06 years, SD = 2.85, range 7-19) referred for neuropsychological consultation through a multidisciplinary Post-COVID-19 clinic. Compared to community and clinically referred samples, on average, long COVID patients showed elevated CDS symptoms, including Sluggish/sleepy (e.g., fatigue) and Low Initiation subscales (e.g., difficulty performing goal directed behaviors). Low Initiation, mood, anxiety, and inattention were associated with functional impairment. In multiple hierarchical regression models, after controlling for mood and anxiety, Low Initiation and inattention were no longer predictive of functional impairment. Instead, anxiety remained the sole predictor of functional impairment. Our results demonstrate that children with long COVID have high levels of CDS symptoms. The association between cognitive difficulties and functional impairment dissipated with the inclusion of mood and anxiety, suggesting behavioral health interventions targeting anxiety may help improve daily functioning and quality of life in pediatric long COVID patients.
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Affiliation(s)
- Jessica C Luedke
- Department of Psychology, University of South Carolina, Columbia, SC, USA
| | - Gray Vargas
- Kennedy Krieger Institute, Baltimore, MD, USA
| | | | - Amanda Morrow
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Laura A Malone
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rowena Ng
- Kennedy Krieger Institute, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
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3
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Miller MC, Shapiro SK, Becker SP. Examining Cognitive Disengagement Syndrome in Relation to Social Problem Solving in Young Adults. J Atten Disord 2024:10870547241247176. [PMID: 38616627 DOI: 10.1177/10870547241247176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
OBJECTIVE Cognitive disengagement syndrome (CDS), previously referred to as sluggish cognitive tempo (SCT), is characterized by symptoms such as excessive daydreaming, mental confusion, and hypoactivity. CDS symptoms are associated with emotional, social, and daily life impairments. The way in which one solves problems in their daily life is associated with experiences of further problems, such that maladaptive problem-solving can lead to further physical and psychological problems. However, there is limited information on how CDS symptoms are associated with problem solving. The current study examined CDS symptoms in relation to different social problem solving approaches. METHOD A total of 280 college students (ages 18-23 years; 77.9% female) completed measures of psychopathology symptoms and social problem solving. RESULTS Above and beyond ADHD and internalizing symptoms, CDS symptoms were independently associated with negative problem orientation and avoidance style domains of maladaptive problem solving. CONCLUSION Findings indicate that CDS symptoms are related to specific difficulties with social problem solving. CDS symptoms may lead to difficulties attending to problems or working through relevant steps needed to identify solutions for the problem, which may then lead to avoidance and social withdrawal. Longitudinal research is needed to evaluate maladaptive problem solving as a potential mechanism in the association between CDS, social withdrawal, and internalizing symptoms.
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Affiliation(s)
- Melissa C Miller
- Auburn University, AL, USA
- Cincinnati Children's Hospital Medical Center, OH, USA
| | | | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
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Inci Izmir SB, Aktan ZD, Ercan ES. Assessing the mediating relationships between psychological factors in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome. Appl Neuropsychol Child 2024:1-17. [PMID: 38615909 DOI: 10.1080/21622965.2024.2341251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2024]
Abstract
This study aims to investigate the predictive and mediating relationships between emotion dysregulation, internalizing disorders, family functionality, loneliness preference, and executive functions (EF) in children with attention deficit hyperactivity disorder and cognitive disengagement syndrome (ADHD + CDS). This study included 176 children and adolescents (92 boys, 84 girls) who were diagnosed with ADHD + CDS according to the Diagnostic and Statistical Manual of Mental Disorders, the Fifth Edition criteria by a fellowship-trained child and adolescent psychiatrist, between ages 8 -12 (M = 10, SD = 1.52) with a convenience sampling method. The solitude scale for children, difficulties in emotion dysregulation scale, Child Behavior Checklist, Barkley Sluggish Cognitive Tempo Scale, Family assessment device, and CNS Vital Signs test were used. The results showed that difficulty in emotion regulation, preference for loneliness, internalizing disorders and CDS symptom severity did not have a mediating effect between family functionality and EF. Still, emotion dysregulation mediates the relationship between EF and internalizing disorders by itself and through loneliness preference. Also, preference for loneliness and emotion dysregulation had a mediating effect between family functionality and internalizing disorders. Finally, it was found that the effect of emotion regulation difficulty, loneliness preference, and internalizing disorders had a mediating role between CDS symptom severity and family functionality. In conclusion, the information obtained from this study on the etiology of CDS may guide future studies.
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Affiliation(s)
| | - Z Deniz Aktan
- Child and Adolescent Clinical Psychology Department, Isik University, Istanbul, Turkey
| | - Eyüp Sabri Ercan
- Child and Adolescent Psychiatry Department, Medical Faculty, Ege University, Izmir, Turkey
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Khalid E, VanLandingham HB, Basurto KS, Nili AN, Gonzalez C, Guilfoyle JL, Ovsiew GP, Durkin NM, Ulrich DM, Resch ZJ, Pliskin NH, Soble JR, Cerny BM. Exploring Subfactors of Adult Cognitive Disengagement Syndrome and Impact on Neuropsychological Performance. J Atten Disord 2024; 28:957-969. [PMID: 38178579 DOI: 10.1177/10870547231218945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2024]
Abstract
OBJECTIVE This study investigated subfactors of cognitive disengagement syndrome (CDS; previously referred as sluggish cognitive tempo) among adults referred for neuropsychological evaluation of attentiondeficit/hyperactivity disorder (ADHD). METHOD Retrospective analyses of data from 164 outpatient neuropsychological evaluations examined associations between CDS subfactors and self-reported psychological symptoms and cognitive performance. RESULTS Factor analysis produced two distinct but positively correlated constructs: "Cognitive Complaints'' and "Lethargy." Both correlated positively with symptom reports (rs = 0.26-0.57). Cognitive Complaints correlated negatively with working memory, processing speed, and executive functioning performance (rs = -0.21 to -0.37), whereas Lethargy correlated negatively only with processing speed and executive functioning performance (rs = -0.26 to -0.42). Both predicted depression symptoms, but only Cognitive Complaints predicted inattention symptoms. Both subfactors demonstrated modest to nonsignificant associations with cognitive performance after accounting for estimated premorbid intelligence and inattention. CONCLUSION Findings indicate a bidimensional conceptualization of CDS, with differential associations between its constituent subfactors, reported symptoms, and cognitive performance.
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Affiliation(s)
- Elmma Khalid
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Hannah B VanLandingham
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Karen S Basurto
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Amanda N Nili
- University of Illinois College of Medicine, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christopher Gonzalez
- University of Illinois College of Medicine, Chicago, IL, USA
- Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Janna L Guilfoyle
- University of Illinois College of Medicine, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nicole M Durkin
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Devin M Ulrich
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Zachary J Resch
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Neil H Pliskin
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Jason R Soble
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Brian M Cerny
- University of Illinois College of Medicine, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
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Yucens B, Basay O, Buber A, Tumkaya S, Kabukcu Basay B, Erdem B, Becker SP, Leonard Burns G. Examining cognitive disengagement syndrome in a psychiatric outpatient sample: Psychometric support and associations with internalizing symptoms and sleep problems. J Clin Psychol 2024. [PMID: 38466830 DOI: 10.1002/jclp.23678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 01/27/2024] [Accepted: 02/26/2024] [Indexed: 03/13/2024]
Abstract
OBJECTIVE The internal (structural) and external validity of a self-report measure of cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) relative to a self-report measure of attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated with adults from university outpatient psychiatric clinics in Turkey. METHODS A total of 274 outpatients (75.9% women; ages 18-64 years; Mage = 31.06; SDage = 10.84; 50.4% anxiety disorders; 41.6% depressive disorders; 2.9% ADHD; 1.5% sleep disorders; 0.7% eating disorders; 2.9% no mental disorder) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), sleep problems, depression, and stress. RESULTS All 15 CDS symptoms measured by the Adult Concentration Inventory (ACI) showed convergent (moderate to high loadings on the CDS factor) and discriminant (loading close to zero on the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations than ADHD-IN with sleep problems, depression, anxiety, and stress, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-HI. CONCLUSION This is the first study to provide support for the scores from this 15 item self-report measure of CDS by the ACI in a clinical sample of adults, with findings consistent with previous studies examining parent and teacher rating scale measures with the same 15 CDS symptoms. These findings provide additional support for usefulness of these 15 CDS symptoms as measured by the ACI to study CDS across various cultures.
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Affiliation(s)
- Bengu Yucens
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Omer Basay
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Ahmet Buber
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Selim Tumkaya
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Burge Kabukcu Basay
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Busra Erdem
- Department of Psychiatry, Faculty of Medicine, Pamukkale University, Denizli, Turkey
| | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, Division of Behavioral Medicine and Clinical Psychology, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - G Leonard Burns
- Department of Psychology, Washington State University, Pullman, Washington, USA
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Yılmaz Y, Uzun Cicek A. Cognitive Disengagement Syndrome in Mothers of Children With Attention-Deficit/Hyperactivity Disorder. J Atten Disord 2024:10870547231224089. [PMID: 38327080 DOI: 10.1177/10870547231224089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2024]
Abstract
OBJECTIVE To examine the cognitive disengagement syndrome (CDS) symptoms of mothers of children with attention-deficit/hyperactivity disorder (ADHD). METHOD The participants consisted of 223 mothers of children with ADHD, and data were collected using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version (SCID-5-CV), the Stroop Test (ST), the Barkley Adult SCT Scale (CDS), and the Adult ADHD Self-Report Scale (ASRS). RESULTS The participants were divided into four groups based on psychopathology: the group without any psychiatric disorder, the group with only ADHD, the group with a psychiatric disorder other than ADHD, and the group with another psychiatric disorder along with ADHD. The group with any psychiatric disorder along with ADHD had the highest CDS scores, while the group without any psychopathology had the lowest CDS scores. CONCLUSION CDS seems to be a construct associated with both ADHD and other internalizing disorders. Further studies are needed to shed more light on these relationships.
