Search

Cognitive disengagement syndrome (CDS; previously referred to as sluggish cognitive tempo) is a set of behaviors, including excessive mind-wandering, mental fogginess, and hypoactivity, that are separate from ADHD inattentive (ADHD-IN) symptoms and linked to functional outcomes. However, CDS and ADHD-IN symptoms are strongly associated, and our understanding of whether personality correlates are similarly or differentially linked to CDS and ADHD-IN is limited. The objective of the current study was to examine personality correlates of CDS and ADHD-IN symptoms across two independent samples of school-aged youth. Study 1 included 207 school-aged children (ages 7–11; 63% male; 87.9% White) with or without teacher-reported elevations in CDS. Study 2 included 263 school-aged children (ages 8–12; 58% male; 75.3% White) with the full range of CDS symptomatology. Parents and teachers completed ratings of ADHD-IN and CDS, and parents also reported on their child's personality dimensions. Across two samples and controlling for demographic characteristics as well as ADHD-IN symptoms and other personality traits, higher levels of FFFS-fear/shyness were uniquely associated with higher levels of parent- and teacher-reported CDS symptoms. In most models, lower levels of BAS-drive were also uniquely associated with higher levels of CDS. In contrast, when controlling for demographic characteristics and CDS symptoms, higher levels of BAS-impulsivity/fun-seeking were uniquely associated with higher levels of parent- and teacher-reported ADHD-IN symptoms. The findings provide the clearest evidence to date that personality dimensions are differentially associated with ADHD-IN and CDS symptoms in children, further underscoring CDS as a distinct construct from ADHD-IN. [ABSTRACT FROM AUTHOR]

Despite distinct peer difficulties, less is known about the peer functioning of children with attention-deficit/hyperactivity disorder (ADHD) predominantly inattentive type (ADHD-I) in comparison to the peer functioning of children with ADHD combined type. Our purpose was to examine whether child sex moderated the relations between negative social preference and internalizing/externalizing problems in children with ADHD-I. Participants included 188 children diagnosed with ADHD-I (110 boys; ages 7-11; 54% Caucasian). Teacher ratings of the proportion of classmates who "like/accept" and "dislike/reject" the participating child were used to calculate negative social preference scores. Children, parents, and teachers provided ratings of anxious and depressive symptoms, and parents and teachers provided ratings of externalizing problems. Boys and girls did not differ on teachers' negative social preference scores. As hypothesized, however, the relation between negative social preference and internalizing symptoms was moderated by sex such that negative social preference was consistently and more strongly associated with internalizing symptoms among girls than in boys. In terms of externalizing problems, negative social preference was associated with teacher (but not parent) ratings, yet no moderation by child sex was found. Negative social preference is associated with teacher-report of externalizing problems for both boys and girls with ADHD-I, whereas negative social preference is consistently associated with girls' internalizing symptoms across child, parent, and teacher ratings. Implications for future research and interventions are discussed.

Although peer difficulties and sluggish cognitive tempo (SCT) are related, studies have yet to examine environmental factors that may advance further understanding of this association. The current study tested whether peer difficulties, specifically social competence and peer victimization, interacted with school support, a component of school climate, in relation to adolescents' SCT symptoms. Further, we explored whether these relations would be differentially associated with SCT in adolescents with and without attention-deficit/hyperactivity disorder (ADHD). Adolescents (N = 288; Mage = 14.08, 45% female, 82.6% White; 52% with ADHD) completed measures of social competence, peer victimization, school climate support, and SCT and ADHD inattentive (IN) symptoms. Parents also reported on adolescents' social competence, SCT, and ADHD-IN symptoms. Results indicated that adolescent and parent ratings of lower social competence were both associated with higher adolescent-reported SCT symptoms in the context of low, but not high, school support. Relational and nonphysical victimization were associated with higher self-reported SCT symptoms in the context of low school support. Lower adolescent- and parent-reported social competence were also related to higher parent-reported SCT symptoms, with these associations not moderated by school support. These results remained after controlling for demographics and ADHD-IN symptoms and were similar across adolescents with and without ADHD. Findings from the current study are the first to provide evidence that peer difficulties and school climate are jointly related to adolescents' self-reported SCT and underscore the importance of continued research investigating social adversity and environmental factors in relation to SCT. [ABSTRACT FROM AUTHOR]

