Factor Structure of a Sluggish Cognitive Tempo Scale in Clinically-Referred Children

Department of Neuropsychology, Kennedy Krieger Institute, 1750 E. Fairmount Ave., Baltimore, MD, 21231, USA, .
Journal of Abnormal Child Psychology (Impact Factor: 3.09). 05/2012; 40(8):1327-37. DOI: 10.1007/s10802-012-9643-6
Source: PubMed

ABSTRACT "Sluggish cognitive tempo" (SCT) is a construct hypothesized to describe a constellation of behaviors that includes daydreaming, lethargy, drowsiness, difficulty sustaining attention, and underactivity. Although the construct has been inconsistently defined, measures of SCT have shown associations with symptoms of attention-deficit/hyperactivity disorder (ADHD), particularly inattention. Thus, better characterization of SCT symptoms may help to better predict specific areas of functional difficulty in children with ADHD. The present study examined psychometric characteristics of a recently developed 14-item scale of SCT (Penny et al., Psychological Assessment 21:380-389, 2009), completed by teachers on children referred for outpatient neuropsychological assessment. Exploratory factor analysis identified three factors in the clinical sample: Sleepy/Sluggish, Slow/Daydreamy, and Low Initiation/Persistence. Additionally, SCT symptoms, especially those loading on the Sleepy/Sluggish and Slow/Daydreamy factors, correlated more strongly with inattentive than with hyperactive/impulsive symptoms, while Low Initiation/Persistence symptoms added significant unique variance (over and above symptoms of inattention) to the predictions of impairment in academic progress.

Download full-text


Available from: Ariana Tart-Zelvin, Mar 31, 2014
106 Reads
  • Source
    • "The importance of considering the multidimensional aspect of SCT appears important for other domains of adjustment as well. Our results are consistent with earlier research indicating SCT to be more strongly associated with depression than with anxiety (Barkley, 2013; Becker, Luebbe, et al., 2014; Jacobson et al., 2012), and further, our regression analyses indicate that SCT may not be associated with anxiety when ADHD-IN is also included in the model (whereas ADHD-IN remains significantly associated with anxiety when the SCT dimensions are included in the model). Moreover, our results indicate that the SCTslowness dimension consisting of slowed behavior, slowed thinking, and drowsiness is uniquely associated with depressive symptomatology in children with ADHD. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Few studies have examined whether separate dimensions of Sluggish Cognitive Tempo (SCT)-inconsistent alertness and slowness-have different external correlates from each other as well as symptoms of ADHD inattention (ADHD-IN). Method: Participants were 131 Spanish children (ages 6-16; 72% boys) diagnosed with ADHD. Results: In regression analyses, ADHD-IN was positively associated with hyperactivity/impulsivity, conduct problems, defiance/aggression, anxiety, peer relations problems, and learning problems. SCT-inconsistent alertness was positively associated with hyperactivity/impulsivity and peer relations problems. In contrast, SCT-slowness was negatively associated with hyperactivity/impulsivity and conduct problems and positively associated with depression and learning problems. Results were consistent after controlling for depression, medication status, and sex. Conclusion: The findings support SCT to be a construct with two dimensions that have unique correlates relative to each other as well as ADHD-IN. Future research on SCT should separate these dimensions of SCT to provide a better understanding of the construct.
    Journal of Attention Disorders 07/2014; DOI:10.1177/1087054714548033 · 3.78 Impact Factor
  • Source
    • "In addition, SCT still predicted academic and social impairment after controlling for ADHD-IN. Although differences do emerge, the results from these three studies were also consistent with other studies with slightly different SCT rating scales (Barkley 2012, 2013; Becker et al. 2014a; Jacobson et al. 2012; Langberg et al. 2014; Penny et al. 2009). The consistency of the external correlates of SCT across the different studies speaks to the robustness of the results. "
    [Show abstract] [Hide abstract]
    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).
    Journal of Abnormal Child Psychology 03/2014; 42(7). DOI:10.1007/s10802-014-9866-9 · 3.09 Impact Factor
  • Source
    • "Importantly, each of these SCT factors relates differently to the ADHD symptom dimensions. The SCT behaviors related to being apathetic and lacking motivation/initiative largely load onto a single factor along with DSM–IV inattention items (Barkley, 2013; Lee, Burns, Snell, & McBurnett, 2014), whereas the sleepy/daydreamy aspects of SCT appear to be empirically distinct from DSM–IV symptoms of inattention (Becker, Luebbe, Fite, Stoppelbein, & Greening, 2014; Jacobson et al., 2012; Penny et al., 2009; Willcutt et al., 2012). These findings have implications for studies examining the relation between sleep and SCT. "
    [Show abstract] [Hide abstract]
    ABSTRACT: Sluggish cognitive tempo (SCT) and daytime sleepiness are both common in individuals with attention-deficit/hyperactivity disorder (ADHD). There appears to be considerable overlap between the tired and lethargic aspects of SCT and behaviors frequently exhibited by individuals with daytime sleepiness. However, no studies have examined the degree to which these constructs overlap and whether or not they are empirically distinct. In Study 1, a confirmatory factor analysis with the SCT subscale of the Barkley Adult ADHD Rating Scale-IV (BAARS-IV) and the Epworth Sleepiness Scale (ESS) was conducted in a sample of 768 college students. Results demonstrated that SCT and daytime sleepiness exhibit considerable overlap but are empirically distinct. In Study 2, we examined the relation between SCT and daytime sleepiness and also the impact of comorbid SCT and sleepiness on the functioning of 58 college students rigorously diagnosed with ADHD. Regression analyses in both Study 1 and Study 2 showed that SCT predicts daytime sleepiness above and beyond symptoms of ADHD, anxiety, and depression. The 2 constructs were significantly related (r = .51), with the highest correlations occurring between the SCT tired and lethargic items with daytime sleepiness. College students with ADHD + SCT and daytime sleepiness were significantly more impaired than college students diagnosed with ADHD without SCT or daytime sleepiness. Together, these results fill an important gap in the literature by confirming SCT to be overlapping but empirically distinct from daytime sleepiness and demonstrating that SCT and daytime sleepiness are associated with functioning in college students with ADHD. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
    Psychological Assessment 03/2014; 26(2). DOI:10.1037/a0036276 · 2.99 Impact Factor
Show more