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Affiliation(s)
- Yavuz Yılmaz
- Department of Psychiatry, Sivas Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
| | - Ayla Uzun Cicek
- Department of Psychiatry, Sivas Cumhuriyet University, Faculty of Medicine, Sivas, Turkey
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Tamm L, Epstein JN, Orban SA, Kofler MJ, Peugh JL, Becker SP. [Formula: see text] Neurocognition in children with cognitive disengagement syndrome: accurate but slow. Child Neuropsychol 2024; 30:221-240. [PMID: 36864603 PMCID: PMC10474248 DOI: 10.1080/09297049.2023.2185215] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 02/17/2023] [Indexed: 03/04/2023]
Abstract
Cognitive disengagement syndrome (CDS), previously termed sluggish cognitive tempo (SCT), is characterized by excessive daydreaming, mental confusion, and slowed behavior or thinking. Prior research has found inconsistent relations between CDS and neurocognition, though most studies have used small or ADHD-defined samples, non-optimal measures of CDS, and/or examined limited neurocognitive domains. Accordingly, this study examined the association of parent- and teacher-reported CDS symptoms using a comprehensive neurocognitive battery in a sample of 263 children (aged 8-12) selected with a range of CDS symptomatology. Parents and teachers provided ratings of CDS and ADHD inattentive (ADHD-IN) symptoms. Path analyses were conducted to examine CDS and ADHD-IN as unique predictors of neurocognitive functioning after covarying for age, sex, and family income. CDS symptoms were uniquely associated with slower performance across a range of cognitive domains, including verbal inhibition, rapid naming/reading, planning, divided attention, and set shifting. In contrast, ADHD-IN symptoms were uniquely associated with poorer performance on a Go/NoGo task (inhibition/distractibility), visual scanning and discrimination, and interference control. Findings from the current study, amongst the first to recruit children based on levels of CDS symptomatology, provide the strongest evidence to date that the neurocognitive phenotype of CDS is characterized by slowed cognitive processing, and add to its validity as a separate syndrome from ADHD. If replicated, these findings have implications for assessment, treatment, and school accommodations for CDS. Neuroimaging studies exploring the neurobiological basis of CDS are also needed.
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Affiliation(s)
- Leanne Tamm
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Jeffery N. Epstein
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Sarah A. Orban
- Department of Psychology, University of Tampa, Tampa, FL, USA
| | - Michael J. Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - James L. Peugh
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Stephen P. Becker
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Simpson TS, Leopold DR, Wilson PE, Peterson RL. Cognitive disengagement syndrome in pediatric spina bifida. Child Neuropsychol 2024; 30:87-104. [PMID: 36803439 PMCID: PMC10440368 DOI: 10.1080/09297049.2023.2181944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Accepted: 02/13/2023] [Indexed: 02/23/2023]
Abstract
The primary aim of this study was to characterize Cognitive Disengagement Syndrome (CDS) symptomatology in youth with spina bifida (SB). One hundred and sixty-nine patients aged 5-19 years old were drawn from clinical cases seen through a multidisciplinary outpatient SB clinic at a children's hospital between 2017 and 2019. Parent-reported CDS and inattention were measured using Penny's Sluggish Cognitive Tempo Scale and the Vanderbilt ADHD Rating Scale. Self-reported internalizing symptoms were measured with the 25-item Revised Children's Anxiety and Depression Scale (RCADS-25). We replicated Penny's proposed 3-factor structure of CDS with slow, sleepy, and daydreamer components. The slow component of CDS overlapped heavily with inattention, while the sleepy and daydreamer components were distinct from inattention and internalizing symptoms. Eighteen percent (22 of 122) of the full sample met criteria for elevated CDS, and 39% (9 of 22) of those patients did not meet criteria for elevated inattention. Diagnosis of myelomeningocele and presence of a shunt were associated with greater CDS symptoms. CDS can be measured reliably in youth with SB and can be discriminated from inattention and internalizing symptoms in this population. ADHD rating scale measures fail to identify a substantial portion of the SB population with attention-related challenges. Standard screening for CDS symptoms in SB clinics may be important to help identify clinically impairing symptoms and design targeted treatment plans.
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Affiliation(s)
- Tess S. Simpson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine
| | - Daniel R. Leopold
- Department of Psychiatry, University of Colorado School of Medicine
- Department of Psychology & Neuroscience, University of Colorado Boulder
| | - Pamela E. Wilson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine
| | - Robin L. Peterson
- Department of Physical Medicine & Rehabilitation, University of Colorado School of Medicine
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Öğütlü H, Kaşak M, Doğan U, Atasoy S, Mcnicholas F. Psychometric Properties of the Turkish version of the Child and Adolescent Behavior Inventory Sluggish Cognitive Tempo Scale (CABI-SCT) in Children and Adolescents. Clin Child Psychol Psychiatry 2023; 28:1580-1594. [PMID: 36802877 DOI: 10.1177/13591045231158869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
Sluggish cognitive tempo (SCT) (cognitive disengagement syndrome) (CDS) describes a cluster of symptoms including slowness, lethargy, and daydreaming. This study aims to evaluate the psychometric properties of the Turkish version of the Child and Adolescent Behavior Inventory (CABI-SCT) scale and its relationship to other psychological difficulties. A total of 328 children and adolescents aged between 6-18 years were included in the study. CABI-SCT, Revised Child Anxiety and Depression Scale (RCADS), Barkley Child Attention Scale (BCAS), ADHD Rating Scale-IV, and Strengths and Challenges Questionnaire (SDQ) were administered to parents of participants. Reliability analysis demonstrated good internal consistency and reliability. Confirmatory factor analysis indicated that the one-factor model of the Turkish version of CABI-SCT is an acceptable construct. This study supports the validity and reliability of the Turkish version of CABI-SCT for use in children and adolescents providing initial data concerning the psychometric properties and difficulties associated with the Turkish version of the CABI-SCT.
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Affiliation(s)
- Hakan Öğütlü
- Department of Child and Adolescent Psychiatry, Cognitive Behavioral Psychotherapies Association, Ankara, Turkey
| | - Meryem Kaşak
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey
| | - Uğur Doğan
- Department of Guidance and Counseling, Muğla Sıtkı Koçman University, Muğla, Turkey
| | - Süha Atasoy
- Department of Child and Adolescent Psychiatry, Ankara City Hospital, Ankara, Turkey
| | - Fiona Mcnicholas
- Department of Child and Adolescent Psychiatry, University College of Dublin, Dublin, Ireland
- Children Hospital Ireland, Crumlin, Dublin, Ireland
- Lucena Rathgar, SJOG CAMHS, Dublin, Ireland
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Uzun Cicek A, Ucuz I, Isık CM, Temelli G. Evaluation of cognitive disengagement syndrome in children with obsessive-compulsive disorder: Clinical implications. Clin Child Psychol Psychiatry 2023; 28:1449-1462. [PMID: 37073420 DOI: 10.1177/13591045231169137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/20/2023]
Abstract
Cognitive disengagement syndrome (CDS) has been found to be associated with internalizing symptoms. Yet, no study thus far has focused on whether there is an association between obsessive-compulsive disorder (OCD) and CDS. The purpose of this study is to examine the symptom frequency and clinical implications of CDS in children with OCD. The study included sixty-one children with OCD and sixty-six typically developing children. Children were evaluated by a semi-constructed diagnosis interview, Obsessive-Compulsive Inventory, Barkley Child Attention Scale, and Stroop test. The frequency of elevated symptoms of CDS, and total time, total error, and total correction scores of the Stroop test were significantly higher in the OCD group compared to the controls. Elevated CDS symptoms were significantly associated with higher OCD symptom prevalence and poorer performance on the Stroop Test. Moreover, poor insight, hoarding symptoms, mental compulsions, and ADHD comorbidity were significantly higher in those with elevated CDS symptoms than in those without CDS in the OCD group. The findings of this study provide clinical implications that CDS symptoms may contribute to deficits in attentional orientation, conceptual flexibility, and cognitive processing speed in OCD.
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Affiliation(s)
- Ayla Uzun Cicek
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Cumhuriyet University, Sivas, Turkey
| | - Ilknur Ucuz
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
| | - Cansu Mercan Isık
- Department of Child and Adolescent Psychiatry, Diyarbakir Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey
| | - Gürkan Temelli
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, İnönü University, Malatya, Turkey
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Kılıçoğlu AG, Zadehgan Afshord T, Derin S, Ertas E, Coskun P, Aktas S, Guler EM. Comparison of Possible Changes in Oxidative Stress, DNA Damage, and Inflammatory Markers in Children/Adolescents Diagnosed with Sluggish Cognitive Tempo and Children/Adolescents Diagnosed with Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2023; 33:325-331. [PMID: 37590480 DOI: 10.1089/cap.2022.0081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Background: There has been a debate on whether sluggish cognitive tempo (SCT) differs from attention-deficit/hyperactivity disorder (ADHD). Although there have been many studies on metabolic parameters in relation to ADHD, no similar studies have been conducted on patients with SCT. We investigated whether there are differences between SCT and ADHD in terms of these factors. Subjects and Methods: Sixty-two participants with ages ranging from 11 to 18 who have diagnosis of ADHD (33 subjects) and SCT (29 subjects) were included in this study. The parents of all participants completed the 48-item Conners' Parent Rating Scale (CPRS) and the Barkley Child Attention Scale (BCAS) forms, and all participants' blood was taken to compare metabolic, oxidative stress, and antioxidant status of the SCT and ADHD groups. A child and adolescent psychiatrist interviewed the parents and children to assess the diagnosis of SCT and ADHD using standard diagnostic procedures. Results: In the comparison between the SCT and ADHD groups in terms of metabolic parameters, statistically significant differences were found in terms of total oxidant status, total antioxidant status, Oxidative Stress Index, total thiol, native thiol, disulfide, interleukin (IL)-1β, IL-6, and DNA damage (p < 0.05), but not in terms of tumor necrosis factor-α (p > 0.05). Conclusions: Our data showed that these two disorders may be different, but we believe that the data that indicate their differences remain inconclusive overall, but this study may be a potential pathway for future research.
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Affiliation(s)
- Ali Güven Kılıçoğlu
- Department of Psychology, Istanbul Sabahattin Zaim University, Istanbul, Turkey
| | | | - Songul Derin
- Department of Child and Adolescent Psychiatry, Bezmialem Vakıf University, Istanbul, Turkey
| | | | - Pınar Coskun
- Department of Child and Adolescent Psychiatry, Bezmialem Vakıf University, Istanbul, Turkey
| | - Selman Aktas
- Department of Biostatistics and Medical Informatics, University of Health Sciences, Istanbul, Turkey
| | - Eray Metin Guler
- Department of Medical Biochemistry, Hamidiye School of Medicine, University of Health Sciences, Istanbul, Turkey
- Haydarpasa Numune Health Application and Research Center, Clinic of Medical Biochemistry, University of Health Sciences, Istanbul, Turkey
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13
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Russell KMH, Redmond SM, Ash AC. Psycholinguistic profiling of children with sluggish cognitive tempo. Clin Linguist Phon 2023; 37:828-844. [PMID: 35748339 PMCID: PMC9789211 DOI: 10.1080/02699206.2022.2092422] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 05/27/2022] [Accepted: 06/14/2022] [Indexed: 06/15/2023]
Abstract
Language disorders are frequently comorbid with attention deficit/hyperactivity disorder (ADHD). Sluggish cognitive tempo (SCT), a second attention disorder, may potentially explain some of the links between language disorders and ADHD. In this study we examined the psycholinguistic abilities of 207 children (mean age 7;10) with and without clinically significant levels of SCT symptoms to determine the degree to which symptoms of language disorder co-occur in cases of SCT. Analyses of children's tense-marking, nonword repetition, and sentence recall indicated that deficits in these areas were not associated with SCT. Instead, SCT appears to be more closely aligned with features of social (pragmatic) communication disorder.
