Psychometric validation of the Barkley SCT (sluggish cognitive tempo) scale in Turkish adolescents: Assessing SCT in a clinically referred, culturally distinct population.

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. In addition to the core symptoms, patients with ADHD often have manifestations of neurocognitive dysfunction (executive functioning deficiency, speech disorders, sluggish cognitive tempo), and about two thirds of children with established ADHD have another comorbid disorder. When prescribing pharmacotherapy, drugs with a positive effect on both the symptoms of ADHD and comorbid disorders are preferred. These include atomoxetine hydrochloride. The possibilities of using atomoxetine in the comorbidity of ADHD with destructive behavior, anxiety disorders, sleep disorders, nocturnal enuresis, tics, stuttering, dyslexia, as well as the effect of atomoxetine on sluggish cognitive tempo and executive functioning are considered. The approaches to optimal dosing and minimization of adverse events during atomoxetine treatment are discussed.

ABSTRACTBackgroundRecently, research on cognitive disengagement syndrome (CDS)—previously known as sluggish cognitive tempo—has expanded considerably. The Adult Concentration Inventory (ACI) is designed to assess CDS, and its psychometric soundness, including validity and reliability, needs to be evaluated across diverse countries and populations.MethodsThis study assesses the questionnaire's psychometric properties in Iran. The study included 2855 people, 69% of whom were female and had a mean age of 27.42. The ACI questionnaire, Patient Health Questionnaire‐9 (PHQ‐9), and Executive Skills Questionnaire‐Revised (ESQ‐R) were completed in this study.ResultsWe found that the three‐factor model (attention problems, sluggishness, and mind‐wandering) matches the questionnaire using exploratory and confirmatory analysis. Based on the fit indices, the original correlated three‐factor model of the ACI was considered adequate: χ2 = 815.20; df = 101; RMSEA = 0.050; CFI = 0.95; TLI = 0.94; IFI = 0.95; SRMR = 0.03.ConclusionsThe results of this study demonstrated that CDS in Iranian society may be measured using the ACI questionnaire.

Distracted and connected: characterizing the clinical phenotype and exploring potential biotype markers of adults with attention deficit hyperactivity disorder (ADHD) and problematic usage of the internet (PUI).

People with attention-deficit/hyperactivity disorder (ADHD) are more likely to use cannabis. However, the effects of chronic and acute cannabis use on people with ADHD remain unclear. 104 adults (26 cannabis users with ADHD, 26 non-users with ADHD, 26 cannabis users without ADHD, and 26 non-users without ADHD) were recruited to assess the impacts of cannabis use on perceived ADHD symptoms and cognition, through a repeated-measures, quasi-experimental study. In session one, participants completed a battery of cognitive tests and provided ADHD symptom (impulsivity, hyperactivity, inattention) and affect (irritability, anxiety, mood) ratings. In session two, cannabis users were observed using their own cannabis product while non-users remained sober, prior to completing the same battery of cognitive tests and symptom ratings. Chronic cannabis users with ADHD self-reported less severe sluggish cognitive tempo than non-users with ADHD. Nevertheless, chronic cannabis users with (and without) ADHD demonstrated worse performance on two objective tests of cognition. Intoxicated cannabis users with ADHD self-reported reductions in impulsivity, irritability, and anxiety as well as enhanced mood, and demonstrated reductions in impulsive responding on two cognitive tests. Nevertheless, intoxicated cannabis users with (and without) ADHD demonstrated reductions in performance on five of the other cognitive outcomes. The present study provides limited evidence that acute cannabis intoxication may selectively reduce subjective and objective impulsivity in people with ADHD, while impairing several other aspects of cognition. In contrast, chronic cannabis use appears to reduce perceptions of sluggish cognitive tempo without producing any objective benefits to cognition.

