A Cross-Sectional and Longitudinal Investigation of the External Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptoms Dimensions

Abstract

The objective was to determine if the external correlates of sluggish cognitive tempo (SCT) and ADHD-inattention (IN) dimensions were the same in cross-sectional and longitudinal analyses. Teachers and aides rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), and depression along with academic impairment in 758 Spanish children (55 % boys) on three occasions (twice at the end of the first grade year [6-week separation] and then again 12-months later at the end of the second grade year). Three of eight SCT symptoms showed substantial loadings on the SCT factor and substantially higher loadings on the SCT factor than the ADHD-IN factor for teachers and aides at each assessment (seems drowsy, thinking is slow, and slow moving). Cross-sectional and longitudinal analyses yielded similar results with SCT and ADHD-IN factors having different and unique external correlates (higher scores on SCT predicted lower scores on ADHD-HI and ODD while higher scores on ADHD-IN predicted higher scores on ADHD-HI and ODD with SCT and ADHD-IN both uniquely predicting academic impairment and depression). Developmental and methodological reasons are discussed for the failure to find an inconsistent alertness SCT factor (daydreams, alertness fluctuates, absent-minded, loses train of though, and confused).

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

“…Still, mixed findings have been reported. For instance, several studies have not found SCT to be associated with academic difficulties after controlling for ADHD symptoms (e.g., Bauermeister et al 2012;Becker and Langberg 2013;Carlson and Mann 2002), whereas other studies have found SCT to remain associated with poorer academic functioning after controlling for ADHD (e.g., Becker et al 2014b;Bernad et al 2014;Burns et al 2013;Langberg et al 2014;Lee et al 2014;Servera et al 2015;Willcutt et al 2014). Interestingly, findings from one recent study suggest that SCT may relate to impairment according to parent ratings but not according to teacher ratings (Watabe et al 2014).…”

“…SCT is characterized by inconsistent alertness (e.g., daydreams, loses train of thought, alertness fluctuates, and confusion) along with slow thinking/slow behavior (Lee et al 2014). Although an agreed-upon symptom set for SCT remains to be established (Becker 2013), research increasingly indicates that SCT and attention-deficit/hyperactivity disorder inattention (ADHD-IN) symptoms represent different dimensions of psychopathology (Barkley 2013;Becker et al 2014b;Bernad et al 2014;Burns et al 2013;Fenollar Cortés et al 2014;Garner et al 2014;Lee et al 2014;McBurnett et al 2014;Penny et al 2009). It is also evident that SCT is distinct from internalizing symptoms of anxiety and depression (Becker et al 2014d;Lee et al 2014;Servera et al 2015;Willcutt et al 2014).…”

“…Several studies show that higher levels of SCT are associated with lower levels of ADHD-hyperactivity/impulsivity (HI) and oppositional defiant disorder (ODD) symptoms after controlling for ADHD-IN, whereas higher levels of ADHD-IN predict higher levels of ADHD-HI and ODD symptoms after controlling for SCT (Becker et al 2014c, d;Bernad et al 2014;Burns et al 2013;Fenollar Cortés et al 2014;Lee et al 2014;McBurnett et al 2014;Penny et al 2009;Servera et al 2015). In addition, multiple studies using parent, teacher, and child self-report ratings of SCT show SCT symptoms are associated with higher levels of depression, academic impairment, and social impairment even after controlling for ADHD-IN (Bauermeister et al 2012;Becker 2014;Becker et al 2014cBecker et al , d, 2015Bernad et al 2014;Burns et al 2013;Fenollar Cortés et al 2014;Flannery et al 2014;Langberg et al 2014;Lee et al 2014;McBurnett et al 2014;Penny et al 2009;Servera et al 2015;Willcutt et al 2014). Still, mixed findings have been reported.…”

“…The second longitudinal SCT study involved a 12-month interval with the same primary and secondary teachers rating children's behavior (each child rated by two teachers) at the end of the first and second grades (Bernad et al 2014). Higher levels of SCT in the first grade predicted lower scores on ADHD-HI and ODD in the second grade after controlling for ADHD-IN while higher scores on ADHD-IN in the first grade predicted higher scores ADHD-HI and ODD in the second grade after controlling for SCT.…”

“…In addition, both SCT and ADHD-IN uniquely predicted academic impairment across the 12-month interval while only ADHD-IN uniquely predicted depression across this interval. This study did not include any measures of anxiety or social impairment (Bernad et al 2014). The third study used the same sample from the Bernad et al (2014) study but examined mothers' and fathers' ratings with a 12-month interval separating the measures of SCT and ADHD-IN from the outcomes (first to second grade; Servera et al 2015).…”