Sluggish cognitive tempo is associated with suicide risk in psychiatrically hospitalized children

Abstract

Background Although identified as a significant public health concern, few studies have examined correlates of suicide risk in school-aged children. Recent studies show a relation between sluggish cognitive tempo (SCT) symptoms and a range of adverse outcomes linked to suicidal ideation, including depression, emotion dysregulation, lowered self-esteem, and peer problems/social withdrawal, yet no study to date has examined SCT in relation to suicide risk. Methods We tested the hypothesis that SCT would be associated with suicide risk in a sample of 95 psychiatrically hospitalized children (74% male; 62% Black) between the ages of 8 and 12 (M=10.01, SD=1.50). Parents completed measures of their child's psychiatric symptoms, including SCT and depression, as well as a measure of their own psychopathology. Children completed measures assessing loneliness and depression. Both parents and children completed measures of suicide risk. Results White children reported greater suicide risk than non-White children. After controlling for demographic characteristics, loneliness, parental psychopathology, and correlated psychiatric symptoms, including both parent- and child self-reported depressive symptoms, SCT remained uniquely associated with children's suicide risk. Results were consistent across both parent and child measures of suicide risk. Conclusions This multi-informant study provides strong preliminary support for an association between SCT symptoms and suicide risk in psychiatrically hospitalized children, above and beyond loneliness, depression, and demographic characteristics. Findings are discussed in the context of the interpersonal theory of suicide. Additional studies are needed to replicate and extend these findings, with a particular need for studies that examine the cognitive processes and daydreaming content of individuals displaying elevated SCT symptomatology.

Sluggish cognitive tempo in children and adolescents with higher functioning autism spectrum disorders: Social impairments and internalizing symptoms

“…At the moment, no official diagnosis for SCT in DSM-5 (American Psychiatric Association, 2013) is defined. Barkley (2014) has suggested that SCT could be a separate psychiatric disorder while Becker et al Becker, Ciesielski et al, 2016;Becker, Leopold et al, 2016;Becker, Withrow et al, 2016), have considered the possibility that SCT could be better defined as a transdiagnostic construct. High rate of SCT symptoms in higher functioning ASD in our study extend the previous literature by indicating that in addition to ADHD, SCT symptoms appear to occur at elevated rates also in ASD.…”

“…The majority of studies on SCT symptoms have focused on children with ADHD and typically developing (TD) children (Becker, ; Lee et al ., ; Marshall et al ., ; Servera et al ., ; Skirbekk et al ., ; Wåhlstedt & Bohlin, ; Willcutt et al ., ). Single studies on SCT symptoms have been conducted in children with behavioral or learning disabilities (Garner et al ., , ), survivors of acute lymphoblastic leukemia (Reeves, Palmer, Gross et al ., ), children with sleep disorders (Becker, Garner et al ., ), and psychiatrically hospitalized children (Becker et al ., ; Becker, Withrow et al ., ). These studies have also indicated that SCT symptoms are separate from ADHD subtype and other psychopathological symptoms (Becker, Garner et al ., ; Garner et al ., , ), and that SCT symptoms are related with social difficulties (Becker, Garner et al ., ; Becker et al ., ), internalizing disorders (Becker, Garner et al ., ; Garner et al ., , ), and academic impairment (Becker, Garner et al ., ) after statistically controlling for symptoms of ADHD‐I and/or ADHD‐HI.…”

“…Additionally, in psychiatrically hospitalized children, SCT symptoms were associated with suicide‐risk after controlling for background variables, loneliness, and other psychopathology (i.e. depression, anxiety, ODD) (Becker, Withrow et al ., ).…”

Can Sluggish Cognitive Tempo Be Distinguished From ADHD Inattention in Very Young Children? Evidence From a Sample of Korean Preschool Children

“…This finding is in line with expectations, as somatization is generally conceptualized as falling within the internalizing domain of psychopathology (including on the CBCL). Furthermore, it is possible that SCT – characterized by daydreaming and getting lost in one’s thoughts – is associated with ruminative cognitive processes (Becker, Withrow, et al, 2016), and SCT is clearly associated with negative affect such as depressive and anxiety symptomatology (Becker, Leopold, et al, 2016). Both rumination and negative affect are themselves associated with somatic complaints (Miers, Rieffe, Meerum Terwogt, Cowan, & Linden, 2007; Saps et al, 2009; Vassend, 1989), so it is not surprising that SCT was associated with somatic complaints in the present study.…”

Sluggish cognitive tempo: the need for global inquiry

“…Consistent with SCT's association with internalizing symptoms, there is emerging evidence of an association between SCT and suicide risk, and SCT symptoms are also associated with social difficulties, particularly social withdrawal and isolation. Findings for academic functioning and neurocognition are somewhat mixed, though there is initial evidence for SCT being associated with greater academic impairment, lower academic achievement scores, slower processing speed, and poorer sustained attention.…”