Skip to main content
SpringerLink
Log in

Validity of the Sluggish Cognitive Tempo Symptom Dimension in Children: Sluggish Cognitive Tempo and ADHD-Inattention as Distinct Symptom Dimensions

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

Abstract

This study examined the validity of the sluggish cognitive tempo (SCT) symptom dimension in children. Ten symptom domains were used to define SCT (i.e., (1) daydreams; (2) attention fluctuates; (3) absent-minded; (4) loses train of thought; (5) easily confused; (6) seems drowsy; (7) thinking is slow; (8) slow-moving; (9) low initiative; and (10) easily bored, needs stimulation). Teacher ratings of 366 children (ages 5 to 13 with 56 % girls) along with parent ratings of 703 children (ages 5 to 13 with 55 % girls) indicated that SCT symptom domains one to eight showed convergent validity (i.e., substantial loadings on the SCT factor) and discriminant validity with the ADHD-IN dimension (i.e., higher loadings on the SCT factor than the ADHD-IN factor). Higher scores on this eight-symptom measure of SCT predicted lower levels of academic and social competence even after controlling for ADHD-IN and ADHD-HI. In addition, higher SCT scores still predicted higher anxiety/depression scores after controlling for ADHD-IN and ADHD-HI. Higher SCT scores also predicted lower ADHD-HI scores after controlling for ADHD-IN and anxiety/depression while higher ADHD-IN and anxiety/depression scores predicted higher ADHD-HI scores after controlling for SCT and anxiety/depression or ADHD-IN. SCT also showed a unique negative relationship with ODD while ADHD-IN and anxiety/depression showed unique positive relationships with ODD. This new measure of the SCT dimension was meaningfully independent from the ADHD-IN and anxiety/depression dimensions and suggests that such an SCT dimension may signify a distinct presentation of ADHD or a different (if highly comorbid) disorder altogether.

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

Similar content being viewed by others

References

  • Adams, Z. W., Milich, R., & Fillmore, M. T. (2010). A case for the return of attention-deficit disorder in DSM-5. The ADHD Report, 18(3), 1–6.

    Article  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders, fourth edition, text revision. Washington, D.C.: American Psychiatric Association.

    Book  Google Scholar 

  • Barkley, R. A. (2012a). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology, 121, 978–990. doi:10.1037/a0023961.

    Article  PubMed  Google Scholar 

  • Barkley, R. A. (2012b). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of Clinical Child and Adolescent Psychology. doi:10.1080/15374416.2012.734259. Advance online publication.

  • Bauermeister, J. J., Matos, M., Reina, G., Salas, C. C., Martínez, J. V., Cumba, E., & Barkley, R. A. (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. doi:10.1111/j.1469-7610.2004.00343.x.

    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., & Langberg, J. M. (2012). Sluggish cognitive tempo among young adolescents with ADHD: relations to mental health, academic and social functioning. Journal of Attention Disorders. doi:10.1177/1087054711435411. Advance online publication.

  • Burns, G. L., & Lee, S. (2010). Child and Adolescent Disruptive Behavior Inventory–Teacher Version 5.0. Pullman, WA: Author.

  • Burns, G. L., & Lee, S. (2011). Child and Adolescent Disruptive Behavior Inventory–Parent Version 5.0. Pullman, WA: Author.

  • 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., Desmul, C., Walsh, J. A., Silpakit, C., & Ussahawanitchakit, P. (2009). A multitrait (ADHD-IN, ADHD-HI, ODD toward adults, academic and social competence) by multisource (mothers and fathers) evaluation of the invariance and convergent/discriminant validity of the Child and Adolescent Disruptive Behavior Inventory with Thai Adolescents. Psychological Assessment, 21, 635–641. doi:10.1037/a0016953.

    Article  PubMed  Google Scholar 

  • Burns, G. L., Walsh, J. A., Servera, M., Lorenzo-Seva, U., Cardo, E., & Rodríguez-Fornells, A. (2012). Construct validity of ADHD/ODD rating scales. Recommendations for the evaluation of the forthcoming DSM-V ADHD/ODD scales. Journal of Abnormal Child Psychology. doi:10.1007/s10802-012-9660-5. Advance online publication.