Psychometric and normative information is provided for the Sluggish Cognitive Tempo, Attention Deficit/Hyperactivity Disorder (ADHD) Inattention, ADHD Hyperactivity/Impulsivity, Oppositional Defiant Disorder, Callous-Unemotional Behaviors (Limited Prosocial Emotions specifier), Anxiety, Depression, Social Impairment, Friendship Difficulties, and Academic Impairment Scales of the Child and Adolescent Behavior Inventory (CABI) with a nationally representative sample of U.S. children. Mothers of 2,056 kindergarten to sixth-grade children (M ± SDage = 8.49 ± 2.15 years; 49% girls) completed the CABI, and 307 randomly selected mothers completed the CABI again 4 weeks later. The 10-factor model (one factor for each CABI scale) provided a close fit for the total sample as well as for boys and girls separately. Each scale showed invariance of like-item loadings and thresholds for boys and girls across a 4-week interval with excellent test–retest factor correlations and no significant factor mean changes. Normative information (T-scores) is provided for the 10 scales separately for boys and girls, with test information functions supporting the use of the scales for screening purposes. The normative information on the CABI provides support for the use of the 10 scales to inform the clinical care of individual children, with the positive psychometric properties of the scores providing additional support for the use of the scales for research. Copies of the scale and norms are available for free to clinicians and researchers. [ABSTRACT FROM AUTHOR]

Objective: Multisource longitudinal network analysis was used to determine if between-child and within-child variance of attention-deficit/hyperactivity disorder (ADHD) symptoms provided unique findings of ADHD relative to latent variable model (LVM) analyses. Method: Mothers and fathers of 802 Spanish first-grade children (54% boys) provided ratings of ADHD symptoms at two time points six weeks apart (assessment 1: 723 mothers and 603 fathers; assessment 2: 667 mothers and 584 fathers). Network and latent variable models were applied to the ratings. Results: Inattention, hyperactivity, and mixed hyperactive/impulsive symptom communities occurred for the within- and between-children's symptom networks with the results being consistent across mothers and fathers, especially for the between-children's symptom networks. LVM analyses identified three factors with the same symptoms on each factor as in the symptom communities. These models also showed invariance across mothers and fathers as well as assessments. Conclusions: Longitudinal networks provided several useful insights for ADHD, including centrality symptoms that differed across between- and within-child levels. However, many findings were also largely consistent with the LVM analyses. Future studies should use novel methods (e.g., intensive longitudinal measurement) and analytic tools to determine if more unique theoretical and clinical findings emerge when applying network analysis to longitudinally measured ADHD symptoms. [ABSTRACT FROM AUTHOR]

A nationally representative sample of U.S. children was used to determine the empirical and clinical differentiation of sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) symptoms using both categorical and dimensional approaches. Mothers of children (N = 2,056, M± SDage = 8.49 ± 2.15 years, 49.3% girls) completed measures of SCT, ADHD, oppositional defiant disorder (ODD), anxiety, depression, sleep difficulties, daily life executive functioning, conflicted shyness, friendship difficulties, and social and academic impairment. Scores greater than the top 5% on SCT and ADHD measures were used to create SCT-only (n = 53, 2.58%), ADHD-only (n = 93, 4.52%), SCT+ADHD (n = 49, 2.38%), and comparison (n = 1,861, 90.52%) groups. Fifty-two percent of the SCT group did not qualify for the ADHD group, whereas 65% of the ADHD group did not qualify for the SCT group. The SCT-only group had higher levels of anxiety, depression, conflicted shyness, and sleep difficulties than the ADHD-only group. In contrast, the ADHD-only group had greater executive functioning deficits and higher ODD than the SCT-only group. SCT-only and ADHD-only groups showed similar levels of friendship, social, and academic impairment. Similar findings emerged when using structural regression analyses to determine the unique clinical correlates of SCT and ADHD dimensions. This is only the second study to examine the distinction of clinically-elevated SCT from ADHD in a national sample of children and extends previous findings to a broader array of functional outcomes. Normative information on the SCT scale also provides a validated rating scale to advance research and clinical care. [ABSTRACT FROM AUTHOR]

Few studies have examined the longitudinal association between sluggish cognitive tempo (SCT) symptoms and internalizing symptoms, and no study has examined the potentially bidirectional associations between SCT and internalizing symptoms. The present study used a short-term longitudinal design to examine the directionality of the associations between SCT, depressive, and anxious symptoms in children. Teachers of 188 children in 1st to 6th grades (6–13 years of age; 47% boys) provided ratings of children's SCT, anxiety, and depressive symptoms in the fall school semester (T1) and again 6 months later (T2). Children in 3rd to 6th grades (n = 133) provided ratings of anxiety and depressive symptoms at both time points. Cross-lagged panel models examining the longitudinal associations between SCT, anxiety, and depressive symptoms were conducted controlling for sex and grade, with separate models for teacher- and child-reported internalizing symptoms. SCT symptoms at Time 1 (T1) predicted increased depressive symptoms at T2, with findings consistent across teacher-rated depression and child-rated depression. Depression at T1 did not predict SCT at T2. SCT symptoms at T1 also predicted increased teacher-rated anxiety at T2 but not child-rated anxiety. Finally, child-rated anxiety at T1 predicted increased SCT at T2. Findings from this study provide the first evidence that SCT symptoms predict subsequent depressive symptoms and not the reverse. Associations between SCT and anxiety are more nuanced, with results differing based on the informant. Additional studies are needed to replicate and extend these findings across longer developmental periods with more time points and to examine mechanisms of the associations between SCT and internalizing symptoms in children. [ABSTRACT FROM AUTHOR]

