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. 2018 Oct;59(10):1094-1104.
doi: 10.1111/jcpp.12946. Epub 2018 Jun 29.

Differential impact of trait sluggish cognitive tempo and ADHD inattention in early childhood on adolescent functioning

Stephen P Becker  1   2 , G Leonard Burns  3 , Daniel R Leopold  4 , Richard K Olson  4   5 , Erik G Willcutt  4   5
Affiliations

Differential impact of trait sluggish cognitive tempo and ADHD inattention in early childhood on adolescent functioning

Stephen P Becker et al. J Child Psychol Psychiatry. 2018 Oct.

Abstract

Background: Sluggish cognitive tempo (SCT) is distinct from attention-deficit/hyperactivity disorder inattention (ADHD-IN) and concurrently associated with a range of impairment domains. However, few longitudinal studies have examined SCT as a longitudinal predictor of adjustment. Studies to date have all used a relatively short longitudinal time span (6 months to 2 years) and only rating scale measures of adjustment. Using a prospective, multi-method design, this study examined whether SCT and ADHD-IN were differentially associated with functioning over a 10-year period between preschool and the end of ninth grade.

Methods: Latent state-trait modeling determined the trait variance (i.e. consistency across occasions) of SCT and ADHD-IN across four measurement points (preschool and the end of kindergarten, first grade, and second grade) in a large population-based longitudinal sample (N = 976). Regression analyses were used to examine trait SCT and ADHD-IN factors in early childhood as predictors of functioning at the end of ninth grade (i.e. parent ratings of psychopathology and social/academic functioning, reading and mathematics academic achievement scores, processing speed and working memory).

Results: Both SCT and ADHD-IN contained more trait variance (Ms = 65% and 61%, respectively) than occasion-specific variance (Ms = 35% and 39%) in early childhood, with trait variance increasing as children progressed from preschool through early elementary school. In regression analyses: (a) SCT significantly predicted greater withdrawal and anxiety/depression whereas ADHD-IN did not uniquely predict these internalizing domains; (b) ADHD-IN uniquely predicted more externalizing behaviors whereas SCT uniquely predicted fewer externalizing behaviors; (c) SCT uniquely predicted shyness whereas both SCT and ADHD-IN uniquely predicted global social difficulties; and (d) ADHD-IN uniquely predicted poorer math achievement and slower processing speed whereas SCT more consistently predicted poorer reading achievement.

Conclusions: Findings of this study - from the longest prospective sample to date - provide the clearest evidence yet that SCT and ADHD-IN often differ when it comes to the functional outcomes they predict.

Keywords: ADHD; academic achievement; attention-deficit/hyperactivity disorder; comorbidity; processing speed; sluggish cognitive tempo; working memory.

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Conflict of interest statement

Conflict of interest statement: No conflicts declared.

Figures

Figure 1
Figure 1
Single source-two construct (SCT and ADHD-IN) latent state-trait—autoregressive model. The supplementary materials show the Mplus code for the model. SCT = sluggish cognitive tempo; ADHD-IN = attention-deficit/hyperactivity-disorder – inattention; SR = state residual factor; IS = indicator (parcel) specific method factor. See Geiser et al. (2017) for additional information on latent state-trait models.
See this image and copyright information in PMC

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