Does Sluggish Cognitive Tempo (SCT) Exist?
Parts of what we now call sluggish cognitive tempo (SCT) has been around since the 1960s, but it was in the late 1980s — long before any attention deficit hyperactivity disorder (ADHD) medications existed — when researchers first demonstrated that SCT symptoms are probably a unique condition or sub-type of ADHD (Lahey et al., 1988; Neeper & Lahey, 1986).
In other words, the scientific foundation for sluggish cognitive tempo has been around for nearly 30 years. It’s not new. And it’s hardly news. Scientists regularly identify dozens of proposed syndromes or symptom constellations in their research. Only a tiny minority of them ever go on to become a recognized mental disorder or diagnosis.
But does SCT really exist? Is it its own condition or disorder?
Scientific research in the study of psychological disorders is a slow and painful process. It takes dozens — and often hundreds — of studies in order to demonstrate a new constellation of symptoms is unique and significantly impacts a person’s daily functioning. Researchers regularly identify syndromes that are interesting to note (like a personality factor), but don’t really seem to negatively affect a person’s life. These never turn into disorders.
Other times, researchers identify syndromes that seem to have clinical significance — they are really messing up people’s lives.
One such thing is attention deficit hyperactivity disorder. Nearly since its inception as a clinical disorder, researchers have argued whether this condition is best reflected by a two- or three-factor model. These factors are derived through statistical analysis by looking at people who complete symptom-based questionnaires and structured clinical interviews.
To date, the two-factor model has won out. That’s why today we consider attention deficit hyperactivity to have two primary presentations: inattentive and hyperactive/compulsive (a third type — combined — is simply a combination of these two).
But some researchers have long believed that another factor is also statistically significant in this discussion — sluggish cognitive tempo (SCT). This term refers to a person who exhibits slow cognitive processing, sluggishness, apathy, drowsiness, and inconsistent alertness in their everyday activities. SCT should not be confused with another disorder, daytime sleepiness, that research has suggested that, while related, are distinct disorders (see Landberg et al., 2014).
Since it was first proposed in the 1980s, dozens of scientific studies have been conducted on SCT — the vast majority of which have had no connection to the pharmaceutical industry.
So Why is SCT Suddenly News Now?
So it was a bit of a disconnect to read an entire article about sluggish cognitive tempo over at the New York Times:
Yet now some powerful figures in mental health are claiming to have identified a new disorder that could vastly expand the ranks of young people treated for attention problems. […]
The Journal of Abnormal Child Psychology devoted 136 pages of its January issue to papers describing the illness, with the lead paper claiming that the question of its existence “seems to be laid to rest as of this issue.”
Ah, I see. Because a scientific, peer-reviewed journal decided to devote most of an issue to this topic, it’s suddenly a “new disorder” that deserves the attention of the New York Times.1 Is anyone awake at the fact-checking desk over there?
Why this attention to SCT now? Because the article tries to make a link between the suggestion this will suddenly become a new disorder — an unlikely prospect — and the fact that there’s been one or two studies funded by pharmaceutical companies on how best to treat SCT.
In logic, we call this sort of sloppy argument an example of “poisoning the well.” It’s a logical fallacy that suggests because pharmaceutical companies are involved in a tiny minority of studies on SCT, SCT must be a made-up disorder whose only purpose will be to push more ADHD medications. The journalist offers no proof for this association or assertion. Simply making the assertion is enough.2
Why Nobody Needs to Worry About SCT Any Time Soon
Despite a single researcher claiming the question of the disorder’s existence “seems to be laid to rest,” nothing of the sort has happened. A research constellation of symptoms doesn’t become a diagnosis quite so easily.
Instead, disorders need to go through a lengthy scientific peer-review process. This isn’t a process that takes years — it can take decades. The last time the DSM — the diagnostic manual for psychiatric disorders — was updated was in 1994. It took 19 years before a new edition, the DSM-5, came out just last year.
Sluggish cognitive tempo disorder — or as a sub-type of ADHD — isn’t even mentioned in the DSM-5.3
Since sluggish cognitive tempo isn’t even in the DSM, it’s unlikely we’re going to see SCT suddenly become a new disorder any time soon. It may be decades — with dozens of additional supporting studies — before it makes that leap.
That doesn’t mean, however, that SCT might not be a legitimate and pressing concern in your life. It may be significantly, negatively impact your daily functioning.
As we often do, we reviewed the research, did our own analyses, and came up with a new test for this mental health concern: the Sluggish Cognitive Tempo Quiz.
Take it now and see for yourself in about a minute’s time if this is a concern you may have.
Read the full article: Idea of New Attention Disorder Spurs Research, and Debate
Lahey, B. B., Pelham, W. E., Schaughency, E. A., Atkins, M. S., Murphy, A., Hynd, G. Lorys-Vernon, A. (1988). Dimensions and types of attention deficit disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 27, 330–335. doi:10.1097/00004583-198805000-00011
Langberg, J. M., Becker, S. P., Dvorsky, M. R., & Luebbe, A. M. (2014). Are Sluggish Cognitive Tempo and Daytime Sleepiness Distinct Constructs? Psychological Assessment. Advance online publication. http://dx.doi.org/10.1037/a0036276
Neeper, R., & Lahey, B. B. (1986). The Children’s Behavior Rating Scale: A factor analytic developmental study. School Psychology Review, 15, 277–288.
- Not mentioned in the article is that peer-reviewed journals regularly devote entire issues to special topics — some of which are disorders, some of which are not. Devoting most of an issue to a single topic doesn’t, in itself, mean anything in particular. [↩]
- Perhaps surprising to no one, few of the researchers in this area would agree to speak to the journalist. [↩]
- The DSM has a section entitled Conditions for Further Study. Before a disorder moves into the main DSM, it will first appear in this section, in order to give researchers and clinicians time to study it more, report on it in clinical encounters, etc. [↩]
Grohol, J. (2014). Does Sluggish Cognitive Tempo (SCT) Exist?. Psych Central. Retrieved on May 7, 2016, from http://psychcentral.com/blog/archives/2014/04/16/does-sluggish-cognitive-tempo-sct-exist/