Objective: There is substantial evidence supporting the distinction between cognitive disengagement syndrome (CDS) and attention-deficit/hyperactivity disorder (ADHD), particularly from the inattentive subtype. However, despite proposed etiological and phenomenological similarities, the relationship between CDS and dissociation remains underexplored. This study investigates the relationship between CDS and dissociation and evaluates their combined impact on functional impairment while accounting for comorbid internalizing and externalizing problems in adolescents with ADHD. Method: A total of 103 adolescents with ADHD (aged 11–17, M = 14.15, SD = 1.71) and their parents participated in this multicenter, cross-sectional study. ADHD diagnosis was established using the Best Estimate Clinical Diagnosis method. Standardized assessments included the Adolescent Dissociative Experiences Scale (A-DES) and the Revised Child Anxiety and Depression Scale-Child Version (RCADS-CV) for self-report, while parents completed the modified version of Sluggish Cognitive Tempo Scale (SCT-S), Strengths and Difficulties Questionnaire-Parent Form (SDQ-P), and Weiss Functional Impairment Rating Scale-Parent Report (WFIRS-P). Results: No significant correlations were observed between the parent-reported CDS Modified Total and the adolescent-reported A-DES Total score (r = −.024, p = .811), or any of its subdomains, after controlling for anxiety symptoms. Regression analyses revealed that CDS Modified Total (β = .0121, p = .032), and A-DES Absorption & Imaginative Involvement (β = .0085, p = .042) were independent predictors of parent-reported functional impairment along with SDQ-P Emotional Symptoms (β = .0399, p = .040), SDQ-P Conduct Problems (β = .0752, p < .001), RCADS-CV Separation Anxiety Disorder (β = .0245, p = .017). The dominance analysis indicated that the parent-reported SDQ Conduct Problems subscale had the highest average R2 contribution (M = 0.1625) while the parent-reported CDS Modified Total demonstrated the lowest average R2 contribution across models (M = 0.0498). Conclusion: The findings suggest that CDS and dissociation represent distinct constructs, at least when rated by different informants, and that both may have significant and independent contributions to functional impairment in adolescents with ADHD. These results highlight the need to consider a broader range of contributing factors beyond symptom severity alone for the effective management of ADHD.

Initially described in the mid-1980s, cognitive disengagement syndrome (CDS; previously termed sluggish cognitive tempo) is a set of symptoms comprising excessive daydreaming, mental confusion, and hypoactivity that is distinct from attention-deficit/hyperactivity disorder and other psychopathology dimensions and independently associated with functional outcomes. This article provides a broad overview of the history of the CDS construct, its terminology, and the current state of the science. Although there has been a marked upsurge in research on CDS, including psychometrically rigorous assessment tools and an emerging pattern of findings across numerous domains of functioning, the existing literature base also points to the importance of marshaling an ambitious research agenda that can guide CDS into its next era. Ten key research domains and open questions are highlighted, including (1) developmental course of CDS across the lifespan, (2) mechanisms linking CDS to functional outcomes and impairment, (3) importance of gathering normative data, (4) clarifying CDS and unidimensional or multidimensional, (5) etiologies of CDS, (6) neurobiology and psychophysiology of CDS, (7) CDS as a transdiagnostic trait, (8) understanding individuals with elevated CDS, (9) promoting participatory approaches and valuing lived experience, and (10) the role of CDS for intervention. Implications of this research for possible conceptualizations of CDS as a distinct disorder, diagnostic specifier, or transdiagnostic dimension are discussed. The road ahead will require increased collaboration, creativity, and rigor to build theory, and, ultimately, support the well-being of individuals with this syndrome. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Background/Objectives: Despite the growing recognition of cognitive disengagement syndrome (CDS), previously termed sluggish cognitive tempo, as a distinct dimension of psychopathology, the neural correlates of CDS remain largely unknown. We investigated the neural correlates of CDS in children using whole-head magnetoencephalography (MEG). Methods: A community-based sample of children (N = 43, ages 8–12 years) was recruited and completed self-report ratings of CDS. MEG was recorded while the children completed an adapted version of the attention network test (ANT). Results: The results indicated that higher levels of self-reported CDS symptoms were associated with larger changes in the root-mean square (ΔRMS) (incongruent—congruent trials) in M2 and M3, suggesting children with higher levels of CDS symptoms might require greater mental effort to overcome distractors during incongruent trials. The source localization analysis initially revealed a negative correlation between child self-reported CDS symptoms and ΔM2 power (incongruent—congruent trials) in the medial prefrontal cortex (mPFC), suggesting insufficient power allocation in a region critical for attentional processing. However, this association was no longer significant after controlling for ADHD status. No significant correlation was found between self-reported CDS symptoms and alerting or orienting. Conclusions: These findings provide initial evidence of the disrupted attentional processing associated with CDS in children. Further replication and extension with larger samples are warranted.