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Affiliation(s)
- Kirsten M Hannig Russell
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
| | - Sean M Redmond
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
| | - Andrea C Ash
- Department of Communication Sciences and Disorders, University of Utah, Salt Lake City, Utah, USA
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14
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Wiggs KK, Thornton K, Fredrick JW, Lowman CN, Langberg JM, Becker SP. Physical and Extracurricular Activity in Adolescents With and Without ADHD: Examining Group Differences and the Role of Cognitive Disengagement Syndrome Symptoms. J Atten Disord 2023; 27:1207-1222. [PMID: 36799448 DOI: 10.1177/10870547231154905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This study examined extracurricular and physical activity related to ADHD (diagnosis and symptoms) and cognitive disengagement syndrome (CDS) symptoms. METHODS Participants were 302 adolescents (ages 12-14) with and without ADHD and primary caregivers. ADHD diagnosis was determined with parent interview. Questionnaires provided information on parent-reported demographic characteristics, ADHD symptoms, and extracurricular activity involvement; and adolescent-reported ADHD and CDS symptoms and indices of physical activity. RESULTS Although ADHD diagnosis and symptom dimensions were correlated with less extracurricular and physical activity involvement, CDS symptoms were most often independently associated with these outcomes. Females and adolescents from lower income homes also often had less involvement in extracurricular and physical activity. CONCLUSIONS Findings point to the need for more research in this area, careful assessment of risk factors (i.e., CDS symptoms, economic burden), and interventions that address inactivity in adolescents with ADHD, including those that address inequity related to income and sex.
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Affiliation(s)
| | | | - Joseph W Fredrick
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
| | | | | | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
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15
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Darow EL, Flax MA, Clark OE, Holmbeck GN, Smith ZR. Comparing Cognitive Disengagement Syndrome Growth in Youth With and Without Spina Bifida. J Pediatr Psychol 2023; 48:720-730. [PMID: 37418009 PMCID: PMC10467645 DOI: 10.1093/jpepsy/jsad038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE Cognitive disengagement syndrome (CDS; formally known as sluggish cognitive tempo), difficulties with social engagement, and lower levels of autonomy have been identified as maladaptive comorbidities in youth with spina bifida (SB). This study compared growth curves of CDS for youth with and without SB and examined whether these trajectories were associated with later functioning. METHODS Longitudinal data spanning 8 years included youth with SB (n = 68, Mage = 8.34) and a demographically matched sample of typically developing (TD) peers (n = 68, Mage = 8.49). Adolescents, along with their caregivers and teachers, reported on youth social skills, behavioral functioning, and CDS. Growth curve models were examined by comparing CDS trajectories by SB status. RESULTS Growth curves indicated that youth with SB had higher levels of teacher-reported CDS at ages 8 and 9, but growth curves were relatively stable for both groups. When predicting social skills, higher levels of teacher-reported (but not mother-reported) CDS at baseline predicted worse social functioning for both youth with and without SB in adolescence. For the slope findings, higher rates of mother-reported CDS over time predicted worse social skills (β = -0.43) and lower levels of youth decision-making (β = -0.43) for the SB group, while higher rates of teacher-reported CDS predicted worse social skills for the TD group. CONCLUSION Next steps include understanding the impact that impaired social functioning and restricted autonomy have on youth with and without SB due to CDS to inform interventions. Additionally, advocacy for increased awareness of CDS-related impairment is needed, particularly for youth with chronic health conditions.
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Affiliation(s)
- Eva L Darow
- Nationwide Children’s Hospital, USA
- Department of Psychology, Loyola University of Chicago, USA
| | - Marcus A Flax
- Department of Psychology, Loyola University of Chicago, USA
| | - Olivia E Clark
- Department of Psychology, Loyola University of Chicago, USA
| | | | - Zoe R Smith
- Department of Psychology, Loyola University of Chicago, USA
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16
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Sadeghi-Bahmani D, Parhoon H, Esmaeili M, Parhoon K, Sadeghi Bahmani L, Khazaie H, Becker SP, Burns GL, Brand S. Validation of the Farsi Version of the Adult Concentration Inventory for Assessing Cognitive Disengagement Syndrome. J Clin Med 2023; 12:4607. [PMID: 37510724 PMCID: PMC10380426 DOI: 10.3390/jcm12144607] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 06/28/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
The internal and external validity of cognitive disengagement syndrome (CDS) relative to attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated herein with Farsi-speaking adults. A total of 837 Iranian adults assessed throughout the whole country (54.72% women, Mage = 23.85; SD = 7.05; age range = 18 to 58 years; 75% between 18 and 24 years old; reporting higher educational training) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), depression, anxiety, and stress. Seven of the fifteen CDS symptoms showed a good convergent (high loadings on the CDS factor) and discriminant (higher loadings on the CDS factor than the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations with depression than ADHD-IN, whereas ADHD-IN showed stronger first-order and unique associations with ADHD-HI and anxiety than CDS. The first-order and unique associations of CDS and ADHD-IN did not differ in relation to stress. This study is the first to support the validity of the self-report of assessing CDS symptoms with the Adult Concentration Inventory with Farsi-speaking individuals residing in Iran, thus further strengthening the transcultural validity of the CDS, and paving the way for further transcultural research in the field of CDS among adults.
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Affiliation(s)
- Dena Sadeghi-Bahmani
- Department of Psychology, Stanford University, Stanford, CA 94305, USA
- Department of Epidemiology & Population Health, Stanford University, Stanford, CA 94305, USA
| | - Hadi Parhoon
- Department of Psychology, Razi University, Kermanshah 6714414971, Iran;
| | - Maryam Esmaeili
- Department of Psychology, Faculty of Education and Psychology, University of Isfahan, Isfahan 8174673441, Iran;
| | - Kamal Parhoon
- Department of Psychology, Kharazmi University, Tehran 1571914911, Iran;
| | - Laleh Sadeghi Bahmani
- Department of Education and Psychology, Shahid Ashrafi Esfahani University, Isfahan 8179949999, Iran;
| | - Habibolah Khazaie
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714415185, Iran;
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA;
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA
| | - G. Leonard Burns
- Department of Psychology, Washington State University, Pullman, WA 99164, USA;
| | - Serge Brand
- Center for Affective, Sleep and Stress Disorders, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland;
- Division of Sport Science and Psychosocial Health, Department of Sport, Exercise and Health, Faculty of Medicine, University of Basel, 4052 Basel, Switzerland
- Substance Abuse Prevention Research Center, Kermanshah University of Medical Sciences (KUMS), Kermanshah 6714415185, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran 1441987566, Iran
- Center for Disaster Psychiatry and Disaster Psychology, Psychiatric Clinics of the University of Basel, 4002 Basel, Switzerland
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17
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Becker SP, Willcutt EG, Leopold DR, Fredrick JW, Smith ZR, Jacobson LA, Burns GL, Mayes SD, Waschbusch DA, Froehlich TE, McBurnett K, Servera M, Barkley RA. Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome. J Am Acad Child Adolesc Psychiatry 2023; 62:629-645. [PMID: 36007816 PMCID: PMC9943858 DOI: 10.1016/j.jaac.2022.07.821] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/28/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this work was 2-fold: (1) to evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT); and (2) to arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. METHOD An international Work Group was convened that, in early 2021, compiled an online archive of all research studies on SCT and summarized the current state of knowledge, noted methodological issues, and highlighted future directions, and met virtually on 10 occasions in 2021 to discuss these topics and terminology. RESULTS Major progress has been made over the last decade in advancing our understanding of SCT across the following domains of inquiry: construct measurement and stability; genetic, environmental, pathophysiologic, and neuropsychological correlates; comorbid conditions; functional impairments; and psychosocial and medication interventions. Findings across these domains are summarized, and potential avenues to pursue in the next generation of SCT-related research are proposed. Following repeated discussions on terminology, the Work Group selected "cognitive disengagement syndrome" (CDS) to replace "SCT" as the name for this construct. This term was deemed to best satisfy considerations that should apply when selecting terms for a condition or syndrome, as it does not overlap with established terms for other constructs, is not offensive, and reflects the current state of the science. CONCLUSION It is evident that CDS (SCT) has reached the threshold of recognition as a distinct syndrome. Much work remains to further clarify its nature (eg, transdiagnostic factor, separate disorder, diagnostic specifier), etiologies, demographic factors, relations to other psychopathologies, and linkages to specific domains of functional impairment. Investigators are needed with interests and expertise spanning basic, clinical, and translational research to advance our understanding and to improve the lives of individuals with this unique syndrome.
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Affiliation(s)
- Stephen P Becker
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio.
| | | | | | - Joseph W Fredrick
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio
| | | | - Lisa A Jacobson
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Susan D Mayes
- Waschbusch are with Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Tanya E Froehlich
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio
| | - Keith McBurnett
- University of California San Francisco, San Francisco, California
| | - Mateu Servera
- IDISBA Institute, University of the Balearic Islands, Palma, Spain
| | - Russell A Barkley
- Virginia Commonwealth University, School of Medicine, Richmond, Virginia
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18
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Öğütlü H, Karatekin Ş, Sürücü Kara İ, McNicholas F. Sluggish cognitive tempo, eating habits, and daytime sleepiness in obese adolescents. Clin Child Psychol Psychiatry 2023; 28:595-609. [PMID: 35638558 DOI: 10.1177/13591045221105194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Rates of obesity have risen steeply in the western world in all age groups. Sluggish Cognitive Tempo (SCT) is characterized by a cluster of symptoms. Daytime sleepiness, commonly seen in obesity, may share a similar origin with sleepiness and daydreaming symptoms of SCT. This study aims to investigate the relationship between obesity, SCT, daytime sleepiness, and eating habits. METHOD Adolescents, aged between 10-17 years, with a BMI >95th centile, were recruited to the study. Clinical interviews were supplemented with standardized questionnaires. RESULTS Of the 35 adolescents, more than one quarter (N = 10, 28.6%) had SCT. Emotional overeating and food enjoyment subscale scores showed moderate correlations with the SCT scores, though these associations were not significant when controlling for ADHD symptoms. Daytime sleepiness score in adolescents with SCT was found to be significantly higher than those without. CONCLUSION Sluggish Cognitive Tempo is frequently present in adolescents with obesity and associated with higher levels of emotional overeating, food enjoyment, and daytime sleepiness. Targeting aspects of SCT might offer additional avenues to assist in weight management programs for youth.
