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Journal of Abnormal Child Psychology

, Volume 39, Issue 4, pp 513–525 | Cite as

The Relationship Between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders

  • Benedicte Skirbekk
  • Berit Hjelde Hansen
  • Beate Oerbeck
  • Hanne Kristensen
Article

Abstract

The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7–13 years were assigned to four groups, i.e., referred children with comorbid AnxDs and ADHD (n = 25), ADHD (n = 39), AnxDs (n = 41), and nonreferred controls (n = 36). Furthermore we explored the association between SCT and several neurocognitive measures (reaction time, verbal memory, and spatial memory). Diagnoses were established using Kiddie-SADS P/L. SCT was assessed using a 17-item mother-reported questionnaire. SCT correlated significantly with inattentiveness, regardless of the subtype of ADHD. Furthermore, we found significant differences in the levels of SCT among the four groups, with the highest SCT scores observed in the comorbid group. SCT correlated with variability in spatial memory; in contrast, there was no correlation between SCT and reaction time.

Keywords

Sluggish cognitive tempo Attention-deficit/hyperactivity disorder Anxiety disorders Spatial memory ADHD subtypes 

Notes

Acknowledgment

The research was funded by the Norwegian Research Council.

Financial disclosures: Skirbekk, Hansen, Oerbeck, and Kristensen report no biomedical financial interest or potential conflict of interest.

