Sluggish Cognitive Tempo in Pediatric Sickle Cell Disease.
Ontology highlight
ABSTRACT: Background
Sickle cell disease (SCD) imparts risk for a range of neurodevelopmental and neurocognitive disorders. Sluggish cognitive tempo (SCT) is a distinct syndrome that often co-occurs with attention-deficit/hyperactivity disorder (ADHD) but has not been described in SCD. We investigated the reliability and validity of a SCT measure in SCD and examined associations with biopsychosocial risk factors and functional outcomes.Materials and methods
Caregivers (n = 85) of children with SCD ages 7-16 reported on socio-demographics and the Kiddie-Sluggish Cognitive Tempo (K-SCT) measure, Behavior Rating Inventory of Executive Function, and Conners 3. Disease-related characteristics were extracted from health records.Results
The K-SCT demonstrated excellent internal consistency (α = 0.92) and test-retest reliability (r = 0.82, p < 0.001). K-SCT scores were correlated with ADHD-Inattention (r = 0.64, p < 0.001) and ADHD-Hyperactive/Impulsive (r = 0.46, p < 0.001) scores, as well as functional outcomes, including learning problems (r = 0.69, p < 0.001). In multivariate analyses controlling for ADHD symptoms, SCT accounted for unique variance in learning (b = 9.67, p < 0.01) and executive functioning (b = 5.93, p < 0.01). Nearly all participants (93%) with elevated levels of co-occurring SCT and ADHD-Inattention symptoms had significant learning problems.Conclusion
The K-SCT is a reliable and valid measure of SCT in SCD. SCT symptoms are associated with learning difficulties even after controlling for ADHD symptoms. Further research is needed to understand the biopsychosocial factors that lead to SCT symptoms in SCD and examine long-term implications of SCT.
SUBMITTER: Hardy SJ
PROVIDER: S-EPMC9301245 | biostudies-literature |
REPOSITORIES: biostudies-literature
Similar Datasets
Project description:ObjectiveSluggish cognitive tempo refers to a constellation of symptoms that include slowed behavior/thinking, reduced alertness, and getting lost in one's thoughts. Despite the moniker "sluggish cognitive tempo," the evidence is mixed regarding the extent to which it is associated globally with slowed (sluggish) mental (cognitive) information processing speed (tempo).MethodA well-characterized clinical sample of 132 children ages 8-13 years (M = 10.34, SD = 1.51; 47 girls; 67% White/non-Hispanic) were administered multiple, counterbalanced neurocognitive tests and assessed for sluggish cognitive tempo symptoms via multiple-informant reports.ResultsBayesian linear regressions revealed significant evidence against associations between sluggish cognitive tempo and computationally modeled processing speed (BF01 > 3.70), and significant evidence for associations with slower working memory manipulation speed. These findings were consistent across parent and teacher models, with and without control for attention-deficit/hyperactivity disorder inattentive symptoms and IQ. There was also significant evidence linking faster inhibition speed with higher parent-reported sluggish cognitive tempo symptoms.ConclusionsThese findings provide strong evidence against characterizing children with sluggish cognitive tempo symptoms as possessing a globally sluggish cognitive tempo. Instead, these symptoms appear to be related, to a significant extent, to executive dysfunction characterized by working memory systems that are too slow and inhibition systems that are too fast. Behaviorally, these findings suggest that requiring extra time to rearrange the active contents of working memory delays responding, whereas an overactive inhibition system likely terminates thoughts too quickly and therefore prevents intended behaviors from starting or completing, thereby giving the appearance that children are absent-minded or failing to act when expected. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
| S-EPMC6814302 | biostudies-literature
Project description:Adolescents with autism spectrum disorder frequently experience social communication difficulties, executive functioning deficits, and anxiety and depressive symptoms, which are similar to the symptoms and correlates of sluggish cognitive tempo. Although sluggish cognitive tempo is related to, but distinct from, the inattentive and hyperactive-impulsive symptoms of attention-deficit/hyperactivity disorder that commonly co-occur with autism spectrum disorder, few studies have examined sluggish cognitive tempo in autism spectrum disorder. We examined whether sluggish cognitive tempo and attention-deficit/hyperactivity disorder were differentially associated with autism symptomatology, daily life executive functioning, and internalizing and externalizing symptoms in 51 adolescents (ages 13-18?years) with autism spectrum disorder without intellectual disability. Regression analyses controlling for age and IQ showed that sluggish cognitive tempo symptoms, but not attention-deficit/hyperactivity disorder symptoms, were associated with increased autism symptomatology and internalizing symptoms. Attention-deficit/hyperactivity disorder symptoms, but not sluggish cognitive tempo symptoms, were associated with increased externalizing behaviors and behavior regulation deficits. Both sluggish cognitive tempo and attention-deficit/hyperactivity disorder were independently associated with increased metacognitive deficits. This study provides preliminary evidence that sluggish cognitive tempo symptoms are elevated in autism spectrum disorder and associated with key clinical correlates, with implications for the assessment and treatment in adolescents with autism spectrum disorder.
