Abstract
ObjectivesSince the elimination of items associated with Sluggish Cognitive Tempo (SCT) during the transition from DSM-III to DSM-IV from the diagnostic criteria of Attention-deficit Hyperactivity Disorder (ADHD), interest in SCT and its associated cognitive as well as emotional and social consequences is on the increase. The current review discusses recent findings on SCT in clinical as well as community based ADHD populations. The focus is further on clinical correlates of SCT in populations different from ADHD, SCT’s genetic background, SCT’s association with internalizing and other behavioral comorbidities, as well as SCT’s association with social functioning and its treatment efficacy.MethodA systematic review of empirical studies on SCT in ADHD and other pathologies in PsycInfo, SocIndex, Web of Science and PubMed using the key terms “Sluggish Cognitive Tempo”, “Cognitive Tempo”, “Sluggish Tempo” was performed. Thirty-two out of 63 studies met inclusion criteria and are discussed in the current review.Results/ConclusionFrom the current literature, it can be concluded that SCT is a psychometrically valid construct with additive value in the clinical field of ADHD, oppositional defiant disorder (ODD), internalizing disorders and neuro-rehabilitation. The taxonomy of SCT has been shown to be far from consistent across studies; however, the impact of SCT on individuals’ functioning (e.g., academic achievement, social interactions) seems remarkable. SCT has been shown to share some of the genes with ADHD, however, related most strongly to non-shared environmental factors. Future research should focus on the identification of adequate SCT measurement to promote symptom tailored treatment and increase studies on SCT in populations different from ADHD.Electronic supplementary materialThe online version of this article (doi:10.1186/2049-9256-2-5) contains supplementary material, which is available to authorized users.
Highlights
The current literature review gives an overview about the research performed on the concept of Sluggish Cognitive Tempo (SCT)
30 to 50% of the children diagnosed with Attention-deficit Hyperactivity Disorder (ADHD)/I have been shown to present with increased levels of symptoms that emerged under the label SCT [20]
The association of SCT with ADHD predominantly inattentive (ADHD/I) was found to be partly due to genetic (r = 0.29) and partly due to non-shared environmental factors (r = 0.21), whereas the association of SCT with ADHD predominantly hyperactive/impulsive (ADHD/HI) was almost purely attributable to genetic factors [26]. These findings indicate that SCT, even though it is genetically related to ADHD, is the least heritable subtype among ADHD [26]
Summary
The current literature review gives an overview about the research performed on the concept of Sluggish Cognitive Tempo (SCT). Based on the observation that approximately twice as many school-aged children are nowadays diagnosed with ADHD/I in contrast to ADHD/HI [21,22] and ADHD/I’s strong association with SCT, there is a need for a thorough definition of SCT’s cascading effects on individuals’ functioning. This being said, the current literature on SCT is rather inconsistent in terms of the definition and measurement of SCT. The presence of SCT symptoms above and beyond ADHD symptoms might be one of the mediating factors in treatment efficacy in psychiatrically referred individuals
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