References

  1. American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders: DSM III (Vol. 3rd). Washington, DC: American Psychiatric Association.Google Scholar
  2. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV (Vol. 4th). Washington, DC: American Psychiatric Association.Google Scholar
  3. American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
  4. Barkley, R. A., & Murphy, K. R. (1998). Attention-deficit hyperactivity disorder: A clinical workbook. New York: Guilford.Google Scholar
  5. Baron, I. S. (2004). Neuropsychological evaluation of the child. Oxford: Oxford University Press.Google Scholar
  6. Canivez, G. L., Konold, T. R., Collins, J. M., & Wilson, G. (2009). Construct validity of the Wechsler abbreviated scale of intelligence and wide range intelligence test: convergent and structural validity. School Psychology Quarterly, 24(4), 252–265.CrossRefGoogle Scholar
  7. Carlson, C. L., & Mann, M. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominantly inattentive type. Journal of Clinical Child and Adolescent Psychology, 31(1), 123–129.PubMedGoogle Scholar
  8. Costello, E. J., Egger, H. L., & Angold, A. (2005). The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child and Adolescent Psychiatric Clinics of North America, 14(4), 631–648.PubMedCrossRefGoogle Scholar
  9. DeCoster, J., Iselin, A. M., & Gallucci, M. (2009). A conceptual and empirical examination of justifications for dichotomization. Psychological Methods, 14(4), 349–366.PubMedCrossRefGoogle Scholar
  10. Derefinko, K. J., Adams, Z. W., Milich, R., Fillmore, M. T., Lorch, E. P., & Lynam, D. R. (2008). Response style differences in the inattentive and combined subtypes of attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 36(5), 745–758.PubMedCrossRefGoogle Scholar
  11. Elia, J., Arcos-Burgos, M., Bolton, K. L., Ambrosini, P. J., Berrettini, W., & Muenke, M. (2009). ADHD latent class clusters: DSM-IV subtypes and comorbidity. Psychiatry Research, 170(2–3), 192–198.PubMedCrossRefGoogle Scholar
  12. Frick, P. J., Lahey, B. B., Applegate, B., & Kerdyck, L. (1994). DSM-IV field trials for the disruptive behavior disorders: symptom utility estimates. Journal of the American Academy of Child and Adolescent Psychiatry, 33(4), 529–539.PubMedCrossRefGoogle Scholar
  13. Garner, A., Marceaux, J., Mrug, S., Patterson, C., & Hodgens, B. (2010). Dimensions and correlates of attention deficit/hyperactivity disorder and sluggish cognitive tempo. Journal of Abnormal Child Psychology, 1–11.Google Scholar
  14. Gomez, R. (2007). Australian parent and teacher ratings of the DSM-IV ADHD symptoms: differential symptom functioning and parent-teacher agreement and differences. Journal of Attention Disorders, 11(1), 17–27.PubMedCrossRefGoogle Scholar
  15. Harrington, K. M., & Waldman, I. D. (2010). Evaluating the utility of sluggish cognitive tempo in discriminating among DSM-IV ADHD subtypes. Journal of Abnormal Child Psychology, 38(2), 173–184.PubMedCrossRefGoogle Scholar
  16. Hartman, C. A., Willcutt, E. G., Rhee, S. H., & Pennington, B. F. (2004). The relation between sluggish cognitive tempo and DSM-IV ADHD. Journal of Abnormal Child Psychology, 32(5), 491–503.PubMedCrossRefGoogle Scholar
  17. Hinshaw, S. P., Carte, E. T., Sami, N., Treuting, J. J., & Zupan, B. A. (2002). Preadolescent girls with attention-deficit/hyperactivity disorder: II. Neuropsychological performance in relation to subtypes and individual classification. Journal of Consulting and Clinical Psychology, 70(5), 1099–1111.PubMedCrossRefGoogle Scholar
  18. Hinshaw, S. P., Carte, E. T., Fan, C., Jassy, J. S., & Owens, E. B. (2007). Neuropsychological functioning of girls with attention-deficit/hyperactivity disorder followed prospectively into adolescence: evidence for continuing deficits? Neuropsychology, 21(2), 263–273.PubMedCrossRefGoogle Scholar
  19. Huang-Pollock, C. L., Nigg, J. T., & Carr, T. H. (2005). Deficient attention is hard to find: applying the perceptual load model of selective attention to attention deficit hyperactivity disorder subtypes. Journal of Child Psychology and Psychiatry and Allied Disciplines, 46(11), 1211–1218.CrossRefGoogle Scholar
  20. Jarrett, M. A., & Ollendick, T. H. (2008). A conceptual review of the comorbidity of attention-deficit/hyperactivity disorder and anxiety: implications for future research and practice. Clinical Psychology Review, 28(7), 1266–1280.PubMedCrossRefGoogle Scholar
  21. Johnson, K. A., Robertson, I. H., Barry, E., Mulligan, A., Daibhis, A., Daly, M., et al. (2008). Impaired conflict resolution and alerting in children with ADHD: evidence from the Attention Network Task (ANT). Journal of Child Psychology and Psychiatry, 49(12), 1339–1347.PubMedCrossRefGoogle Scholar
  22. Kaufman, J., Birmaher, B., Brent, D., & Rao, U. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36(7), 980–988.PubMedCrossRefGoogle Scholar
  23. Kristensen, H., & Torgersen, S. (2008). Is social anxiety disorder in childhood associated with developmental deficit/delay? European Child & Adolescent Psychiatry, 17(2), 99–107.CrossRefGoogle Scholar
  24. Lahey, B. B. (2001). Should the combined and predominantly inattentive types of ADHD be considered distinct and unrelated disorders? Not now, at least. Clinical Psychology, 8(4), 494–497.Google Scholar