The objective was to determine the proportion of trait (consistency across occasions) and occasion-specific variance in sluggish cognitive tempo (SCT), attention deficit/hyperactivity disorder (ADHD)–inattention (IN), ADHD–hyperactivity/impulsivity (HI), and oppositional defiant disorder (ODD) symptom ratings. A single trait factor-multiple state factors model was applied to parent ratings of SCT, ADHD-IN, ADHD-HI, and ODD symptoms for 978 children (50% female) across prekindergarten (M = 4.90 years), kindergarten (M = 6.27 years), 1st-grade (M = 7.42 years), 2nd-grade (M = 8.45 years), and 4th-grade (M = 10.45 years) assessments. For the prekindergarten assessment, SCT, ADHD-IN, ADHD-HI, and ODD contained more occasion-specific than trait variance (54%, 64%, 56%, and 55% occasion-specific variance, respectively). In contrast, SCT, ADHD-IN, ADHD-HI, and ODD contained more trait than occasion-specific variance for the kindergarten through 4th-grade assessments (62%–72%, 65%–68%, 71%–75%, and 60%–69% trait variance, respectively). SCT, ADHD-IN, ADHD-HI, and ODD are slightly to moderately more state-like than trait-like during the prekindergarten developmental period but are more stable traits than fluctuating states from kindergarten to 4th grade. Findings indicate that, particularly after children start formal schooling, these psychopathology dimensions are primarily stable traits; implications for assessment are discussed. [ABSTRACT FROM AUTHOR]

A recent meta-analysis identified optimal items for assessing sluggish cognitive tempo (SCT) as distinct from attention deficit/hyperactivity disorder inattention (ADHD-IN), and a preliminary study with teacher ratings of children in the United States found strong support for the convergent and discriminant validity of 15 SCT items. The current study evaluated whether the same 15 SCT items demonstrated convergent and discriminant validity from ADHD-IN in a large, community-based sample of children in Spain, and whether validity results were replicated across mother, father, and teacher ratings. Mothers, fathers, and teachers completed measures of SCT, ADHD-IN, ADHD-hyperactivity/impulsivity, oppositional defiant disorder, limited prosocial emotions, anxiety, depression, shyness, peer rejection, social impairment, and academic impairment on 2,142 Spanish children (49.49% girls; ages 8–13). The 15 SCT symptoms demonstrated convergent validity along with discriminant validity with ADHD-IN across all three informants. The SCT symptom ratings also showed measurement invariance across the informants. In addition, SCT and ADHD-IN factors had different and unique associations with the other symptom and impairment factors. The 15 SCT symptoms identified in this study—consistent across mother, father, and teacher ratings—appear appropriate to serve as a standard symptom set for assessing SCT in children. Use of a common set of symptoms in future studies will advance our understanding of the SCT construct, including its etiology and developmental progression, associations with ADHD and other psychopathologies, links to impairment, and implications for clinical intervention. [ABSTRACT FROM AUTHOR]

Resilience models suggest that there are likely to be multiple trajectories of self-worth and that despite experiencing impairment, some youth with attention deficit/hyperactivity disorder (ADHD) may maintain a positive self-worth, which could buffer them against negative outcomes. The present study used a cohort-sequential longitudinal design to evaluate developmental trajectories of global self-worth in a sample of 324 middle-school-age adolescents (71% male) diagnosed with ADHD between ages 11 and 14 in predicting outcomes at age 15. Sex, medication status, and ADHD/oppositional defiant disorder symptom severity were included as covariates in the models. Using growth mixture modeling, 3 distinct self-worth trajectory groups were identified: (a) high and increasing (44.4% of participants), (b) moderate and decreasing (48.8%), and (c) low and decreasing (6.8%). Participants with high and increasing global self-worth were less likely to exhibit co-occurring depressive symptoms and had better social functioning and higher grades at age 15 relative to those in either decreasing trajectory. Implications of these findings for monitoring and supporting positive global self-worth for adolescents with ADHD are discussed. [ABSTRACT FROM AUTHOR]