  • Capdevila-Brophy, C., Artigas-Pallarés, J., Navarro-Pastor, J. B., García-Nonell, K., Rigau-Ratera, E., & Obiols, J. E. (2012). ADHD predominantly inattentive subtype with high sluggish cognitive tempo: a new clinical entity? Journal of Attention Disorders. doi:10.1177/1087054712445483. Advance online publication.

  • 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.

    PubMed  Google Scholar 

  • Carr, L., Henderson, J., & Nigg, J. T. (2010). Cognitive control and attentional selection in adolescents with ADHD versus ADD. Journal of Clinical Child and Adolescent Psychology, 39, 726–740. doi:10.1080/15374416.2010.51768.

    Article  PubMed Central  PubMed  Google Scholar 

  • Garner, A. A., Marceaux, J. C., Mrug, S., Patterson, C., & Hodgens, B. (2010). Dimensions and correlates of attention deficit/hyperactivity disorder and sluggish cognitive tempo. Journal of Abnormal Child Psychology, 38, 1097–1107. doi:10.1007/s10802-010-9436-8.

    Article  PubMed Central  PubMed  Google Scholar 

  • Garner, A. A., Mrug, S., Hodgens, B., & Patterson, C. (2012). Do symptoms of sluggish cognitive tempo in children with ADHD symptoms represent comorbid internalizing difficulties? Journal of Attention Disorders. doi:10.1177/1087054711431456. Advance online publication.

  • 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, 173–184. doi:10.1007/s10802-009-9355-8.

    Article  PubMed  Google Scholar 

  • Hartman, C. A., Willcutt, E. G., Rhee, S., & Pennington, B. F. (2004). The relation between sluggish cognitive tempo and DSM-IV ADHD. Journal of Abnormal Child Psychology, 32, 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, 1099–1111.

    Article  PubMed  Google Scholar 

  • Jacobson, L. A., Murphy-Bowman, S. C., Pritchard, A. E., Tart-Zelvin, A., Zabel, T. A., & Mahone, E. M. (2012). Factor structure of a sluggish cognitive tempo scale in clinically referred children. Journal of Abnormal Child Psychology, 40, 1327–1337. doi:10.1007/s10802-012-9643-6.

    Article  PubMed  Google Scholar 

  • Khadka, G., & Burns, G. L. (2012). A measurement framework to determine the construct validity of ADHD/ODD rating scales: additional evaluations of the child and adolescent disruptive behavior inventory. Journal of Psychopathology and Behavioral Assessment. doi:10.1007/s10862-012-9336-z. Advance online publication.

  • Lahey, B. B., & Willcutt, E. G. (2010). Predictive validity of a continuous alternative to nominal subtypes of attention-deficit/hyperactivity disorder for DSM-V. Journal of Clinical Child and Adolescent Psychology, 39, 761–775. doi:10.1080/15374416.2010.517173.

    Article  PubMed Central  PubMed  Google Scholar 

  • Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, H. A., Hynd, G., Russo, M. A., Hartdagen, S., & Lorys-vernon, A. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 27, 330–335.

    Article  PubMed  Google Scholar 

  • McBurnett, K. (2010). Kiddie-Sluggish Cognitive Tempo Diagnostic Interview Module for Children and Adolescents. San Francisco: Author.

    Google Scholar 

  • McBurnett, K., & Pfiffner, L. J. (2005). Sluggish Cognitive Tempo (SCT Scale). San Francisco: Author.

    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, 207–213.

    Article  PubMed  Google Scholar 

  • Moura, M. A., & Burns, G. L. (2010). Oppositional defiant behavior toward adults and oppositional defiant behavior toward other children: evidence for two separate constructs with mothers’ and fathers’ ratings of Brazilian children. Journal of Child Psychology and Psychiatry, 51, 23–30. doi:10.111/j.1469-7610.2009.02130.x.

    Article  PubMed  Google Scholar 

  • Mikami, A. Y., Huang-Pollck, C. L., Pfiffner, L. J., McBurnett, K., & Hangai, D. (2007). Social skills differences among attention-deficit/hyperactivity disorder types in a chat room assessment task. Journal of Abnormal Child Psychology, 35, 509–521. doi:10.1007/s10802-007-9108-5.

