The Child Concentration Inventory (CCI): Initial validation of a child self-report measure of sluggish cognitive tempo.

Abstract

Sluggish cognitive tempo (SCT) is characterized by excessive daydreaming, mental confusion, slowness, and low motivation. Several teacher- and parent-report measures of SCT have recently been developed but a child self-report measure of SCT does not yet exist despite clear links between SCT and internalizing psychopathology (for which self-report is often desired). This study examined the initial reliability and validity of the Child Concentration Inventory (CCI), a child self-report measure of SCT symptoms, in a school-based sample of 124 children (ages 8-13; 55% female). Children completed the CCI and measures of academic/social functioning, emotion regulation, and self-esteem. Teachers completed measures of psychopathology symptoms (including SCT) and academic/social functioning. Although exploratory structural equation modeling (ESEM) supported a 3-factor model of the CCI (consisting of slow, sleepy, and daydreamer scales closely resembling the factor structure of the parent-report version of this measure), bifactor modeling and omega reliability indices indicated that the CCI is best conceptualized as unidimensional. CCI scores were significantly correlated with teacher-rated SCT and were statistically distinct from teacher-rated ADHD and child-rated anxiety/depression. After controlling for sex, grade, and other psychopathology symptoms, the CCI total score was significantly associated with poorer child-reported academic/social functioning and self-worth in addition to increased loneliness and emotion dysregulation. Child ratings on the CCI were moderately to strongly correlated with poorer teacher-rated academic/social functioning but these associations were reduced to nonsignificance after controlling for demographics and other psychopathology symptoms. Findings provide preliminary support for the CCI, and future directions include replication with adolescents and clinical samples in order to further examine the CCI's factor structure, reliability, validity, and clinical utility.

The Internal, External, and Diagnostic Validity of Sluggish Cognitive Tempo: A Meta-Analysis and Critical Review

“…Analyses of one sample of children found a high correlation between ratings by mothers and fathers 24 and ratings by teachers and teachers’ aides 23 , and another study reported a high correlation between children’s self-ratings of SCT and teacher ratings 21 . In contrast, correlations were more modest between parent and teacher ratings of children and between young adults’ self-report ratings and ratings completed by their parents (Table 4).…”

“…SCT is also uniquely associated with lower self-reported self-esteem and emotion regulation difficulties when controlling for ADHD 16,21,43,51,52 . Although no study has examined SCT and sleep functioning in children, SCT symptoms remain associated with adults’ daytime sleepiness, poorer sleep quality, and nighttime sleep disturbance when controlling for ADHD symptoms 36,55,56 .…”

“…Several studies have found SCT symptoms to be associated with significant social impairment even when symptoms of ADHD, oppositional defiant disorder, conduct disorder, and depression were controlled 20,21,30,33,34,45,51,53,54 . SCT is also uniquely associated with lower self-reported self-esteem and emotion regulation difficulties when controlling for ADHD 16,21,43,51,52 .…”

Internal and External Validity of Sluggish Cognitive Tempo and ADHD Inattention Dimensions with Teacher Ratings of Nepali Children

“…For instance, ADHD-IN is consistently associated with higher levels of externalizing behaviors, and this association is unchanged when controlling for SCT; in contrast, SCT is unassociated (parent ratings) or negatively associated (teacher ratings) with externalizing behaviors when controlling for ADHD-IN (Bernad et al 2014Lee et al 2014;McBurnett et al 2014). Additional evidence is found for SCT's external validity in that higher levels of SCT predict higher levels of anxiety, depression, academic impairment, and social impairment even after controlling for ADHD-IN (Becker 2014;Becker et al 2014aBecker et al , 2015Bernad et al 2014Bernad et al , 2015Lee et al 2015;Servera et al 2015;Willcutt et al 2014). …”

“…Although the SCT construct has been of interest for some time (Becker et al 2014a), only recently have traditional psychometric procedures been used to develop measures of SCT (Barkley 2013;Becker et al 2015;Lee et al 2014;McBurnett et al 2014;Penny et al 2009). These new measures have led to a series of recent studies on SCT's validity.…”