What evidence is there for the terms SCT?

[Peripheral]

I remember Dr.Barkley saying something like SCT might be a separate disorder,

and it is currently underdebate.

I noticed the use of the term SCT used around the forums a lot lately.


I was wondering if it has been decided that SCT is not ADD?

Does anybody have any research?

I really don't know.

[Drewbacca]

You may want to look at:
Milich R, Balentine AC, Lynam DR (2001) ADHD combined
type and ADHD predominantly inattentive type are distinct and
unrelated disorders. Clin Psychol Sci Pract 8:463–488

Barkley seems to agree with this hypothesis and has been working on how to distinguish ADHD from SCT based on symtom threshold.
See: Journal of Abnormal Psychology
Distinguishing Sluggish Cognitive Tempo From
Attention-Deficit/Hyperactivity Disorder in Adults
Russell A. Barkley
Online First Publication, May 23, 2011.

In this paper, Barkley gives the following references concerning the distinction:

Early research suggested some validity to the I-Type relative to the C-Type (Carlson, Lahey, & Neeper, 1986; Carlson & Mann, 2002; Milich, Balentine, & Lynam, 2001) as did some studies using neuropsychological measures (Solanto et al., 2007). More recent reviews that compare these types have typically concluded that this approach does not so much identify distinct subtypes of a disorder but variations in disorder severity (Baeyens, Roeyers, &
Walle, 2006; Lahey & Willcutt, 2010; Nigg, Tannock, & Rohde, 2010). The subtypes are also unreliable, being highly related to the methods and sources of information used to assess ADHD (Valo & Tannock, 2010) and are not especially stable over development
(Lahey & Willcutt, 2010). Another approach to subtyping that may have some merit was suggested in early studies comparing the C- and I-Types of ADHD (Carlson et al., 1986; Carlson & Mann, 2000) where a distinct set of inattention symptoms not represented in DSM criteria characterized a sizable minority of cases diagnosed with I-Type. Those I-Type cases had very low levels of HI symptoms and were likely to manifest problems with daydreaming, staring, mental fogginess, and confusion, hypoactivity, sluggishness or slow movement, lethargy, apathy, and sleepiness (Barkley, DuPaul, & McMurray, 1990; Carlson & Mann, 2002; Diamond, 2005; McBurnett, Pfiffner, & Frick, 2001; Milich et al., 2001). This constellation came to be labeled “sluggish cognitive tempo” (SCT; McBurnett et al., 2001) or more recently simply as attention-deficit disorder (ADD; Adams, Milich, & Fillmore, 2010; Diamond, 2005).

Regarding the inclusion of SCT in the DSM-IV, the following has this to say:

ADHD Combined Type and ADHD Predominantly
Inattentive Type Are Distinct and Unrelated Disorders
Richard Milich, Amy C. Balentine, and Donald R. Lynam

Although there are few studies specifically examining the nature of the attention problems for the two ADHD subtypes, the available studies suggest that the two subtypes may experience dramatically different types of attention problems. This possibility was first raised in studies examining the DSM-III subtypes, in which the performance of the ADD/H group was characterized by distractibility and impulsivity, whereas the behavior of the ADD/WO group was characterized by what has come to be called a “sluggish cognitive tempo” (SCT), consisting of behaviors such as drowsiness, lethargy, and hypoactivity (Carlson & Mann, in press). Although these latter items sound as though they have to
do with activity level, they tend to load on the inattention factor in factor analytic studies (see Lahey et al., 1997). Achenbach has reported two similar inattention dimensions in his factor analyses of both his rating scales (Achenbach, 1996) and his Direct Observation Form (Achenbach, 1991; McConaughy, Achenbach, & Gent, 1988). Items relating to this sluggish cognitive tempo were included in the DSM-IV field trials for ADHD (Frick et al., 1994), but they were not included in the final symptom lists for ADHD, primarily because the DSM-IV work group wanted to keep the inattention symptoms identical for all of the subtypes (Lahey et al., 1994).

[Verile]

Well, my entire life for starters. But there's also this:

http://www.ncbi.nlm.nih.gov/pubmed/22179974
http://www.ncbi.nlm.nih.gov/pubmed/19731006
http://www.ncbi.nlm.nih.gov/pubmed/21604823
http://www.dsm5.org/ProposedRevision...n.aspx?rid=383

[Peripheral]

Originally Posted by Verile

Well, my entire life for starters. But there's also this:

http://www.ncbi.nlm.nih.gov/pubmed/22179974
http://www.ncbi.nlm.nih.gov/pubmed/19731006
http://www.ncbi.nlm.nih.gov/pubmed/21604823
http://www.dsm5.org/ProposedRevision...n.aspx?rid=383

Thanks for the info,

I don't understand much yet?

