View Full Version : About time that SCT get pinned to the top of the board?


scuro
07-02-17, 01:05 AM
It's been a while...but there is new information on this disorder

-It will not be a new disorder in the DSM5 mainly because of a backlash to too many new disorders having been created and a hesitancy to "create" new ones
-It is very distinct from ADHD, they share very few traits in common
-30-50% of all ADHD is SCT, so ADHD which was thought to be 7-8 percent of the population, is really 4% of both ADHD and SCT
-It's more impairing than ADHD at work and just as impairing at school

http://www.youtube.com/watch?v=MKavCm3qHBE

sarahsweets
07-02-17, 03:13 PM
Is this new research? I thought the dsm was already out?

Batman55
08-04-17, 12:13 AM
Any research on the overlap and/or similarity between SCT and autistic spectrum disorder?

Anything to suggest a language processing issue with SCT (affecting either auditory learning, or comprehension itself)?

Proneness to frequent, simple errors is allegedly not a hallmark of ADHD itself; however as I understand SCT, it is one of the most distinctive symptoms, one of the ways to differentiate SCT from ADHD.

But it also looks to me, there is a very similar thing going on with autistic spectrum disorders. Your stereotypical autistic person literally *cannot* be distracted. There is basically *one* tunnel of attention possessed by your generalized autistic person; any kind of distraction (including background noise, someone talking to them, etc.) could cause them to stop and need to re-start again, in order to avoid catastrophic simple error. They can only do one thing at a time, if that; in order to maintain this "one thing at a time", they cannot tolerate even the simplest distraction.

It looks a lot like SCT seems to look, and vice-versa.

This is leading up to my ultimate question. Could SCT actually be a kind of autistic spectrum disorder?

sarahsweets
08-04-17, 06:22 AM
I dont know if its fair to say that SCT is more impairing than adhd.

daveddd
08-04-17, 07:02 AM
While I'm sure there have been or is disorders that encompass sct. They mine as well

Will giving it its own name help in treatment?

I personally don't buy in to the massive amount of supposedly separate and distinct disorders if they think it will help treatments do it. Just keep it mind it hasn't really helped in other areas of mental illness. Or if people need it for validation purposes I guess that's fine too

Barkley hasn't done any meaningful research on ADHD in about 5 years cause of sct so he's the guy to go to I'd say

daveddd
08-04-17, 07:07 AM
I dont know if its fair to say that SCT is more impairing than adhd.

Well he just said at work. Which who knows. All the best workers I know have hyperactive ADHD

But I think we get them in all other areas. Police. Drugs. Emotions.

mildadhd
08-04-17, 02:06 PM
Questions

Is Dr.Barkley saying..

..ADD is SCT?

..ADHD is a separate condition?

..7% of the population has ADD (SCT)?

..7% of the population has ADHD?


What about the % of combined AD(H)D population?




M

Lunacie
08-04-17, 02:14 PM
Questions

Is Dr.Barkley saying..

..ADD is SCT?

..ADHD is a separate condition?

..7% of the population has ADD (SCT)?

..7% of the population has ADHD?


What about the % of combined AD(H)D population?




M

In the video (which I'm about halfway through) Dr. Barkley says that SCT is
quite separate and different from ADHD.

If he discusses percentages of population, I haven't gotten to that part yet.

mildadhd
08-04-17, 02:29 PM
At about 0:10 seconds into the video, the title is..


Russell Barkley
The second Attention Disorder: Slugish Cognitive Tempo (or ADD) vs. ADHD






M

Lunacie
08-04-17, 02:37 PM
At about 0:10 seconds into the video, the title is..



M

I am hoping that he will explain all six of those different kinds of attention, not
just the one that signals adhd and the one that signals SCT.

SashaBV
11-11-17, 05:28 PM
I'd never heard or SCT, but it sounds pretty much more impairing. Hmm. My ADD brain is tired today and can't function. Excessive daydreaminess? Wish there was a job like that for me.

allesandro1
11-20-17, 07:15 PM
I can identify with every one of the symptoms that Barkley describes much more precisely than with all of the symptoms of ADD. It's like someone took out and deleted all of the symptoms that don't apply to me and honed in exactly on what is applicable. I wonder if anyone else can identify so markedly with all of these symptoms?

OyVeyKitty
11-21-17, 11:00 AM
That was an interesting video, thank you for sharing! I have heard lots of praise of Dr. Russell Barkley's work by other people who suffer from ADHD but haven't gotten around to checking out any of it until now. I'm glad I did and somehow I even managed to sit through the whole hour and a half, which is a rare thing for me. :lol:

For the people wondering about whether he is conflating ADD with SCT (or CDD as he prefers to call it,) I don't think that's the case. The text in the introduction seems a bit misleading. What I gathered from the video is that he is saying is that ADD is synonymous with ADHD, just an older term for it, which is technically correct. He merely seems to suggest that many (but not necessarily all) people diagnosed with primarily inattentive traits of ADHD would better fit the diagnosis for SCT instead of ADHD.

Here's my CliffsNotes version of the video:

Studies seem very promising but are still in early stages.


ADHD and SCT are two quite distinct conditions.


ADHD is primarily a problem with productivity while SCT is primarily a problem with accuracy. People with ADHD scored slightly, but not too markedly, below average in math tests. People who suffer from SCT scored well below both. SCT may cause people to interpret the problem incorrectly (for example missing that a division sign is not a minus sign,) sometimes leading to significant impairment.


SCT does not lead to problems with inhibition. People who suffer from SCT may in fact be less impulsive than the average person.


ADHD does not impair the quality of a person's work, if you can somehow get them to start a task and keep to it. That's where the problem lies with ADHD. SCT on the other hand, due to accuracy impairment, does cause a decline in work quality.


