Validity of the sluggish cognitive tempo symptom dimension in children: sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions

Lee, SoYean; Burns, G. Leonard; Snell, Jerry; McBurnett, Keith

doi:10.1007/s10802-013-9714-3

Cited by 200Attention Deficit Hyperactivity DisorderDevelopmental and Educational NeuropsychologyChild and Adolescent Psychosocial and Emotional Development

Validity of the sluggish cognitive tempo symptom dimension in children: sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions

Lee, SoYean, Burns, G. Leonard, Snell, Jerry, McBurnett, Keith·2014·Journal of Abnormal Child Psychology

DOI 10.1007/s10802-013-9714-3

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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.

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Although ADHD has three DSM-defined subgroups (Inattentive, Hyperactive/Impulsive, and Combined), these are currently inadequate to capture the full range of symptoms or to predict treatment response.
“Although ADHD has three DSM-defined subgroups (Inattentive, Hyperactive/Impulsive, and Combined), these are currently inadequate to capture the full range of symptoms (Lee et al., 2014) or to predict treatment response (Mueller et al., 2017).”
From Investigating functional brain network integrity using a traditional and novel categorical scheme for neurodevelopmental disorders (2019) · cites this paper as Lee et al., 2014
Empirically based SCT scales have been developed and validated.
“empirically-based SCT scales have been developed and validated [7,9,25-28].”
From Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology (2019) · cites this paper as [9]
SCT has been shown to be statistically distinct from depression, anxiety, and daytime sleepiness.
“More recently, SCT has been shown to be statistically distinct from other psychopathology domains including depression, anxiety, and daytime sleepiness [6-11].”
From Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology (2019) · cites this paper as [9]
ADHD-IN was uniquely linked to poorer sustained attention, greater distractibility, more cognitive interference errors, and worse Symbol Search.
“In contrast, and consistent with the ADHD literature, ADHD-IN was uniquely associated with poorer sustained attention, increased distractibility, and more errors related to cognitive interference [4,43], and worse Symbol Search performance [44], the latter likely related to poor focused attention and inhibition [45].”
From Neurocognition in children with cognitive disengagement syndrome: accurate but slow (2024) · cites this paper as [44]

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Authors: Lee, S., Burns, G. L., Snell, J., & McBurnett, K.
Affiliations: Washington State University (US)
University of California, San Francisco (US)
Corresponding author: Burns, G. Leonard
ORCID: Lee, SoYean
Burns, G. Leonard
McBurnett, Keith
Venue: Journal of Abnormal Child Psychology
Publisher: Springer Science and Business Media LLC
Published: 2013-01-17
Volume: 42
Issue: 1
Pages: 7-19
ISSN: 0091-0627 (ISSN-L)
1573-2835
DOI: 10.1007/s10802-013-9714-3
OpenAlex: W1990000563
Cited by: 200
References: 41
Citations by year: 2026: 14 · 2025: 9 · 2024: 14 · 2023: 17 · 2022: 12 · 2021: 15 · 2020: 18 · 2019: 14 · 2018: 13 · 2017: 10 · 2016: 21 · 2015: 16 · 2014: 15 · 2013: 12
FWCI: 15.12
Type: journal article
Language: en
Open access: closed
Licence: www.springer.com/tdm (tdm)
Locations: Research on Child and Adolescent Psychopathology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords: sluggish cognitive tempo, children, symptom dimensions, convergent validity, discriminant validity, academic competence, social competence, anxiety, depression, oppositional defiant disorder, comorbidities, teacher ratings, parent ratings
MeSH terms: Adolescent, Attention, Attention Deficit Disorder with Hyperactivity, Child, Child, Preschool, Cognition, Cognition Disorders, Female, Humans, Male, Memory, Short-Term, Motivation, Predictive Value of Tests, Regression Analysis, Reproducibility of Results

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Validity of the sluggish cognitive tempo symptom dimension in children: sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions

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