ABSTRACT Recent investigations into Sluggish Cognitive Tempo (SCT), also known as Cognitive Disengagement Syndrome, have primarily focused on its association with ADHD. However, emerging evidence suggests SCT may be a distinct clinical entity, despite frequent co-occurrence with ADHD symptomatology. While ADHD studies have elucidated sleep patterns and chronotype preferences, SCT research has largely focused on ADHD-comorbid cases, providing limited data on community-based adolescents and adults. This study aims to investigate sleep disturbances and chronotype characteristics in individuals with pure SCT compared to those with ADHD and healthy controls within a clinical sample. We utilized the DSM-IV-based Disruptive Behavior Disorders Rating Scale (DBDRS-parent and teacher form), Barkley Sluggish Cognitive Tempo Scale (BSCTS), the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version (K-SADS), Children’s Sleep Habit Questionnaire, and Children’s Chronotype Questionnaire for the evaluation of children with SCT, ADHD, and healthy controls. Our findings revealed shorter sleep duration in ADHD (n: 67) children compared to both SCT (n: 50) and healthy controls (n: 50), with no significant difference between SCT and healthy controls (p < 0.001). Eveningness tendencies were highest in SCT but also elevated in ADHD compared to controls (p < 0.001). Additionally, daytime sleepiness was highest in SCT and higher in ADHD than controls (p < 0.001). Regression analyses demonstrated that SCT severity predicted both daytime sleepiness and eveningness.

Abstract Introduction Menstrual pain and premenstrual symptoms are known to influence affective, social, and cognitive functioning in adult women. However, these associations are less studied in adolescence—a sensitive developmental period when sleep is undergoing key changes and menstrual-related disorders emerge. This study examined the effects of sleep and menstrual problems, as well as their interaction, on daily psychosocial functioning in adolescent girls. Methods Data from 2,131 post-menarcheal girls (Mean age=13.09 years, range=12–15 years) in the ongoing Adolescent Brain and Cognitive Development (ABCD) Study® were analyzed. Sleep behavior was assessed with the Munich Chronotype Questionnaire (youth self-report), and menstrual problems were evaluated through self-reported menstrual cycle characteristics. Affective, social, and cognitive functioning outcomes were measured using the Child Behavior Checklist (caregiver-report). Linear mixed effect models examined associations between sleep, menstrual problems, and functioning outcomes, with age, time since menarche, BMI, hormonal contraceptive use, and socio-demographic factors as covariates. Results More severe premenstrual symptoms were associated with higher levels of anxiety and depressive symptoms (p&amp;lt;.01), stress (p&amp;lt;.01), somatic symptoms (p&amp;lt;.01), social problems (p&amp;lt;.01), sluggish cognitive tempo (p=.001) and attention problems (p=.002). Menstrual pain and its impact on daily life were positively associated with anxiety and depressive symptoms (p&amp;lt;.01 and p&amp;lt;.01, respectively), stress (p&amp;lt;.01 and p&amp;lt;.01), somatic symptoms (p&amp;lt;.01 and p&amp;lt;.01), and social problems (p=.042 and p=.003), but not with cognitive outcomes. Sleep behavior moderated multiple associations. Adolescents with later bedtimes and more pain impact had higher anxiety and depressive symptoms (p=.033) and more social problems (p=.007). Later bedtimes combined with greater pain intensity or higher impact of premenstrual symptoms on daily life had more social problems (p=.005 and p=.008). Those with shorter sleep duration and high pain impact or severe premenstrual symptoms had higher sluggish cognitive tempo scores (p=.021 and p=.019). Additionally, later bedtimes were associated with more attention problems in those experiencing greater pain intensity (p=.031). Conclusion Menstrual pain and premenstrual symptoms are associated with poorer affective, social, and cognitive functioning in adolescent girls, and sleep behavior moderates these associations. Addressing both sleep and menstrual health could enhance our understanding of female adolescent well-being during this critical developmental stage. Support (if any) National Institutes of Health: U01DA041022 and R01MH128959.