Sluggish cognitive tempo (SCT) symptoms are associated with social difficulties in children, though findings are mixed and many studies have used global measures of social impairment. The present study tested the hypothesis that SCT would be uniquely associated with aspects of social functioning characterized by withdrawal and isolation, whereas attention deficit/hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms would be uniquely associated with aspects of social functioning characterized by inappropriate responding in social situations and active peer exclusion. Participants were 158 children (70% boys) between 7-12 years of age being evaluated for possible ADHD. Both parents and teachers completed measures of SCT, ADHD, ODD, and internalizing (anxiety/depression) symptoms. Parents also completed ratings of social engagement and self-control. Teachers also completed measures assessing asociality and exclusion, as well as peer ignoring and dislike. In regression analyses controlling for demographic characteristics and other psychopathology symptoms, parent-reported SCT symptoms were significantly associated with lower social engagement (e.g., starting conversations, joining activities). Teacher-reported SCT symptoms were significantly associated with greater asociality/withdrawal and ratings of more frequent ignoring by peers, as well as greater exclusion. ODD symptoms and ADHD hyperactive-impulsive symptoms were more consistently associated with other aspects of social behavior, including peer exclusion, being disliked by peers, and poorer self-control during social situations. Findings provide the clearest evidence to date that the social difficulties associated with SCT are primarily due to withdrawal, isolation, and low initiative in social situations. Social skills training interventions may be effective for children displaying elevated SCT symptomatology. [ABSTRACT FROM AUTHOR]

This goal of this study was to assess the initial feasibility and efficacy of a play-based intervention targeting executive functions (EF) and parent-child relationships in preschoolers compared with an active control group. Preschoolers with EF deficits (M age = 3.7 ± 0.47, predominantlyWhite boys) and their parents were randomized to intervention (n = 36) or active control (n = 32) conditions. Child performance on EF tasks, parent and masked teacher ratings of EF and behavior, and masked clinician ratings of severity were collected at baseline and at 3 and 6months postbaseline. Partial etasquared effect sizes at .02 or higher comparing performance across the two groups was considered evidence of meaningful, albeit small, intervention effects. Intervention effects were observed for parent ratings of inattention, hyperactivity/impulsivity, and number/severity of problems experienced in various home situations, teacher ratings of severity of problems in various school situations, parent and teacher ratings of overall impairment, and clinician ratings of impairment. Intervention effects for functional improvements were maintained at the 6-month follow-up. No effect of the intervention was observed on the objective EF measures, although parent ratings of emotional control were improved for children in the intervention group. An intervention utilizing play-based activities targeting EF, when administered in a structured way by parents, is a promising approach for improving behavior in preschoolers with self-regulation deficits. More work is needed to investigate potential impact on EF and to disentangle mechanisms of action. It may be that the intervention's focus on the structure and quality of parent-child interactions is a mediator of outcomes, rather than improved EFs. [ABSTRACT FROM AUTHOR]

There is considerable evidence that externalizing disorders such as attention deficit/hyperactivity disorder (ADHD) put youth at risk for a range of adverse academic outcomes. It is importantly to note that some youth avoid these negative outcomes, yet there is a gap in our understanding of these resilient youth. The purpose of this study was to longitudinally evaluate social acceptance and social skills as potential protective factors of the associations between inattentive, hyperactive/impulsive, and oppositional defiant behaviors with academic outcomes. Participants included a sample of 93 middle school students comprehensively diagnosed with ADHD. Parents and adolescents completed ratings of social skills and perceived social acceptance. School grades and teacher-rated academic impairment were assessed 18 months later as longitudinal academic functioning outcomes. Inattention and social acceptance were associated with academic outcomes 18 months later. Regression analyses revealed that parent- and adolescent-rated social acceptance demonstrated promotive effects for grades and against teacher-rated academic impairment. Further, social acceptance significantly interacted with inattention in predicting school grades, such that high parent- and adolescent-rated social acceptance significantly attenuated the relationship between inattention and poor grades, even after controlling for baseline grades and intelligence. The presence of social acceptance was especially critical for adolescents with high levels of inattention. Specifically, adolescents with high inattention and high social acceptance had a mean grade point average of 2.5, and adolescents with high inattention and low social acceptance had a mean grade point average of 1.5. These findings demonstrate that social acceptance may be an important intervention target for improving academic outcomes among adolescents with ADHD. [ABSTRACT FROM AUTHOR]

