Abstract
Adolescents with Sluggish Cognitive Tempo (SCT) exhibit symptoms of slowness, mental confusion, excessive daydreaming, low motivation, and drowsiness/sleepiness. Although many symptoms of SCT reflect internalizing states, no study has evaluated the clinical utility of self-report of SCT in an attention-deficit/hyperactivity disorder (ADHD) sample. Furthermore, it remains unclear whether SCT is best conceptualized as a unidimensional or multidimensional construct. In a sample of 262 adolescents comprehensively diagnosed with ADHD, the present study used adolescent- and parent reports of SCT to evaluate the predictive utility of a general SCT factor from a bifactor modeling approach compared the utility of three specific SCT factors (slow, sleepy, and daydreamer) for predicting academic impairment and internalizing psychopathology. Overall, a multidimensional framework of SCT was supported, with the three SCT factors differentially predicting impairment and in one case (school grades), predicting impairment when the general factor did not. Consistent with prior research, SCT slow behaviors appear to be most strongly associated with impairment, predicting both academic impairment and internalizing psychopathology. Parent report of SCT was most useful for predicting academic functioning, whereas youth self-report was important for predicting anxiety and depression. Implications of the findings for the assessment and potential treatment of SCT are discussed.
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Becker SP, Leopold DR, Burns GL, Jarrett MA, Langberg JM et al (2016) The internal, external, and diagnostic validity of Sluggish Cognitive Tempo: a meta-analysis and critical review. J Am Acad Child Psy 55:163–178
Becker SP, Marshall SA, McBurnett K (2014) Sluggish Cognitive Tempo in abnormal child psychology: a Historical overview and introduction to the special section. J Abnorm Child Psychol 42:1–6
Barkley RA (2013) Distinguishing Sluggish Cognitive Tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. J Clin Child Adolesc 42:161–173
Fenollar Cortés J, Servera M, Becker SP, Burns GL (2014) External validity of ADHD Inattention and Sluggish Cognitive Tempo dimensions in Spanish children with ADHD. J Atten Disord. doi:10.1177/1087054714548033
Lee S, Burns GL, Snell J, McBurnett K (2014) Validity of the Sluggish Cognitive Tempo symptom dimension in children: Sluggish Cognitive Tempo and ADHD-inattention as distinct symptom dimensions. J Abnorm Child Psychol 42:7–19
McBurnett K, Villodas M, Burns GL et al (2014) Structure and validity of Sluggish Cognitive Tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder. J Abnorm Child Psychol 42:37–48
Smith ZR, Becker SP, Garner AA, Rudolph CW, Molitor SJ, Oddo LE, Langberg JM (2016) Evaluating the structure of Sluggish Cognitive Tempo using confirmatory factor analytic and bifactor modeling with parent and youth ratings. Assessment. doi:10.1177/1073191116653471
Willcutt EG, Chhabildas N, Kinnear M et al (2014) The internal and external validity of Sluggish Cognitive Tempo and its relation with DSM-IV ADHD. J Abnorm Child Psychol 42:21–35
Becker SP, Langbergm JM, Luebbe AM, Dvorsky MR, Flannery AJ (2014) Sluggish Cognitive Tempo is associated with academic functioning and internalizing symptoms in college students with and without attention-deficit/hyperactivity disorder. J Clin Psychol 70:388–403
Penny AM, Waschbusch DA, Klein RM, Corkum P, Eskes G (2009) Developing a measure of Sluggish Cognitive Tempo for children: content validity, factor structure, and reliability. Psychol Assess 21:380–389
Jacobson LA, Murphy-Bowman SC, Pritchard AE et al (2012) Factor structure of a Sluggish Cognitive Tempo scale in clinically-referred children. J Abnorm Child Psychol 40:1327–1337
Farrell AD (1999) Statistical methods in clinical research. In: Kendall PC, Butcher JN, Holmbeck GN (eds) Handbook of research methods in clinical psychology, 2nd edn. Willey, New York, pp 72–106
Floyd FJ, Widaman KF (1995) Factor analysis in the development and refinement of clinical assessment instruments. Psychol Assess 7:286–299
Bernad MD, Servera M, Becker SP, Burns GL (2015) Sluggish Cognitive Tempo and ADHD inattention as predictors of externalizing, internalizing, and impairment domains: a two-year longitudinal study. J Abnorm Child Psychol. doi:10.1007/s10802-015-0066-z