Investigating the Shared and Divergent Neuroanatomical Features of Attentional Deficits in Adolescents.

ABSTRACT This study investigates the relationship between Sluggish Cognitive Tempo (SCT) and circadian preferences in children and adolescents. We also aimed to assess the relationship between digital game addiction and SCT, as existing literature is insufficient, particularly given the similarities between SCT and Attention Deficit Hyperactivity Disorder (ADHD) in relation to internalizing symptoms and comorbidity. This study involved 72 children and adolescents with SCT and 77 healthy controls, aged 11–16 years, who were referred to the Child and Adolescent Psychiatry outpatient clinic. We used Sociodemographic Data Form, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version- Turkish Version (K-SADS-PL), Turgay’s DSM-IV Based Screening and Assessment Scale for Disruptive Behavior Disorders in Children and Adolescents (T-DSM-IV-S), Child and Adolescent Behavior Inventory-SCT (CABI-SCT), Children’s Chronotype Questionnaire (CCQ), Digital Game Addiction Scale (DGAS). In the group with SCT, we found that eveningness preference and digital game addiction were statistically significant. Correlation analyses revealed a moderate positive relationship between chronotype scores (eveningness preferences higher scores) and digital game addiction. Additionally, a strong positive correlation was found between chronotype and SCT scale scores, as well as between digital game addiction and SCT scale scores. These findings highlight the potential role of digital game addiction and circadian preferences in shaping profile of SCT, providing valuable insights into the understanding of SCT symptoms.

Objective Comorbidity between Obsessive-Compulsive Disorder (OCD) and Attention Deficit/Hyperactivity Disorder (ADHD) appears complex in terms of etiology, phenomenology, and treatment. There is a need to identify possible factors which are related to the co-occurrence of OCD and ADHD in adults. Cognitive Disengagement Syndrome (CDS) may contribute to this comorbidity through its associations with ADHD, emotional dysregulation, cognitive processes, and neuropsychological deficits. Methods In this study, we compared CDS and various sociodemographic and clinical characteristics in OCD patients with (n = 44) and without ADHD (n = 72), and healthy controls (n = 43), using the Yale Brown Obsessive-Compulsive Scale, Wender Utah Rating Scale, Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale, Barkley’s Adult Sluggish Cognitive Tempo Rating Scale, Beck Depression Inventory, and Beck Anxiety Inventory. Results In addition to contamination obsessions (OR = 7.733, p = 0.002), male gender (OR = 3.732, p = 0.031), high anxiety (OR = 1.053, p = 0.02), and high CDS symptoms (OR = 1.145, p = 0.037) were associated with comorbidity between OCD and ADHD. Conclusion We suggest that CDS may serve as a valuable construct for understanding the nature of comorbidity between OCD and ADHD.

Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement syndrome (CDS; previously sluggish cognitive tempo) may also be more prevalent in young adults and associated with poorer functioning. However, the relation between CDS symptoms and anxiety, depression, stress, and insomnia remains insufficiently investigated among young adults. Given this, the aims of the present study were as follows: (1) to investigate the associations between CDS and symptoms of depression, anxiety, stress, and insomnia; (2) to investigate if and which dimensions of ill-being were more robustly related to higher CDS scores; (3) to explore if stress scores moderated the associations between CDS symptoms and insomnia; and (4) to explore if higher insomnia categories were associated with higher CDS scores. Methods: A total of 246 young adult students in Switzerland (mean age = 22.62; 56.3% females) completed a booklet of questionnaires covering socio-demographic information, cognitive disengagement syndrome (Adult Concentration Inventory; ACI), and symptoms of depression, anxiety, stress, and insomnia as part of this cross-sectional study. Results: Higher CDS scores on the ACI were associated with higher scores for depression, anxiety, stress, and insomnia. Depression, anxiety, stress, and insomnia were independently associated with higher scores for CDS. Higher categories of stress moderated the associations between higher CDS scores and higher insomnia. Higher insomnia categories were related to higher CDS scores. Conclusions: The present data showed that among a small sample of young adult students, higher CDS scores were associated with higher psychological ill-being (depression, anxiety, stress, and insomnia). If we consider CDS as a trait, specific performance-enhancing medication or psychotherapeutic interventions might favorably influence dimensions of psychological ill-being such as depression, anxiety, stress, and insomnia.

Aim: This study examined how well parent and teacher reports are concordant in evaluating Cognitive Disengagement Syndrome (CDS) symptoms in school-age children. Method: The epidemiological sample consisted of 268 randomly chosen children aged 7 to 11 from four metropolitan cities in Turkey. Both parents and teachers evaluated the children by completing the Barkley Sluggish Cognitive Tempo Scale- Children and Adolescents (BSCTS-CA) and the CDS-Child Behavior Checklist (CDS-CBCL). Agreement and correlations between parent and teacher reports regarding CDS were assessed via coefficients of Cohen’s Kappa (k) and Spearman’s Rho (r). Results: Parents were not in agreement with teachers concerning the presence/absence of CDS (k=0,143, p=0,042 according to BSCTS-CA evaluation; k=0,039, p=0,366 according to CDS-CBCL evaluation). However, parent and teacher ratings on CDS-daydreaming and CDS-sluggish scores of BSCTS-CA showed medium correlation (r=0,375, r=0,305; respectively; all p

Impact of trauma recognition on recovery optimism and blame: An experimental vignette study of sluggish cognitive tempo (cognitive disengagement syndrome).

BackgroundDespite previous research demonstrating an independent association between cognitive disengagement syndrome (CDS; previously termed sluggish cognitive tempo) and depressive symptoms, studies have yet to examine what factors may moderate this link. A negative interpretation bias (i.e., maladaptive information processing whereby emotionally aversive meaning is perceived in ambiguous situations) is associated with the development and maintenance of depression and may moderate the association between CDS and depression. Using a multi‐informant, multi‐method design, this study examined whether negative interpretation bias exacerbated the association between CDS and depressive symptoms.Methods336 adolescents (ages 10–12 years; 52.7% female; 61.9% White) and their caregivers completed measures of CDS and depressive symptoms. Adolescents completed the Scrambled Sentences Test, a task‐based measure of interpretation bias. Regression analyses were conducted to examine interpretation bias as a potential moderator of the association between CDS and depressive symptoms.ResultsFor adolescent‐reported depressive symptoms, higher caregiver‐ and adolescent‐reported CDS symptoms and interpretation bias scores were each independently associated with higher depressive symptoms (all ps < .01), but CDS and interpretation bias did not interact in predicting depression (ps > .05). By contrast, significant CDS symptoms × interpretation bias interactions were found in models using both caregiver‐ and adolescent‐reported CDS symptoms in relation to caregiver‐reported depressive symptoms (ps = .01 and .003, respectively), such that CDS was more strongly associated with depression at higher levels of interpretation bias.ConclusionsNegative interpretation bias strengthens the association between CDS symptoms and depressive symptoms when depressive symptoms are rated by caregivers, but not by adolescents. Findings highlight the importance of multiple informants when examining CDS and internalizing symptoms, with a need for longitudinal research to examine CDS and interpretation bias in relation to the progression and maintenance of depression across adolescence.