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Affiliation(s)
- Hakan Öğütlü
- Department of Child and Adolescent Psychiatry, 536164Ankara City Hospital, Ankara, Turkey
| | - Şeyma Karatekin
- Department of Pediatrics, 375269Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Sürücü Kara
- Division of Pediatric Metabolism, Department of Pediatrics, 37504Ankara University, Ankara, Turkey
| | - Fiona McNicholas
- Child and Adolescent Psychiatry Department, 8797University College of Dublin, Dublin, Ireland.,Children Hospital Ireland, Crumlin, Dublin, Ireland.,SJOG C AMHS, Lucena Rathgar, Dublin, Ireland
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19
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East PL, Doom JR, Blanco E, Burrows R, Lozoff B, Gahagan S. Iron Deficiency in Infancy and Sluggish Cognitive Tempo and ADHD Symptoms in Childhood and Adolescence. J Clin Child Adolesc Psychol 2023; 52:259-270. [PMID: 34519599 PMCID: PMC8918441 DOI: 10.1080/15374416.2021.1969653] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To determine whether iron deficiency in infancy is associated with sluggish cognitive tempo (SCT) or attention-deficit/hyperactive-impulsive (AD-HI) symptoms in childhood and adolescence, and whether such behaviors contribute concurrently and predictively to lower verbal and mathematical abilities. METHOD Chilean children (N = 959; 50% male, of Spanish or indigenous descent from working-class backgrounds) were rated by mothers for SCT or AD-HI symptoms at ages 5, 10, and 16 years. Children completed standardized tests assessing verbal and mathematical abilities at ages 5, 10, and 16. At ages 12 and 18 months, children were assessed for iron deficiency. RESULTS Adjusting for a comprehensive panel of covariates, greater severity of iron deficiency in infancy was associated with more frequent SCT and AD-HI symptoms at all ages studied. Most effects of iron deficiency on children's verbal and math skills were indirect, mediated through AD-HI behaviors. Children's AD-HI symptoms related to lower verbal and math test scores within age and across age. CONCLUSIONS The long-term associations found between infant iron deficiency and SCT and AD-HI behaviors suggest that the neurodevelopmental alterations that stem from postnatal iron deficiency might play an etiological role in the development of ADHD. Screening for early-life nutritional deficiencies among children with SCT or ADHD symptoms might prove useful, and behavioral screening of children with a history of iron deficiency seems warranted. Interventions that support brain development after early nutritional deprivation also would be beneficial.
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Affiliation(s)
- Patricia L East
- Department of Pediatrics, University of California, San Diego
| | | | - Estela Blanco
- Department of Pediatrics, University of California, San Diego
- Department of Public Health, Pontifical Catholic University of Chile
| | - Raquel Burrows
- Institute of Nutrition and Food Technology, University of Chile
| | - Betsy Lozoff
- Department of Pediatrics, University of Michigan
| | - Sheila Gahagan
- Department of Pediatrics, University of California, San Diego
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20
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Godoy VP, Serpa ALDO, Fonseca RP, Malloy-Diniz LF. Executive Functions Contribute to the Differences Between ADHD and Sluggish Cognitive Tempo (SCT) in Adults. J Atten Disord 2023; 27:623-634. [PMID: 36802940 DOI: 10.1177/10870547231153948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
OBJECTIVES This paper analyses the relationship between sociodemographic variables, executive dysfunctions, Sluggish Cognitive Tempo (SCT) and the mainly dimensions of ADHD: hyperactivity-impulsivity (ADHD-H/I) and inattention (ADHD-IN) in Brazilian adults. METHOD A cross-sectional, exploratory, and comparative design was used. A total of 446 participants (295 women) aging from 18 to 63 years old (M = 3,499 years, SD = 10.7) were recruited on the internet. Correlations, t independent tests and regressions were conducted. RESULTS Higher scores in ADHD dimensions were associated to more executive functioning problems and time perception distortions in comparison to those participants without significant ADHD symptoms. However, ADHD-IN dimension as well as SCT were higher associated with these dysfunctions than ADHD-H/I. The regression results showed that ADHD-IN was more related to Self-Management to time while ADHD-H/I to Self-Restraint and SCT to Self-Organization/Problem Solving. CONCLUSION This paper contributed to the distinction between SCT and ADHD in adults in important psychological dimensions.
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21
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Nelson JM, Lovett BJ. Sluggish Cognitive Tempo (SCT), Comorbid Psychopathology, and Functional Impairment in College Students: The Clinical Utility of SCT Subfactors. J Atten Disord 2023; 27:313-323. [PMID: 36576055 DOI: 10.1177/10870547221142458] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Sluggish cognitive tempo (SCT) has been proposed to be either its own distinct disorder or a transdiagnostic process. OBJECTIVE To examine SCT within ADHD (and its specific presentations) and internalizing disorders and its relationship with functional impairment, particularly when considered from a multidimensional perspective. METHOD Undergraduate students (N = 2,806) completed self-report scales measuring SCT, ADHD, anxiety, depression, and functional impairment. The SCT scale consisted of three subfactors identified in prior research. RESULTS Students with internalizing disorders were equally as likely as those with ADHD to report clinically significant SCT, and having multiple other disorders predicted especially high levels of SCT symptoms. Only sleepy/sluggish symptoms incrementally predicted impairment. CONCLUSIONS These findings provide more support for SCT as a transdiagnostic process than as a distinct disorder. All areas of SCT symptoms are associated with ADHD, anxiety, and depression, but the sleepy/sluggish symptoms may be uniquely associated with problems in everyday living.
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22
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Cerny BM, Reynolds TP, Chang F, Scimeca LM, Phillips MS, Ogram Buckley CM, Leib SI, Resch ZJ, Pliskin NH, Soble JR. Cognitive Performance and Psychiatric Self-Reports Across Adult Cognitive Disengagement Syndrome and ADHD Diagnostic Groups. J Atten Disord 2023; 27:258-269. [PMID: 36354066 DOI: 10.1177/10870547221136216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Cognitive disengagement syndrome (CDS) is characterized by inattention, under-arousal, and fatigue and frequently co-occurs with attention-deficit/hyperactivity disorder (ADHD). Although CDS is associated with cognitive complaints, its association with objective cognitive performance is less well understood. METHOD This study investigated neuropsychological correlates of CDS symptoms among 169 adults (Mage = 29.4) referred for outpatient neuropsychological evaluation following inattention complaints. We evaluated cognitive and self-report differences across four high/low CDS and positive/negative ADHD groups, and cognitive and self-report correlates of CDS symptomology. RESULTS There were no differences in cognitive performance, significant differences in self-reported psychiatric symptoms (greater CDS symptomatology, impulsivity among the high CDS groups; greater inattention among the positive ADHD/high CDS groups; greater hyperactivity among the positive ADHD groups), significant intercorrelations within cognitive and self-report measures, nonsignificant correlations between cognitive measures and self-report measures. CONCLUSION Findings support prior work demonstrating weak to null associations between ADHD and CDS symptoms and cognitive performance among adults.
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Affiliation(s)
- Brian M Cerny
- University of Illinois College of Medicine, Chicago, USA.,Illinois Institute of Technology, Chicago, USA
| | | | - Fini Chang
- University of Illinois College of Medicine, Chicago, USA.,University of Illinois at Chicago, USA
| | - Lauren M Scimeca
- University of Illinois College of Medicine, Chicago, USA.,Illinois Institute of Technology, Chicago, USA
| | - Matthew S Phillips
- University of Illinois College of Medicine, Chicago, USA.,The Chicago School of Professional Psychology, IL, USA
| | - Caitlin M Ogram Buckley
- University of Illinois College of Medicine, Chicago, USA.,University of Rhode Island, Kingston, USA
| | - Sophie I Leib
- University of Illinois College of Medicine, Chicago, USA.,Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Neil H Pliskin
- University of Illinois College of Medicine, Chicago, USA
| | - Jason R Soble
- University of Illinois College of Medicine, Chicago, USA
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23
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Çiftçi E, Başay Ö, Özdemir C. Turkish Adaptation, Validity, and Reliability Study of the Children and Adolescent Behavior Inventory Family Questionnaire. Noro Psikiyatr Ars 2023; 60:73-80. [PMID: 36911569 PMCID: PMC9999229 DOI: 10.29399/npa.28194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/08/2022] [Indexed: 11/07/2022] Open
Abstract
Introduction This study aimed to conduct the Turkish adaptation, validity, and reliability analyses of the Children and Adolescent Behavior Inventory (CABI) Family Questionnaire. Method A total of 1015 parents of children and adolescents aged 6-14 years, with 762 from the community sample and 253 from the clinical sample, participated in the study. After the language adaptation of the scale was completed by experts, its construct validity was determined using exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and discriminant validity. The reliability was assessed with Cronbach's alpha internal consistency coefficients, and the test-retest reliability of the scale was tested on 100 participants. Results The results of the EFA showed that the scale had 10 factors. The items associated with the 10th factor, which was different from the original scale, aligned with the subscales of the Sluggish Cognitive Tempo. The results of the CFA indicated that the factor load values were statistically significant, and the fit index values were at moderate, good, and excellent levels. A comparison of the subscale scores of the clinical and population sample groups showed that the scale had a distinctive feature. The Cronbach's alpha value of the total scale score was calculated to be 0.94. No statistically significant difference was found between the mean test-retest scores obtained on the subscales. The test-retest correlation coefficient was found to be within the range of r=0.605-0.853 for the subscales (p<0.01). Conclusion This study proved that the CABI Family Questionnaire was a valid and reliable scale and could be administered to the parents of Turkish children and adolescents aged between six and 14 years in population and clinical samples.
