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Cited by 63Sleep and related disordersAttention Deficit Hyperactivity DisorderChild and Adolescent Psychosocial and Emotional Development

Sluggish Cognitive Tempo in Children Referred to a Pediatric Sleep Disorders Center: Examining Possible Overlap with Sleep Problems and Associations with Impairment

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Becker, Stephen P., Garner, Annie A., Byars, Kelly C.·2016·Journal of Psychiatric Research
DOI 10.1016/j.jpsychires.2016.03.005PMC PMC4826847
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Abstract

Research supports the distinctness of sluggish cognitive tempo (SCT) (e.g., mental confusion and slowed behavior/thinking) from other psychopathologies. However, the relation between SCT and sleep functioning has not been adequately studied. We examined the association between SCT and sleep functioning in 325 children (62% male) ages 6-10 years referred to a pulmonary-based, accredited Sleep Disorders Center. Correlations between caregiver ratings of SCT, other psychopathologies (i.e., inattention/hyperactivity, oppositionality, depression, anxiety), sleep functioning (both behavioral and organic symptoms), as well as sleep disorder diagnoses, were examined. Unique effects of SCT and other psychopathologies on sleep problem severity controlling for child demographics were assessed using regressions. Regression analyses were also conducted to examine the unique effects of SCT on impairment (i.e., academic difficulties, parenting stress, and other psychopathologies) controlling for child demographics, sleep problem severity, and other psychopathology symptoms. SCT was weakly to moderately correlated with most measures of sleep (rs=.07-.39) and moderately to strongly correlated with measures of daytime sleepiness (rs=.33 and .53). SCT was uniquely associated with greater sleep functioning severity and impairment in academic functioning. SCT was also uniquely associated with higher levels of depression and inattention/hyperactivity, but not anxiety, and negatively associated with oppositionality. Finally, SCT symptoms were uniquely associated with greater parent-child dysfunctional interaction. Findings demonstrate that SCT is related to, but not redundant with, sleep problems and daytime sleepiness specifically. Further, SCT remained associated with several domains of functional impairment in sleep-disordered children after controlling for clinically-relevant variables, highlighting the potential value in assessing SCT symptoms in children with sleep problems.

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  • Studies of SCT and social skills have yielded mixed results.

    “and studies of SCT and social skills have yielded mixed results.23,24,134”

    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 [24]

    The Discussion describes a clear, established link between SCT and social or peer problems, rather than mixed findings. The paper examines parent-child interactions, not social skills specifically, so its contrary statement concerns the closely related social/peer-problems literature. (LLM, conf=0.75)

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  • Self-reported SCT is linked to poorer self-reported emotion regulation in children and adults.

    “Self-reported SCT has been linked to poorer self-reported emotion regulation among children19,24 and adults39,88,89,109,110”

    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 [24]

    The Discussion (page unavailable) says SCT is linked to problems in emotion regulation in children, supporting the association attributed to this source. It does not say that either SCT or emotion regulation was self-reported; the Methods describe caregiver-reported SCT. The citation appears with the child studies, not the adult studies. (LLM, conf=0.85)

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  • CDS is associated with significant deficits in academic performance, social interactions, and overall adaptive functioning across both youth and adulthood.

    “These impairments contribute to significant deficits in academic performance, social interactions, and overall adaptive functioning across both youth and adulthood [1,4].”

    From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [1]

    The Results section on academic functioning reports associations between SCT (CDS) symptoms and poorer performance in several subjects among children referred to a sleep disorders center. The Discussion describes social and parent–child difficulties, but does not establish deficits in overall adaptive functioning. The Participants and Limitations sections show that the study examined children aged 6–10 and cannot support the claim about adulthood. (LLM, conf=0.88)

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  • CDS has small but significant correlations with oppositional defiant disorder and conduct disorder, but these associations typically become non-significant or negative when ADHD symptoms are accounted for.

    “While small but significant correlations have been observed between CDS and conditions such as oppositional defiant disorder and conduct disorder, these associations typically become non-significant or even negative when ADHD symptoms are accounted for [1].”

    From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [1]

    The Results section, “SCT in Relation to Other Psychopathologies” (page unavailable), reports a significant negative association between SCT and oppositionality after adjustment; the Discussion identifies this as ODD symptoms after controlling for ADHD and other psychopathology. The cited passages do not establish small, significant unadjusted correlations with ODD or conduct disorder, and the Measures section does not list conduct disorder among the symptom scales used. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • CDS is strongly associated with depression in children and adults.

    “CDS has been strongly associated with depression in both children and adults [1,54]”

    From Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies (2025) · cites this paper as [1]

    The Results section, “SCT in Relation to Other Psychopathologies” (page unavailable), reports a significant positive association between SCT and depression in children referred to a sleep disorders center. The paper does not establish the claimed association in adults, and statistical significance alone does not establish that the association is strong. (LLM, conf=0.86)

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Authors
Becker, S. P., Garner, A. A., & Byars, K. C.
Affiliations
  • Cincinnati Children's Hospital Medical Center (US)
  • Saint Louis University (US)
Corresponding author
Becker, Stephen P.
ORCID
Venue
Journal of Psychiatric Research
Publisher
Elsevier BV
Published
2016-06
Volume
77
Pages
116-124
ISSN
0022-3956 (ISSN-L)
DOI
10.1016/j.jpsychires.2016.03.005
PMC
PMC4826847
OpenAlex
W2301633740
Semantic Scholar
99474e3d5b6be19700c429d642948057e060fa82
Cited by
63
References
64
Citations by year
2026: 5 · 2025: 7 · 2024: 7 · 2023: 6 · 2022: 8 · 2021: 8 · 2020: 5 · 2019: 5 · 2018: 5 · 2017: 3 · 2016: 4
FWCI
8.07
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Journal of Psychiatric Research (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Institute of Mental Health (NIMH) (K23MH108603)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Psychiatry and Mental health › Attention Deficit Hyperactivity Disorder
  • Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
Keywords
sluggish cognitive tempo, children, sleep disorders, daytime sleepiness, hyperactivity/inattention, depression, oppositionality, anxiety, academic impairment, parental stress, parent-child dysfunctional interaction, psychopathology, pediatric sleep disorders
MeSH terms
Achievement, Anxiety, Attention Deficit Disorder with Hyperactivity, Child, Cognition, Cognition Disorders, Depression, Female, Humans, Male, Parents, Regression Analysis, Sleep Wake Disorders, Stress, Psychological

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