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Sluggish Cognitive Tempo and ADHD Inattention as Predictors of Externalizing, Internalizing, and Impairment Domains: A 2-Year Longitudinal Study

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Abstract

Although sluggish cognitive tempo (SCT) is distinct from attention-deficit/hyperactivity disorder inattention (ADHD-IN), few studies have examined whether SCT longitudinally predicts other symptom or impairment dimensions. This study used 4 sources (mothers, fathers, primary teachers, and secondary teachers) and 3 occasions of measurement (first, second, and third grades) with 758 first grade (55 % boys), 718 second grade (54 % boys), and 585 third grade (53 % boys) children from Spain to determine SCT’s and ADHD-IN’s unique longitudinal relationships with psychopathology, academic impairment, and social impairment over the 1- and 2-year intervals (i.e., first to third grade, second to third grade). For 1- and 2-year intervals using both mothers’ and fathers’ ratings, higher levels of SCT uniquely predicted higher levels of anxiety, depression, academic impairment, and social impairment whereas higher levels of ADHD-IN uniquely predicted higher levels of ADHD-HI, ODD, and academic impairment. For 1- and 2-year intervals across different primary and secondary teachers (i.e., first/second and third grade ratings were provided by different teachers), higher scores on ADHD-IN uniquely predicted poorer outcomes across domains whereas higher scores on SCT uniquely predicted lower levels of ADHD-HI and ODD for both intervals in addition to higher levels of depression (for primary teachers only), academic impairment (for 1-year interval only), and peer rejection (2-year interval only for primary teachers). Overall, SCT was significantly associated with important outcomes independent of ADHD-IN over 1- and 2-year intervals and across four different raters. This study provides further evidence for distinguishing between SCT and ADHD-IN in home and school settings.

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References

  • Barkley, R. A. (2013). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of Clinical Child and Adolescent Psychology, 42, 161–173. doi:10.1080/15374416.2012.734259.

    Article  PubMed  Google Scholar 

  • Barkley, R. A. (2014). Sluggish cognitive tempo (concentration deficit disorder?): current status, future directions, and a plea to change the name. Journal of Abnormal Child Psychology, 42, 117–125. doi:10.1007/s10802-013-9824-y.

    Article  PubMed  Google Scholar 

  • Bauermeister, J. J., Barkley, R. A., Bauermeister, J. A., Martinez, J. V., & McBurnett, K. (2012). Validity of the sluggish cognitive tempo, inattention, and hyperactivity symptom dimensions: neuropsychological and psychosocial correlates. Journal of Abnormal Child Psychology, 40, 683–697. doi:10.1007/s10802-011-9602-7.

    Article  PubMed  Google Scholar 

  • Becker, S. P. (2013). Topical review: sluggish cognitive tempo: research findings and relevance for pediatric psychology. Journal of Pediatric Psychology, 38, 1051–1057. doi:10.1093/jpepsy/jst058.

    Article  PubMed  Google Scholar 

  • Becker, S. P. (2014). Sluggish cognitive tempo and peer functioning in school-aged children: a six-month longitudinal study. Psychiatry Research, 217, 72–78. doi:10.1016/j.psychres.2014.02.007.

    Article  PubMed  Google Scholar 

  • Becker, S. P., & Langberg, J. M. (2013). Attention-deficit/hyperactivity disorder and sluggish cognitive tempo dimensions in relation to executive functioning in adolescents with ADHD. Child Psychiatry and Human Development, 45, 1–11. doi:10.1007/s10578-013-0372-z.

    Article  Google Scholar 

  • Becker, S. P., & Langberg, J. M. (2014). Sluggish cognitive tempo among young adolescents with ADHD: relations to mental health, academic, and social functioning. Journal of Attention Disorders, 17, 681–689. doi:10.1177/1087054711435411.

    Article  Google Scholar 

  • Becker, S. P., Fite, P. J., Garner, A. A., Greening, L., Stoppelbein, L., & Luebbe, A. M. (2013). Reward and punishment sensitivity are differentially associated with ADHD and sluggish cognitive tempo symptoms in children. Journal of Research in Personality, 47, 719–727. doi:10.1016/j.jrp.2013.07.001.