Capdevila-Brophy C, Artigas-Pallares J, Navarro-Pastor JB, Garcia-Nonell K, Rigau-Ratera E, Obiols JE (2014) ADHD predominantly inattentive subtype with high Sluggish Cognitive Tempo: a new clinical entity? J Atten Disord 18:607–616
Garner AA, Marceaux JC, Mrug S, Patterson C, Hodgens B (2010) Dimensions and correlates of attention deficit/hyperactivity disorder and Sluggish Cognitive Tempo. J Abnorm Child Psychol 38:1097–1107
Bernad MD, Servera M, Grases G, Collado S, Burns GL (2014) A cross-sectional and longitudinal investigation of the external correlates of Sluggish Cognitive Tempo and ADHD-inattention symptoms dimensions. J Abnorm Child Psychol 42:1225–1236
Skirbekk B, Hjelde Hansen B, Oerbeck B, Kistrensen H (2011) The relationship between Sluggish Cognitive Tempo subtypes of attention-deficit/hyperactivity disorder, and anxiety disorders. J Abnorm Child Psychol 39:513–525
Langberg JM, Becker SP, Dvorsky MR (2014) The association between Sluggish Cognitive Tempo and academic functioning in youth with attention-deficit/hyperactivity disorder (ADHD). J Abnorm Child Psychol 42:91–103
Pelham WE, Fabiano GA, Massetti GM (2005) Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. J Clin Child Adolec 34:449–476
Klein DN, Dougherty LR, Olino TM (2005) Towards guidelines for evidence-based assessment of depression in children and adolescents. J Clin Child Adolec 34:412–432
Silverman WK, Ollendick TH (2005) Evidence-based assessment of anxiety and its disorders in children and adolescents. J Clin Child Adolec 34:380–411
Becker SP, Luebbe AM, Joyce AM (2015) The child concentration inventory (CCI): initial validation of a child self-report measure of Sluggish Cognitive Tempo. Psychol Assess 27:1037–1052
Weller EB, Weller RA, Fristad MA, Rooney MT, Schecter J (2000) Children’s interview for psychiatric syndromes (ChIPS). J Am Acad Child Psy 39:76–84
Reynolds CR, Kamphaus RW (2004) Behavior assessment system for children-second edition. Circle Pines, Minnesota
Wolraich ML, Lambert EW, Doffing MA et al (2003) Psychometric properties of the vanderbilt ADHD diagnostic parent rating scale in a referred population. J Pediatr Psychol 28:559–568
Wechsler D (2003) Wechsler intelligence scale for children—fourth edition. The Psychological Coorporation, TX
Wechsler D (2009) Wechsler individual achievement test—third edition. Pearson, TX
Fristad MA, Teare M, Weller EB, Weller RA, Salmon P (1998) Study III: development and concurrent validity of the children’s interview for psychiatric syndromes—parent version (P-ChIPS). J Child Adol Psychop 8:221–226
Leffler JM, Riebel J, Hughes HM (2015) A review of child and adolescent diagnostic interviews for clinical practitioners. Assessment 22:690–703. doi:10.1177/1073191114561253
Power TJ, Dombrowski SC, Watkins MW, Mautone JA, Eagle JW (2007) Assessing children’s homework performance: development of multi-dimensional, multi-informant rating scales. J School Psychol 45:333–348
Becker SP, Langberg JM (2014) Attention-deficit/hyperactivity disorder and Sluggish Cognitive Tempo dimensions in relation to executive functioning in adolescents with ADHD. Child Psychiatry Hum Dev 45:1–11
Jiménez EAA, Ballabriga MCJ, Bonillo Martin A, Arrufat FJ, Giacobo RS (2015) Executive functioning in children and adolescents with symptoms of Sluggish Cognitive Tempo and ADHD. J Atten Disord 19:507–514
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, VA
Willcutt EG (2012) The prevalence of DSM-IV attention-deficit/hyperactivity disorder: a meta-analytic review. Neurotherapeutics 9:490–499
Acknowledgement
This research was supported by a grant awarded to Dr. Langberg from the Institute of Education Sciences (R305A130011).
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All human studies have been approved by the appropriate ethics committee and have, therefore, been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.
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Smith, Z.R., Langberg, J.M. Predicting academic impairment and internalizing psychopathology using a multidimensional framework of Sluggish Cognitive Tempo with parent- and adolescent reports. Eur Child Adolesc Psychiatry 26, 1141–1150 (2017). https://doi.org/10.1007/s00787-017-1003-1
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DOI: https://doi.org/10.1007/s00787-017-1003-1