Differential Diagnosis of Executive Functions in 8- to 11-year-old boys with Attention Deficit / Hyperactivity Disorder and Sluggish Cognitive Tempo Disorder
Subject Areas : Clinicalkhoshdavi ebrahimzade 1 , farhad ghadiri 2 , Roya Zare 3 , Mehrnoush Javaezi Shishavan 4
1 - Psychology, Faculty of literature and Humanities, University of Urmia, Urmia, Iran.
2 - Psychology, Faculty of literature and Humanities, University of Urmia, Urmia, Iran.
3 - General Psychology, Department of Psychology, Islamic Azad University Ardabil Branch, Ardabil, Iran.
4 - General Psychology, Urmia Branch, Islamic Azad University, Urmia, Iran.
Keywords: attention deficit/ hyperactivity disorder, sluggish cognitive tempo, executive functions, 8- to 11-year-old boys.,
Abstract :
Executive functions are one of the important factors in distinguishing attention deficit/hyperactivity disorder and sluggish cognitive tempo disorder. The aim of this study was to explain the differential diagnosis of executive functions in 8- to 11-year-old boys with attention deficit / hyperactivity disorder and sluggish cognitive tempo disorder. The method of the present study was descriptive in the frame of Casual Comparative design and the statistical population included all 8-11 year-old male students with sluggish cognitive tempo and attention deficit /hyperactivity disorder in Urmia in 2021. The statistical sample size was 100 subjects (50 subjects with sluggish cognitive tempo and 50 subjects with attention deficit / hyperactivity disorder) from the statistical population who were selected by convenience sampling. In this study, to collect data from the Child Behavior Rating Scale (Swanson et al., 1980), the Sluggish Cognitive Tempo Questioner (Penny et al., 2009) and the Children and Adolescent Functional Performance Scale (Barclay, 2012) was used. To analyze the data, multivariate analysis of variance was used using SPSS version 26 software. The results of the research showed that in terms of response inhibition, spontaneity and emotion self-regulation, there is a significant difference between children with attention deficit/hyperactivity disorder and children with sluggish cognitive tempo disorder (P<0.01), however, there was no significant difference between the two groups in problem solving and time management (P>0.01). Considering the problems of executive functions in children with sluggish cognitive tempo disorder and attention deficit/hyperactivity disorder, it is suggested that therapists consider interventions to strengthen executive functions in these two groups of children to improve their social and academic performance.
Abdool Gafoor, L., Burke, A., & Fourie, J. (2021). The efficacy of the Senior South African individual scale Revised in distinguishing between attention deficit hyperactivity disorder, normal and sluggish cognitive tempo children. African Journal of Psychological Assessment, 3(0), 1-7.
American Psychiatric Association, D. S., & American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders: DSM-5 (Vol. 5). Washington, DC: American psychiatric association.
Araujo Jiménez, E. A., Jané Ballabriga, M. C., Bonillo Martin, A., Arrufat, F. J., & Serra Giacobo, R. (2015). Executive functioning in children and adolescents with symptoms of sluggish cognitive tempo and ADHD. Journal of Attention Disorders, 19(6), 507-514.
Barkley, R. A. (2006). The relevance of the still lecturesto attention-deficit/hyperactivity disorder: A commentary. Journal of Attention Disorders, 10(2), 137-140.
Barkley, R. A. (2018). Barkley sluggish cognitive tempo scale – children and adolescents. New York, NY: Guilford.
Barkley, R.A. (2013) Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: executive functioning, impairment, and comorbidity. Journal of Clinical Child & Adolescent Psychology, 42(2), 161-173.
Becker, S. P., & Barkley, R. A. (2021). Field of daydreams? Integrating mind wandering in the study of sluggish cognitive tempo and ADHD. Journal of Child Psychology and Psychiatry Advances, 1(1), e12002.
Becker, S. P., & Langberg, J. M. (2014). Attention-deficit/hyperactivity disorder and sluggish cognitive tempo dimensions in relation to executive functioning in adolescents with ADHD. Journal of Child Psychiatry & Human Development, 45(1), 1-11.
Becker, S. P., & Willcutt, E. G. (2019). Advancing the study of sluggish cognitive tempo via DSM, RDoC, and hierarchical models of psychopathology. Journal of European Child & Adolescent Psychiatry, 28(5), 603-613.
Becker, S. P., Fite, P. J., Garner, A. A., Greening, L., Stoppelbein, L., & Luebbe, A. M. (2013). Reward and punishment sensitivity are differentially associated with ADHD and sluggish cognitive tempo symptoms in children. Journal of Research in Personality, 47(6), 719-727.
