Distinguishing Sluggish Cognitive Tempo From ADHD in Children and Adolescents: Executive Functioning, Impairment, and Comorbidity

• Published in: Journal of clinical child and adolescent psychology Vol. 42; no. 2; pp. 161 - 173
• Main Author: Barkley, Russell A.
• Format: Journal Article
• Language: English
• Published: England Taylor & Francis Group 01.03.2013; Routledge; Routledge, Taylor & Francis Group
• Subjects: Adolescent; Attention; Attention Deficit Disorder with Hyperactivity - complications; Attention Deficit Disorder with Hyperactivity - diagnosis; Attention Deficit Disorder with Hyperactivity - psychology; Attention Deficit Disorders; Attention Deficit Hyperactivity Disorder; Child; Child psychology; Children; Children & youth; Clinical Diagnosis; Cognition & reasoning; Cognition Disorders - complications; Cognition Disorders - diagnosis; Cognition Disorders - psychology; Comorbidity; Comparative Analysis; Conceptual Tempo; Control Groups; Demographics; Depression (Psychology); Diagnosis, Differential; Executive Function; Female; Health Surveys; Humans; Male; Measures (Individuals); Morbidity; National Surveys; Neuropsychological Tests; Parent Attitudes; Parents; Psychiatric Status Rating Scales; Questionnaires; Rating Scales; Regression (Statistics); Self Management; Symptoms; Symptoms (Individual Disorders); Tempo
• ISSN: 1537-4416; 1537-4424
• DOI: 10.1080/15374416.2012.734259

Controversy continues as to whether sluggish cognitive tempo (SCT) is a subtype of attention-deficit/hyperactivity disorder (ADHD) or a distinct disorder. This study examined differences between these disorders in demographics, executive functioning (EF), impairment, and prior professional diagnoses to address the issue. There were 1,800 children 6 to 17 years of age of both sexes from various U.S. ethnic backgrounds who were divided into four groups: (a) high SCT but not ADHD (N = 41), (b) high ADHD but not SCT (N = 95), (c) high in both SCT and ADHD (N = 61), and (d) the control group (N = 1,603). Besides providing demographics, parents completed scales assessing ADHD and SCT symptoms, EF deficits, and psychosocial impairment and reported their child's history of professional diagnoses. SCT symptoms formed two distinct but interrelated factors separate from those for ADHD. SCT differed from ADHD in demographics (age, sex ratio, parental education, income). ADHD was associated with more severe and pervasive EF deficits than SCT, whereas SCT was chiefly associated with mild deficits in Self-Organization. ADHD contributed far more variance to EF deficits than did SCT. Both disorders were impairing, but ADHD was more severely and pervasively so than SCT, especially in Home-School domains; SCT was most impairing in Community-Leisure domains. Different patterns of comorbidity were evident between SCT and ADHD. SCT showed less comorbidity and was particularly associated with depression. SCT may comprise a distinct disorder from ADHD but both may coexist in 39% to 59% of cases each.