Validity of the Sluggish Cognitive Tempo, Inattention, and Hyperactivity Symptom Dimensions: Neuropsychological and Psychosocial Correlates
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This study examined the latent structure and validity of inattention, hyperactivity-impulsivity, and sluggish cognitive tempo (SCT) symptomatology. We evaluated mother and teacher ratings of ADHD and SCT symptoms in 140 Puerto Rican children (55.7% males), ages 6 to 11 years, via factor and regression analyses. A three-factor model (inattention, hyperactivity-impulsivity, and SCT) provided the best fit for both sets of ratings. Inattention was the strongest correlate of lower scores on neuropsychological, achievement, and psychosocial measures. Externalizing problems were most strongly associated with hyperactivity-impulsivity, and internalizing problems were most strongly associated with parent-rated SCT and teacher-rated Inattention. SCT was not associated with executive function but was negatively associated with math. Inattention accounted for a disproportionate amount of ADHD-related impairment, which may explain the restricted discriminant validity of DSM-IV types. The distinct factors of hyperactivity-impulsivity and SCT had unique associations with impairing comorbidities and are roughly equivalent in predicting external correlates of ADHD-related impairment.
KeywordsAttention deficit hyperactivity disorder (ADHD) Sluggish cognitive tempo (SCT) Inattentive subtype Diagnostic classification Executive function
Data for this study were obtained through NIMH funded grant: 5R24MH49368-06DHHS and the University of Puerto Rico Institutional Fund for Research. We thank Rafael R. Ramírez, Maribel Matos and our research team for their continuous support.
Dr. José J. Bauermeister was an international consultant to Eli Lilly and receives book royalties from Guilford Publications
Dr. Barkley is a speaker/consultant to Eli Lilly, Shire, Janssen-Ortho, Janssen-Cilag, and Novartis. He has also served as an expert witness for Lilly Canada. He receives product royalties from Guilford Publications, Jones and Bartlett, J & K Seminars, and ContinuingEdOnline.com.
Dr. McBurnett has received research funding, acted as a consultant, and/or served on an advisory board or speaker's bureau for NIMH, Eli Lilly, Lexicor, McNeil Pediatrics, Shire, Abbott Laboratories, Cephalon, Johnson & Johnson, New River, and Sigma-Tau.
Dr. José A. Bauermeister and Dr. Martínez have no financial disclosures to report.
- Achenbach, T. M. (1991a). Manual for the child behavior checklist/4-18, and 1991 profile. Burlington: University of Vermont Department of Psychiatry.Google Scholar
- Achenbach, T. M. (1991b). Manual for the teacher’s report form and 1991 profile. Burlington: University of Vermont Department of Psychiatry.Google Scholar
- American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders (3rd ed.). Washington, DC: Author.Google Scholar
- American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision.). Washington, DC: Author.Google Scholar
- Barkley, R. A. (1997). Niños desafiantes [defiant children]. New York: Guilford.Google Scholar
- Barkley, R. A. (2011). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0023961
- Barkley, R. A., Edwards, G., Laneri, M., Fletcher, K., & Metevia, L. (2001). Executive functioning, temporal discounting, and sense of time in adolescents with Attention Deficit Hyperactivity Disorder (ADHD) and Oppositional Defiant Disorder (ODD). Journal of Abnormal Child Psychology, 29, 541–557.PubMedCrossRefGoogle Scholar
- Bauermeister, J. J. (1994). Development and utilization of the School Behavior Inventory (SBI) for Puerto Rican children. San Juan: Atención, Inc.Google Scholar
- Bauermeister, J. J., Matos, M., Reina, G., Salas, C. C., Martínez, J. V., Cumba, E., & Barkley, R. (2005). Comparison of the DSM-IV combined and inattentive types of ADHD in a school-based sample of Latino/Hispanic children. Journal of Child Psychology and Psychiatry, 46, 166–179.PubMedCrossRefGoogle Scholar
- Bentler, P. M. (2008). EQS 6.1 for windows. Encino: Multivariate Software.Google Scholar
- Conners, C. K. (1995). Conners’ continuous performance test. Canada: Multi-Health Systems.Google Scholar
- Golden, C. J. (1978). Stroop color and word test: A manual for clinical and experimental use. Chicago: Stoelting.Google Scholar
- Gresham, F., & Elliott, S. (1990). Social skills rating system. Circle Pines: American Guidance Service.Google Scholar
- Herrans, L. L., & Rodríguez, J. M. (1992). Manual EIWN-R de Puerto Rico [WISC-R Puerto Rico manual]. San Antonio: The Psychological Corporation.Google Scholar
- 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, 1099–1111.PubMedCrossRefGoogle Scholar
- Hofvander, B., Ståhlberg, O., Nydén, A., Wentz, E., Degl'innocenti, A., Billstedt, E., & Anckarsäter, H. (2011). Life history of aggression scores are predicted by childhood hyperactivity, conduct disorder, adult substance abuse, and low cooperativeness in adult psychiatric patients. Psychiatry Research, 185, 280–285.PubMedCrossRefGoogle Scholar
- Kaufman, A. S., & Kaufman, N. L. (1983). K-ABC interpretive manual. Circle Pines: American Guidance Service.Google Scholar
- Lahey, B. B., Carlson, C. L., & Frick, P. J. (1997). Attention-deficit disorder without hyperactivity. In T. A. Widiger, A. J. Frances, H. A. Pincus, R. Ross, M. B. First, & W. Davis (Eds.), DSM-IV sourcebook (pp. 163–188). Washington: American Psychiatric.Google Scholar
- Ludwig, H. T., Matte, B., Katz, B., & Rohde, L. A. (2009). Do sluggish cognitive tempo symptoms predict response to methylphenidate in patients with attention-deficit/hyperactivity disorder-inattentive type? Journal of Child and Adolescent Psychopharmacology, 19, 461–465.PubMedCrossRefGoogle Scholar
- Massetti, G. M., Lahey, B. B., Pelham, W. E., Loney, J., Ehrhardt, A., Lee, S. S., & Kipp, H. (2008). Academic achievement over 8 years among children who met modified criteria for attention-deficit/hyperactivity disorder at 4–6 years of age. Journal of Abnormal Child Psychology, 36, 399–410.PubMedCrossRefGoogle Scholar
- Matos, B. (2000). A study of the psychometric properties of the Tower of Hanoi, Hand Movements, and Simon tests in a sample of Puerto Rican children. Unpublished doctoral dissertation, San Juan, Puerto Rico: Carlos Albizu University.Google Scholar
- McBurnett, K., Pfiffner, L. J., Willcutt, E., Tamm, L., Lerner, M., Ottolini, Y. L., & Furman, M. A. (1999). Experimental cross-validation of DSM-IV types of attention-deficit/hyperactivity disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 17–24.PubMedCrossRefGoogle Scholar
- McBurnett, K., Pfiffner, L. J., & Ottolini, Y. L. (2000). Types of ADHD in DSM-IV. In P. Accardo, T. Blondis, & M. A. Stein (Eds.), The attention deficit disorders (pp. 229–240). New York: Marcel Dekker.Google Scholar
- Newby, R. (1989). The wisconsin selective reminding test. Milwaukee, WI: Author.Google Scholar
- Shaffer, D., Fisher, P., Lucas, C. P., Dulcan, M. K., & Schwab-Stone, M. E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 39, 28–38.PubMedCrossRefGoogle Scholar
- Woodcock, R. W. (1982). Batería woodcock psicoeducativa en Español[woodcock Spanish psycho-educational battery]. Allen: DLM Teaching Resources.Google Scholar