SCT does not cause cognitive impairment, ADHD does. People with ADHD scored, on average, 7 to 10 points below average on IQ tests. Dr. Barkley points out that this is likely because IQ tests rely on working memory, which is significantly impaired with ADHD. Addendum: a study by Zhang et al. (2011) showed that IQ scores of ADHD children increased when administered methylphenidate, not due to an increase in intelligence but likely due to lessening of impairment.


SCT children tend to be withdrawn and socially shy, though they are less socially impaired than children suffering from ADHD.


SCT can be co-morbid with ADHD, the other way around is less common, but naturally does occur as well. Co-morbid cases are severely impaired.


Stimulants do not appear to be effective in treating SCT, potentially better options are suggested but actual studies have yet to be conducted.


In the end ADHD is a more impairing disorder than SCT, but SCT does impair some areas of life (e.g. school, work) more than ADHD does.


Super short version:

SCT causes daydreaming, brain fog, trouble with alertness, increased confusion, lethargy and apathy.


ADHD causes impulsiveness, distractibility, no trouble with alertness (but with attention instead), no increase in confusion, perseveration ("hyperfocusing").


Co-morbidity between the two exists. It's bad.


Summary:

So the most obvious differences seem to be in alertness, impulsiveness, energy levels and working memory. For example even ADHD adults who no longer show outwardly hyperactive behavior report feeling internally restless, while people who suffer from SCT do not experience this. People suffering from ADHD want things and they want them right now, while people suffering from SCT do not show this trait.

Reference:
Zhang, Lishan & Jin, Xingming & Zhang, Yiwen. (2011). Effect of Methylphenidate on Intelligence Quotient Scores in Chinese Children With Attention-Deficit/Hyperactivity Disorder. Journal of clinical psychopharmacology. 31. 51-5. 10.1097/JCP.0b013e3182060f3f.

Batman55
11-22-17, 01:02 AM
I have the impulsivity problem, the poor working memory... in addition to chronic daydreaming and significant problems with accuracy and following directions properly.

Maybe that's why I'm such a worthless creature, unable to do anything right or complete anything. :D

Comorbidity of ADD and SCT seems to explain my condition well, UNLESS it is better explained by autistic disorder, which could still be the case.

IMHO there is too much overlap between inattentive ADD (presuming serious social problems are present) and HFA to draw a meaningful line between them, any more. Somehow this needs to be cleared up.

OyVeyKitty
11-22-17, 09:11 AM
I have the impulsivity problem, the poor working memory... in addition to chronic daydreaming and significant problems with accuracy and following directions properly.

Maybe that's why I'm such a worthless creature, unable to do anything right or complete anything. :D

Comorbidity of ADD and SCT seems to explain my condition well, UNLESS it is better explained by autistic disorder, which could still be the case.

IMHO there is too much overlap between inattentive ADD (presuming serious social problems are present) and HFA to draw a meaningful line between them, any more. Somehow this needs to be cleared up.

HFA and SCT

He did specifically bring up HFA. He said the symptoms are not the same, saying that people on the spectrum are aloof, while people with SCT are merely shy. It was around 31:00.

Directions

What specifically is the problem you have with following directions? Both ADHD and SCT can cause that. In my non-expert, one-SCT-video-educated understanding, someone with ADHD would fail because they forget the instructions while they are being conveyed. This is what happens to me. For someone with SCT, that would be because they are off in their own world and not listening.

The latter can sort of happen with ADHD where you freak out about having to remember all the directions you are given. First you try to focus on the first instruction and then miss the others because you're focusing on remembering instead of paying attention, try to correct that by listening again and then you realize you missed some instructions already. You try to remember them and thus lose focus again and in the end your brain just goes haywire with this. You end up catching bits and pieces that amount to nothing at all. :doh:

With SCT however, you might miss stuff because you started thinking about something else completely, like feeding your cat or that you need to wash your car. So there's a complete loss of focus and slipping into daydreaming whereas with ADHD you just mess up because your working memory isn't long enough to retain all the instructions. Learned behavior trying to correct the ADHD problem makes it even worse. With SCT you might register the given information poorly due to brain fog blurring it up, while people with ADHD do seem to more or less correctly register the bits and pieces they manage to actually hear.

If you were to read the instructions and put them into your long term memory instead of working memory, how would you fare? Someone with ADHD will do more or less fine with that, as long as they actually manage to get started on each step and don't run off to do something else in the midst of it. They could recount the steps with reasonable accuracy when asked. Someone with SCT might have read the instructions improperly in the first place and so following them they end up with the wrong result.

Co-morbidity would presumably show up with both symptoms. From the way you described it, it could very well be that you have both. If you not only have trouble sticking with the instructions in the first place, but when you manage to not be distracted long enough to do it, you get them wrong on top of that. Needless to say, that's going to make life real difficult! :(

Daydreaming

As for the daydreaming, I do think people with ADHD do it as well, just differently. Note that this is totally me throwing out a wild hypothesis here, because I don't think Dr. Barkley talked about it. However, when I tend to miss something because I'm in my head, it's because what's going on in the outside world is not stimulating enough and I have no way of getting physical stimuli by moving or talking to people (e.g. in a classroom or a meeting). In these scenarios exciting ideas about what to do after the event might pop into my head instead and my mind tends to want to focus on these exciting things instead of what I'm supposed to pay attention to.

There is a part about this where Dr. Barkley did briefly touch upon it, and that is that people with SCT are more prone to depression because their thoughts presumably drift towards the negative as they daydream. He said it is common for everyone (NT or not) to think about their problems while driving, and that SCT daydreaming is similar to that. This does not happen with me while doing my bored "daydreaming" while it indeed does when I'm driving, when I go into my head when I'm supposed to pay attention it tends to be to seek internal stimuli when I can't get it externally. Current problems are very boring compared to exciting novel ideas.