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Affiliation(s)
- Erol Çiftçi
- Bayburt State Hospital, Child and Adolescent Psychiatry, Bayburt,Turkey
| | - Ömer Başay
- Pamukkale University School of Medicine, Child and Adolescent Psychiatry, Denizli, Turkey
| | - Caner Özdemir
- Ankara University School of Medicine, Public Health, Ankara, Turkey
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24
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Chutko LS, Surushkina SY, Yakovenko EA, Anisimova TI, Cherednichenko DV, Didur MD, Chekalova SA. [Cognitive impairment in children with organic asthenic disorder]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:92-99. [PMID: 37942979 DOI: 10.17116/jnevro202312309292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
OBJECTIVE To study cognitive impairment and neurophysiological characteristics in children with organic asthenia, as well as the effectiveness of the drug Cogitum in the treatment of this pathology. MATERIAL AND METHODS The main study group included 40 children aged 8 to 10 years with a diagnosis of «Organic asthenic disorder» (F06.6). The control group consisted of 30 children aged 8 to 10 years without manifestations of asthenia. The following research methods were used in the work: the asthenic state scale (ASS) by L.D. Malkova to assess the severity of asthenic syndrome, the S. Lee «SCT» (sluggish cognitive tempo) scale to assess manifestations of low cognitive tempo, the «Random Access Memory» method to quantify working memory, the TOVA (The Test of Variables of Attention) computer test to quantify assessment of attention disorders and impulsivity level, electroencephalogram (routine and spectral analysis) (p<0.05). For the treatment of patients from the study group, the drug Cogitum was used at a dose of 10 ml of a drinking solution per day for 30 days. RESULTS In was shown that children from the study group were characterized by a decrease in working memory (7.8±2.9 vs 14.9±5.4), a statistically significant increase in SCT scores (p<0.05), a significantly greater degree of inattention and impulsivity with a tendency to an increase in the number of errors in the second half of the TOVA test (p<0.05). Comparative analysis of EEG relative power data showed a statistically significant increase in the power of waves in the alpha and theta ranges in the fronto-central leads of both hemispheres in the group of children with organic asthenic disorder (p<0.05). When re-evaluating the condition of children after treatment, a statistically significant decrease in the manifestations of asthenia on the ASS scale was recorded in 77.5% of cases. At the same time, there was a significant improvement in attention, memory, and indicators characterizing a low cognitive pace. The results of an electroencephalographic study after a course of treatment showed a decrease in the relative power of the EEG in the theta and alpha ranges in the anterior sections of the cerebral cortex (p<0.05), which indicates an increase in the level of activation of neocortical structures. CONCLUSION Thus, the use of the drug Cogitum for the treatment of organic asthenic disorder leads not only to a decrease in asthenia and cognitive impairment, but also to an improvement in the functional state of the brain.
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Affiliation(s)
- L S Chutko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - S Yu Surushkina
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - E A Yakovenko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - T I Anisimova
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - D V Cherednichenko
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - M D Didur
- N. Bekhtereva Institute of Human Brain Russian Academy of Sciences, St. Petersburg, Russia
| | - S A Chekalova
- Research Institute of Hygiene and Health of Children and Adolescents Federal State Autonomous Institution «NMIC for Children's Health», Moscow, Russia
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Fredrick JW, Becker SP. Cognitive Disengagement Syndrome ( Sluggish Cognitive Tempo) and Social Withdrawal: Advancing a Conceptual Model to Guide Future Research. J Atten Disord 2023; 27:38-45. [PMID: 35927980 DOI: 10.1177/10870547221114602] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Cognitive disengagement syndrome (CDS, previously referred to as "sluggish cognitive tempo") is a set of symptoms defined by excessive mind-wandering, mental confusion, and slowed behaviors separable from ADHD inattention. METHOD Of the studies examining CDS in relation to psychosocial outcomes, one of the most established correlates of CDS is social withdrawal. However, studies have yet to test mechanisms or moderators of the link between CDS and social withdrawal. RESULTS As a parallel body of literature exists in developmental psychopathology on predictors and outcomes of social withdrawal, this review merges these literatures to identify themes and advance a conceptual model on mechanisms (e.g., task-unrelated thought, poorer social skills, social anxiety) and moderators (e.g., behavioral inhibition, sex, parenting) of the CDS and social withdrawal link. CONCLUSION This model provides researchers and clinicians with testable hypotheses to better understand the link between CDS and social withdrawal and to identify treatment targets to improve the social engagement of youth with CDS.
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Affiliation(s)
- Joseph W Fredrick
- Cincinnati Children's Hospital Medical Center, OH, USA.,University of Cincinnati College of Medicine, OH, USA
| | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, OH, USA.,University of Cincinnati College of Medicine, OH, USA
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Firoozehchi ZR, Mashhadi A, Bigdeli I. The comparison of sluggish cognitive tempo, processing speed, and executive functions in female children with specific learning disabilities and typically developing female children: A pilot study. Appl Neuropsychol Child 2023; 12:1-8. [PMID: 34807791 DOI: 10.1080/21622965.2021.2007097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
This study investigated the association of sluggish cognitive tempo (SCT), processing speed, and executive function (EF) in children with specific learning disabilities (SLD), and the typically developing children (TD) (60 female students aged between 8 and 10). Child and Adolescent Behavior Inventory-Parent Version (CABI), the Barkley Deficits in Executive Functioning Scale-Children and Adolescents (BDEFS-CA), and Wechsler Intelligence Scale for Children-IV (the Processing Speed Index (PSI) were used to assess SCT, processing speed, and EF. The results showed that SCT problems were higher in children with SLD (p < 0.001). In addition, results showed that children with SLD had poorer performance on processing speed (p < 0.001) compared to the TD group. Executive dysfunctioning in self-management to time, self-organization, problem-solving, self-restraint, self-motivation, and self-regulation of emotions were poorer in children with SLD than TD group (p < 0.05). This study provides initial evidence that SCT symptoms are poor in female children with SLD, and associated with executive dysfunction and poor processing speed.
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Affiliation(s)
| | - Ali Mashhadi
- Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
| | - Imanollah Bigdeli
- Department of Psychology, Ferdowsi University of Mashhad, Mashhad, Iran
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27
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Rhodes JD. An Examination of the Role of Sluggish Cognitive Tempo as a Moderator of the Relationship Between ADHD and Nicotine Use. J Atten Disord 2023; 27:220-227. [PMID: 36264077 DOI: 10.1177/10870547221130454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE ADHD is a neurodevelopmental disorder characterized by executive dysfunction and functional impairments including nicotine consumption. Sluggish cognitive tempo (SCT) has been associated with ADHD and posited as an independent construct. The present study hypothesized that SCT would moderate the relationships between ADHD and nicotine-related behaviors. METHOD Participants (n = 309) were recruited using Mechanical Turk and completed measures of ADHD symptoms, SCT, and smoking history. RESULTS ADHD was associated with age of initiation of smoking and more severe withdrawal symptoms for both combustible and electronic cigarettes. SCT significantly moderated the relationship between ADHD and withdrawal symptom severity (both electronic and combustible cigarettes). CONCLUSION The results of the present study suggest that SCT plays an important role in the complex relationship between ADHD and smoking withdrawal. Future research should further explore the construct of SCT to better understand its role in psychopathology and intervention strategies.
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Fredrick JW, Yeaman KM, Yu X, Langberg JM, Becker SP. A multi-method examination of sluggish cognitive tempo in relation to adolescent sleep, daytime sleepiness, and circadian preference. J Child Psychol Psychiatry 2022; 63:1658-1667. [PMID: 35045192 DOI: 10.1111/jcpp.13568] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The field's understanding of the association between sluggish cognitive tempo (SCT) and sleep is severely limited by the lack of multi-method and multi-informant research designs that move beyond global ratings, often focused on a limited number of sleep-related domains, such as daytime sleepiness. The current study begins to address these limitations by using actigraphy, daily sleep diary, and self- and parent-report global ratings of sleep in adolescents, a developmental period marked by changes in SCT, sleep, and circadian function. As SCT and sleep are also associated with ADHD symptoms, we tested these associations in a sample of adolescents with and without ADHD. METHODS Adolescents (N = 302; M age = 13.17 years, 44.7% female) with (n = 162) and without ADHD (n = 140) and parents completed global ratings of sleep and daytime sleepiness, and adolescents completed a measure of circadian preference. Adolescents also wore actigraphs for approximately two weeks, during which daily diaries were completed. RESULTS Above and beyond demographic characteristics (i.e., sex, race, and family income), pubertal development, medication use, and ADHD group status, adolescents' self-reported SCT symptoms were uniquely associated with shorter sleep duration and later sleep onset per both actigraphy and daily diary. SCT symptoms were also uniquely associated with longer sleep onset latency and poorer overall sleep (per daily diary), more sleep/wake problems and daytime sleepiness (per adolescent rating), more difficulties initiating and maintaining sleep (per parent rating), and later eveningness preference (per adolescent rating). Nearly all significant effects remained in sensitivity analyses controlling for adolescent- or parent-reported ADHD symptom dimensions. CONCLUSIONS Findings provide the strongest evidence to date for SCT being uniquely linked to poorer sleep, greater daytime sleepiness, and a later evening circadian preference across subjective and objective measures. Longitudinal studies are needed to evaluate predictive and bidirectional associations.
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Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kiley M Yeaman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Xiaoqian Yu
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Fredrick JW, Becker SP, Langberg JM. Low School Support Exacerbates the Association between Peer Difficulties and Sluggish Cognitive Tempo in Adolescents. J Clin Child Adolesc Psychol 2022; 51:1024-1038. [PMID: 34081553 PMCID: PMC8639839 DOI: 10.1080/15374416.2021.1923021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Although peer difficulties and sluggish cognitive tempo (SCT) are related, studies have yet to examine environmental factors that may advance further understanding of this association. The current study tested whether peer difficulties, specifically social competence and peer victimization, interacted with school support, a component of school climate, in relation to adolescents' SCT symptoms. Further, we explored whether these relations would be differentially associated with SCT in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). METHOD Adolescents (N = 288; Mage = 14.08, 45% female, 82.6% White; 52% with ADHD) completed measures of social competence, peer victimization, school climate support, and SCT and ADHD inattentive (IN) symptoms. Parents also reported on adolescents' social competence, SCT, and ADHD-IN symptoms. RESULTS Results indicated that adolescent and parent ratings of lower social competence were both associated with higher adolescent-reported SCT symptoms in the context of low, but not high, school support. Relational and nonphysical victimization were associated with higher self-reported SCT symptoms in the context of low school support. Lower adolescent- and parent-reported social competence were also related to higher parent-reported SCT symptoms, with these associations not moderated by school support. These results remained after controlling for demographics and ADHD-IN symptoms and were similar across adolescents with and without ADHD. CONCLUSIONS Findings from the current study are the first to provide evidence that peer difficulties and school climate are jointly related to adolescents' self-reported SCT and underscore the importance of continued research investigating social adversity and environmental factors in relation to SCT.
