Poster #10 - Sluggish Cognitive Tempo, but not Inattention, Consistently Predicts Cognitive Control

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Attention, Learning, Memory

Integrative Statement

Introduction: Sluggish cognitive tempo (SCT) is characterized by such behaviors as being slow to complete tasks, easily confused, or mentally foggy; appearing drowsy, sleepy, or lost in thought; and/or lacking initiative (Becker & Langberg, 2013; Carlson & Mann, 2002; Penny et al., 2009). SCT may represent a distinct behavioral phenotype that overlaps, yet is distinct from Attention-deficit/Hyperactivity Disorder (ADHD; Barkley, 2012) and other childhood disorders. In contrast, SCT may also represent a dimensional, trans-diagnostic construct that falls within the biological constructs of attention/arousal or cognitive control. Following the National Institutes of Mental Health's call for more dimensional approaches to mental health research (i.e., Research Domain Criteria—RDoC), there is interest in examining how SCT can best be conceptualized (Becker & Willcutt, 2018). We examined relative contributions of SCT and inattention to performance on tasks of basic attention (e.g., auditory span, simple working memory) and tasks of cognitive control (e.g., inhibitory control, set-shifting/mental flexibility).

Method: In a large sample of clinically-referred children (N=656, ages 5-21 years; 59.8% male; 67.1% Caucasian, 19.5% African-American) seen for psychological/neuropsychological assessment, hierarchical regression analyses examined the unique contributions of parent-reported SCT symptoms and inattention symptoms to performance on measures of attention and cognitive control. Standardized measures were used, including the Penny SCT scale, the ADHD Rating Scale-5, and subtests from the age-appropriate Wechsler measures (Vocabulary, Digit Span), Differential Ability Scales-II (Naming Vocabulary, Recall of Digits), NEPSY-II (Inhibition), Test of Everyday Attention for Children (Creature Counting), and Delis-Kaplan Executive Function System (Trail Making Test, Color-Word Interference).

Results: After controlling for verbal ability (Vocabulary) and parent-rated inattention symptom severity, SCT accounted for a significant amount of variance in inhibitory control (ΔR2=.03, p<.001, B= -.175) and set-shifting/flexibility (ΔR2=.02, p=.001, B= -.181). In contrast, after controlling for verbal ability and SCT, inattention symptoms predicted set-shifting (ΔR2=.021, p=.001), but not inhibitory control (p=.705). Neither SCT nor inattention symptom severity contributed significantly to performance on measures of more foundational cognitive constructs such as attention span (SCT p=.601; Inattention p=.852) or working memory (SCT p=.286; Inattention p=.436).

Discussion: Although effect sizes are modest, findings suggest that SCT is significantly associated with complex, timed cognitive control –but not basic attention performance-- in youth referred for evaluation. Specifically, the time emphasis within the low initiation component of SCT (e.g., lacks initiative, needs extra time, slow or delayed in completing work), but not the sluggish or daydreamy sub-components, appears to account for a small but significant component of variance in performance-based measures of timed cognitive control, even after controlling for verbal ability and inattention symptoms. In contrast, SCT appears distinct from other RDoC dimensions of attention and working memory. Findings have implications for the construct of cognitive efficiency/control as well as characterization of the SCT construct itself.

Authors

• Lisa A. Jacobson, Kennedy Krieger Institute/ Johns Hopkins
  Presenting Author

• Matt Ryan, Kennedy Krieger Institute
  Non-Presenting Author

• E. Mark Mahone, Kennedy Krieger Institute/ Johns Hopkins
  Non-Presenting Author