Sorry for the long post, I'm just excited about this topic. :o

ginniebean
11-22-17, 01:34 PM
As far as I'm aware there is no treatment for SCT. I also think there are overlooked overlaps with people diagnosed with ADHD and autism. I have many autistic features but I can't see any point to getting it diagnosed as there is nothing to do for it. I just take myself as a quasi unique whole and work on my quasi unique problems as best I can. One lifetime is not sufficient. Lol

peripatetic
11-22-17, 01:48 PM
moderator note

a new sticky has been made in this section with the thread start and two purely informational/synopsis posts. you can find it here: http://www.addforums.com/forums/showthread.php?p=1974858#post1974858

feel free to continue to use this thread to discuss your personal experiences with SCT and/or its relationship to ADHD or HFA.

carry on,
-peri

WhiteOwl
11-22-17, 09:24 PM
What specifically is the problem you have with following directions? Both ADHD and SCT can cause that. In my non-expert, one-SCT-video-educated understanding, someone with ADHD would fail because they forget the instructions while they are being conveyed. This is what happens to me. For someone with SCT, that would be because they are off in their own world and not listening.

The latter can sort of happen with ADHD where you freak out about having to remember all the directions you are given. First you try to focus on the first instruction and then miss the others because you're focusing on remembering instead of paying attention, try to correct that by listening again and then you realize you missed some instructions already. You try to remember them and thus lose focus again and in the end your brain just goes haywire with this. You end up catching bits and pieces that amount to nothing at all. :doh:

With SCT however, you might miss stuff because you started thinking about something else completely, like feeding your cat or that you need to wash your car. So there's a complete loss of focus and slipping into daydreaming whereas with ADHD you just mess up because your working memory isn't long enough to retain all the instructions. Learned behavior trying to correct the ADHD problem makes it even worse. With SCT you might register the given information poorly due to brain fog blurring it up, while people with ADHD do seem to more or less correctly register the bits and pieces they manage to actually hear.

I am obviously not Batman and can only speak for myself, but I have the same problems he mentioned in his post, so I wanted to weigh in. I often feel like I have something in addition to ADD, something I can't pinpoint. I've also wondered if I have mild Autism. I haven't watched the video yet, but read your cliff notes and it's still kind of confusing to me.

I not only forget the directions while they're being conveyed, but there are also times when I daydream and start thinking about something else completely. This happens to me very often. People will be talking to me and I don't even hear them, I'm completely in my own world. I don't even realize it starting to happen, I just finally "come to" and snap out of it. I though this was pretty common with ADD, though, so now I'm confused.

I also have the problem with only being able to do one thing at a time and completely lose focus if I'm distracted.


If you were to read the instructions and put them into your long term memory instead of working memory, how would you fare? Someone with ADHD will do more or less fine with that, as long as they actually manage to get started on each step and don't run off to do something else in the midst of it. They could recount the steps with reasonable accuracy when asked. Someone with SCT might have read the instructions improperly in the first place and so following them they end up with the wrong result.

It worries me a little that I feel like I could accurately say I would have trouble taking instructions, placing them in my long-term memory and recalling them accurately. I make a lot of little mistakes. I'm not sure if this is a good example, but nearly every time I put something together, no matter how carefully I read the instructions, I always read something wrong and have to go back and re-do things. Is that an example that sounds indicative of SCT? Or if someone is giving me directions, I have trouble even interpreting the first step of the instructions. It's not just that I'm trying to remember it, I might not even understand what they mean! It's entirely possible I'm just stupid.


As for the daydreaming, I do think people with ADHD do it as well, just differently. Note that this is totally me throwing out a wild hypothesis here, because I don't think Dr. Barkley talked about it. However, when I tend to miss something because I'm in my head, it's because what's going on in the outside world is not stimulating enough and I have no way of getting physical stimuli by moving or talking to people (e.g. in a classroom or a meeting). In these scenarios exciting ideas about what to do after the event might pop into my head instead and my mind tends to want to focus on these exciting things instead of what I'm supposed to pay attention to.

There is a part about this where Dr. Barkley did briefly touch upon it, and that is that people with SCT are more prone to depression because their thoughts presumably drift towards the negative as they daydream. He said it is common for everyone (NT or not) to think about their problems while driving, and that SCT daydreaming is similar to that. This does not happen with me while doing my bored "daydreaming" while it indeed does when I'm driving, when I go into my head when I'm supposed to pay attention it tends to be to seek internal stimuli when I can't get it externally. Current problems are very boring compared to exciting novel ideas.


I'm a little confused about what you mean by saying your "bored" daydreaming is different than the daydreaming when you drive. I understand your "bored" daydreaming being caused by lack of external stimuli. I have that problem, too. But what is the cause of "driving" daydreaming? It kind of all seems the same, to me. I don't have depression and I don't just daydream about problems, but it can be any random thing, including happy or neutral things. It seems like when I space out while there is a lot of action and noise going on around me, it can't be due to boredom and seeking internal stimuli, so idk.

allesandro1
11-22-17, 09:50 PM
I think that understanding the distinction between SCT and ADD is important because it's the first step in designing and discovering more effective treatment; that is, understanding that the symptoms of SCT are not under the auspices of executive function of the brain has significant implications both psychopharmacologically, psychodynamically, and behaviorally. Specifically, knowing that the mind wandering and slow information processing are controlled by the prefrontal cortex has significant implications for pharmacological intervention. Medications like Strattera and the SNRI's would be likey more effective because they decrease norepinephrine reuptake by the brain. It's important to know which neurotransmitters are affected so that we know which medications to target and which behavioral treatments to employ; that is, if the symptoms do not fall under executive function of the brain, why try to treat as though the person had control over it? Perhaps behavioral shaping methods of finding the functional baseline of a behavior and incrementally increasing it might be more effective ( I don't know, I'm just guessing).
I think just identifying this disorder, the part of the brain involved, and the implications of this for treatment is so important to the next step of fine tuning the psychodynamic treatment as well. The person needs to know why the ritalin had limited effects, and why the treatments they've tried thus far have met with limited success as well. It's the first step

Batman55
11-23-17, 01:13 AM
As far as I'm aware there is no treatment for SCT. I also think there are overlooked overlaps with people diagnosed with ADHD and autism. I have many autistic features but I can't see any point to getting it diagnosed as there is nothing to do for it. I just take myself as a quasi unique whole and work on my quasi unique problems as best I can. One lifetime is not sufficient. Lol

That is the way I think of it as well. I guess it may invalidate me as an accurate source of information about some things, since I haven't gone into much official investigation of what it is I have vs. don't have.