| S-EPMC6517090 | biostudies-literature
Project description:ObjectiveAlthough absent from traditional diagnostic nosologies, Sluggish Cognitive Tempo (SCT) may have transdiagnostic utility given its robust associations with ADHD and internalizing symptoms as well as with cognitive impairments common to these conditions. Within-person variation in SCT symptoms may also serve to link ADHD, cognitive deficits, and internalizing psychopathology, however, few studies have utilized intensive longitudinal designs to probe within-person variation in SCT and its links to cognitive deficits and psychopathology.MethodEcological Momentary Assessment was used to measure between and within-person variance in SCT 4 times per day across 7 days (28 time-points) in 158 college students (approximately 51% with elevated ADHD and/or internalizing symptoms). Participants also completed ratings of current and childhood ADHD symptoms, cognitive function and internalizing psychopathology. Parameters derived from longitudinal multilevel models indexing between and within person variation in SCT were examined as mediators of the associations between (1) ADHD and internalizing symptoms and (2) self-reported cognitive functioning and internalizing symptoms.ResultsResults indicated that between-person differences in SCT, but not within-person variability, linked current and childhood ADHD and internalizing symptoms. Similarly, problems in time-management and organization influenced internalizing psychopathology via between-person differences in SCT.ConclusionResults found that SCT may be a transdiagnostic link bridging mental health comorbidities, cognitive dysfunction, and internalizing psychopathology.
| S-EPMC10786088 | biostudies-literature
Project description:ObjectivesAlthough pediatric obstructive sleep apnea (OSA) is estimated to affect 2-3% of the general population, its prevalence in sickle cell disease (SCD) is much higher, with research suggesting a prevalence rate of upwards of 40%. Despite the similar underlying pathophysiological mechanisms of neurocognitive effects in pediatric OSA and SCD, there is a scarcity of information on how these two conditions interact. The aim of this study was to better understand the contribution of sleep apnea to neurocognitive deficits in children diagnosed with SCD.MethodThis study assessed cognitive function in 26 children with comorbid SCD and OSA, 39 matched comparisons with SCD only, and 59 matched comparisons in children without a chronic health condition.ResultsThere were significant differences on measures of processing speed and reading decoding, with children without a chronic health condition scoring better than both chronic health condition groups. Additionally, the no chronic health condition group performed better on a test of quantitative knowledge and reasoning and a test of visual-spatial construction than the SCD-only group. Contrary to our hypotheses, there were no between-group differences suggesting an additive impact of OSA on cognition. Exploratory analyses revealed associations within the group that had OSA showing that more severe OSA correlated with lower performance on measures of processing speed and quantitative knowledge/reasoning.ConclusionsChildren with comorbid OSA and SCD do not present with greater deficits in cognitive functioning than children with SCD alone. However, severe OSA may confer additional risk for neurocognitive impairments.
| S-EPMC6774893 | biostudies-literature
Project description:Sluggish cognitive tempo (SCT) symptoms may confer risk for academic impairment in attention-deficit/hyperactivity disorder (ADHD). We investigated SCT in relation to academic performance and impairment in 252 children (ages 6-12, 67% boys) with ADHD. Parents and teachers completed SCT and academic impairment ratings, and achievement in reading, math, and spelling was assessed. Simultaneous regressions controlling for IQ, ADHD, and comorbidities were conducted. Total SCT predicted parent-rated impairments in writing, mathematics, and overall school but not reading. Parent-rated SCT Slow predicted poorer reading and spelling, but not math achievement. Teacher-rated SCT Slow predicted poorer spelling and math, but not reading achievement. Parent-rated SCT Slow predicted greater academic impairment ratings across all domains, whereas teacher-rated SCT Slow predicted greater impairment in writing only. Age and gender did not moderate these relationships with the exception of math impairment; SCT slow predicted math impairment for younger but not older children. Parent and teacher SCT Sleepy and Daydreamy ratings were not significant predictors. SCT Slow appears to be uniquely related to academic problems in ADHD, and may be important to assess and potentially target in intervention. More work is needed to better understand the nature of SCT Slow symptoms in relation to inattention and amotivation.
