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Cited by 161Attention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional DevelopmentDevelopmental and Educational Neuropsychology

Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo

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Marshall, Stephen A., Evans, Steven W., Eiraldi, Ricardo B., Becker, Stephen P., Power, Thomas J.·2014·Journal of Abnormal Child Psychology
DOI 10.1007/s10802-013-9758-4PMC PMC12326726
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Abstract

Sluggish cognitive tempo (SCT) was originally identified as a construct that characterized the inattention problems of some children with attention deficit disorder (ADD). Research has indicated that using SCT symptoms to identify a subset of youth with attention-deficit/hyperactivity disorder, predominately inattentive type (ADHD-IT) may elucidate distinct patterns of impairment and thereby improve the external validity of ADHD subtypes. The objective of the current study was to investigate whether youth with clinically-assessed ADHD-IT and high levels of SCT exhibit unique social and academic impairments. In a clinic-referred sample of youth (N = 209; 23 % female) aged 6 to 17 years, participants who met criteria for three different groups were identified: ADHD, Combined Type (ADHD-CT; n = 80), ADHD-IT with low SCT symptoms (n = 74), and ADHD-IT with high SCT symptoms (n = 55). These groups were compared on indicators of social and academic functioning while considering the effects of co-occurring internalizing and disruptive behavior disorders. Youth with ADHD-IT high in SCT exhibited uniquely elevated withdrawal, as well as low leadership and low peer-directed relational and overt aggression, which were not accounted for by co-occurring disorders. This high-SCT group was also the only group to have more homework problems than the ADHD-CT group, but only when other disruptive behavior disorders were absent. The distinctiveness of the high-SCT group, which was primarily evident in social as opposed to academic functioning, provides partial support for the external validity and clinical utility of SCT.

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  • Associations between SCT and standardized measures of reading, mathematics, or writing achievement are variable, especially after covarying IQ and/or inattention.

    “Associations between SCT and standardized measures of reading, mathematics, or writing achievement are variable, especially after covarying IQ and/or inattention.80,82,134,137–143”

    From Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome (2023) · cites this paper as [137]

    The SCT and Academic Impairment section describes mixed findings for math and reading achievement, and the Results (Group Comparisons of Academic Impairment; page not provided) find no subgroup differences on standardized word-reading, numerical-operations, or spelling scores after controlling for IQ. The paper uses spelling rather than a standardized measure of writing achievement, and its achievement analyses do not directly covary inattention; those parts of the claim are not established by this source. (LLM, conf=0.83)

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  • SCT is associated with social withdrawal.

    “social withdrawal (Becker et al., 2019; Becker, Burns, Leopold, Olson, & Willcutt, 2018; Marshall, Evans, Eiraldi, Becker, & Power, 2014; Willcutt et al., 2014)”

    From Physiological Correlates of Sluggish Cognitive Tempo in Children: Examining Autonomic Nervous System Reactivity During Social and Cognitive Stressor Tasks (2020) · cites this paper as Marshall, Evans, Eiraldi, Becker, & Power, 2014

  • Children with higher SCT, especially sluggish/sleepy symptoms, showed less improvement in ADHD symptoms across methylphenidate doses and were more likely to be nonresponders or placebo responders than other children with ADHD.

    “A recent medication trial of children with ADHD found that children with higher SCT (and sluggish/sleepy symptoms specifically) had less improvement in their ADHD symptoms across doses of methylphenidate (MPH) and were also more likely to be MPH nonresponders or placebo responders compared to other children with ADHD [40].”

    From Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology (2019) · cites this paper as [40]

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Research works printed but not linked: 2

  1. Crichton A (1798). An inquiry into the nature and origin of mental derangement: Comprehending a concise system of the physiology and pathology of the human mind and a history of the passions and their effects. In Cadell T Jr., and Davies W (Eds.), London. (Reprinted by AMS Press, New York, 1976.)
  2. Wechsler D (1991). Wechsler intelligence scale for children (WISC-III) (3rd ed.). San Antonio: The Psychological Corporation.

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Authors
Marshall, S. A., Evans, S. W., Eiraldi, R. B., Becker, S. P., & Power, T. J.
Affiliations
  • Ohio University (US)
  • Children's Hospital of Philadelphia (US)
  • Miami University (US)
ORCID
Venue
Journal of Abnormal Child Psychology
Publisher
Springer Science and Business Media LLC
Published
2013-05-25
Volume
42
Issue
1
Pages
77-90
ISSN
  • 0091-0627 (ISSN-L)
  • 1573-2835
DOI
10.1007/s10802-013-9758-4
PMC
PMC12326726
OpenAlex
W1978070001
Semantic Scholar
3a5cb8592696a193131ac35ef4e25f07422cac39
Cited by
161
References
70
Citations by year
2026: 5 · 2025: 9 · 2024: 13 · 2023: 11 · 2022: 8 · 2021: 11 · 2020: 18 · 2019: 13 · 2018: 20 · 2017: 10 · 2016: 16 · 2015: 10 · 2014: 11 · 2013: 6
FWCI
10.16
Type
journal article
Language
en
Open access
Licence
www.springer.com/tdm (tdm)
Locations
  • Research on Child and Adolescent Psychopathology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (K23MH064080)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
  • Social Sciences › Psychology › Neuropsychology and Physiological Psychology › Developmental and Educational Neuropsychology
Keywords
sluggish cognitive tempo, attention deficit hyperactivity disorder, predominantly inattentive type, ADHD subtypes, social dysfunction, academic impairment, social withdrawal, leadership, peer aggression, homework problems, internalizing disorders, disruptive behavior disorders
MeSH terms
Adolescent, Aggression, Analysis of Variance, Attention Deficit Disorder with Hyperactivity, Child, Cognition Disorders, Educational Status, Female, Humans, Internal-External Control, Interpersonal Relations, Male, Social Behavior, Social Behavior Disorders, Comorbidity

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