Social anxiety is definitely certain and diagnosed. And I do indeed have an informal ADD diagnosis which is good enough for me, I think ADD-I in my case cannot be questioned even if there is something else going on. I got that ADD diagnosis after a relatively long history of addiction/substance abuse, not to mention an entire lifetime of being told by teachers and everyone else that I'm "not paying attention, makes careless mistakes, daydreams too much" I have everything that goes along with ADD, it's a shame a proper intervention never occurred when it was so obvious.

But anyway it's a complex case as to what happened and I'm also at fault for a lot of things. I don't want to go over it all.

Batman55
11-23-17, 01:22 AM
It worries me a little that I feel like I could accurately say I would have trouble taking instructions, placing them in my long-term memory and recalling them accurately. I make a lot of little mistakes. I'm not sure if this is a good example, but nearly every time I put something together, no matter how carefully I read the instructions, I always read something wrong and have to go back and re-do things. Is that an example that sounds indicative of SCT? Or if someone is giving me directions, I have trouble even interpreting the first step of the instructions. It's not just that I'm trying to remember it, I might not even understand what they mean! It's entirely possible I'm just stupid.

Long sequences of instructions screw me up no matter what. I can't get the sequence of anything with a lot of steps to "stay in place" and recall it in the proper order without extreme repetition, and even that may not be good enough, I still make careless mistakes or forget steps or whatever.

Interpretation of directions is another related problem. I may read the instructions too literally or think it means something else altogether. Getting very clear instructions in short simple steps would work for me probably, as it seems nothing else does.

I feel that comprehension problems may be more of an autistic trait than ADD or SCT, but again I'm not sure. Problems with receptive language are a hallmark of autism.

Batman55
11-23-17, 01:26 AM
HFA and SCT

He did specifically bring up HFA. He said the symptoms are not the same, saying that people on the spectrum are aloof, while people with SCT are merely shy. It was around 31:00.


Excessive shyness as a child, I don't know if I was aloof then; shyness and aloofness as an adult. I don't want to be involved socially very much, it is too much processing and takes away too much energy, I don't have the flexibility to both socialize and attend to my own interests/routines/whatever.

OyVeyKitty
11-23-17, 07:07 AM
I apologize ahead of time for the length of this, Owly. I tried to break it up and make it as concise as I could to make it readable, but I'm in a bit of a rush and there was a lot going on in your post that I wanted to reply to. :o

I'm a little confused about what you mean by saying your "bored" daydreaming is different than the daydreaming when you drive.[...] It seems like when I space out while there is a lot of action and noise going on around me, it can't be due to boredom and seeking internal stimuli, so idk.

Personally, if there's a lot of noise or action around me it drives me absolutely bonkers. Not only can't I focus on anything, I can't daydream either. My attention will jump from one thing to the next and I won't have any control over it, I am pretty much incapacitated under those conditions.

As for the daydreaming, more specifically he called it mind-wandering. You can listen to that section around 1:02:00 (one hour, 2 minutes) into the video. I'm not entirely sure what the difference is either. It was just a wild hypothesis of mine that I based on my own experience and a guess of what might be different based on what he talked about in the video. Listening to it again, I think it might be better to interpret it more simply as daydreaming a lot more than people with ADHD do. That's of course difficult to quantify. :scratch:

He does talk about daydreaming in the video in other parts too, but they are all over the place. Just in case it helps, here's the list of proposed SCT symptoms from his lecture slides:


Daydreaming excessively
Trouble staying alert or awake in boring situations
Easily confused
Spacey or “in a fog”; Mind seems to be elsewhere
Stares a lot
Lethargic, more tired than others
Underactive or have less energy than others
Slow moving or sluggish
Doesn’t seem to understand or process information as quickly or accurately as others
Apathetic or withdrawn; less engaged in activities
Gets lost in thought
Slow to complete tasks
Needs more time than others (doesn’t discriminate from ADHD)
Lacks initiative to complete work or effort fades quickly (same)


Note that he also said that sometimes people with ADHD have trouble staying awake too, but people with SCT tend to be worse in this regard.

I not only forget the directions while they're being conveyed, but there are also times when I daydream and start thinking about something else completely. This happens to me very often. People will be talking to me and I don't even hear them, I'm completely in my own world. I don't even realize it starting to happen, I just finally "come to" and snap out of it. I though this was pretty common with ADD, though, so now I'm confused.

If someone is boring or talking at me instead of talking with me, my attention will go elsewhere pretty quickly too. I don't realize it's happening when it does either. It doesn't happen as much with friends, for example, because we're typically having interesting discussions or doing things and having fun. This is one of the things I wish Dr. Barkley had been more specific about, especially since it's supposed to be one of the major defining features of SCT. How do you draw the line between ADHD loss of attention and SCT daydreaming?

I did do some Googling around yesterday and here is what Russell Ramsay says in his book:

The classic presentation of ADHD involves [...] attention and sustained concentration being engaged but then being punctuated and interrupted. In contrast, SCT/CDD is characterized by difficulties orienting and engaging attention, effort, and alertness in the first place. Individuals with SCT/CDD exhibit difficulties associated with being day-dreamy, sleepy (particularly with boring tasks), lethargic and sluggish, the first two descriptors being the most distinctive factors of SCT/CDD.