Becker, S. P., Luebbe, A. M., & Joyce, A. M. (2015). The child concentration inventory (CCI): Initial validationof a child self-report measure of sluggish cognitive tempo. Journal of Psychological Assessment, 27(3), 1037-1052.
Boshomane,T.T., Pillay, B.J., & Meyer, A. (2021) Mental flexibility (set-shifting) deficits in children with ADHD: A replication and extension study. Journal of Psychology in Africa, 31(4), 344-349.
Burns, G. L., & Becker, S. P. (2021). Sluggish cognitive tempo and ADHD symptoms in a nationally representative sample of US children: Differentiation using categorical and dimensional approaches. Journal of Clinical Child & Adolescent Psychology, 50(2), 267-280.
Bussing, R., Fernandez, M., Harwood, M., Hou, W., Garvan, C. W., Eyberg, S. M., & Swanson, J. M. (2008). Parent and teacher SNAP-IV ratings of attention deficit hyperactivity disorder symptoms: psychometric properties and normative ratings from a school district sample. Journal of Assessment, 15(3), 317-328.
Collado-Valero, J., Navarro-Soria, I., Delgado-Domenech, B., Real-Fernández, M., Costa-López, B., Mazón-Esquiva, I., & Lavigne-Cerván, R. (2021). ADHD and sluggish cognitive tempo: Comparing executive functioning response patterns. Journal of Sustainability, 13(19), 1-15.
De Luca, F., Petrucci, M., Monachesi, B., Lavidor, M., & Pecchinenda, A. (2020). Asymmetric contributions of the fronto-parietal network to emotional conflict in the word–face interference task. Journal of Symmetry, 12(10), 1-18.
Faraone, S.V., Banaschewski, T., Coghill, D., Zheng, Y., Biederman, J., Bellgrove, M.A., Newcorn, J.H., Gignac, M., Al Saud, N.M., Manor, I. and Rohde, L.A. (2021). The World Federation of ADHD International Consensus Statement: 208 evidence-based conclusions about the disorder. Journal of Neuroscience & Biobehavioral Reviews, 128, 789–818.
Fassbender, C., Krafft, C.E., & Schweitzer, J.B. (2015). Differentiating SCT and inattentive symptoms in ADHD using fMRI measures of cognitive control. Journal of NeuroImag Clinical, 8(1), 390-397.
Flannery, A. J., Becker, S. P., & Luebbe, A. M. (2016). Does emotion dysregulation mediate the association between sluggish cognitive tempo and college students’ social impairment? Journal of attention disorders, 20(9), 802-812.
Friedman, N.P., & Robbins, T.W. (2022). The role of prefrontal cortex in cognitive control and executive function. Journal of Neuropsychopharmacol, 47(1), 72–89.
Goth-Owens, T. L., Martinez-Torteya, C., Martel, M. M., & Nigg, J. T. (2010). Processing speed weakness in children and adolescents with non-hyperactive but inattentive ADHD (ADD). Journal of Child Neuropsychology, 16(6), 577-591.
Goulardins, J. B., Marques, J. C., & De Oliveira, J. A. (2017). Attention deficit hyperactivity disorder and motor impairment: A critical review. Journal of Perceptual and Motor Skills, 124(2), 425-440.
Hakim Shooshtari, M., Shariati, B., Kamalzadeh, L., Naserbakht, M., Tayefi, B., & Taban, M. (2021). The prevalence of attention deficit hyperactivity disorder in Iran: An updated systematic review. Medical Journal of The Islamic Republic of Iran, 35(1), 60-71.
Khanjani, Z., Mohammadi, E., & Shadbafi, M. (2020). The prediction of children's accident proneness based on attention deficit hyperactivity disorder and sluggish cognitive tempo symptoms: the mediating role of sensitivity to reward and punishment. Journal of Child Mental Health, 7(1), 44-56. [In Persian]
Kilincel, S., & Usta, M.B. (2021). Detection of Sluggish Cognitive Tempo with d-CPT in children with ADHD. Journal of Psychiatry and Behavioral Sciences,11(1), 50-56.
Kim, K., & Kim, H. J. (2021). Normal executive attention but abnormal orienting attention in individuals with sluggish cognitive tempo. International Journal of Clinical and Health Psychology, 21(1), 46-56.