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Affiliation(s)
- Joseph W. Fredrick
- Department of Psychology, Miami University, Oxford, Ohio, USA
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Joshua M. Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia, USA
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Kim K, Lee JH. The effect of feedback in virtual attention training on orienting attention in individuals with sluggish cognitive tempo. J Atten Disord 2022; 26:1640-1652. [PMID: 35491754 DOI: 10.1177/10870547221090664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE This study was conducted to assess the effectiveness of feedback in a virtual attention training program to improve the attentional characteristics of sluggish cognitive tempo (SCT). METHOD The SCT group (N = 60) and control group (N = 30) were identified, and the attention network test-revised (ANT-R) was performed to measure attention characteristics. Based on this result, a virtual reality (VR) feedback attention training program was developed to improve the efficiency of engagement and disengagement of attention in SCT. Sixty participants with SCT were recruited and grouped into two conditions: VR feedback (n = 30) and no-feedback (n = 30) conditions. RESULTS The results show that the VR attention training program with feedback significantly improves the attention-orienting network. CONCLUSION This suggests that it is necessary to provide immediate feedback for effective attention training for SCT and continuous intervention may be possible when feedback is provided together.
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Affiliation(s)
- Kyunghwa Kim
- College of Social Science, Chung-Ang University, Seoul, South Korea
| | - Jang-Han Lee
- College of Social Science, Chung-Ang University, Seoul, South Korea
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31
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Hossain B, Bent S, Parenteau C, Widjaja F, Davis M, Hendren RL. The Associations Between Sluggish Cognitive Tempo, Internalizing Symptoms, and Academic Performance in Children With Reading Disorder: A Longitudinal Cohort Study. J Atten Disord 2022; 26:1576-1590. [PMID: 35373641 PMCID: PMC9373189 DOI: 10.1177/10870547221085493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate whether sluggish cognitive tempo (SCT) was associated with anxiety, depression, and academic performance (AP) in children with reading disorder (RD), and whether ADHD-Inattention (ADHD-IN) moderated these relationships. METHOD Parents and teachers of children with RD (N = 147, ages 6-18) completed evaluations of SCT, ADHD, anxiety, depression, and AP, every 3 months for 18 months. Baseline and longitudinal associations between SCT and outcomes, and effect moderation of ADHD-IN, were assessed. RESULTS Teacher-rated SCT was positively associated with teacher-rated anxiety (p < .001) and negatively associated with AP (p < .001) cross-sectionally and longitudinally, with significant effect modification by ADHD-IN for both outcomes. SCT was not associated with depression in adjusted cross-sectional and longitudinal analyses. There were no significant findings for any parent-reported measures. CONCLUSION SCT has negative effects on anxiety and AP in children with RD among individuals with low ADHD-IN according to teacher report. Targeted treatment of SCT may provide substantial benefits.
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Affiliation(s)
- Bushra Hossain
- University of California, San
Francisco, CA, USA,Bushra Hossain, Department of Psychiatry,
University of California, 401 Parnassus Avenue, San Francisco, CA 94143, USA.
| | - Stephen Bent
- University of California, San
Francisco, CA, USA
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Wu ZM, Liu J, Wang P, Wang YF, Yang BR. Neuropsychological characteristics of children with Attention-Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo. J Atten Disord 2022; 26:1631-1639. [PMID: 35470726 DOI: 10.1177/10870547221090662] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The present study aims to explore the neuropsychological features of children with Attention-Deficit/Hyperactivity Disorder (ADHD) and Sluggish Cognitive Tempo (SCT). METHODS Fifty-eight children with ADHD+SCT, 480 children with ADHD-SCT, and 105 healthy controls (HC) were recruited. Neuropsychological tests and the Behavior Rating Inventory of Executive Function (BRIEF) were used. RESULTS The ADHD+SCT group performed worse than the HC in processing speed (p = .005), set-shifting (p = .0003), interference control (p = .00014), and visual memory (p = .007), while the ADHD-SCT group performed worse than the HC in sustained attention measurements (all p < .0001). The ADHD+SCT group scored higher than the ADHD-SCT group in the following factors from BRIEF: plan/organize (p = .00083), working memory (p < .001), and shift (p = .0054). CONCLUSION Our results indicated that SCT symptoms are associated with worse executive function in children with ADHD except for sustained attention.
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Affiliation(s)
- Zhao-Min Wu
- Shenzhen Children's Hospital, Shenzhen, China
| | - Juan Liu
- Shenzhen Children's Hospital, Shenzhen, China
| | - Peng Wang
- Cardiac Rehabilitation Center, Fuwai Hospital, CAMS & PUMC, Beijing, China
| | - Yu-Feng Wang
- Peking University Sixth Hospital/Institute of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,Peking University, Beijing, China
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33
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Kamradt JM, Eadeh HM, Nikolas MA. Sluggish Cognitive Tempo as a Transdiagnostic Link Between Adult ADHD and Internalizing Symptoms. J Psychopathol Behav Assess 2022; 44:699-712. [PMID: 38221987 PMCID: PMC10786088 DOI: 10.1007/s10862-021-09926-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/07/2021] [Indexed: 11/25/2022]
Abstract
Objective Although absent from traditional diagnostic nosologies, Sluggish Cognitive Tempo (SCT) may have transdiagnostic utility given its robust associations with ADHD and internalizing symptoms as well as with cognitive impairments common to these conditions. Within-person variation in SCT symptoms may also serve to link ADHD, cognitive deficits, and internalizing psychopathology, however, few studies have utilized intensive longitudinal designs to probe within-person variation in SCT and its links to cognitive deficits and psychopathology. Method Ecological Momentary Assessment was used to measure between and within-person variance in SCT 4 times per day across 7 days (28 time-points) in 158 college students (approximately 51% with elevated ADHD and/or internalizing symptoms). Participants also completed ratings of current and childhood ADHD symptoms, cognitive function and internalizing psychopathology. Parameters derived from longitudinal multilevel models indexing between and within person variation in SCT were examined as mediators of the associations between (1) ADHD and internalizing symptoms and (2) self-reported cognitive functioning and internalizing symptoms. Results Results indicated that between-person differences in SCT, but not within-person variability, linked current and childhood ADHD and internalizing symptoms. Similarly, problems in time-management and organization influenced internalizing psychopathology via between-person differences in SCT. Conclusion Results found that SCT may be a transdiagnostic link bridging mental health comorbidities, cognitive dysfunction, and internalizing psychopathology.
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Affiliation(s)
- Jaclyn M Kamradt
- Department of Psychological and Brain Sciences, University of Iowa
| | - Hana-May Eadeh
- Department of Psychological and Brain Sciences, University of Iowa
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa
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34
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Lee CA, Goh PK, Shelton CR, Hartung CM. Networks of ADHD and SCT Symptoms in Emerging Adulthood. J Atten Disord 2022; 26:991-1000. [PMID: 34693775 DOI: 10.1177/10870547211045743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Emerging adulthood (18-25 years) is a transitional and understudied developmental period. Yet, little is known about how specific symptoms of ADHD, as well as those from the related SCT domain, may differentially relate to one another during this period, if there are differences based on biological sex, or how closely results will align with adulthood. METHODS We used network analysis techniques to explore the structure of ADHD and SCT symptoms within emerging adulthood, with additional comparisons between sexes as well as between emerging adulthood and adulthood. Using an online platform, 8,506 adults reported on their symptoms of ADHD and SCT. RESULTS Symptoms grouped together within their respective domains during emerging adulthood with no significant differences in overall network structure between sexes. Similarly, network structure appeared to be robust across emerging adulthood and adulthood. CONCLUSION Such consistency supports a conceptualization of ADHD in emerging adulthood as similar to adulthood.
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35
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Becker SP, Fredrick JW, Foster JA, Yeaman KM, Epstein JN, Froehlich TE, Mitchell JT. "My mom calls it Annaland": A Qualitative Study of Phenomenology, Daily Life Impacts, and Treatment Considerations of Sluggish Cognitive Tempo. J Atten Disord 2022; 26:915-931. [PMID: 34623188 DOI: 10.1177/10870547211050946] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To conduct qualitative analysis of interviews to understand phenomenology, daily life impact, and treatment considerations of sluggish cognitive tempo (SCT) behaviors in children and adolescents. Method: Youth with elevated SCT symptoms (N = 15, ages 9-16 years) and their parents completed interviews focused on their perception and daily life impact of SCT behaviors. Parents were also asked about intervention targets. Results: Parents and youth had both negative and positive perceptions of SCT, with SCT fostering creativity/imagination and a break from stressors while also negatively impacting daily functioning. The domains most frequently selected by parents as SCT intervention targets were academics, emotions, mind wandering, morning routines, and self-esteem. Conclusion: Children and their parents share negative and positive views of SCT behaviors, while also detailing specific ways that SCT negatively impacts day-to-day functioning. This study offers insights into possible intervention targets as provided by youth and parents directly impacted by SCT.
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Affiliation(s)
- Stephen P Becker
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
| | | | - Josalyn A Foster
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati, OH, USA
| | | | - Jeffery N Epstein
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
| | - Tanya E Froehlich
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
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36
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Smith ZR, Del Castillo A, Clark OE, Holmbeck GN. Working memory and cognitive flexibility predict growth trajectories of sluggish cognitive tempo in youth with spina bifida. Child Neuropsychol 2022; 28:1052-1071. [PMID: 35196965 DOI: 10.1080/09297049.2022.2042503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
As sluggish cognitive tempo (SCT) shows similar inattention and neuropsychological dysfunction as youth with spina bifida (SB), it is important to examine whether neuropsychological functioning may affect the development of SCT in this population. Participants were 140 youth with SB and their parents who participated in five waves of a longitudinal study across eight years (ages 8-15 years at Time 1). At Time 1, teacher-, mother-, and father-report of SCT showed 9%, 8.3%, and 5.3% impairment in SCT respectively compared to other youth in the sample. Growth curves were used to examine changes over time in mother-, father-, and teacher-reported SCT. Four neurocognitive variables were included (attention, working memory, cognitive flexibility, plan/organize) as predictor variables of SCT growth and intercepts. Mother, father, and teacher-report of SCT were included in separate models. Age and shunt status were included as covariates in the growth models. Inattentive symptoms were also included as a covariate in working memory, shift, and plan/organize models. Worse working memory at Time 1 predicted an increase in mother-reported SCT symptoms over eight years (β = -.28) and poorer cognitive shifting skills predicted higher rates of teacher-reported SCT over time (β = -.61). All other neurocognitive variables predicted the intercept, but not the slope of SCT symptoms. Results indicate that worse neurocognitive functioning is associated with higher levels of SCT symptoms and that worse working memory and cognitive flexibility at baseline predicted an increase in SCT symptoms as youth with SB age. It may be important for clinicians to monitor and assess levels of SCT in youth with SB.