All sluggish cognitive tempo (SCT) research has been conducted in North America and Western Europe, with the addition of 1 study in Chile. Our objective was to determine the internal and external validity of 9 SCT and 9 Diagnostic and Statistical Manual of Mental Disorders (5th ed.) attention deficit/hyperactivity disorder inattention (ADHD-IN) symptoms in South Korean children. Mothers, fathers, and teachers rated SCT, ADHD-IN, ADHD hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, and social impairment in 1st- to 6th-grade children (6-13 years of age) from South Korea (Sample 1: mothers rated 885 children and fathers rated 646 children; 941 unique children, 54% girls; Sample 2: 99 teachers rated 297 children, 44% girls). The SCT and ADHD-IN symptoms showed convergent validity (substantial loadings on their respective factors) and discriminant validity (loadings near zero on the alternative factor) across all three raters. Although ADHD-IN showed a positive relationship with ADHD-HI and ODD even after controlling for SCTacross all three raters, SCTwas nonsignificantly (mothers and fathers) or negatively (teachers) related to ADHD-HI and ODD after controlling for ADHD-IN. Higher SCTscores predicted higher anxiety, depression, academic impairment (teachers only), and social impairment (teachers only) even after controlling for ADHD-IN, whereas higher ADHD-IN scores predicted higher anxiety (mothers and fathers only), depression, academic impairment, and social impairment after controlling for SCT. The study provides initial evidence for the internal and external validity of SCT relative to ADHD-IN in South Korean children, thereby providing the first evidence for SCT's validity in Asian children. [ABSTRACT FROM AUTHOR]

Objective Method Results Conclusions The identification of a common set of symptoms for assessing cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) for early childhood (ages 5–8), middle childhood (ages 9–12), and adolescence (ages 13–16) is needed to advance research on the developmental psychopathology of CDS (i.e. a common symptom set with comparable internal and external validity for each age group).Parents of a nationally representative sample of 5,525 Spanish children and adolescents (ages 5 to 16, 56.1% boys) completed measures of CDS, attention-deficit/hyperactivity disorder-inattention (ADHD-IN), and other measures.First, the 15 CDS symptoms showed convergent and discriminant validity relative to the ADHD-IN symptoms within each age group. Second, CDS showed stronger first-order and unique associations than ADHD-IN with anxiety, depression, somatization, daytime sleep-related impairment, and nighttime sleep disturbance, whereas ADHD-IN showed stronger first-order and unique associations than CDS with ADHD-hyperactivity/impulsivity, oppositional defiant disorder, and academic impairment. Third, CDS showed stronger first-order and unique associations than ADHD-IN with a history of having an anxiety, depression, or bipolar disorder diagnosis, whereas ADHD-IN showed stronger first-order and unique associations with having an ADHD diagnosis.The identification of a common set of CDS symptoms spanning early childhood to adolescence allows for the advancement of research on CDS, with a particular need now for longitudinal studies and examination of CDS with other functional outcomes and across other cultural contexts. [ABSTRACT FROM AUTHOR]

The present study examined anxiety and depressive symptoms in relation to the social functioning of young adolescents with attention-deficit/hyperactivity disorder (ADHD) and builds upon prior work by incorporating youths' self-reports of internalizing symptoms and examining distinct anxiety and depression dimensions to increase specificity. Participants were 310 young adolescents (ages 10–14; 71% male, 78% Caucasian) diagnosed with ADHD. Youth provided ratings of anxiety/depression, and parents provided ratings of their own depression. Parents and youth both reported on youths' social skills and perceived social acceptance. Path analyses indicated that above and beyond child demographics, ADHD and oppositional defiant disorder symptom severity, and parents' own depression, self-reported social anxiety and anhedonia were both associated with lower youth-reported social skills and both parent- and youth-reported social acceptance. Negative self-evaluation was associated with poorer parent-reported social skills. Finally, harm avoidance waspositivelyassociated with both youth- and parent-reported social skills. A path analysis using comorbid diagnoses (rather than symptom dimensions) indicated that that having a comorbid disruptive behavior disorder or depression diagnosis (but not a comorbid anxiety diagnosis) was associated with poorer parent-reported social functioning. Results demonstrate that the relation between internalizing symptoms and social functioning among young adolescents with ADHD is nuanced, with social anxiety and anhedonia symptoms associated with lower social skills and social acceptance in contrast to harm avoidance being associated with higher ratings of social skills (and unrelated to social acceptance). In terms of comorbid diagnoses, depression is more clearly related than anxiety to poorer social functioning among young adolescents with ADHD. These results point to the importance of attending to specific facets of anxiety and depression in clinical care and future research. [ABSTRACT FROM AUTHOR]