Is “Sluggish Cognitive Tempo” a Symptom of ADHD?

Individuals diagnosed with Attention-Deficit Hyperactivity Disorder have been classified into three subtypes: Predominantly Hyperactive-Impulsive (HI), Predominantly Inattentive (I), or Combined (C). I-Type individuals tend to be more lethargic, hypoactive, and often daydream or experience periods of mental confusion. “This constellation came to be labeled “sluggish cognitive tempo” (SCT); or more recently simply as attention-deficit disorder (ADD),” said Russell A. Barkley, of the Department of Psychiatry at the Medical University of South Carolina. “SCT symptoms also show a stronger association with degree of internalizing symptoms and social withdrawal and a weaker association with measures of executive functioning (EF) and state regulation.” He added, “These findings imply that the nature of the inattention seen in cases of SCT may be of a distinctly different form than that found in ADHD-C, representing a separate disorder from ADHD.” Few studies have been conducted to determine how symptoms of SCT affect adult daily functioning and overall quality of life. Therefore, Barkley surveyed 1,249 adults to determine exactly how SCT influenced various life activities, including earning potential, education and self-organization.

The participants in the study ranged in age from 18 to 96 and were evaluated for several measures. Nearly 7% had ADHD, almost 6% had SCT symptoms and over half had both. The results revealed that the SCT group had less education and earned less money than the ADHD and control groups, and also reported higher levels of impairment in education and work. “In their EF, both SCT groups reported greater difficulties with self-organization and problem solving than controls or the ADHD-only group. Otherwise, the SCT + ADHD group reported significantly greater problems with all other domains of EF than the other groups,” said Barkley. “The present findings suggest that the nature of the attention disorder associated with high levels of SCT is distinct from that arising in ADHD and likely has different demographic correlates, associations with EF deficits, and different domains of psychosocial impairment than does ADHD.” He added, “In other words, SCT is not a type of ADHD.”

Barkley, R. A. (2011, May 23). Distinguishing Sluggish Cognitive Tempo From Attention-Deficit/Hyperactivity Disorder in Adults. Journal of Abnormal Psychology. Advance online publication. doi: 10.1037/a0023961

© Copyright 2011 by By John Smith. All Rights Reserved. Permission to publish granted to

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  • Trey

    October 19th, 2011 at 4:19 AM

    What is the recommended treatment for this?

  • harriet k

    October 19th, 2011 at 11:24 AM

    interesting to see that the two are being said to be different from each other.ADHD is becoming a major problem what with the number of people affected but it seems like SCt could be more harmful than even ADHD.What kind of numbers are we talking about on a national level?

  • Collin

    October 19th, 2011 at 12:53 PM

    When I read this I saw myself and my entire school career flash before my eyes. I was the kid who could not get motivated to do anything of benefit because I was too busy flitting from one thought to the next inside. My teachers hated me because I think that they saw that the potential was there, but they thought that the motivation wasn’t. My parents too. But looking back I see that it was not for lack of interest or motivation- I could never focus on the task at hand, or sometimes I would over focus and let everything else fall to the side. Needless to say my gpa was less than stellar and it took me a while to find the right fit for college, but it is manageable. So if you have a kid like this or he is in your classroon, please continue to encourage, because in most of us the success is there- we just have to be shown the path to get there. Thanks-

  • Guilherme Vieira

    July 4th, 2012 at 9:56 PM

    Also extremely curious regarding suggested treatment and past experiments. Ritalin had no effect in me, and I’m sure I have most of the symptoms of SCT, however I have been diagnosed ADHD. And this kills me.

  • Jennifer

    October 17th, 2012 at 4:34 PM

    In the near future or even now (in some other forms of the treatment as well, such as Biofeedback as an additional treatment perhaps, and some other Neurotherapy-related treatments), Neurofeedback will help! Right now it is predominantly not covered by insurance, but please do keep eyes on it and it’s continued development and keep it in mind! : )

  • Ettina

    June 30th, 2013 at 8:25 PM

    What if it isn’t sluggish cognitive tempo, but dissociative tendencies? Many children with PTSD show ADHD traits as well. And the scale for sluggish cognitive tempo includes similar items to many scales for childhood dissociation.

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