Sluggish Cognitive Tempo: What is It? Symptoms and Treatments of SCT

Russell Barkley, Ph.D. distinguished Sluggish Cognitive Tempo as an attention issue that is separate from ADHD, although it frequently overlaps with it. It is distinguished by confused, drowsy, or lethargic demeanor.


Sluggish Cognitive Tempo: What Is It?

The attention issue known as Sluggish Cognitive Tempo (SCT) is linked to the following symptoms, which are indicative of inattentive ADHD: excessive daydreaming, sluggish behavior, poor memory retrieval, inability to stay focused in dull situations, delayed information processing, and a reclusive demeanor.

Studies also indicate that 30 to 63 percent of individuals with inattentive-type ADHD also have high levels of SCT. Approximately half of all patients with SCT are also diagnosed with attention deficit disorder, generally known as ADHD or ADD. However, according to Russell Barkley, Ph.D., who has written extensively about SCT and supports its recognition as a diagnosis distinct from ADHD, SCT “is far more likely to be linked to symptoms of anxiety and extreme sadness and far less likely to be associated with disruptive, oppositional conduct or antisocial symptoms than is ADHD.”

In 1984, the term SCT was initially used in reference to research on attention issues that were not usually linked to ADHD. In addition to advocating for more study and thought among medical professionals, Dr. Barkley has pushed for the alternative term Concentration Deficit Disorder (also known as CDD).


How Can a SCT Be Diagnosed?

Although SCT is not listed in diagnostic literature like the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a psychiatrist or psychologist may make the diagnosis after closely observing a child’s or adult’s inattentive behavior in the absence of significant hyperactivity or impulsivity. Also, a questionnaire about the patient’s behavior could be given to family members. Since there is no formal diagnostic instrument for SCT, an appropriate diagnosis is typically made by comparing the patient’s symptoms to those of other ailments, such as anxiety, mood disorders, and ADHD.

Barkley created his own SCT rating scale for adults in 2012 and then created a 12-item rating scale for children’s SCT symptoms, which he first distributed to 1,922 parents in the United States. The list has been enlarged by further researchers to include the following 16 symptoms in children:

  1. Sluggish or slow-moving behavior

  2. Disoriented in a mist

  3. Yawns or is drowsy during the day 

  4. Stares off into space

  5. Daydreams

  6. Loses concentration 

  7. Low activity level (e.g., underactive)

  8. Gets absorbed in one’s own thoughts

  9. Easily worn out 

  10. Exhausted

  11. Forgets what they were about to say 

  12. Gets easily perplexed

  13. Lacks the drive to finish activities (apathetic, for example)

  14. Leaves or enters a zone of confusion

  15. Thoughts move slowly

  16. difficulty speaking (e.g., becomes “tongue-tied”)

Despite a lack of research, evidence points to a genetic basis for SCT. Family history is therefore examined as part of an SCT examination.


How Is SCT Handled?

There is no established course of care for SCT, and there is currently no research on the relationship between stimulant or nonstimulant drugs and meaningful symptom relief. Nevertheless, a lot of experts advise combining a few of these strategies to help with SCT symptoms as well as those of related disorders such ADHD, severe depression, and anxiety:

  • Ritalin and other stimulants deal with overlapping symptoms of ADHD

  • Patients with ADHD and dyslexia, ADHD alone, or dyslexia alone report less symptoms of SCT when taking the non-stimulant norepinephrine reuptake inhibitor atomoxetine.

  • Excessive melancholy and overlapping anxiety may be treated with SSRIs and CBT.

  • Luvox may be used to treat daydreaming.

  • Exercise, a balanced diet, and good sleep practices can all assist with fatigue and difficulty concentrating.

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