Sluggish Cognitive Tempo and ADHD

There are a grand total of 19 studies on Sluggishprior to publishing the DSM IV failed to demonstrate a
Cognitive Tempo (SCT) that have been published andpositive predictive value in diagnosing Predominantly
recorded at the National Institute of Health data base.Inattentive ADHD using the symptoms of SCT and
Two studies validated that the symptoms of Sluggishthese sluggishness items were discarded from the
Cognitive Tempo include: slow Processing, increasedInattentive ADHD symptom list.
reaction,under arousal and faulty Selective MemoryRussell Barkley, a very well respected ADHD authority,
Several studies concluded that people with symptomsbelieves that SCT and Predominantly Inattentive
of SCT meet the classification of PredominantlyADHD are one and the same. The American
Inattentive ADHD, but not all people who meet thePsychiatric Association disagreed with this opinion and
diagnostic criteria for ADHD Inattentive meet theremoved the SCT symptoms from the ADHD
diagnostic criteria for SCT. Put another way, havingcategory in the DSM IV. They are currently thinking
SCT strongly predicts that you will be diagnosed withthat SCT is an entity separate from ADHD and are
the Predominantly Inattentive subtype of ADHDconsidering placing it in a category of its own.
(ADHD-PI) but being Predominantly Inattentive does notSome may argue that it does not really matter if SCT
predict that you will have symptoms of Sluggishand ADHD-PI are treated as the same disorder. SCT
Cognitive Tempo.and ADHD-I respond about equally well to medication
Three studies report symptoms in individuals withand behavioral therapy, both have inattention, both
Sluggish Cognitive Tempo that were not present inhave fewer disruptive symptoms or externalizing
individuals with symptoms of Predominantly Inattentivesymptoms when they are compared to people with
ADHD without SCT. These symptoms included:ADHD Combined type or ADHD Hyperactive
Higher rates of depression, more social withdrawal,Impulsive, and both are more likely to have symptoms
and more social dysfunction.of anxiety and depression when they are compared
One study looked at treatment with Methylphenidateto the other subtypes. You could argue that the
(Ritalin) and found that the response to treatment wasdifference in these two problems are pretty much the
the same for Predominantly Inattentive ADHD with andsame and so the distinction is not important
without symptoms of SCT. One study found thatIn people with SCT a treatment that addresses
ADHD-PI individuals with and without Sluggish Cognitivearousal level is imperative whereas in ADHD-PI the
Tempo responded positively to Behavioral Therapytreatment should be tailored to address inattention
and that both inattentive symptoms and sluggishnesswithout affecting arousal level. To treat either SCT or
symptoms were improved by the behavioralADHD-PI properly, the treatments must be tailored to
intervention.the symptoms. A 'one size fits all' approach is not
One large study of over 2800 children found that girlsadvocated in treating the three different subtypes of
were more likely to have SCT symptoms withADHD and a 'one size fits all' approach for
Predominantly Inattentive ADHD symptoms and thatPredominantly Inattentive ADHD and Sluggish Cognitive
boys were likely to be inattentive without symptoms ofTempo may not be appropriate either.
SCT.Individuals with Sluggish Cognitive Tempo and
The diagnostic manual, third edition, the DSM III had aindividuals with Inattentive ADHD have the symptom of
diagnosis that was called Attention Deficit Disorderinattention in common but their differences are
without Hyperactivity. This diagnosis was for peoplesignificant enough that these two disorders should be
who were inattentive and had "inconsistent levels oftreated by parents, physician's and teachers as
orientation and alertness. They were described in theseparate disorders.
DSM III as sluggish, drowsy, and 'daydreamy'. Field trials