The way I interpret that is that people with ADHD have no trouble starting to pay attention, but trying to sustain it doesn't work. People with SCT seem to have trouble even engaging their attention. So I guess someone with SCT might not even always notice when you start to talk to them? That would not happen with me, because any noise will draw my attention away from what I'm currently focusing on.

It worries me a little that I feel like I could accurately say I would have trouble taking instructions, placing them in my long-term memory and recalling them accurately. I make a lot of little mistakes. I'm not sure if this is a good example, but nearly every time I put something together, no matter how carefully I read the instructions, I always read something wrong and have to go back and re-do things. Is that an example that sounds indicative of SCT? Or if someone is giving me directions, I have trouble even interpreting the first step of the instructions. It's not just that I'm trying to remember it, I might not even understand what they mean! It's entirely possible I'm just stupid.

Aw no! :( You're definitely not stupid, that's for sure! This part sounds like what he described as a lack of accuracy in the video. If someone is giving me instructions verbally, there's a very good chance I will just have bits and pieces of it in my memory, but the bits and pieces will be more or less correct. Let me give an example of how this might look for me:

"OK, drive 2 miles north until you come to Cedar Road, then turn right and go to the Walmart immediately on the left. They have the peanut butter I really like. Oh, and pick up some bananas while you're at it, will you?"

My mind might have: "OK, drive north and find a Walmart somewhere and get PB and bananas," if I'm lucky. I don't have inaccurate information, just very lacking because I didn't have time to store specific directions. Memorizing anything at all only happens if my brain doesn't go haywire trying to remember specifics and if the instructions are any longer than this I will forget pretty much all of it anyway.

If I can read those instructions and consciously memorize them I will remember them pretty well. I can tell you that I need to drive two miles north, take a right and look for a Walmart to the left. I can tell you I need PB and bananas. If the list of items or directions is longer then I will start forgetting things, but I will almost never remember them incorrectly. Also, while at the store I can completely forget to buy some of the things I was supposed to get even though I knew I they were on the list. It might be because my attention is drawn elsewhere while shopping or simply because my mind is elsewhere, doing the mind-wandering thing.

Remember that this is just my interpretation based on one video and comparing its contents to my own life, so take everything I say with a good pinch of salt! Also, just for the sake of completion, there are people in the medical field who are critical and skeptical of SCT. As Dr. Barkley points out in the beginning of the video, he is sponsored in his research by the drug company Eli Lilly, which makes Strattera (which he proposes would be best for treatment of SCT.) I still think he makes a good case for SCT being a separate condition, but he isn't entirely without bias.

That's all I've got, but hopefully that clears some of it up a little at least. On the other hand, I'm still a bit confused about where we're supposed to draw the line with daydreaming and mind-wandering myself. :confused:

References:
Barkley, A. Russell (2014), Slides from lecture: The Second Attention Disorder: Sluggish Cognitive Tempo. https://drive.google.com/file/d/0B885LHMHOu5BNE51cUhNMUJiaWM/view, slide 8.
Ramsay, J. Russell (2014), Cognitive-behavioral therapy for adult ADHD: An integrative psychosocial and medical approach (2 ed.). Routledge. pp. 11–12.

Batman55
11-24-17, 12:45 AM
I wonder if anyone else has the "not good at anything" trait which may go hand in hand with being confused and lost all the time.

I was reading today how some Boy Scout achieved a rare feat of attaining all 139 merit badges--that's right, he achieved every single one possible--and was complaining that he didn't have more to get, all the while being heavily involved in student council and scoring perfect grades in every subject, and preparing to study electrical engineering in college.

I remembered that when I was in Boy Scouts, I guess I achieved the opposite rare feat of getting ZERO merit badges... largely because I did not know what was going on or what I was supposed to do, I was bored and uninterested, etc.

It's tangential I guess, but I think the point is probably a lot of SCT types--if they're even remotely similar to me--probably deal with a lot of envy, especially when high achievement is normalized and expected, not to mention, high-achievers are the only ones you ever hear about. It's a problem for me anyway. Maybe I should stop reading the news altogether?

SashaBV
11-24-17, 01:03 PM
I remember in college some students saying that they get more from lectures or discussion during study sessions. They said they didn't get as much from the book. OTOH, I understood better from the book...IF it was a good book that explained clearly the info. My ability to process info from lectures was a bit impaired, I think. My mind took more time to process what it heard, so it kind of depended on how fast a person was speaking. I tried recording lectures, and replaying them. I'd have to stop it and go back sometimes to try to understand it. With the book, I could do it more slowly. Time-consuming, however, either way. My daughter, who doesn't have ADD, didn't deal with that problem and could learn quickly without spending much time studying.

Ronelh
12-23-17, 12:02 PM
I'm still confused about SCT. If it's not considered a separate disorder, just what is it? Some materials I've read talk as though it were just another name for ADHD-PI, others like it is a common symptom of ADHD. But some of the comments in the thread above sound like maybe it should be a separate disorder, but it just isn't officially listed as one.

sarahsweets
12-24-17, 01:14 PM
I'm still confused about SCT. If it's not considered a separate disorder, just what is it? Some materials I've read talk as though it were just another name for ADHD-PI, others like it is a common symptom of ADHD. But some of the comments in the thread above sound like maybe it should be a separate disorder, but it just isn't officially listed as one.

http://www.youtube.com/watch?v=ME4UoIWCs4s

PoppnNSailinMan
12-25-17, 02:35 AM
Until we understand the underlying biological mechanisms in the brain behind the symptoms of ADHD and other psychiatric conditions, figuring out how everything should really be organized will not be easy. I've been diagnosed with both Predominantly Inattentive type and Combined type and also show or have shown some symptoms (but not others) that appear on lists for SCT.

