Journal of Abnormal Child Psychology

, Volume 42, Issue 1, pp 21–35 | Cite as

The Internal and External Validity of Sluggish Cognitive Tempo and its Relation with DSM–IV ADHD

  • Erik G. Willcutt
  • Nomita Chhabildas
  • Mikaela Kinnear
  • John C. DeFries
  • Richard K. Olson
  • Daniel R. Leopold
  • Janice M. Keenan
  • Bruce F. Pennington


Studies of subtypes of DSM-IV attention-deficit/hyperactivity disorder (ADHD) have provided inconsistent support for the discriminant validity of the combined type (ADHD-C) and predominantly inattentive type (ADHD-I). A large sample of children and adolescents with ADHD (N = 410) and a comparison group without ADHD (N = 311) were used to test the internal and external validity of sluggish cognitive tempo (SCT), a dimension characterized by low energy and sleepy and sluggish behavior. SCT scores were then incorporated in analyses of ADHD subtypes to test whether the discriminant validity of ADHD-C and ADHD-I could be improved by including SCT symptoms as part of the criteria for ADHD-I. Factor analyses of parent and teacher ratings indicated that six SCT items loaded on a factor separate from symptoms of ADHD and other psychopathology, providing important support for the internal validity of SCT. The external validity of SCT was supported by significant associations between SCT and measures of functional impairment and neuropsychological functioning when symptoms of ADHD and other psychopathology were controlled. However, contrary to initial predictions, high levels of SCT did not identify a subgroup of ADHD-I that was clearly distinct from ADHD-C. Instead, the current results suggest that DSM-IV inattention and SCT are separate but correlated symptom dimensions that are each independently associated with important aspects of functional impairment and neuropsychological functioning.


ADHD Sluggish tempo Subtypes DSM-IV Inattention Hyperactivity-impulsivity 


Funding Information and Disclosures

Primary funding for the study was provided by a grant from the National Institute of Child Health and Human Development (P50 HD27802). The authors were also supported by NIH grants R01 HD 47264, R01 DC 05190, R01 HD38526, R01 MH 62120, R01 MH 63941, and R01 MH 70037 during the preparation of this report. Portions of these data were included in masters and doctoral theses at the University of Denver (N. A. Chhabildas). Earlier subsets of these results were presented at the annual meetings of the International Society for Research on Child and Adolescent Psychopathology and the International Neuropsychological Society.

Supplementary material

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erik G. Willcutt
    • 1
  • Nomita Chhabildas
    • 1
  • Mikaela Kinnear
    • 1
  • John C. DeFries
    • 1
  • Richard K. Olson
    • 1
  • Daniel R. Leopold
    • 1
  • Janice M. Keenan
    • 2
  • Bruce F. Pennington
    • 2
  1. 1.Department of Psychology and Neuroscience, UCB 345University of ColoradoBoulderUSA
  2. 2.University of DenverDenverUSA

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