Objective: This study aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) symptoms in children/adolescents and their parents within the Turkish population, examining the association with co-occurring ADHD symptoms, peer/social relationships, and total difficulties. Method: The study included 229 parents aged 18 to 50 with children aged 6 to 18 from the staff of Karabuk Training and Research Hospital. Data collection occurred from April to September 2022. Participants completed various scales, including the Adult Concentration Inventory (ACI), Adult ADHD Self-Report Scale (ASRS), Depression Anxiety Stress Scale-21 (DASS-21), Conners’ Parent Rating Scale-Revised Short Form (CPRS-R), Strengths and Difficulties Questionnaire (SDQ), and Child and Adolescent Behavior Inventory Sluggish Cognitive Tempo Scale (CABI-SCT). Results: A positive correlation was found between CDS symptoms in children/adolescents and their parents. CDS symptoms in children were also associated with significant comorbidities, such as ADHD, oppositional defiance, peer problems, and internalization problems. In parents, CDS was observed to be associated with levels of depression, anxiety, and stress. Conclusion: The study highlights the strong relationship between CDS symptoms in children and their parents, suggesting potential genetic and environmental factors. CDS is associated with significant mental health comorbidities across all age groups. The findings underscore the need for interventions to support the mental health of both children and parents with CDS. Further research is needed to elucidate the impact and etiology of CDS on family dynamics and mental health.

Recently, an association between cognitive disengagement syndrome (CDS), formerly sluggish cognitive tempo, and autism has been documented, but it is not known if the association is due to overlapping autism and CDS traits or if CDS is empirically distinct from autism. Mothers rated 2,209 children 4-17years (1,177 with autism, 725 with ADHD-Combined type, and 307 with ADHD-Inattentive type) on the Pediatric Behavior Scale. Factor analysis of the Pediatric Behavior Scale items indicated that CDS and autism traits are empirically distinct from each other without cross-loading and are distinct from eight other factors (attention deficit, impulsivity, hyperactivity, oppositional behavior, irritability/anger, conduct problems, depression, and anxiety). CDS total scores were significantly higher in the autism + ADHD-Inattentive and autism + ADHD-Combined groups than in the autism, ADHD-Combined, and ADHD-Inattentive only groups with a nonsignificant difference between the latter three groups. CDS and autism are empirically distinct from each other and from other psychopathology dimensions. Overlapping traits do not explain the association between autism and CDS. Autism in combination with ADHD-Combined or ADHD-Inattentive increases the likelihood of CDS relative to youth who have autism, ADHD-Combined, or ADHD-Inattentive only. Because of the known associations between autism, CDS, and ADHD, both autism and ADHD must be assessed in CDS research and clinically to better understand and explain research findings and provide targeted clinical intervention.

Objective: The aim of this study was to compare the effectiveness of resilience training and cognitive emotion regulation training on emotional processing and anxiety in children with sluggish cognitive tempo. Methodology: The research method was quasi-experimental with a pretest-posttest and follow-up design including a control group. The statistical population consisted of all 9 to 12-year-old male elementary school students diagnosed with sluggish cognitive tempo in the city of Tabriz in 2023. The sample included 45 participants selected through purposive sampling and randomly assigned to experimental and control groups. The first experimental group received resilience training over 10 sessions of 45 minutes each across four weeks, while the second experimental group received cognitive emotion regulation training in the same format. The control group did not receive any intervention. Research instruments included the Sluggish Cognitive Tempo Questionnaire, the Emotional Processing Scale, and the Spence Children's Anxiety Scale. Data were analyzed using repeated measures analysis of variance. Findings: The results indicated that both resilience training and cognitive emotion regulation training significantly influenced emotional processing and anxiety in children with sluggish cognitive tempo (p &lt; .05). However, follow-up tests revealed no significant difference between the two intervention methods in terms of emotional processing and anxiety (p &gt; .05). Conclusion: The findings of this study highlight the importance of implementing targeted psychological interventions, such as resilience and cognitive emotion regulation training, to enhance emotional components in children with sluggish cognitive tempo, emphasizing the need to address their needs in educational programs.