    Article  PubMed  Google Scholar 

  • Milich, R., Ballentine, A. C., & Lynam, D. R. (2001). ADHD combined type and ADHD predominantly inattentive types are distinct and unrelated disorders. Clinical Psychology: Science and Practice, 8, 463–488.

    Google Scholar 

  • Muthén, L. K., & Muthén, B. O. (1998). Mplus User’s Guide (7 th Edition). Los Angeles: Muthén and Muthén.

    Google Scholar 

  • Nigg, J. T., Tannock, R., & Rohde, L. A. (2010). What is to be the fate of ADHD subtypes? An introduction to the special section on research on the ADHD subtypes and implications for the DSM–V. Journal of Clinical Child and Adolescent Psychology, 39, 723–725. doi:10.1080/15374416.2010.517171.

    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, 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 

  • Schmitz, M., Ludwig, H., & Rohde, L. A. (2010). Do hyperactive symptoms matter in ADHD-I restricted phenotype? Journal of Clinical Child and Adolescent Psychology, 39, 741–748. doi:10.1080/15374416.2010.517170.

    Article  PubMed  Google Scholar 

  • Shipp, F., Burns, G. L., & Desmul, C. (2010). Construct validity of ADHD-IN, ADHD-HI, ODD toward adults, academic and social competence dimensions with teacher ratings of Thai adolescents: additional validity for the child and adolescent disruptive behavior inventory. Journal of Psychopathology and Behavioral Assessment, 32, 557–564. doi:10.1007/s10862-010-9185-6.

    Article  Google Scholar 

  • Skansgaard, E. P., & Burns, G. L. (1998). Comparison of DSM-IV ADHD 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.

    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 

  • Solanto, M. V., Gilbert, S. N., Raj, A., Zhu, J., Pope-Boyd, S., Stepak, B., Vail, L., & Newcorn, J. H. (2007). Neurocognitive functioning in AD/HD, predominantly inattentive and combined subtypes. Journal of Abnormal Child Psychology, 35, 729–744. doi:10.1007/S10802-007-91236.

    Article  PubMed Central  PubMed  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, 588–597. doi:10.1097/01.chi.0000117309.94712.a4.

    Article  PubMed  Google Scholar 

  • Valo, S., & Tannock, R. (2010). Diagnostic instability of DSM–IV ADHD Subtypes: effects of Informant source, instrumentation, and methods for combining symptom reports. Journal of Clinical Child and Adolescent Psychology, 39, 749–760. doi:10.1080/15374416.2010.517172.

    Article  PubMed  Google Scholar 

  • Wåhlstedt, 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), 250–365. doi:10.1080/09297041003671176.

    Article  Google Scholar 

  • Weinberg, W. A., & Brumback, R. A. (1990). Primary disorder of vigilance: a novel explanation of inattententiveness, daydreaming, boredom, restlessness, and sleepiness. Journal of Pediatrics, 116, 720–725.

    Article  PubMed  Google Scholar 

  • Willcut, E. G., Nigg, J. T., Pennington, B. F., Solanto, M. V., Rohde, L. A., Tannock, R., & Lahey, B. B. (2012). Validity of DSM-IV attention deficit/hyperactivity disorder symptom dimensions and subtypes. Journal of Abnormal Psychology, 121, 991–1010. doi:10.1037/a0027347.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

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

    SoYean Lee & G. Leonard Burns

  2. Clarkston School District, Clarkston, USA

    Jerry Snell

  3. University of California at San Francisco, San Francisco, USA

    Keith McBurnett

Authors
  1. SoYean Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. G. Leonard Burns
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jerry Snell
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keith McBurnett
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to G. Leonard Burns.

Additional information

The authors would like to acknowledge the support of the parents, teachers and principals, Heather Lang, Don Lee, Samantha Ogden and Eric Price, of the Clarkston Washington elementary schools whose assistance made the research possible.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Lee, S., Burns, G.L., Snell, J. et al. Validity of the Sluggish Cognitive Tempo Symptom Dimension in Children: Sluggish Cognitive Tempo and ADHD-Inattention as Distinct Symptom Dimensions. J Abnorm Child Psychol 42, 7–19 (2014). https://doi.org/10.1007/s10802-013-9714-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10802-013-9714-3

Keywords

Search

Navigation