    Article  Google Scholar 

  • Becker, S. P., Ciesielski, H. A., Rood, J. E., Froehlich, T. E., Garner, A. A., Tamm, L., & Epstein, J. N. (2014a). Uncovering a clinical portrait of sluggish cognitive tempo within an evaluation for attention-deficit/hyperactivity disorder: a case study. Clinical Child Psychology and Psychiatry. doi:10.1177/1359104514554312.

    PubMed  Google Scholar 

  • Becker, S. P., Langberg, J. M., Luebbe, A. M., Dvorsky, M. R., & Flannery, A. J. (2014b). Sluggish cognitive tempo is associated with academic functioning and internalizing symptoms in college students with and without attention-deficit/hyperactivity disorder. Journal of Clinical Psychology, 70, 388–403. doi:10.1002/jclp.22046.

    Article  PubMed  Google Scholar 

  • Becker, S. P., Luebbe, A. M., Fite, P. J., Stoppelbein, L., & Greening, L. (2014c). Sluggish cognitive tempo in psychiatrically hospitalized children: factor structure and relations to internalizing symptoms, social problems, and observed behavioral dysregulation. Journal of Abnormal Child Psychology, 42, 49–62. doi:10.1007/s10802-013-9719-y.

    Article  PubMed  Google Scholar 

  • Becker, S. P., Luebbe, A. M., & Langberg, J. M. (2014d). Attention-deficit/hyperactivity disorder dimensions and sluggish cognitive tempo symptoms in relation to college students’ sleep functioning. Child Psychiatry & Human Development, 45, 675–685. doi:10.1007/s10578-014-0436-8.

    Article  Google Scholar 

  • Becker, S. P., Marshall, S. A., & McBurnett, K. (2014e). Sluggish cognitive tempo in abnormal child psychology: an historical overview and introduction to the Special Section. Journal of Abnormal Child Psychology, 42, 1–6. doi:10.1007/s10802-013-9825-x.

    Article  PubMed  Google Scholar 

  • Becker, S. P., Luebbe, A. M., & Joyce, A. M. (2015). The Child Concentration Inventory (CCI): Initial validation of a child self-report measure of sluggish cognitive tempo. Psychological Assessment. Advance online publication. doi:10.1037/pas0000083.

  • Belmar, M., Servera, M., Becker, S. P., & Burns, G. L. (2015). Validity of sluggish cognitive tempo in South America: an initial examination using mother and teacher ratings of Chilean children. Journal of Attention Disorders. doi:10.1177/1087054615597470.

    PubMed  Google Scholar 

  • Bernad, M. M., Servera, M., Grases, G., Collado, S., & Burns, G. L. (2014). A cross-sectional and longitudinal investigation of the external correlates of sluggish cognitive tempo and ADHD-IN symptom dimensions. Journal of Abnormal Child Psychology, 42, 1225–1236. doi:10.1007/s10802-014-9866-9.

    Article  Google Scholar 

  • Burns, G. L., Moura, M. A., Walsh, J. A., Desmul, C., Silpakit, C., & Sommers-Flanagan, J. (2008). Invariance and convergent and discriminant validity between mothers’ and fathers’ ratings of oppositional defiant disorder toward adults, ADHD-HI, ADHD-IN, and academic competence factors within Brazilian, Thai, and American children. Psychological Assessment, 20, 121–130. doi:10.1037/1040-3590.20.2.121.

    Article  PubMed  Google Scholar 

  • Burns, G. L., Servera, M., Bernad, M. M., Carrillo, J. M., & Cardo, E. (2013). Distinctions between sluggish cognitive tempo, ADHD-IN and depression symptom dimensions in Spanish first grade children. Journal of Clinical Child and Adolescent Psychology, 42, 796–808. doi:10.1080/15374416.2013.838771.

    Article  PubMed  Google Scholar 

  • Burns, G. L., Lee, S., Becker, S. P., Servera, M., & McBurnett, K. (2014a). Child and adolescent disruptive behavior inventory—parent version 5.0. Pullman, WA: Author.

