Skip to main content

Advertisement

SpringerLink
Log in

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

  • Published:
Journal of Abnormal Child Psychology Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders: DSM III (Vol. 3rd). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV (Vol. 4th). Washington, DC: American Psychiatric Association.

    Google Scholar 

  • American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Barkley, R. A., & Murphy, K. R. (1998). Attention-deficit hyperactivity disorder: A clinical workbook. New York: Guilford.

    Google Scholar 

  • Baron, I. S. (2004). Neuropsychological evaluation of the child. Oxford: Oxford University Press.

    Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • DeCoster, J., Iselin, A. M., & Gallucci, M. (2009). A conceptual and empirical examination of justifications for dichotomization. Psychological Methods, 14(4), 349–366.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  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(5), 1099–1111.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Kristensen, H., & Torgersen, S. (2008). Is social anxiety disorder in childhood associated with developmental deficit/delay? European Child & Adolescent Psychiatry, 17(2), 99–107.

    Article  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    PubMed  Google Scholar 

  • Sheslow, D., & Adams, W. (1990). Wide range assessment of memory and learning. Manual. Wilmington: Jastak.

    Google Scholar 

  • Snow, J. B., & Sapp, G. L. (2000). WISC-III subtest patterns of ADHD and normal samples. Psychological Reports, 87(3 Pt 1), 759–765.

    Article  PubMed  Google Scholar 

  • SPSS Inc (2006). The statistical package for social sciences (Version 15.0 for Windows). Chicago: SPSS Inc.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • 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 

  • Wechsler, D. (1999). Wechsler abbreviated scale of intelligence; WASI. Manual. Norwegian Manual Supplement 2007 (Pearson Assessment). San Antonio: The Psychological Corporation.

    Google Scholar 

Download references

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.

Author information

Authors and Affiliations

  1. Centre for Child and Adolescent Mental Health, Eastern and Southern Norway, PO BOX: 4623, Nydalen, 0405, Oslo, Norway

    Benedicte Skirbekk, Berit Hjelde Hansen, Beate Oerbeck & Hanne Kristensen

  2. Nic Waal’s Institute, Lovisenberg Diakonale Hospital, Oslo, Norway

    Benedicte Skirbekk & Hanne Kristensen

  3. Akershus University Hospital, Akershus, Norway

    Berit Hjelde Hansen

Authors
  1. Benedicte Skirbekk
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Berit Hjelde Hansen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Beate Oerbeck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Hanne Kristensen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benedicte Skirbekk.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Skirbekk, B., Hansen, B.H., Oerbeck, B. et al. The Relationship Between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders. J Abnorm Child Psychol 39, 513–525 (2011). https://doi.org/10.1007/s10802-011-9488-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-011-9488-4

Keywords

Search

Navigation