Maria del Mar Bernad

Distinctions Between Sluggish Cognitive Tempo, ADHD-IN, and Depression Symptom Dimensions in Spanish First-Grade Children

The objective of this study was to evaluate the validity of a new parent rating scale of Sluggish Cognitive Tempo (SCT). SCT was defined with 10 symptom domains—daydreams; attention fluctuates; absentminded; loses train of thought; easily confused; seems drowsy; thinking is slow; slow-moving; low initiative; and easily bored, needs stimulation—with each domain represented by multiple examples. Mothers’ and fathers’ ratings of SCT, ADHD-IN, ADHD-HI, oppositional defiant disorder (ODD), and depression symptoms along with ratings of academic and social impairment were obtained for a sample of 802 Spanish first-grade children (54% boys). SCT Symptom Domains 4 to 8 showed substantial loadings on the SCT factor (i.e., convergent validity) and substantially higher loadings on the SCT factor than the ADHD-IN factor (i.e., discriminant validity). This 5-domain measure of SCT showed good interrater and test–retest reliability for a 6-week interval. Higher scores on the 5-domain measure of SCT predicted higher levels of academic and social impairment even after controlling for ADHD-IN and depression. In contrast, higher levels of SCT were not uniquely related (or uniquely negatively related) to ADHD-HI and ODD, whereas ADHD-IN and depression were uniquely positively related to ADHD-HI and ODD. The new measure of SCT more clearly establishes that SCT, ADHD-IN, and depression represent independent symptom dimensions, thus providing a measurement tool to help determine if SCT and ADHD-IN dimensions have unique biological correlates and if SCT and ADHD meet the criteria for different disorders.

Longitudinal Correlates of Sluggish Cognitive Tempo and ADHD-Inattention Symptom Dimensions with Spanish Children

The objective was to examine the longitudinal correlates of sluggish cognitive tempo (SCT) and attention deficit/hyperactivity disorder (ADHD)-Inattention (IN) dimensions with mothers’ and fathers’ ratings of Spanish children. Mothers and fathers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), depression, academic impairment, and social impairment on 3 occasions (twice in first-grade year [6-week separation] and once in the second-grade year [12 months after the first assessment]) in Spanish children (758, 746, and 718 children at the 3 time-points with approximately 55% boys). The results showed that (a) higher levels of SCT from earlier assessments predicted higher levels of depression, academic impairment, and social impairment at Assessment 3 after controlling for ADHD-IN at earlier assessments; (b) higher levels of ADHD-IN from earlier assessments predicted higher levels of depression, academic impairment, and social impairment at Assessment 3 after controlling for SCT at earlier assessments; (c) higher levels of ADHD-IN from earlier assessments predicted higher levels of ADHD-HI and ODD at Assessment 3 after controlling for SCT from earlier assessments; and (d) higher levels of SCT from earlier assessments either showed no unique relationship with ADHD-HI and ODD or predicted lower levels of ADHD-HI and ODD at Assessment 3 after controlling for ADHD-IN from earlier assessments. Initial evidence is provided of SCTs unique longitudinal relationships with depression and academic/social impairment and different longitudinal relationships with ADHD-HI and ODD relative to ADHD-IN, thus adding to a growing body of research underscoring the importance of SCT as distinct from ADHD-IN.

Sluggish Cognitive Tempo and Attention-Deficit/Hyperactivity Disorder (ADHD) Inattention in the Home and School Contexts: Parent and Teacher Invariance and Cross-Setting Validity.

This study examined whether sluggish cognitive tempo (SCT) and attention-deficit/hyperactivity disorder (ADHD) inattention (IN) symptoms demonstrated cross-setting invariance and unique associations with symptom and impairment dimensions across settings (i.e., home SCT and ADHD-IN uniquely predicting school symptom and impairment dimensions, and vice versa). Mothers, fathers, primary teachers, and secondary teachers rated SCT, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), oppositional defiant disorder (ODD), anxiety, depression, academic impairment, social impairment, and peer rejection dimensions for 585 Spanish 3rd-grade children (53% boys). Within-setting (i.e., mothers, fathers; primary, secondary teachers) and cross-settings (i.e., home, school) invariance was found for both SCT and ADHD-IN. From home to school, higher levels of home SCT predicted lower levels of school ADHD-HI and higher levels of school academic impairment after controlling for home ADHD-IN, whereas higher levels of home ADHD-IN predicted higher levels of school ADHD-HI, ODD, anxiety, depression, academic impairment, and peer rejection after controlling for home SCT. From school to home, higher levels of school SCT predicted lower levels of home ADHD-HI and ODD and higher levels of home anxiety, depression, academic impairment, and social impairment after controlling for school ADHD-IN, whereas higher levels of school ADHD-IN predicted higher levels of home ADHD-HI, ODD, and academic impairment after controlling for school SCT. Although SCT at home and school was able to uniquely predict symptom and impairment dimensions in the other setting, SCT at school was a better predictor than ADHD-IN at school of psychopathology and impairment at home. Findings provide additional support for SCT’s validity relative to ADHD-IN.

Ratings of ADHD symptoms and academic impairment by mothers, fathers, teachers, and aides: construct validity within and across settings as well as occasions.

A Multiple Indicator × Multiple Trait × Multiple Source × Multiple Occasion design was used to evaluate invariance, convergent and discriminant validity of ADHD-inattention (IN), ADHD-hyperactivity/impulsivity (HI), and academic impairment scores from the Child and Adolescent Disruptive Behavior Inventory (CADBI) using confirmatory factor analysis. Mothers, fathers, teachers, and aides completed the CADBI on 811 Spanish 1st-grade children (54% boys) twice (6-week separation). For mothers and fathers, like loadings, thresholds/intercepts, factor means, factor variances, and factor covariances/correlations were invariant across sources and occasions. All 3 factors also showed convergent (convergent correlations from .69 to .83) and significant discriminant validity. For teachers and aides, there was also invariance of parameters along with convergent and discriminant validity over sources and occasions (convergent correlations from .67 to .87). With construct validity established for home and school, it was meaningful to test construct validity between home and school. Like-item loadings and thresholds/intercepts were invariant between home and school, with the ADHD-HI factor mean being lower at school. Convergent validity of ADHD-IN, ADHD-HI, and academic impairment factors, especially ADHD-IN and ADHD-HI, was much weaker between home and school (convergent correlations from .36 to .47 for IN and HI). The strong convergent validity of ADHD-IN and ADHD-HI scores within home and school in conjunction with weak convergent validity across home and school has implications for the assessment and diagnosis of ADHD (i.e., the diagnostic criteria of symptom occurrence in 2 or more settings).