Dr. Barkley says its not ADHD or ADD?

Its a separate disorder?

Is there a SCTForums?

What is the treatment for SCT?

I'm pretty confused on this topic.

It doesn't seem to be a subtype of ADHD or ADD?

[Amtram]

That's what he's aiming for. On this, I think I might be more in agreement with him than I have on other issues. What it comes down to is that by separating SCT out from ADHD, it makes a better clinical distinction between the two of them, which means better treatment procedures. There's enough of a difference in symptomology that it could save a lot of people with SCT the trouble of going through the gamut of ADHD medications until they end up with one that addresses their symptoms better.

[Peripheral]

Fortunately, children with SCT may have a far better response to cognitive-behavioral therapy which works less well in typical ADHD. They also might benefit from social skills training unlike those with classic ADHD.

http://www.pensivepediatrician.com/2...tempo-vs-adhd/

People with ADHD can be treated with cognitive-behavioral therapy and social skills training.

I wish I had SCT.

Maybe I do.

That would be great!!!

[Peripheral]

Originally Posted by Amtram

That's what he's aiming for. On this, I think I might be more in agreement with him than I have on other issues. What it comes down to is that by separating SCT out from ADHD, it makes a better clinical distinction between the two of them, which means better treatment procedures. There's enough of a difference in symptomology that it could save a lot of people with SCT the trouble of going through the gamut of ADHD medications until they end up with one that addresses their symptoms better.

Sorry I don't understand,

what is Dr.Barkley not aiming for in this one?

Dr.Barkley says he thinks it is a separate disorder.

[Verile]

Right. The way Barkley put it is that the SCT kids got put in the Inattentive without H/I because they had nowhere else to go. But if it's a separate disorder with its own symptoms and responses to medications then what you have is a heterogeneous group of people you're doing research on.

Ultimately it means we're skewing each others' data on what would help our groups most clinically speaking.

[Verile]

Originally Posted by Geronimoo Back-Y-Rita

People with ADHD can be treated with cognitive-behavioral therapy and social skills training.

I wish I had SCT.

Maybe I do.

That would be great!!!

Could we not open that can of worms where you wish you had someone else's disorder because you perceive it to be easier to deal with?

[Peripheral]

Originally Posted by Verile

Could we not open that can of worms where you wish you had someone else's disorder because you perceive it to be easier to deal with?

Dr.Barkley says it it is.

I'm not opening worms,

its what Dr.Barkley said.

I am being serious.

Maybe I do have SCT.

I was diagnosed ADD,

not ADHD.

And everyone knows I think ADD can be treated,

maybe that is where I am going wrong?

might be a fit for me.

Maybe that is why so many people disagree,

maybe we are all right.

Sure gives people the right to talk about treatment that others disagree with.

Because it is right for them,

but not right for others.

[Peripheral]

Originally Posted by Verile

Right. The way Barkley put it is that the SCT kids got put in the Inattentive without H/I because they had nowhere else to go. But if it's a separate disorder with its own symptoms and responses to medications then what you have is a heterogeneous group of people you're doing research on.

Ultimately it means we're skewing each others' data on what would help our groups most clinically speaking.

What cognitive, behavioral and social therapy do you do?

Does it work for you?

I would like to try what ever SCTers do for treatment,

any recommendations?

[Peripheral]

What causes SCT?

Can't be genetic.

Or can it?

If it was genetic,

how could it respond to cognitive, behavior and social therapy?

And ADHD not?

[Peripheral]

Originally Posted by Verile

Could we not open that can of worms where you wish you had someone else's disorder because you perceive it to be easier to deal with?

I didn't say SCT would be easier to deal with,

SCT responds to treatment that people say ADHDers don't.

I think it is great news for a person who might be diagnosed ADD when they are really SCT.

I might fit that profile.

[Peripheral]

Sorry for so many posts in a row,

but this news got me all excited.

[plank80]

Originally Posted by Geronimoo Back-Y-Rita

What causes SCT?

Can't be genetic.

Or can it?

If it was genetic,

how could it respond to cognitive, behavior and social therapy?

And ADHD not?

I think SCT is a dysfunction in the parietal lobe not the frontal lobe so prob is genetic just a different part of the brain affected.