    Google Scholar 

  • Burns, G. L., Lee, S., Becker, S. P., Servera, M., & McBurnett, K. (2014b). Child and adolescent disruptive behavior inventory—teacher version 5.0. Pullman: Author.

    Google Scholar 

  • Burns, G. L., Servera, M., Bernad, M. M., Carrillo, J. M., Geiser, C., Burns, G. L., Servera, M., Bernad, M. M., Carrillo, J. M., & Geiser, C. (2014c). Ratings of ADHD symptoms and academic impairment by mothers, fathers, teachers, and aides: construct validity within and across settings as well as occasions. Psychological Assessment, 26, 1247–1258. doi:10.1037/pas0000008.

    Article  PubMed  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, 123–129. doi:10.1207/S15374424JCCP3101_14.

    Article  PubMed  Google Scholar 

  • Dishion, T. J. (1990). The peer context of troublesome child and adolescent behavior. In P. E. Leone (Ed.), Understanding troubled and troubling youth: multiple perspectives (pp. 128–153). Thousand Oaks: Sage.

    Google Scholar 

  • Fenollar Cortés, J. F., Servera, M., Becker, S. P., & Burns, G. L. (2014). External validity of ADHD inattention and sluggish cognitive tempo dimensions in Spanish children with ADHD. Journal of Attention Disorders. doi:10.1177/108705471454803.

    PubMed  Google Scholar 

  • Flannery, A. J., Becker, S. P., & Luebbe, A. M. (2014). Does emotion dysregulation mediate the association between sluggish cognitive tempo and college students’ social adjustment? Journal of Attention Disorders. doi:10.1177/1087054714527794.

    PubMed  Google Scholar 

  • Garner, A. A., Peugh, J., Becker, S. P., Kingery, K. M., Tamm, L., Vaughn, A. J., Ciesielski, H., Simon, J. O., Loren, R. E., & Epstein, J. N. (2014). Does sluggish cognitive tempo fit within a bi-factor model of ADHD? Journal of Attention Disorders. doi:10.1177/1087054714539995.

    PubMed Central  Google Scholar 

  • Jarrett, M. A., Rapport, H. F., Rondon, A. T., & Becker, S. P. (2014). ADHD dimensions and sluggish cognitive tempo symptoms in relation to self-report and laboratory measures of neuropsychological functioning in college students. Journal of Attention Disorders. doi:10.1177/1087054714560821.

    PubMed  Google Scholar 

  • Klein, D. N., Dougherty, L. R., & Olino, T. M. (2005). Toward guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 412–432. doi:10.1207/s15374424jccp3403_3.

    Article  PubMed  Google Scholar 

  • Langberg, J. M., Becker, S. P., & Dvorsky, M. R. (2014). The association between sluggish cognitive tempo and academic functioning in youth with attention-deficit/hyperactivity disorder (ADHD). Journal of Abnormal Child Psychology, 42, 91–103. doi:10.1007/s10802-013-9722-3.

    Article  PubMed  Google Scholar 

  • Lee, S., Burns, G. L., Snell, J., & McBurnett, K. (2014). Validity of the sluggish cognitive tempo symptom dimension in children: sluggish cognitive tempo and ADHD-Inattention as distinct symptom symptoms. Journal of Abnormal Child Psychology, 42, 7–19. doi:10.1007/s10802-013-9714-3.

    Article  PubMed  Google Scholar 

  • Loeber, R., Green, S. M., & Lahey, B. B. (1990). Mental health professionals’ perception of the utility of children, mothers, and teachers as informants on child psychopathology. Journal of Clinical Child Psychology, 19, 136–143. doi:10.1207/s15374424jccp1902_5.

    Article  Google Scholar 

  • Marshall, S. A., Evans, S. W., Eiraldi, R. B., Becker, S. P., & Power, T. J. (2014). Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo. Journal of Abnormal Child Psychology, 42, 77–90. doi:10.1007/s10802-013-9758-4.