Most of my symptoms are on the inattentive list for ADHD (8 out of 9) and I also have symptoms that appear in a proposed list for SCT such as the one in the Wikipedia article (but not all of them), and some of the ones I have or had were more apparent when I was a child or a young man than what they are now:

https://en.wikipedia.org/wiki/Sluggish_cognitive_tempo


Daydreaming excessively
Mind seems to be elsewhere
Stares blankly into space
Gets lost in own thoughts
Processes information not as quickly/accurately


I used to daydream a lot, sometimes for hours a day when I was younger. I have a picture that my mother took of me when I was in my early 20s where I'm sitting on the couch and just staring off into space with a kind of glassy look in my eyes. I know that I used to do that kind of thing a lot. I do still get lost in my thoughts sometimes, etc. As I've posted before, when I was about 30 and was teaching a class, one of my students wrote in an evaluation at the end of the semester, "He doesn’t always respond as well as he could to students’ questions. It’s not that he doesn’t want to answer them, but just that he gets absorbed in his own thoughts and doesn’t really hear what’s being asked."

On the other hand, I've never been lethargic, slow moving or sluggish, so don't fit those symptoms on the proposed list for SCT.

The Wikipedia article also says about SCT, "Most consistent across studies was a pattern of reticence and social withdrawal in interactions with peers." In my old report cards, reticence and social withdrawal is what stood out to my teachers, not any kind of hyperactivity:


"He...still tends to withdraw from the other children. Encourage him to take his place as a member of the group" (4th grade).
"He is shy with the children when it comes to active play” (5th grade).
"He doesn’t participate very much in group discussions" (6th grade).
"He seems to shy away from sports" (6th grade).
"Attentive but shy about participating" (7th grade).
"Does not assert himself in P.E. activities, is very passive in all games – perhaps a greater effort could be made" (7th grade).
“He still works best when doing research work on his own, but is gradually being drawn into more class discussion work” (7th grade).
"He does need to express himself more in class" (7th grade).
“At times intimidated by others and afraid to take part whole-heartedly” (PE, 7th grade).


I never considered myself to be hyperactive or impulsive, although my partner says that I have more of these qualities than what I realize. I think that they've come out more as I've gotten older and have become less inhibited and have overcome the extreme shyness that I had when I was younger. This is especially true around people I know well where I can "talk excessively," "interrupt or intrude on others," and "blurt out answers too early." The psychiatrist who diagnosed me with Combined type must have seen more hyperactive/impulsive symptoms than I was really aware of.

Anyway, I have no idea where I fit exactly or how SCT is related to ADHD and I don't think anyone else has a clear idea either at this stage.

allesandro1
12-25-17, 05:44 PM
Russell Barkley does say that SCT children often present with many of the same symptoms as kids with dyspraxia or developmental coordination disorder (DCD) I was wondering if anyone has any familiarity with dyspraxia?

PoppnNSailinMan
12-25-17, 06:34 PM
Russell Barkley does say that SCT children often present with many of the same symptoms as kids with dyspraxia or developmental coordination disorder (DCD) I was wondering if anyone has any familiarity with dyspraxia?

I don't have any familiarity with dyspraxia, but according to Wikipedia:

Developmental coordination disorder (DCD),[1][2][3][4][5] also known as developmental dyspraxia or simply dyspraxia,[6][7][8][9] is a chronic neurological disorder beginning in childhood. It is also known to affect planning of movements and co-ordination as a result of brain messages not being accurately transmitted to the body. Impairments in skilled motor movements per a child's chronological age which must interfere with activities of daily living.......

In addition to the physical impairments, developmental coordination disorder is associated with problems with memory, especially working memory.[14] This typically results in difficulty remembering instructions, difficulty organizing one's time and remembering deadlines, increased propensity to lose things or problems carrying out tasks which require remembering several steps in sequence (such as cooking).

https://en.wikipedia.org/wiki/Developmental_coordination_disorder

Some of the symptoms that have to do with working memory are similar to those found in ADHD which also involves problems with working memory. But I'm not sure how we can tell if the two sets of similar symptoms are connected below the surface.

Batman55
12-26-17, 12:01 AM
I don't have any familiarity with dyspraxia, but according to Wikipedia:



https://en.wikipedia.org/wiki/Developmental_coordination_disorder

Some of the symptoms that have to do with working memory are similar to those found in ADHD which also involves problems with working memory. But I'm not sure how we can tell if the two sets of similar symptoms are connected below the surface.

Another one I have symptoms of, right here. Can't remember instructions to save my life. And the problems with sequences I've always had. Also, when younger trouble catching/throwing a ball, well behind my peers (mostly normal now).. also some fine motor issues, such as inconsistent quality of handwriting... trouble buttoning sleeves, that kind of thing... although these last 2 still exist in some form.

But as I understand, dyspraxia by itself does not cause social skill deficiencies nor should it lead to repetitive behavior or obsessions.

How is it someone can strike boxes for so many different things?

How can one tell whether autism is the cause of his developmental problems, vs. something else with overlapping symptoms? It's just too unclear.

PoppnNSailinMan
12-26-17, 01:59 AM
How can one tell whether autism is the cause of his developmental problems, vs. something else with overlapping symptoms? It's just too unclear.

I agree. Individual symptoms, those seem reasonably clear. What's causing them and how they're related to each other, not very clear at all.

Ronelh
12-26-17, 06:34 AM
http://www.youtube.com/watch?v=ME4UoIWCs4s
I guess you are saying the video would answer my question - which would make sense. Thanks for the tip. I would like to watch it, but I live in Africa with limited internet so I haven't been able to watch it yet. Hopefully sometime soon I will be able to do so.

mildadhd
12-27-17, 12:49 AM
Are there any differences between ADD-PI (DSM 4) and ADHD-PI (DSM 5)?









M

Lunacie
12-27-17, 12:20 PM
I don't have any familiarity with dyspraxia, but according to Wikipedia:



https://en.wikipedia.org/wiki/Developmental_coordination_disorder

Some of the symptoms that have to do with working memory are similar to those found in ADHD which also involves problems with working memory. But I'm not sure how we can tell if the two sets of similar symptoms are connected below the surface.