  25. Lahey, B. B., Schaughency, E. A., Hynd, G. W., & Carlson, C. L. (1987). Attention deficit disorder with and without hyperactivity: comparison of behavioral characteristics of clinic-referred children. Journal of the American Academy of Child and Adolescent Psychiatry, 26(5), 718–723.PubMedCrossRefGoogle Scholar
  26. Manassis, K., Tannock, R., Young, A., & Francis-John, S. (2007). Cognition in anxious children with attention deficit hyperactivity disorder: a comparison with clinical and normal children. Behavioral and Brain Functions, 3, doi: 10.1186/1744-9081-1183-1184.
  27. Mayes, S. D., Calhoun, S. L., Chase, G. A., Mink, D. M., & Stagg, R. E. (2009). ADHD subtypes and co-occurring anxiety, depression, and oppositional-defiant disorder: differences in Gordon Diagnostic System and Wechsler Working Memory and Processing Speed Index scores. Journal of Attention Disorders, 12(6), 540–550.PubMedCrossRefGoogle Scholar
  28. McBurnett, K., Pfiffner, L. J., & Frick, P. J. (2001). Symptom properties as a function of ADHD type: an argument for continued study of sluggish cognitive tempo. Journal of Abnormal Child Psychology, 29(3), 207–213.PubMedCrossRefGoogle Scholar
  29. Milich, R., Balentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive type are distinct and unrelated disorders. Clinical Psychology, 8(4), 463–488.Google Scholar
  30. Newcorn, J. H., Halperin, J. M., Jensen, P. S., Abikoff, H. B., Arnold, E., Cantwell, D. P., et al. (2001). Symptom profiles in children with ADHD: effects of comorbidity and gender. Journal of the American Academy of Child and Adolescent Psychiatry, 40(2), 137–146.PubMedCrossRefGoogle Scholar
  31. Nigg, J. T. (2005). Neuropsychologic theory and findings in attention-deficit/hyperactivity disorder: the state of the field and salient challenges for the coming decade. Biological Psychiatry, 57(11), 1424–1435.PubMedCrossRefGoogle Scholar
  32. Penny, A. M., Waschbusch, D. A., Klein, R. M., Corkum, P., & Eskes, G. (2009). Developing a measure of sluggish cognitive tempo for children: content validity, factor structure, and reliability. Psychological Assessment, 21(3), 380–389.PubMedCrossRefGoogle Scholar
  33. Pfiffner, L. J., Mikami, A. Y., Huang-Pollock, C., Easterlin, B., Zalecki, C., & McBurnett, K. (2007). A randomized, controlled trial of integrated home-school behavioral treatment for ADHD, predominantly inattentive type. Journal of the American Academy of Child and Adolescent Psychiatry, 46(8), 1041–1050.PubMedCrossRefGoogle Scholar
  34. Power, T. J., Costigan, T. E., Eiraldi, R. B., & Leff, S. S. (2004). Variations in anxiety and depression as a function of ADHD subtypes defined by DSM-IV: do subtype differences exist or not? Journal of Abnormal Child Psychology, 32(1), 27–37.PubMedCrossRefGoogle Scholar
  35. Raggio, D. J., Scattone, D., & May, W. (2010). Relationship of the Kaufman brief intelligence test—second edition and the Wechsler abbreviated scale of intelligence in children referred for ADHD. Psychological Reports, 106(2), 513–518.PubMedCrossRefGoogle Scholar
  36. Rueda, M. R., Fan, J., McCandliss, B. D., Halparin, J. D., Gruber, D. B., Lercari, L. P., et al. (2004). Development of attentional networks in childhood. Neuropsychologia, 42(8), 1029–1040.PubMedCrossRefGoogle Scholar
  37. Schatz, D. B., & Rostain, A. L. (2006). ADHD with comorbid anxiety: a review of the current literature. Journal of Attention Disorders, 10(2), 141–149.PubMedCrossRefGoogle Scholar
  38. Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P. J., Fischer, P., Bird, H., et al. (1983). A children’s global assessment scale (CGAS). Archives of General Psychiatry, 40(11), 1228–1231.PubMedGoogle Scholar
  39. Sheslow, D., & Adams, W. (1990). Wide range assessment of memory and learning. Manual. Wilmington: Jastak.Google Scholar
  40. Snow, J. B., & Sapp, G. L. (2000). WISC-III subtest patterns of ADHD and normal samples. Psychological Reports, 87(3 Pt 1), 759–765.PubMedCrossRefGoogle Scholar
  41. SPSS Inc (2006). The statistical package for social sciences (Version 15.0 for Windows). Chicago: SPSS Inc.Google Scholar
  42. Todd, R. D., Rasmussen, E. R., Wood, C., Levy, F., & Hay, D. A. (2004). Should sluggish cognitive tempo symptoms be included in the diagnosis of attention-deficit/hyperactivity disorder? Journal of the American Academy of Child and Adolescent Psychiatry, 43(5), 588–597.PubMedCrossRefGoogle Scholar
  43. Wahlstedt, C., & Bohlin, G. (2010). DSM-IV-defined inattention and sluggish cognitive tempo: independent and interactive relations to neuropsychological factors and comorbidity. Child Neuropsychology, 16(4), 350–365.PubMedCrossRefGoogle Scholar
  44. Wechsler, D. (1991). Wechsler intelligence scale for children-third edition; WISC-III. Manual. Norwegian Manual Supplement 2003 (Pearson Assessment). San Antonio: The Psychological Corporation.Google Scholar
  45. Wechsler, D. (1999). Wechsler abbreviated scale of intelligence; WASI. Manual. Norwegian Manual Supplement 2007 (Pearson Assessment). San Antonio: The Psychological Corporation.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2011

Authors and Affiliations

  • Benedicte Skirbekk
    • 1
    • 2
  • Berit Hjelde Hansen
    • 1
    • 3
  • Beate Oerbeck
    • 1
  • Hanne Kristensen
    • 1
    • 2
  1. 1.Centre for Child and Adolescent Mental HealthEastern and Southern NorwayOsloNorway
  2. 2.Nic Waal’s Institute, Lovisenberg Diakonale HospitalOsloNorway
  3. 3.Akershus University HospitalAkershusNorway

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