Sluggish Cognitive Tempo - History of The Term SCT and Its Relationship To The DSM

History of The Term SCT and Its Relationship To The DSM

Sluggishness, drowsiness, and daydreaming were initially found to be common in children receiving the diagnosis of Attention Deficit Disorder (ADD) without Hyperactivity in the 1980s. It is unclear if the term SCT was coined by Ben Lahey and his colleagues in their study on this set of symptoms or was first used by Neeper in his dissertation with Caryn Carlson around this same time. Both identified a separate dimension or factor of inattention based on these symptoms that was distinct from that seen in ADHD. While this SCT dimension correlated more highly with the Inattention factor associated with ADHD, it was not as highly related to that of Hyperactivity-Impulsivity symptoms associated with ADHD.

Currently the American Psychiatric Association (APA) is working on creating the DSM-5. In the published preliminary draft revisions, APA writes that more research is needed to assess the "sluggish cognitive tempo" construct. A proposition in the DSM-5 draft's is creating a 4th category in the general ADHD diagnosis called RPI (restrictive predominantly inattentive) which would be for individuals with no more than 2 hyperactive/impulsive symptoms. This proposition will provide a descriptive name for a disorder with little or no hyperactivity which may address the Sluggish cognitive tempo construct as a clinical diagnosis and promote future research. Despite this proposal, at this time (March 2012) it does not appear as if either the original ADHD subtypes will be retained into DSM-5 much less that a distinct disorder for SCT will be included. That is because the committees working on revising these disorders do not wish to unduly increase the prevalence of psychiatric disorders in children without overwhelming evidence supporting the existence and utility of identifying a new psychiatric disorder. So it is likely that SCT will remain a category used more by researchers than a formal diagnoses recognized in clinical practice for the time being.