Thank you for sharing that link. OMG ... so much of that is me.

The proprioception issue got me good yesterday. After loading the wheelchair
into the back of the minivan, I went to close the lift gate and it came down
on my nose! It knocked my glasses off and thankfully other than needing
some adjustment they survived. My nose looks like road rash ... but grateful
that I don't have any black eyes.

I'm supposed to be navigator on this trip, despite not doing a good job on
the last few trips. Have never been able to tell right from left without stopping
to think. If I tell someone to turn left at the next corner, it often comes out
of my mouth "turn right" instead.

The poor handwriting, the clumsiness, difficulty with hand eye coordination
... yep, got 'em in spades. I'm using my daughter's laptop this morning, no
mouse, it's incredibly difficult for me to manage scrolling. I have never been
able to play games that use a joystick, or up-down-left-right keys. So driving
the electric wheelchair the last couple of days has been rediculous. Have run
over everyone's toes at least once, including my own!

We got lost twice inside the very big and VERY busy mall. Thankfully you
can't get lost in IKEA. :lol:

mildadhd
12-27-17, 12:50 PM
Are there any differences between ADD-PI (DSM 4) and ADHD-PI (DSM 5)?









M



Sorry, I started a new thread to discuss this question, so I do not derail this thread discussion.

http://www.addforums.com/forums/showthread.php?p=1980060#post1980060








M

mildadhd
12-27-17, 12:59 PM
In all the videos, I have never heard Dr. Barkley say SCT is not ADD-PI?







M

namazu
12-27-17, 10:35 PM
In all the videos, I have never heard Dr. Barkley say SCT is not ADD-PI?
I haven't watched the videos, but he discusses SCT extensively in this fact sheet: "Sluggish Cognitive Tempo - A Review of the Scientific Evidence (http://www.russellbarkley.org/factsheets/SluggishCognitiveTempo.pdf)" (2014ish?)

Among other things, he writes:


Sluggish Cognitive Tempo (CDD (SCT)) is an impairment of attention in hypoactive appearing individuals, which first presents in childhood. It is characterized by a cognitive dimension of symptoms comprising daydreaming, sleepy, staring, “spaciness,” and mental fogginess and confusion, along with a motor dimension of slow movement, hypoactivity, lethargy, and passivity.
The symptom dimensions forming CDD (SCT) are distinct from yet partially correlated with those forming ADHD.
[...]
Evidence supports the view that CDD (SCT) is distinct from ADHD and not a subtype of it. But the two conditions can overlap in nearly half of all cases of each.
Future diagnostic taxonomies, such as the DSM, should create a higher order category of Attention Disorders under which one would then break out ADHD and CDD as separate, semi-distinct conditions much like is done now for the supra-category of Learning Disabilities (LDs) rather than continue the mistaken view that CDD/SCT is a subtype of ADHD.


Basically, he seems to feel that ADHD is primarily an executive function disorder, and SCT (which he prefers to call "concentration deficit disorder" or "CDD") isn't. He associates SCT more with problems with alertness/arousal, concentration, and pathological daydreaming. (Whether or not those things all under "executive function" depends, of course, on who's defining executive function!)

A person can have ADHD with or without CDD/SCT, and a person can have CDD/SCT with or without ADHD, though often people have both.

He seems to think that some people who were diagnosed with ADHD, predominantly inattentive type, might be more accurately said to have a mild form of classic (i.e., combined type) ADHD, while others might be more accurately said not to have ADHD at all, but rather CDD/SCT. (And some might have both, and perhaps some have neither...)

I get the impression that if it were up to him, there would be no "predominantly inattentive" label applied to ADHD -- there would just be ADHD (with "combined" symptoms, in varying numbers and to varying degrees) and a CDD/SCT diagnosis.

mildadhd
12-29-17, 06:26 PM
Dr. Barkley does not say SCT is not ADHD-I.

There are three types of ADHD.

ADHD-Inattentive, ADHD-Hyperactive-Implusive and ADHD-Combined.

I am all for promoting awareness of the possible similarities and the possible differences between ADHD-I, ADHD-HI, and ADHD-Combined, but why change the name of ADHD-I to SCT?












M

mildadhd
12-29-17, 07:05 PM
Just because a person who has ADHD-I does not appear to have all the same symptoms, as another person who also has ADHD-I, does not mean they both do not have ADHD-I.







M

Lunacie
12-29-17, 07:29 PM
Dr. Barkley does not say SCT is not ADHD-I.

There are three types of ADHD.

ADHD-Inattentive, ADHD-Hyperactive-Implusive and ADHD-Combined.

I am all for promoting awareness of the possible similarities and the possible differences between ADHD-I, ADHD-HI, and ADHD-Combined, but why change the name of ADHD-I to SCT?




M

The double negative is confusing to me.

I believe that Dr. Barkley thinks that SCT (or Concentration Deficit Disorder
as he calls it) is different than ADHD-PI. That they are two distinct disorders.

He suggests that with SCT the problem is with locking in attention in the first
place, not with maintaining it.

The problem is not impulse control, it is a processing disorder.

Those with SCT are not likely to get hyperfocused on things they enjoy.

Their symptoms of daydreaming and failing to complete work look like ADHD
and so they have been lumped in with it, but they are different.

mildadhd
12-29-17, 08:39 PM
The double negative is confusing to me.

I believe that Dr. Barkley thinks that SCT (or Concentration Deficit Disorder
as he calls it) is different than ADHD-PI. That they are two distinct disorders.

He suggests that with SCT the problem is with locking in attention in the first
place, not with maintaining it.

The problem is not impulse control, it is a processing disorder.

Those with SCT are not likely to get hyperfocused on things they enjoy.

Their symptoms of daydreaming and failing to complete work look like ADHD
and so they have been lumped in with it, but they are different.

ADHD-Inattentive

Excessive daydreaming and failing to complete work are symptoms of moderate ADHD-I and severe ADHD-I.









