Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function
IntroductionSluggish Cognitive Tempo (SCT) is a syndrome characterized by cognitive hypo-arousal that often appears as daytime sleepiness or drowsiness, mental fogginess, being easily confused, having difficulty with holding and manipulating information in working memory, and being forgetful. Althou...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-07-01
|
| Series: | Frontiers in Child and Adolescent Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/frcha.2023.1188901/full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832593454830452736 |
|---|---|
| author | Beth Krone Lenard A. Adler Deepti Anbarasan Terry Leon Richard Gallagher Pooja Patel Stephen V. Faraone Jeffrey H. Newcorn |
| author_facet | Beth Krone Lenard A. Adler Deepti Anbarasan Terry Leon Richard Gallagher Pooja Patel Stephen V. Faraone Jeffrey H. Newcorn |
| author_sort | Beth Krone |
| collection | DOAJ |
| description | IntroductionSluggish Cognitive Tempo (SCT) is a syndrome characterized by cognitive hypo-arousal that often appears as daytime sleepiness or drowsiness, mental fogginess, being easily confused, having difficulty with holding and manipulating information in working memory, and being forgetful. Although it frequently co-travels with attention-deficit/hyperactivity disorder (ADHD) or other conditions and confers significantly greater impairment, there are few studies examining SCT among adults with ADHD. Understanding what features SCT confers in association with ADHD, distinct from other conditions associating with ADHD, is critically important to confirm if SCT is a distinct syndrome that requires special assessment methods and special, distinct treatment efforts to reduce its impact. This study describes the clinical and neuropsychological features of SCT in a sample of adults with well-defined ADHD, and examines the relationship of SCT with other measures of ADHD, neurocognition, executive function (EF), and impairment.MethodsA sample of n = 106 adults with ADHD, ages 18-57 years, was assessed for SCT using the Barkley SCT scale. Adults with (SCT+) and without (SCT-) SCT received a comprehensive clinical assessment battery, and neuropsychological testing. Clinical and neuropsychological variables were examined for their associations with SCT. The variables were treated with Principal Axis Factoring with Promax with Kaiser Normalization to elucidate latent constructs and determine performance profiles associated with SCT among people with ADHD.ResultsEF Deficits and emotional dyscontrol (ED) symptoms significantly differentiated adults with ADHD and SCT whether measured via self or clinician report. Additionally, significantly greater impairment via both clinician and participant report was seen in the SCT + versus SCT - cohorts. SCT was also associated with a significantly distinct profile on the neuropsychological battery, characterized by a pattern of slower latencies and cognitive strategy choices across CANTAB and WAIS subtests, that reveals difficulty with increased cognitive load, which primarily accounted for the higher level of impairment in the SCT group.DiscussionThe convergence of clinical ratings and neurocognitive measures of EF deficits is consistent with the conclusion that SCT represents a distinct subgroup of adults with ADHD. |
| format | Article |
| id | doaj-art-2242ea8f2da94b58830babc3c558095d |
| institution | Kabale University |
| issn | 2813-4540 |
| language | English |
| publishDate | 2023-07-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Child and Adolescent Psychiatry |
| spelling | doaj-art-2242ea8f2da94b58830babc3c558095d2025-01-20T14:23:21ZengFrontiers Media S.A.Frontiers in Child and Adolescent Psychiatry2813-45402023-07-01210.3389/frcha.2023.11889011188901Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive functionBeth Krone0Lenard A. Adler1Deepti Anbarasan2Terry Leon3Richard Gallagher4Pooja Patel5Stephen V. Faraone6Jeffrey H. Newcorn7Department of Psychiatry, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United StatesDepartment of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United StatesDepartment of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United StatesDepartment of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United StatesDepartment of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United StatesDepartment of Psychiatry, New York University (NYU) Grossman School of Medicine, New York, NY, United StatesNorton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, United StatesDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai (ISMMS), New