    Article  PubMed  Google Scholar 

  • McBurnett, K., Villodas, M., Burns, G. L., Hinshaw, S. P., Beaulieu, A., & Pfiffner, L. J. (2014). Structure and validity of sluggish cognitive tempo using an expanded item pool in children with attention-deficit/hyperactivity disorder. Journal of Abnormal Child Psychology, 42, 37–38. doi:10.1007/s10802-013-9801-5.

    Article  PubMed  Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998–2012). Mplus user’s guide (7th Ed.). Los Angeles, CA: Muthén & Muthén.

  • 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, 380–389. doi:10.1037/a0016600.

    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, 1041–1050. doi:10.1097/chi.0b013e318064675f.

    Article  PubMed  Google Scholar 

  • Servera, M., Bernad, M. M., Carrillo, J. M., Collado, S., & Burns, G. L. (2015). Longitudinal correlates of sluggish cognitive tempo and ADHD-inattention symptom dimensions with Spanish children. Journal of Clinical Child and Adolescent Psychology. doi:10.1080/15374416.2015.1004680.

    PubMed  Google Scholar 

  • Silverman, W. K., & Ollendick, T. H. (2005). Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 380–411. doi:10.1207/s15374424jccp3403_2.

    Article  PubMed  Google Scholar 

  • Skansgaard, E. P., & Burns, G. L. (1998). Comparison of DSM-IVADHD combined and predominantly inattention types: Correspondence between teacher ratings and direct observations of inattentive, hyperactivity/impulsivity, slow cognitive tempo, oppositional defiant, and overt conduct disorder symptoms. Child & Family Behavior Therapy, 20, 1–14. doi:10.1300/J019v20n01_01.

    Article  Google Scholar 

  • Skirbekk, B., Hansen, B. H., Oerbeck, B., & Kristensen, H. (2011). The relationship between sluggish cognitive tempo, subtypes of attention-deficit/hyperactivity disorder, and anxiety disorders. Journal of Abnormal Child Psychology, 39, 513–525. doi:10.1007/s10802-011-9488-4.

    Article  PubMed  Google Scholar 

  • Watabe, Y., Owens, J. S., Evans, S. W., & Brandt, N. E. (2014). The relationship between sluggish cognitive tempo and impairment in children with and without ADHD. Journal of Abnormal Child Psychology, 42, 105–115. doi:10.1007/s10802-013-9767-3.

    Article  PubMed  Google Scholar 

  • Willcutt, E. G., Chhabildas, N., Kinnear, M., DeFries, J. C., Olson, R. K., Leopold, D. R., Keenan, J. M., & Pennington, B. F. (2014). The internal and external validity of sluggish cognitive tempo and its relation with DSM-IV ADHD. Journal of Abnormal Child Psychology, 42, 21–35. doi:10.1007/210802-013-9800-6.

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

A Ministry of Economy and Competitiveness grant PSI2011-23254 (Spanish Government) and a predoctoral fellowship co-financed by the European Social Fund and the Balearic Island Government (FPI/1451/2012) supported this research. We thank Cristina Trias and Cristina Solano for their help in data collection. The authors also thank the parents and teachers whose kind assistance made the research possible.

Conflict of Interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. University of the Balearic Islands & Research Institute on Health Sciences (IUNICS), Palma, Spain

    Maria del Mar Bernad & Mateu Servera

  2. Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Stephen P. Becker

  3. Department of Psychology, Washington State University, Pullman, WA, 99164-4820, USA

    G. Leonard Burns

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  1. Maria del Mar Bernad
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  2. Mateu Servera
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  3. Stephen P. Becker
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  4. G. Leonard Burns
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Correspondence to G. Leonard Burns.

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del Mar Bernad, M., Servera, M., Becker, S.P. et al. Sluggish Cognitive Tempo and ADHD Inattention as Predictors of Externalizing, Internalizing, and Impairment Domains: A 2-Year Longitudinal Study. J Abnorm Child Psychol 44, 771–785 (2016). https://doi.org/10.1007/s10802-015-0066-z

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