M

Lunacie
12-29-17, 10:40 PM
ADHD-Inattentive

Excessive daydreaming and failing to complete work are symptoms of moderate ADHD-I and severe ADHD-I.




M

Yes, there are some cross-over symptoms.

Just as there are cross-over symptoms between adhd and autism,
and between adhd and bipolar, and between adhd and depression.

But if there are also a number of different symptoms, it may be that
there should be a different diagnosis and different treatment.

From what I've read, the people with the SCT symptoms don't respond
to stimulant meds. Most people with adhd do respond to these meds.

namazu
12-30-17, 12:15 AM
Dr. Barkley does not say SCT is not ADHD-I.
Yes, Barkley has said that SCT is not ADHD:
Evidence supports the view that CDD (SCT) is distinct from ADHD and not a subtype of it.

There may be other researchers who disagree, or who do not feel the evidence is sufficient to decide yet.

mildadhd
12-30-17, 12:58 AM
Yes, Barkley has said that SCT is not ADHD:



I have heard Dr. Barkley say, SCT is not ADHD.

But I have also heard Dr. Barkley does not believe in the ADHD-Inattentive label.

So I am wondering, if Dr. Barkley actually says, SCT is not ADHD-Inattentive, or is Dr. Barkley relabelling ADHD-Inattentive (aka ADD) as SCT?

I have all the symptoms of ADHD-Inattentive, and i think the symptoms being associated with so called SCT are symptoms of ADHD-Inattentive.

According to the title of the video posted in this thread’s opening post, “SCT (or ADD) verses ADHD”?



(0:10 seconds)
The second Attention Disorder: Slugish Cognitive Tempo (or ADD) vs. ADHD

http://m.youtube.com/watch?v=MKavCm3qHBE











M

namazu
12-30-17, 01:29 AM
So I am wondering, if Dr. Barkley actually says, SCT is not ADHD-Inattentive, or is Dr. Barkley relabelling ADHD-Inattentive (aka ADD) as SCT?

I think I already addressed that question:
He seems to think that some people who were diagnosed with ADHD, predominantly inattentive type, might be more accurately said to have a mild form of classic (i.e., combined type) ADHD, while others might be more accurately said not to have ADHD at all, but rather CDD/SCT. (And some might have both, and perhaps some have neither...)
In other words, he's not exactly relabeling (all) predominantly inattentive ADHD as "SCT" (or "CDD").
He's basically arguing that "predominantly inattentive ADHD" is a confusing label in general: it includes some people who appear to have subthreshold ADHD (combined presentation), and some people who more accurately could be said to have SCT/CDD, who really don't fit his conception of ADHD very well at all.

I think you're right that he doesn't seem to "believe in" a purely inattentive ADHD (with absolutely no hyperactive or impulsive symptoms at all) that really fits his model of ADHD.

If you meet the criteria for ADHD (any presentation), and you also have a lot of symptoms assocaited with "SCT" (or "CDD"), then I think Barkley would probably say that you have both conditions.

mildadhd
12-30-17, 02:36 AM
I think I already addressed that question:

In other words, he's not exactly relabeling (all) predominantly inattentive ADHD as "SCT" (or "CDD").
He's basically arguing that "predominantly inattentive ADHD" is a confusing label in general: it includes some people who appear to have subthreshold ADHD (combined presentation), and some people who more accurately could be said to have SCT/CDD, who really don't fit his conception of ADHD very well at all.

I think you're right that he doesn't seem to "believe in" a purely inattentive ADHD (with absolutely no hyperactive or impulsive symptoms at all) that really fits his model of ADHD.

If you meet the criteria for ADHD (any presentation), and you also have a lot of symptoms assocaited with "SCT" (or "CDD"), then I think Barkley would probably say that you have both conditions.

What are the symptoms you are associating with SCT (or ADD), that are not listed as symptoms associated with ADHD-Inattentive, in the DSM?





M

namazu
12-30-17, 03:27 AM
What are the symptoms you are associating with SCT (or ADD), that are not listed as symptoms associated with ADHD-Inattentive, in the DSM?
There are various lists of them in different places, and they're not all the same, which is one of the challenges in discussing SCT/CDD.

Some of the ones Barkley mentions here (http://www.russellbarkley.org/factsheets/SluggishCognitiveTempo.pdf) (based on research from a number of different researchers) include:
(1) daydreaming,
(2) trouble staying awake/alert,
(3) mentally foggy/easily confused,
(4) stares a lot,
(5) spacey, mind is elsewhere,
(6) lethargic,
(7) under-active,
(8) slowmoving/sluggish,
(9) doesn’t process questions or explanations accurately,
(10) drowsy/sleepy appearance,
(11) apathetic/withdrawn,
(12) lost in thoughts,

Now, I personally think this list has problems, if it's meant as a list of unique symptoms -- it seems to me that "lethargic", "under-active", and "slowmoving/sluggish" may all be describing the same "symptom". Similarly, "spacey/mind is elsewhere" and "lost in thoughts" and "daydreaming" all seem similar, and so do "drowsy/sleepy appearance" and "trouble staying awake/alert".

Barkley addresses this, in saying that from this list, the most reliable things that emerge are 2 distinct factors: "Daydream/Slow" [to process/respond?] and "Sleepy/Sluggish/Underactive".

Neither excessive daydreaming/slowness, nor sleepiness/sluggishness/hypoactivity is among the DSM-5 "inattentive" criteria for ADHD.

Barkley goes on to say:
While correlated to a low-to-moderate degree with the ADHD symptom dimensions, the two (or more) dimensions of CDD (SCT) are more highly correlated with each other than with those of ADHD. The relationship between CDD (SCT) and ADHD dimensions is similar to that found for other dimensions of psychopathology that are semi-related yet also rather distinct from each other, as between anxiety and depression or between oppositionality and ADHD.

I don't think that this is the final word on the subject, but it seems like an interesting premise.