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Affiliation(s)
- Zoe R Smith
- The Psychology Department, Loyola University Chicago, Chicago, IL, USA
| | | | - Olivia E Clark
- The Psychology Department, Loyola University Chicago, Chicago, IL, USA
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Abstract
Sluggish Cognitive Tempo (SCT) has been proposed as a serious problem of attention, however there no validated psychometric measures for its evaluation in Turkish in a community sample. The present study aimed to examine the psychometric characteristics of the first SCT scale in Turkish in children and adolescents. A total of 418 children and adolescents between the ages of 6-18 years (9.83±2.8) were recruited. The data was obtained from parents using Sluggish Cognitive Tempo Scale and Strengths and Difficulties Questionnaire. The SCT scale-Turkish form demonstrated very good internal homogeneity (Cronbach's α = .90), good test-retest reliability (r = .98), good concurrent validity (r range = .35- .65) and good construct validity. Goodness of fit indices were found to be acceptable and statistically significant associations were found between SDQ and SCT scales. The SCT scale is a valid and reliable instrument in Turkish children and adolescents.
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Abstract
OBJECTIVE Eveningness diurnal preference is common in psychiatric conditions, including attention-deficit/hyperactivity disorder (ADHD) and internalizing disorders. Little is known about how diurnal preference relates to sluggish cognitive tempo (SCT)-a distinct clinical construct associated with functional impairment-in clinical samples. METHOD Adult outpatients (n = 65; 43 with ADHD, 22 with internalizing/adjustment disorders) self-reported on SCT symptoms (total symptoms; slow/daydreamy, sleepy/sluggish, and low initiation/persistence factors) and diurnal preference. RESULTS Greater eveningness was associated with overall SCT severity and sleepy/sluggish symptoms in the full sample. Relationships between eveningness and overall SCT severity and slow/daydreamy symptoms were stronger for those with internalizing/adjustment disorders compared to ADHD. The relationship between eveningness and sleepy/sluggish symptoms was uniform across groups. CONCLUSION Findings suggest a potential role of eveningness preference in adult SCT presentation. Future studies should investigate underlying mechanisms linking these two constructs and the efficacy of circadian interventions in the treatment of SCT among adult outpatients.
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Sevincok D, Avcil S, Ozbek MM. The relationship between theory of mind and sluggish cognitive tempo in school-age children with attention deficit and hyperactivity disorder. Clin Child Psychol Psychiatry 2021; 26:1137-1152. [PMID: 34237232 DOI: 10.1177/13591045211030665] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Sluggish cognitive tempo (SCT) is considered as a cognitive-emotional style. Theory of mind (ToM) skills form the basis of human cognition and social behavior. The aim of this study is to contribute to SCT literature by examining the relationship between SCT and cognitive and affective ToM in school-age children with attention deficit and hyperactivity disorder (ADHD). Fifty school-age children with ADHD (43 boys and seven girls) and 40 typically developing children (34 boys and six girls) were assessed using Parent-rated Barkley Child Attention Scale and Child Behavior Checklist/6-18, cognitive (first- and second-order ToM) and affective ToM (Reading Mind in the Eyes Test and Unexpected Outcomes Test (UOT)) tests. Multiple linear regression analysis was performed to determine the variables that may predict SCT levels in children with ADHD. Attention deficit and hyperactivity disorder-inattention (Exp(B) = .334, p = .027), internalization (Exp(B) = .305, p = .006), and UOT scores (Exp(B) = .933, p = .015) significantly predicted SCT severity in children with ADHD. SCT severity was significantly associated with impaired cognitive ToM skills as measured by second-order ToM (Exp(B) = 1.933, p = .045). Our findings may indicate that affective ToM developing with age, and impaired cognitive ToM skills are associated with increasing SCT severity.
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Affiliation(s)
- Doga Sevincok
- Department of Child and Adolescent Psychiatry, Agri Training and Research Hospital, Agri, Turkey
| | - Sibelnur Avcil
- Department of Child and Adolescent Psychiatry, 64036Aydin Adnan Menderes University, Aydin, Turkey
| | - Mutlu M Ozbek
- Department of Child and Adolescent Psychiatry, Kars 4264Harakani State Hospital, Kars, Turkey
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40
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Fredrick JW, Becker SP. Sluggish Cognitive Tempo Symptoms, But Not ADHD or Internalizing Symptoms, Are Uniquely Related to Self-Reported Mind-Wandering in Adolescents With ADHD. J Atten Disord 2021; 25:1605-1611. [PMID: 32463332 PMCID: PMC8019063 DOI: 10.1177/1087054720923091] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Objective: The purpose of this study was to test the relation between sluggish cognitive tempo (SCT) symptoms and self-reported mind-wandering in a sample of adolescents with ADHD. Method: Adolescents (N = 79; aged 13-17 years; 70% male) diagnosed with ADHD completed measures of SCT, ADHD, anxiety, and depression symptoms, in addition to mind-wandering. Parents also provided ratings of adolescents' ADHD symptoms. Results: All adolescent-reported psychopathology dimensions, including ADHD, internalizing, and SCT, were significantly bivariately correlated with greater mind-wandering. However, in regression analysis that considered psychopathologies simultaneously, SCT was the only dimension uniquely associated with greater mind-wandering. This finding was unchanged when parent-reported ADHD symptoms were included in the model. Conclusion: These findings are the first to show that SCT symptoms are uniquely related with self-reported mind-wandering in adolescents with ADHD and underscore the importance of considering co-occurring SCT symptoms when testing the interrelations between ADHD and mind-wandering. Replication is needed in larger samples and with other measures of mind-wandering.
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Affiliation(s)
| | - Stephen P. Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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41
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Fredrick JW, Burns GL, Langberg JM, Becker SP. Examining the Structural and External Validity of the Adult Concentration Inventory for Assessing Sluggish Cognitive Tempo in Adults. Assessment 2021; 29:1742-1755. [PMID: 34243678 DOI: 10.1177/10731911211027224] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The Adult Concentration Inventory (ACI) is an adult self-report measure of sluggish cognitive tempo (SCT) developed following a meta-analysis identifying items distinguishing SCT from attention-deficit/hyperactivity disorder (ADHD) inattention. To date, only one study conducted in college students has examined the structural and external validity of the ACI. The current study evaluated the convergent and discriminative validity of the ACI in a community sample of adults, in addition to testing unique associations with internalizing symptoms, daily life executive functions, and sleep. Adults (N = 286; Mage = 44.45; 83.6% female) completed ratings of SCT, ADHD symptom dimensions, and external correlates. An a priori two-factor model with cross-loadings found 10 of the 16 SCT items to have high loadings on the SCT factor and low loadings on the ADHD inattention factor. SCT was uniquely associated with higher internalizing symptoms, time management and self-organization difficulties, poorer sleep quality, shorter sleep duration, lower sleep efficiency, and more daytime sleepiness. These findings replicate and extend support for the ACI in assessing SCT in adults.
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Affiliation(s)
- Joseph W Fredrick
- Miami University, Oxford, OH, USA.,Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | | | | | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
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42
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Fırat S, Gul H, Aysev A. An Open-Label Trial of Methylphenidate Treating Sluggish Cognitive Tempo, Inattention, and Hyperactivity/Impulsivity Symptoms Among 6- to 12-Year-Old ADHD Children: What Are the Predictors of Treatment Response at Home and School? J Atten Disord 2021; 25:1321-1330. [PMID: 32064995 DOI: 10.1177/1087054720902846] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: This study investigated the effects of sluggish cognitive tempo (SCT), other psychiatric symptoms, age, dose, and pretreatment ADHD severity on methylphenidate (MPH) treatment response among ADHD children in both home and school. In addition, the predictors of the MPH-SCT treatment response were examined. Methods: One hundred eighty-five (6-12 years old) ADHD children who were treated with MPH included in the study. Results: MPH improved SCT total and SCT-Daydreaming scores both at home and school while improved SCT-Sluggish scores in only school. Higher pretreatment Daydreaming score predicted lower treatment response for inattention (B = .301, p = .002), and higher Daydreaming-Sluggish scores predicted lower treatment response for total ADHD symptoms at school (B = .456, p = .006; B = .888, p = .04, respectively). Also higher oppositional defiant disorder symptoms have negative effects on MPH treatment response in ADHD. Older age positively affected the MPH-SCT treatment response in paternal and teacher ratings. Conclusion: SCT symptoms have negative effects on MPH treatment response at school.
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Affiliation(s)
| | - Hesna Gul
- Gulhane Research and Training Hospital, Keçiören, Turkey
| | - Ayla Aysev
- Ankara University School of Medicine, Çankaya, Turkey
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43
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Abstract
Objective: Sluggish cognitive tempo (SCT) refers to a set of symptoms that prior research has found to be related to several different psychological disorders, especially the predominantly inattentive presentation of ADHD. This study collected evidence relevant to the question of whether SCT is a distinct disorder. Method: College students (N = 910) completed measures of SCT, ADHD, depression, anxiety, sleep quality, and substance misuse. Results: Students reporting clinically high SCT (reporting at least five symptoms often or very often) had significantly higher levels and rates of other types of psychopathology. Moreover, when students reporting clinically significant levels of ADHD, depression, and anxiety symptoms, poor sleep quality, or hazardous levels of alcohol or cannabis use were removed, very few students reporting high SCT remained (only 4.8% of the original high-SCT group). Conclusion: SCT may be best thought of as a symptom set common to many types of psychopathology, and it may be caused by sleep problems or substance misuse as well.
