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Sep 20

ADHD (ADD) – and Sluggish Cognitive Tempo


By Keath Low,
Attention deficit hyperactivity disorder (ADHD) is defined by three distinct subtypes: the predominantly inattentive type the predominantly hyperactive-impulsive type the combined type

Some individuals with the predominately inattentive type of ADHD also display a subset of symptoms that are typified by sluggish-lethargic behavior and mental fogginess. It is this subset of characteristics that has been described as “sluggish cognitive tempo” (or SCT).

Symptoms of SCT include:
frequent daydreaming tendency to become confused easily mental fogginess sluggish-lethargic behavior drowsiness frequent staring into space slow processing of information poor memory retrieval social passiveness, reticence and withdrawal

People with SCT often have difficulty with problem-solving, self-organization, self-initiation and processing competing sources of information. They are often characterized as hypoactive (less active).
Sluggish cognitive symptoms are not represented in the current DSM inattention category because they have been found to have only a weak association with the other inattention symptoms.
Inattention is often reflective of distractibility. Current diagnostic criteria for the inattention associated with ADHD include: Often does not give close attention to details or makes careless mistakes at work, in schoolwork or other activities.Often has trouble sustaining attention in tasks or activities.Often does not seem to listen when spoken to directly.Often does not follow through on instructions; starts tasks but quickly loses focus and is easily sidetracked; fails to finish schoolwork, household chores or tasks in the workplace.Often has difficulty organizing tasks and activities.Often avoids, dislikes or is reluctant to engage in tasks that require sustained mental effort.Often loses things needed for tasks and activities (such as school assignments, pencils, books, keys, wallet, glasses, paperwork, etc.).Is often easily distracted by extraneous stimuli.Is often forgetful in daily activities, chores, etc.

Children and adults with the sluggish cognitive tempo (SCT) cluster of symptoms tend to display a different kind of inattention that has more of a daydreamy, hypoactive and passive feel, as opposed to a distractible quality. Individuals with SCT tend to exhibit less overt, externalizing symptoms and more internalizing symptoms of anxiety, depression, social withdrawal and more information-processing deficits. Although SCT is thought to be a separate, distinct disorder from ADHD, with different causes and treatment approaches, SCT does frequently co-occur with ADHD.

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