York, NY, United StatesIntroductionSluggish Cognitive Tempo (SCT) is a syndrome characterized by cognitive hypo-arousal that often appears as daytime sleepiness or drowsiness, mental fogginess, being easily confused, having difficulty with holding and manipulating information in working memory, and being forgetful. Although it frequently co-travels with attention-deficit/hyperactivity disorder (ADHD) or other conditions and confers significantly greater impairment, there are few studies examining SCT among adults with ADHD. Understanding what features SCT confers in association with ADHD, distinct from other conditions associating with ADHD, is critically important to confirm if SCT is a distinct syndrome that requires special assessment methods and special, distinct treatment efforts to reduce its impact. This study describes the clinical and neuropsychological features of SCT in a sample of adults with well-defined ADHD, and examines the relationship of SCT with other measures of ADHD, neurocognition, executive function (EF), and impairment.MethodsA sample of n = 106 adults with ADHD, ages 18-57 years, was assessed for SCT using the Barkley SCT scale. Adults with (SCT+) and without (SCT-) SCT received a comprehensive clinical assessment battery, and neuropsychological testing. Clinical and neuropsychological variables were examined for their associations with SCT. The variables were treated with Principal Axis Factoring with Promax with Kaiser Normalization to elucidate latent constructs and determine performance profiles associated with SCT among people with ADHD.ResultsEF Deficits and emotional dyscontrol (ED) symptoms significantly differentiated adults with ADHD and SCT whether measured via self or clinician report. Additionally, significantly greater impairment via both clinician and participant report was seen in the SCT + versus SCT - cohorts. SCT was also associated with a significantly distinct profile on the neuropsychological battery, characterized by a pattern of slower latencies and cognitive strategy choices across CANTAB and WAIS subtests, that reveals difficulty with increased cognitive load, which primarily accounted for the higher level of impairment in the SCT group.DiscussionThe convergence of clinical ratings and neurocognitive measures of EF deficits is consistent with the conclusion that SCT represents a distinct subgroup of adults with ADHD.https://www.frontiersin.org/articles/10.3389/frcha.2023.1188901/fullAttention Deficit Hyperactivity Disorder (ADHD)Sluggish Cognitive Tempo (SCT)Cognitive Disengagement Syndrome (CDS)Adult ADHDExecutive FunctionNeurocognitive Phenotyping |
| spellingShingle | Beth Krone Lenard A. Adler Deepti Anbarasan Terry Leon Richard Gallagher Pooja Patel Stephen V. Faraone Jeffrey H. Newcorn Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function Frontiers in Child and Adolescent Psychiatry Attention Deficit Hyperactivity Disorder (ADHD) Sluggish Cognitive Tempo (SCT) Cognitive Disengagement Syndrome (CDS) Adult ADHD Executive Function Neurocognitive Phenotyping |
| title | Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function |
| title_full | Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function |
| title_fullStr | Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function |
| title_full_unstemmed | Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function |
| title_short | Characteristics of Sluggish Cognitive Tempo among adults with ADHD: objective neurocognitive measures align with self-report of executive function |
| title_sort | characteristics of sluggish cognitive tempo among adults with adhd objective neurocognitive measures align with self report of executive function |
| topic | Attention Deficit Hyperactivity Disorder (ADHD) Sluggish Cognitive Tempo (SCT) Cognitive Disengagement Syndrome (CDS) Adult ADHD Executive Function Neurocognitive Phenotyping |
| url | https://www.frontiersin.org/articles/10.3389/frcha.2023.1188901/full |
| work_keys_str_mv | AT bethkrone characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT lenardaadler characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT deeptianbarasan characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT terryleon characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT richardgallagher characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT poojapatel characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT stephenvfaraone characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction AT jeffreyhnewcorn characteristicsofsluggishcognitivetempoamongadultswithadhdobjectiveneurocognitivemeasuresalignwithselfreportofexecutivefunction |