Evaluating the Utility of Sluggish Cognitive Tempo in Discriminating Among DSM-IV ADHD Subtypes

Abstract

The objective of the current study was to evaluate how the inclusion of 3 Sluggish Cognitive Tempo (SCT) symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnostic criteria influences the external validity of the ADHD subtypes. The sample comprised 228 children (166 boys, 62 girls) ranging in age from 5-18 years who were referred to clinics for attentional, behavioral, and/or learning problems and diagnosed with DSM-IV ADHD (124 Combined type, 81 Inattentive type, 23 Hyperactive-Impulsive type). Parent ratings of ADHD symptoms were obtained using the Emory Combined Rating Scale (ECRS), which assesses symptoms of the common DSM-IV childhood psychiatric disorders. Regression analyses incorporating planned comparisons were conducted to examine how the inclusion of SCT symptoms affects differences among ADHD subtypes on several external validity indicators (i.e., gender, age-of-onset, and overlapping conditions). The regression analyses did not yield any significant differences in gender ratios, mean age-The objective of the current study was to evaluate how the inclusion of 3 Sluggish Cognitive Tempo (SCT) symptoms in Attention-Deficit/Hyperactivity Disorder (ADHD) diagnostic criteria influences the external validity of the ADHD subtypes. The sample comprised 228 children (166 boys, 62 girls) ranging in age from 5-18 years who were referred to clinics for attentional, behavioral, and/or learning problems and diagnosed with DSM-IV ADHD (124 Combined type, 81 Inattentive type, 23 Hyperactive-Impulsive type). Parent ratings of ADHD symptoms were obtained using the Emory Combined Rating Scale (ECRS), which assesses symptoms of the common DSM-IV childhood psychiatric disorders. Regression analyses incorporating planned comparisons were conducted to examine how the inclusion of SCT symptoms affects differences among ADHD subtypes on several external validity indicators (i.e., gender, age-of-onset, and overlapping conditions). The regression analyses did not yield any significant differences in gender ratios, mean age-of- onset, or overlapping externalizing or internalizing problems when the ADHD Inattentive type was subdivided into high- versus low-SCT groups. In conclusion, the current results suggest that the inclusion of parent-reported SCT symptoms in the ADHD diagnostic criteria has limited utility for isolating diagnostically meaningful subgroups of the Inattentive type or for enhancing the external validity of the ADHD subtypes in clinic-referred samples.

Attention-Deficit/Hyperactivity Disorder

“…These DSM-V presentations are explicitly not expected to be stable, as children diagnosed with the disorder can change presentation over time from year to year (Lahey et al 2005). Furthermore, ADHD-inattentive presentation includes children who are sluggish and hypoactive as well as children who are active but shy of reaching criteria for ADHD-combined presentation, and some experts argue that these distinctions may represent etiologically distinct phenomena (Carlson and Mann 2002;Harrington and Waldman 2010;Bauermeister et al 2012). Yet, ADHD is still heterogeneous.…”

The Relationship Between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders

“…SCT has been correlated with attention deficit without hyperactivity (Lahey et al 1987). The utility and impact of the construct of SCT in identifying children with specific attention problems that may represent subgroups of attention-deficit/hyperactivity disorder (ADHD), or even an attention deficit disorder that is distinct from ADHD, have been debated in previous decades (Harrington and Waldman 2010;Lahey et al 1987;Milich et al 2001).…”

Desordenes en funciones ejecutivas y síntomas de desorden de comportamiento adaptativo en niños preescolares

“…They have no initiative to plan, organize, and develop strategies to solve a problem. This information may be an additional contribution to current research on ADHD-I care about providing an appropriate term to describe the group of symptoms that represent only inattention (Carlson & Mann, 2002;Derefinko et al, 2008;Garner, Marceaux, Mrug, Patterson, & Hodgens, 2010;Harrington & Waldman, 2010). The strong association shown between ADHD and EF coincides with recent research on the subject, that define ADHD as a disorder of EF, as it is known that deficiencies in executive functioning are one of the major impairments that characterize children with ADHD and prevent them from social relations and an efficient optimal school performance (Barkley, 1998;Brown, 2006).…”