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44
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Becker SP. Systematic Review: Assessment of Sluggish Cognitive Tempo Over the Past Decade. J Am Acad Child Adolesc Psychiatry 2021; 60:690-709. [PMID: 33166623 DOI: 10.1016/j.jaac.2020.10.016] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 10/01/2020] [Accepted: 10/22/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To conduct a systematic review of the measures designed to assess sluggish cognitive tempo (SCT) since the first SCT scale using careful test-construction procedures was published in 2009. METHOD MEDLINE (PubMed), Embase, PsychINFO, and Web of Science databases were searched from September 2009 through December 2019. Articles reporting on reliability (internal consistency, test-retest, and interrater reliability), structural validity (an aspect of construct validity focused on items' convergent and discriminant validity), concurrent and longitudinal external validity, invariance, or intervention/experimental findings were included. RESULTS Full criteria for data extraction and inclusion were met by 76 studies. Nine measures for assessing SCT were identified (7 assessing parent report, teacher report, and/or self-report in children and 2 assessing self-report and/or collateral informant report in adults). Each measure demonstrated acceptable to excellent reliability. All or at least the majority of SCT items on each measure also had structural validity (high loadings on an SCT factor and low loadings on an attention-deficit/hyperactivity disorder [ADHD] inattention factor). Studies have supported the invariance of SCT across sex and time, and there is initial evidence of invariance across informants, youths with ADHD and youths without ADHD, and ADHD presentations. The Child and Adolescent Behavior Inventory (CABI), Child Concentration Inventory, Second Edition (CCI-2), and Barkley Adult ADHD Rating Scale-IV (BAARS-IV) have particularly strong support for assessing parent/teacher-reported, youth self-reported, and adult self-reported SCT, respectively. CONCLUSION The SCT measures included in this review share numerous positive properties, have promising psychometric support, and have proven useful for examining the external correlates of SCT across the life span. Although substantial progress has been made over the last decade, work remains to be done to further improve the assessment of SCT and key directions for future research are provided.
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45
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Burns GL, Becker SP. Convergent and Discriminant Validity of the Child and Adolescent Behavior Inventory Scale Scores With Well-Established Psychopathology and Academic Achievement Measures in Adolescents With ADHD. Assessment 2021; 29:1086-1098. [PMID: 33754837 DOI: 10.1177/10731911211001929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The convergent and discriminant validity of the parent version of the Child and Adolescent Behavior Inventory (CABI) symptom and impairment scale scores were evaluated with the scale scores from multiple methods including a semistructured diagnostic interview, rating scales, and an academic achievement test. Participants were 82 adolescents (70% male, 78% non-Hispanic White) aged 13 to 17 years (M = 15.01) diagnosed with attention-deficit/hyperactivity disorder (77% predominantly inattentive presentation) and parents. CABI scale scores showed moderate (rs = .42 to .49) to substantial (rs = .62 to .91) convergent correlations with scores from similar measures. CABI scale scores also showed significant discriminant validity (convergent correlation significantly larger than discriminant correlation) with the scores on the other measures. These findings provide additional support for use of the CABI in research and clinical practice, and copies of the scale and norms are freely available.
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Affiliation(s)
| | - Stephen P Becker
- Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH, USA
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46
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Abstract
Objective: Sluggish cognitive tempo (SCT) symptoms uniquely contribute to psychiatric and functional outcomes in child samples; however, the psychometric properties of SCT measures among adult outpatients are unknown. Method: Adults (n = 124) presenting for an ADHD evaluation provided self- and collateral report of SCT symptoms. Results: The SCT scale had good internal consistency and yielded three factors across raters: Slow/Daydreamy, Sleepy/Sluggish, and Low Initiation/Persistence. SCT scores exhibited convergent validity with ADHD symptoms across raters. Individuals with ADHD received higher SCT ratings than those without ADHD via collateral report, a pattern that was similar when comorbidity was considered. SCT was associated with poorer functioning after accounting for ADHD symptoms with some differential effects based on reporting source. Conclusion: Findings support the internal consistency and validity of a three-factor SCT scale among adult outpatients. Differential results between self- and collateral report demonstrate the importance of multiple reporters of SCT in clinical settings.
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47
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Tahıllıoğlu A, Ercan ES. Atomoxetine might be more effective in improving sluggish cognitive tempo symptoms after switching from methylphenidate: A case report. Clin Case Rep 2021; 9:612-617. [PMID: 33598212 PMCID: PMC7869347 DOI: 10.1002/ccr3.3592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 11/02/2020] [Accepted: 11/10/2020] [Indexed: 11/12/2022] Open
Abstract
Although there is no proven evidence regarding pharmacotherapy of Sluggish Cognitive Tempo (SCT), we experienced atomoxetine had more effects in decreasing SCT symptoms after switching from methylphenidate in a case with SCT and subthreshold ADHD.
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Affiliation(s)
- Akın Tahıllıoğlu
- Department of Child and Adolescent PsychiatryEge University Faculty of MedicineIzmirTurkey
| | - Eyüp Sabri Ercan
- Department of Child and Adolescent PsychiatryEge University Faculty of MedicineIzmirTurkey
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48
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Yung TWK, Lai CYY, Chan JYC, Ng SSM, Chan CCH. Examining the Role of Attention Deficits in the Social Problems and Withdrawn Behavior of Children With Sluggish Cognitive Tempo Symptoms. Front Psychiatry 2021; 12:585589. [PMID: 34017271 PMCID: PMC8129013 DOI: 10.3389/fpsyt.2021.585589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 04/06/2021] [Indexed: 12/21/2022] Open
Abstract
Previous studies have found that sluggish cognitive tempo (SCT) symptoms are often associated with social problems and withdrawn behavior. However, the possible neuropsychological mechanism underlying this relationship remains unclear. Some studies have also found that SCT symptoms are related to deficits in sustained attention and selective attention. However, no study has examined whether attention deficits are related to social problems and withdrawn behavior in children with SCT. This study was the first to examine the neuropsychological correlates of social problems and withdrawn behavior among children with SCT symptoms. The results showed that sustained attention measure (omission) predicted the severity of social problems and withdrawn behavior in children with SCT even after controlling for symptoms of attention-deficit hyperactivity disorder. Selective attention measure (response latency mean) was also found to predict the severity of social problems. These results suggest that the social problems commonly exhibited by children with SCT are related to deficits in sustained attention and attentional control. Thus, our results provide an initial support to the link between attention deficits and social problems among children with SCT.
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Affiliation(s)
- Trevor W K Yung
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Cynthia Y Y Lai
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Jacob Y C Chan
- Department of Counseling Psychology, Social Psychology, and Counseling, Ball State University, Muncie, IN, United States
| | - Shamay S M Ng
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong
| | - Chetwyn C H Chan
- Applied Cognitive Neuroscience Laboratory, Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Kowloon, Hong Kong.,University Research Facility in Behavioral and Systems Neuroscience, The Hong Kong Polytechnic University, Kowloon, Hong Kong
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49
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Camprodon-Rosanas E, Ribas-Fitó N, Batlle S, Persavento C, Alvarez-Pedrerol M, Sunyer J, Forns J. Association Between Sluggish Cognitive Tempo Symptoms and Attentional Network and Working Memory in Primary Schoolchildren. J Atten Disord 2020; 24:1787-1795. [PMID: 28397576 DOI: 10.1177/1087054717702245] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Few consistent data are available in relation to the cognitive and neuropsychological processes involved in sluggish cognitive tempo (SCT) symptoms. The objective of this study was to determine the association of working memory and attentional networks with SCT symptoms in primary schoolchildren. Methods: The participants were schoolchildren aged 7 to 10 years (n = 183) from primary schools in Catalonia (Spain). All the participants completed a working memory task (n-back) and an attentional network task (ANT). Their parents completed an SCT-Child Behavior Checklist self-report and a questionnaire concerning sociodemographic variables. Teachers of the participants provided information on ADHD symptoms and learning determinants. Results: SCT symptoms were correlated with lower scores in both the n-back and ANT. In multivariate regression analysis, SCT symptoms were associated with slower hit reaction times from the ANT. Conclusions: Our results suggest that SCT symptoms are associated with a neuropsychological profile that is different from the classical ADHD profile and characterized by slower reaction times.
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Affiliation(s)
- E Camprodon-Rosanas
- Child and Adolescent Psychiatry and Psychology Department of Hospital Sant Joan de Déu of Barcelona, Passeig Sant Joan de Déu, 2, 08950 Esplugues de Llobregat, Barcelona, Spain
| | | | - S Batlle
- Institut de Neuropsiquiatria i Addiccions, CSMIJ, Parc de Salut Mar, Barcelona, Spain
| | - C Persavento
- Institut de Salut Global de Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health, Barcelona, Spain
| | - M Alvarez-Pedrerol
- Institut de Salut Global de Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health, Barcelona, Spain
| | - J Sunyer
- Institut de Salut Global de Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health, Barcelona, Spain
| | - J Forns
- Institut de Salut Global de Barcelona, Spain.,Hospital del Mar Research Institute, Barcelona, Spain.,Spanish Consortium for Research on Epidemiology and Public Health, Barcelona, Spain
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50
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Little K, Raiker J, Coxe S, Campez M, Jusko M, Smith J, Gnagy E, Greiner A, Villodas M, Coles E, Pelham WE. A Preliminary Evaluation of the Utility of Sluggish Cognitive Tempo Symptoms in Predicting Behavioral Treatment Response in Children with Behavioral Difficulties. Psychol Rep 2020; 124:2063-2091. [PMID: 32921265 DOI: 10.1177/0033294120957239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Interest in symptoms of sluggish cognitive tempo (SCT) has led to a number of studies evaluating how these symptoms respond to treatment commonly utilized in youths with symptoms of ADHD. No study to date, however, has examined the extent to which symptoms of SCT predict behavioral treatment response in youths across multiple domains of functioning. The current preliminary investigation integrates a number of methodological (e.g., direct observations) and analytic (e.g., Poisson regression) refinements to evaluate the extent to which symptoms of SCT predict treatment responses across multiple domains including behavioral (e.g., interruptions, rule violations), social (e.g., social skills, negative verbalizations), and severe behavioral difficulties (e.g., intentional aggression) above and beyond other demographic characteristics (e.g., symptom severity, Full Scale Intelligence Quotient [FSIQ]). A relatively small sample of 37 children, aged six to 12 years (M = 8.03, SD = 1.83, 35 males: 2 females) attending an eight week multi-component intensive behavioral treatment program for youths with behavioral difficulties participated in the current study. Baseline parental perceptions of SCT were collected prior to the initiation of treatment. Results from this preliminary investigation revealed that pre-treatment SCT symptoms only predicted a less robust treatment response to time out which was associated also with parent's perceptions of underlying working memory problems. Results revealed also that pre-treatment SCT symptoms failed to predict paraprofessional counselor's and teacher's improvement ratings of both rule following and social skills following treatment. Notably, other potential predictors (e.g., symptom severity, FSIQ) also largely failed to predict behavioral treatment response.
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Affiliation(s)
- Kelcey Little
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Joseph Raiker
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Stefany Coxe
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Mileini Campez
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Morgan Jusko
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Jessica Smith
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Elizabeth Gnagy
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Andrew Greiner
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Miguel Villodas
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - Erika Coles
- Center for Children and Families, Florida International University, Miami, FL, USA
| | - William E Pelham
- Center for Children and Families, Florida International University, Miami, FL, USA
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