Sluggish cognitive tempo: An examination of clinical correlates for adults with autism

Abstract

Adults with autism spectrum disorder often experience co-occurring mental health problems such as attention-deficit/hyperactivity-disorder, as well as impairments in executive function. Sluggish cognitive tempo, a cluster of behaviors including slow processing, daydreaming, and mental fogginess, has been shown to be associated with attention-deficit/hyperactivity-disorder. This study was designed to assess sluggish cognitive tempo in young adults with autism spectrum disorder. Specifically, we sought to establish a preliminary estimate of clinically significant sluggish cognitive tempo symptoms and to better understand its phenomenology and associations with executive function and psychiatric symptoms in the context of autism spectrum disorder. Young adults with autism spectrum disorder ( n = 57; age 16–25 years; 84.2% male) completed a laboratory-based executive function task, and parents and participants completed measures of the participants’ sluggish cognitive tempo, attention-deficit/hyperactivity-disorder, depression, and anxiety symptoms. Nearly one-third of the sample exhibited clinically impairing levels of sluggish cognitive tempo. Although sluggish cognitive tempo and attention-deficit/hyperactivity-disorder symptoms were significantly correlated, findings suggest the constructs are distinct. Results also suggest that increased sluggish cognitive tempo is related to executive function impairment and depression, but not anxiety symptoms. Considerations for assessment and long-term impacts of sluggish cognitive tempo for adults with autism spectrum disorder are discussed. Lay abstract Adults with autism spectrum disorder often experience a range of co-occurring mental health problems such as attention-deficit/hyperactivity-disorder, as well as difficulties with executive function. Sluggish cognitive tempo, a cluster of behaviors including slow processing, daydreaming, and mental fogginess, has been shown to be associated with attention-deficit/hyperactivity-disorder, and limited research has suggested that individuals with autism spectrum disorder may experience sluggish cognitive tempo. We examined co-occurring mental health problems and executive function in 57 young adults with autism spectrum disorder, aged 16–25 years to better understand sluggish cognitive tempo in autism spectrum disorder. Parents of the young adults answered questions about their children’s sluggish cognitive tempo, attention-deficit/hyperactivity-disorder, depression, and anxiety symptoms, and the young adults completed tests of their executive function. Results demonstrated that nearly one-third of the sample exhibited clinically impairing levels of sluggish cognitive tempo. Although sluggish cognitive tempo and attention-deficit/hyperactivity-disorder symptoms were related, our findings suggest they are not the same constructs. Increased sluggish cognitive tempo is related to more difficulties with executive function and increased depression, but not anxiety symptoms. Results demonstrate that sluggish cognitive tempo may pose heightened difficulties for adults with autism spectrum disorder, making it an important construct to continue studying. Considerations for assessment and long-term impacts of sluggish cognitive tempo for adults with autism spectrum disorder are discussed.

Sluggish cognitive tempo is associated with autistic traits and anxiety disorder symptoms in children with attention-deficit/hyperactivity disorder

“…In contrast, a more recent study in adults with ASD reported that co-occurring SCT may not pose a heightened risk for anxiety symptoms. 8 Temperamental traits of certain anxiety dimensions may also shed light on the link between SCT and anxiety. For instance, social anxiety is usually accompanied by marked behavioral inhibition, and said inhibition may partly explain the SCT characteristics of hypoactivity and lower engagement in social situations.…”

“…In contrast, a more recent study in adults with ASD reported that co-occurring SCT may not pose a heightened risk for anxiety symptoms. 8 …”

“…According to these studies, SCT+ASD was found to be associated with a higher degree of social and global impairment than ASD alone; mixed results were reported on comorbid psychopathology and executive functioning deficits. [5][6][7][8] It appears that additional research is warranted to examine the phenomenology of SCT in ASD across different developmental periods.…”

Atomoxetine Might Be More Effective in Improving Sluggish Cognitive Tempo Symptoms Compared to Methylphenidate: A Case Report

“…The relationship between ASD and SCT was first examined in a current study and SCT symptoms were found to be significantly higher in adolescent cases with ASD (24). An up-to-date study in young adults with ASD found that one-third of these cases had high levels of SCT symptoms (25). The coexistence of these two psychopathologies may be associated with a possible similarity or overlap between their symptoms.…”

Atomoxetine might be more effective in improving sluggish cognitive tempo symptoms after switching from methylphenidate: A case report

“…A study found SCT symptoms to be significantly higher in adolescent cases with ASD 24 . An up‐to‐date study in young adults with ASD found that one‐third of these cases had high levels of SCT symptoms 25 . The coexistence of these two psychopathologies may be associated with a possible similarity or overlap between SCT and ASD symptoms.…”