2012年6月19日 星期二

Sluggish Cognitive Tempo and It's Relationship to Inattentive ADHD


The diagnosis of Sluggish Cognitive Tempo is made in individuals who process information slowly. These individuals appear to be in a constantly under aroused state. They appear as though they are in a fog and are slow with both the input and the output of information. Individuals with SCT seem to lack energy and motivation.

There is currently no formal mental health diagnosis for Sluggish Cognitive Tempo (SCT). SCT is currently a sub-category of the Inattentive type of ADHD (ADHD-PI) in the Diagnostic and Statistical Manual of Mental Disorders (DSM) which is published by the American Psychiatric Association. The current version of the DSM-IV is due for revision and the new DSM-V is due to be published in 2012.

The American Psychiatric Association is reconsidering the current classification of SCT and it is likely that this mental health condition will likely have its own category separate from the Inattentive ADHD category in the 2012 DSM-V.

It is unknown how many individuals with ADHD-PI have symptoms of SCT. Some researchers have put the estimate at 30% and others at as high as 50%. What is clear, however, is that the majority of people with ADHD-PI do not also have SCT. This is important because many authorities in the field of ADHD have proposed that these two conditions are all part of one diagnosis.

Some psychiatrist, psychologist, and teachers fail to see a distinction between people with Inattentive ADHD and people with SCT. Teachers often expect a child who is primarily inattentive to have sluggish cognitive skills. This assumption can sometimes impair a child's ability to get the classroom accommodation that they need. Winnie the Pooh is used by some psychiatrist and psychologist to demonstrate the characteristics of Inattentive ADHD. Winnie the Pooh is a better characterization of SCT. Using Winnie the Pooh to describe ADHD-PI is unfortunate and misleading because often ADHD-PI occurs without symptoms of SCT.

The symptom of Sluggish Cognitive Tempo in combination with the diagnosis of Inattentive ADD is simply a combination of symptoms or an accompanying condition (a comorbidity) to the ADHD. This particular combination is not unlike the symptom of hyperactivity in a person with the diagnosis of combined type of ADHD (ADHD-C). People with ADHD-C have significant symptoms of Inattention and impulsiveness and they are hyperactive. People with Inattentive ADD and SCT have significant symptoms of Inattention and they have sluggish processing.

People with a diagnosis of ADHD Hyperactive/Impulsive have significant symptoms of hyperactivity and Impulsiveness without a significant amount of inattention. People with ADHD-PI have significant symptoms of Inattention without hyperactivity, sluggishness, or impulsiveness. There have not been many studies done on individuals with Sluggish Cognitive Tempo but anecdotal reports suggest that a person with SCT may also have symptoms of inattention and impulsiveness. This finding is interesting as individuals diagnosed with ADHD-PI do not have impulsiveness symptoms.

It is very common for people with the combined type of ADHD to also have a diagnosis of Oppositional Defiance Disorder or depression. Sensory integration problems such as auditory or visual processing issues are also very common in people with ADHD. It would appear that SCT is a comorbity of ADHD much like these other problems.

There would need to be many additional ADHD subtypes to adequately categorize all the possible combinations of ADHD symptoms. If we were to make a fourth subtype for individuals with ADHD-PI and Sluggish Cognitive Tempo the symptoms would break down as follows:

ADHD-HI: Symptoms of hyperactivity and Impulsiveness without a significant amount of inattention.

ADHD-C: Symptoms of Inattention, hyperactivity, and impulsiveness.

ADHD-PI: Symptoms of Inattention without hyperactivity, sluggishness, or impulsiveness.

ADHD-PI/SCT: Symptoms of Inattention and slow processing without symptoms of impulsiveness

Sluggish Cognitive Tempo can is a condition where an individual, cognitively, is continually in an under aroused state. Not all individuals with Inattentive ADHD have symptoms of SCT. Currently SCT is classified as a subcategory of the Predominantly Inattentive subtype of ADHD. The American Psychiatric Association is reconsidering the current classification of SCT and it is likely that this mental health condition will likely have its own category separate from the Inattentive ADHD category in the 2012 DSM-V.




For more information on Primarily Inattentive ADHD please visit Tess Messer at http://www.primarilyinattentiveadd.com/2010/02/why-blog.html. There you will find information on ADHD symptoms, ADHD treatment, alternatives to medications, Information on ADHD vitamins and supplements and much more. Looking forward to meeting you there!





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