Honing in on the Social Difficulties Associated With Sluggish Cognitive Tempo in Children: Withdrawal, Peer Ignoring, and Low Engagement

Abstract

Objective Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impairment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention-deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropriate responding in social situations and active peer exclusion. Method Participants were 158 children (70% boys) between ages 7–12 years being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depression) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike. Results In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly associated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/withdrawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations. Conclusions Findings provide the clearest evidence to date that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology.

Differential impact of trait sluggish cognitive tempo and ADHD inattention in early childhood on adolescent functioning

“…These efforts have generally reported consistent findings linking SCT to increased internalizing symptoms (e.g. depression, anxiety, somatization; Barkley, 2013;Becker, Luebbe, Fite, Stoppelbein, & Greening, 2014;Lee, Burns, & Becker, 2017;Penny, Waschbusch, Klein, Corkum, & Eskes, 2009) and social difficulties including social withdrawal/isolation specifically (Becker, Garner, Tamm, Antonini, & Epstein, 2017;Carlson & Mann, 2002;Marshall, Evans, Eiraldi, Becker, & Power, 2014;Willcutt et al, 2014). In addition, SCT and ADHD-IN are differentially related to externalizing behaviors; whereas ADHD-IN symptoms are strongly, positively associated with externalizing behaviors (e.g.…”

“…These efforts have generally reported consistent findings linking SCT to increased internalizing symptoms (e.g., depression, anxiety, somatization) (Barkley, 2013; Becker et al, 2014; Lee et al, 2017; Penny et al, 2009) and social difficulties including social withdrawal/isolation specifically (Becker et al, 2017; Carlson & Mann, 2002; Marshall et al, 2014; Willcutt et al, 2014). In addition, SCT and ADHD-IN are differentially related to externalizing behaviors; whereas ADHD-IN symptoms are strongly, positively associated with externalizing behaviors (e.g., hyperactivity-impulsivity [ADHD-HI], oppositional defiant disorder [ODD], aggression), SCT is either unassociated with these behaviors or negatively associated with externalizing behaviors when controlling for ADHD-IN (Becker et al, 2016).…”

Do sluggish cognitive tempo symptoms improve with school‐based ADHD interventions? Outcomes and predictors of change

“…SCT is also associated with impairment domains outside of academics, with studies finding high levels of comorbidity with internalizing symptoms (Smith, Eadeh, Breaux, & Langberg, ; Ward et al, ) and social skills deficits (Becker, Garner, Tamm, Antonini, & Epstein, ). To address these deficits, interventions that include cognitive behavioral therapy and social skills training should be examined to determine whether they affect SCT symptoms.…”

“…To address these deficits, interventions that include cognitive behavioral therapy and social skills training should be examined to determine whether they affect SCT symptoms. Importantly, although social skills training for youth with ADHD is not associated with robust effects, it is most effective for youth that are withdrawn (Mikami, ) and could be beneficial for youth with SCT, as they have high levels of withdrawal and social impairment (Becker et al, ; Ward et al, ). Thus, including a combination of CBT and social skills training (e.g., initiating conversations, assertiveness) should be considered when adapting interventions for youth with high levels of SCT.…”

Dikkat Eksikliği Hiperaktivite Bozukluğu’na Eşlik Eden Yavaş Bilişsel Tempo'nun Klinik Özellikleri

“…Bu çalışmada dikkat sorunları ve ağırkanlı (sluggish) olma, arkadaş ilişkileri ile negatif ilişkili olarak bulunmuştur. [21] YBT'yi DEHB 'den ayıran en belirgin özellik sosyal beceri alanı gibi görünmektedir.…”