Kofler, M. J., Irwin, L. N., Sarver, D. E., Fosco, W. D., Miller, C. E., Spiegel, J. A., & Becker, S. P. (2019). What cognitive processes are “sluggish” in sluggish cognitive tempo? Journal of consulting and clinical psychology, 87(11), 1030-1042.
Kofler, M. J., Rapport, M. D., Sarver, D. E., Raiker, J. S., Orban, S. A., Friedman, L. M., & Kolomeyer, E. G. (2013). Reaction time variability in ADHD: A meta-analytic reviewof 319 studies. Journal of Clinical Psychology Review, 33(6), 795-811.
Krieger, V., & Amador-Campos, J. A. (2018). Assessment of executive function in ADHD adolescents: contribution of performance tests and rating scales. Journal of Child Neuropsychology, 24(8), 1063-1087.
Larsson, H., Dilshad, R., Lichtenstein, P., & Barker, E. D. (2011). Developmental trajectories of DSM‐IV symptoms of attention‐deficit/hyperactivity disorder: Genetic effects, family risk and associated psychopathology. Journal of Child Psychology and Psychiatry, 52(9), 954-963.
Leache, L., Arrizibita, O., Gutiérrez-Valencia, M., Saiz, L. C., Erviti, J., & Librero, J. (2021). Incidence of Attention Deficit Hyperactivity Disorder (ADHD) Diagnoses in Navarre (Spain) from 2003 to 2019. International Journal of Environmental Research and Public Health, 18(17), 1-12.
Leikauf, J. E., & Solanto, M. V. (2017). Sluggish cognitive tempo, internalizing symptoms, and executive function in adults with ADHD. Journal of Attention Disorders, 21(8), 701-711.
Lezak, M. D. (2004). Executive functions and motor performance. In M. D. Lezak (Ed.), Neuropsychological assessment (Fourth ed., pp. 611-646). New York: Oxford University Press.
Li, Q., Fu, Y., Liu, C., & Meng, Z. (2022). Transcranial Direct Current Stimulation of the Dorsolateral Prefrontal Cortex for Treatment of Neuropsychiatric Disorders. Journal of Frontiers in Behavioral Neuroscience, 16, 1-16.
Montalva-Valenzuela, F., Andrades-Ramírez, O., & Castillo-Paredes, A. (2022). Effects of Physical Activity, Exercise and Sport on Executive Function in Young People with Attention Deficit Hyperactivity Disorder: A Systematic Review. European Journal of Investigation in Health Psychology and Education, 12(1), 61-76.
Nasir, H., Tan, C.-S., Pheh, K-S. (2021). The Executive Skills Questionnaire-Revised: Adaptationand Psychometric Properties in the Working Context of Malaysia. International Journal of Environmental Research and Public Health, 18(17), 1-13.
Otero, T. M., Barker, L. A., & Naglieri, J. A. (2014). Executive function treatment and intervention in schools. Journal of Applied Neuropsychology: Child, 3(3), 205–214.
Owens, E.B., Zalecki, C., Gillette, P., & Hinshaw, S.P. (2017). Girls with childhood ADHD as adults: cross-domain outcomes by diagnostic persistence. Journal of Consulting and Clinical Psychology, 85(7), 723–736.
Penny, A. M., Waschbusch, D. A., Klein, R. M., Corkum, P., & Eskes, G. (2009). Developing a measure of sluggish cognitive tempo for children: content validity, factor structure, and reliability. Journal of Psychological Assessment, 21(3), 380-389.
Petersen, S. E., & Posner, M. I. (2012). The atten-tion system of the human brain: 20 years after. Journal of Annual Review of Neuroscience, 35, 73-89.
Powell, V., Riglin, L., Hammerton, G., Eyre, O., Martin, J., Anney, R., Thapar, A., & Rice, F. (2020). What explains the link between childhood ADHD and adolescent depression? Investigating the role of peer relationships and academic attainment. Journal of European Child & Adolescent Psychiatry, 29(11), 1581–1591.
Riley, C., DuPaul, G. J., Pipan, M., Kern, L., Van Brakle, J., & Blum, N. J. (2008). Combined type versus ADHD predominantly hyperactive-impulsive type: is there a difference in functional impairment? Journal of Developmental & Behavioral Pediatrics, 29(4), 270-275.
Rubia, K., Westwood, S., Aggensteiner, P. M., & Brandeis, D. (2021). Neurotherapeutics for Attention Deficit/Hyperactivity Disorder (ADHD): A Review. Journal of Cells, 10(8), 1-34.