| S-EPMC6431536 | biostudies-literature
Project description:We evaluated sluggish cognitive tempo (SCT) symptoms in relation to personality as assessed via both the Reinforcement Sensitivity Theory (BIS/BAS) and Five Factor (Big 5) Model of personality. 3,172 students from five universities completed psychopathology, BIS/BAS, and Big 5 measures. Correlations and path models with SCT, attention-deficit/hyperactivity disorder (ADHD) dimensions, and anxiety/depression in relation to personality were examined. SCT evidenced a different pattern of relations to adult personality than ADHD and anxiety/depression. SCT was significantly uniquely associated with higher BIS and Neuroticism, as well as higher BAS Fun-Seeking. SCT was uniquely associated with lower Extraversion and Conscientiousness. This study provides the first evidence linking SCT to adult personality and underscores the importance of differentiating SCT from both ADHD and anxiety/depression.
| S-EPMC6615739 | biostudies-literature
Project description: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.
| S-EPMC6599489 | biostudies-literature
Project description:Sluggish cognitive tempo (SCT) is a kind of attentional symptoms characterized by symptoms of slowness in behavior or in thinking. The aim of the present study was to develop a preliminary attention training program based on real-time eye-gaze feedback using an eye-tracker. A total of 38 participants with SCT were randomly assigned to one of following two conditions: eye-feedback (N = 19; Mean Age = 21.21; range 18-26) or control (N = 19; Mean Age = 20.68; range 18-25). The participants in the eye-feedback condition received three repeated trainings on the modified version of the Posner's spatial cueing test; we also used real-time constant eye-gaze feedback designed to lead the participants to quickly and accurately engage and to disengage, with pre- and post- measurement of eye-movements (overt attention) and the revised attention network test (ANT-R; covert attention). The participants in the control condition received three repeated same trainings without any feedback, with pre- and post-measurement of eye-movements measure and ANT-R. The results revealed that the eye-feedback group showed a greater improvement in engaging and disengaging attention through the overt attention measure than the control group. The eye-feedback group also showed a greater increase only in the orienting network related to disengaging attention in the covert attention measure compared to the control group. These results suggested that the eye-feedback can be meaningfully used in attention training to enhance the efficiency of attention in clinical settings.
| S-EPMC7090146 | biostudies-literature
Project description:Studies of subtypes of DSM-IV attention-deficit/hyperactivity disorder (ADHD) have provided inconsistent support for the discriminant validity of the combined type (ADHD-C) and predominantly inattentive type (ADHD-I). A large sample of children and adolescents with ADHD (N = 410) and a comparison group without ADHD (N = 311) were used to test the internal and external validity of sluggish cognitive tempo (SCT), a dimension characterized by low energy and sleepy and sluggish behavior. SCT scores were then incorporated in analyses of ADHD subtypes to test whether the discriminant validity of ADHD-C and ADHD-I could be improved by including SCT symptoms as part of the criteria for ADHD-I. Factor analyses of parent and teacher ratings indicated that six SCT items loaded on a factor separate from symptoms of ADHD and other psychopathology, providing important support for the internal validity of SCT. The external validity of SCT was supported by significant associations between SCT and measures of functional impairment and neuropsychological functioning when symptoms of ADHD and other psychopathology were controlled. However, contrary to initial predictions, high levels of SCT did not identify a subgroup of ADHD-I that was clearly distinct from ADHD-C. Instead, the current results suggest that DSM-IV inattention and SCT are separate but correlated symptom dimensions that are each independently associated with important aspects of functional impairment and neuropsychological functioning.
| S-EPMC3947432 | biostudies-literature
Project description:OBJECTIVE:To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. METHOD:Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). RESULTS:Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including more than 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, interrater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not in adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (r = 0.38-0.44). Effects for neuropsychological functioning are mixed, although there is initial support for SCT being associated with processing speed, sustained attention, and metacognitive deficits. CONCLUSION:This meta-analytic review provides strong support for the internal validity of SCT and preliminary support for the external validity of SCT. In terms of diagnostic validity, there is currently not enough evidence to describe SCT in diagnostic terms. Key directions for future research are discussed, including evaluating the conceptualization of SCT as a transdiagnostic construct and the need for longitudinal research.
| S-EPMC4764798 | biostudies-literature