Sadrosadat, S.J., Houshyari, Z., Zamani, R., & Sadrosadat, L. (2008). Determinatio of psychometrics index of SNAP -IV rating scale in parents execution. Journal of Archives of Rehabilitation, 8(4), 59 –65. [Persian]
Sawhney, I.., Perera, B., Bassett, P., Zia, A., Alexander, R. T., & Shankar, R. (2021). Attention-deficit hyperactivity disorder in people with intellectual disability: statistical approach to developing a bespoke screening tool. Journal of BJPsych open, 7(6), 1-7.
Saxbe, C., & Barkley, R.A. (2014). The second attention disorder? Sluggish cognitive tempo vs. attention-deficit/hyperactivity disorder: update for clinicians. Journal of Psychiatric Practice, 20(1), 38-49.
Scheres, A., & Solanto, M. V. (2021). Do ADHD symptoms, executive function, and study strategies predict temporal reward discounting in college students with varying levels of ADHD symptoms? A pilot study. Journal of Brain Sciences, 11(2), 1-14.
Servera, M., Saez, B., Burns, G.L., & Becker, S.P. (2018). Clinical differentiation of sluggish cognitive tempo and attention-deficit/hyperactivity disorder in children. Journal of Abnormal Psychology, 127(8), 818-829.
Smith, J. N., & Suhr, J. A. (2021) Sluggish Cognitive Tempo Factors in Emerging Adults: Symptomatic and Neuropsychological Correlates. Journal of Developmental Neuropsychology, 46(3), 169-183.
Smith, Z. R., Langberg, J. M., Cusick, C. N., Green, C. D., & Becker, S. P. (2020). Academic motivation deficits in adolescents with ADHD and associations with academic functioning. Journal of Abnormal Child Psychology, 48(2), 237-249.
Soltani Kouhbanani, S., Zarenezhad, S., & Bordbar, M. (2020). Psychometric properties of the home executive functions environment (HEFE) questionnaire. Journal of Child Mental Health, 7 (2), 17-30. [In Persian]
Spagna, A., Mackie, M. A., & Fan, J. (2015). Supramodal executive control of attention. Frontiers in Psychology, 6 (65), 1-14.
Swanson, J., Nolan, W., Pelham, WE. (1980). the SNAP Rating Scale for the Diagnosis of the Attention Deficit Disorder. Paper presented at the meeting of the American Psychological Association, Los Angeles.
Tirapu-Ustárroz, J., Ruiz-García, B. M., Luna-Lario, P., & Hernáez-Goñi, P. (2015). Tempo cognitivo lento: Una revisión actualizada. Journal of Revista de Neurología, 61(7), 323-331.
Wahlstedt, C., & Bohlin, G. (2010). DSM-IV-defined inattention and sluggish cognitive tempo: independent and interactive relations to neuropsychological factors and comorbidity. Journal of Child Neuropsychology, 16(4), 350-365.
Wiest, G. M., Rosales, K. P., Looney, L., Wong, E. H., & Wiest, D. J. (2022). Utilizing Cognitive Training to Improve Working Memory, Attention, and Impulsivity in School-Aged Children with ADHD and SLD. Journal of Brain Sciences, 12(2), 1-16.
Willcutt, E. G., Chhabildas, N., Kinnear, M., DeFries, J. C., Olson, R. K., Leopold, D. R., ... & Pennington, B. F. (2014). The internal and external validity of sluggish cognitive tempo and its relation with DSM–IV ADHD. Journal of Abnormal Child Psychology, 42(1), 21-35.
Young, S., Gudjonsson, G., Chitsabesan, P., Colley, B., Farrag, E., Forrester, A., Hollingdale, J., Kim, K., Lewis, A., Maginn, S., & Mason, P. (2018). Identification and treatment of offenders with attention-deficit/hyperactivity disorder in the prison population: a practical approach based upon expert consensus. Journal of BMC Psychiatry, 18(1), 1-16.
Yung, T. W., Lai, C. Y., Chan, J. Y., Ng, S. S., & Chan, C. C. (2020). Neuro-physiological correlates of sluggish cognitive tempo (SCT) symptoms in school-aged children. Journal of European Child & Adolescent Psychiatry, 29(3), 315-326.
Yung, T.W.K., Lai, C.Y.Y., Chan, J.Y.C., Ng, S.S.M., Chan, & C.C.H. (2021). Examining the role of attention deficits in the social problems and withdrawn behavior of children with sluggish cognitive tempo symptoms. Journal of Frontiers in Psychiatry, 12, 1-12.