The primary goals of this study were to evaluate the dimensionality of the Penny et al. Sluggish Cognitive Tempo Scale and to compare model fits for parent- and youth self-report versions. Participants were 262 young adolescents (ages 10-15) comprehensively diagnosed with attention-deficit/hyperactivity disorder. Both confirmatory factor analysis (CFA) and bifactor modeling were used to determine if the proposed three-factor structure previously identified through exploratory factor analysis could be confirmed. Results showed that although the three-factor CFA had better fit statistics than a one- or two-factor CFA, the bifactor model was the best-fitting model for both parent report and self-report. This implies that Sluggish Cognitive Tempo Scale is best conceptualized as having an underlying general factor, with three specific factors that may represent different etiologies. Importantly, results also showed low-to-moderate correlations between raters and equivalent or better fit statistics for self-report in comparison with parent report.
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
2.
BarkleyR. A. (2012). Distinguishing sluggish cognitive tempo from attention-deficit/hyperactivity disorder in adults. Journal of Abnormal Psychology, 121, 978-990.
3.
BarkleyR. A. (2013). Distinguishing sluggish cognitive tempo from ADHD in children and adolescents: Executive functioning, impairment, and comorbidity. Journal of Clinical Child and Adolescent Psychology, 42, 161-173.
4.
BarkleyR.A. (2014). Sluggish cognitive tempo (concentration deficit disorder?): Current status, future directions, and a plea to change the name. Journal of Abnormal Child Psychology, 42, 117-25.
5.
BeckerS. P. (2013). Topical review: Sluggish cognitive tempo: Research findings and relevance for pediatric psychology. Journal of Pediatric Psychology, 38, 1051-1057.
6.
BeckerS. P.GarnerA. A.ByarsK. C. (2016). Sluggish cognitive tempo in children referred to a pediatric sleep disorders center: Examining possible overlap with sleep problems and associations with impairment. Journal of Psychiatric Research, 77, 116-124. doi:10.1016/j.jpsychires.2016.03.005
7.
BeckerS. P.LangbergJ. M. (2013). Sluggish cognitive tempo among young adolescents with ADHD: Relations to mental health, academic, and social functioning. Journal of Attention Disorders, 17, 681-689.
8.
BeckerS. P.LangbergJ. M. (2014). Attention-deficit/hyperactivity disorder and sluggish cognitive tempo dimensions in relation to executive functioning in adolescents with ADHD. Child Psychiatry & Human Development, 45, 1-11.
9.
BeckerS. P.LeopoldD. R.BurnsG. L.JarrettM. A.LangbergJ. M.MarshallS. A.. . . WillcuttE. G. (2016). The internal, external, and diagnostic validity of sluggish cognitive tempo: A meta-analysis and critical review. Journal of the American Academy of Child & Adolescent Psychiatry, 55, 163-178. doi:10.1016/j.jaac.2015.12.006
10.
BeckerS. P.LuebbeA. M.FiteP. J.StoppelbeinL.GreeningL. (2014). Sluggish cognitive tempo in psychiatrically hospitalized children: Factor structure and relations to internalizing symptoms, social problems, and observed behavioral dysregulation. Journal of Abnormal Child Psychology, 41, 49-62.
11.
BeckerS. P.LuebbeA. M.LangbergJ. M. (2014). Attention-deficit/hyperactivity disorder dimensions and sluggish cognitive tempo symptoms in relation to college students’ sleep functioning. Child Psychiatry & Human Development, 45, 675-685.
12.
BeckerS. P.LuebbeA. M.JoyceA. M. (2015). The Child Concentration Inventory (CCI): Initial validation of a child self-report measure of sluggish cognitive tempo. Psychological Assessment, 27, 1037-1052.
13.
BeckerS. P.MarshallS. A.McBurnettK. (2014). Sluggish Cognitive Tempo in abnormal child psychology: A historical overview and introduction to the special section. Journal of Abnormal Child Psychology, 42, 1-6.
14.
BeckerS. P.PfiffnerL. J.SteinM. A.BurnsG. L.McBurnettK. (2015). Sleep habits in children attention-deficit/hyperactivity disorder predominantly inattentive type and associations with comorbid psychopathology symptoms. Sleep Medicine. Advance online publication. doi:10.1016/j.sleep.2015.11.011
15.
BernadM.ServeraM.GrasesG.ColladoS.BurnsG. L. (2014). A cross-sectional and longitudinal investigation of the external correlates of sluggish cognitive tempo and ADHD-inattention symptoms dimensions. Journal of Abnormal Child Psychology, 42, 1225-1236.
16.
BurnsG. L.MouraM. A.BeauchaineT. P.McBurnettK. (2014). Bifactor latent structure of ADHD/ODD symptoms: Predictions of dual-pathway/trait-impulsivity etiological models of ADHD. Journal of Child Psychology and Psychiatry, 55, 393-401.
17.
BurnsG. L.ServeraM.BernadM. M.CarrilloJ.CardoE. (2013). Distinctions between Sluggish Cognitive Tempo, ADHD-IN, and depression symptom dimensions in Spanish first-grade children. Journal of Clinical Child and Adolescent Psychology, 42, 796-808.
18.
Capdevila-BrophyC.Artigas-PallaresJ.Navarro-PastorJ. B.Garcia-NonellK.Rigau-RateraE.ObiolsJ. E. (2014). ADHD predominantly inattentive subtype with high sluggish cognitive tempo: A new clinical entity?Journal of Attention Disorders, 18, 607-616.
19.
CarlsonC. L.MannM. (2002). Sluggish cognitive tempo predicts a different pattern of impairment in the attention deficit hyperactivity disorder, predominantly inattentive type. Journal of Clinical Child and Adolescent Psychology, 31, 123-129.
20.
EbesutaniC.McLeishA. C.LubertoC. M.YoungJ.MaackD. J. (2014). A bifactor model of anxiety sensitivity: Analysis of the Anxiety Sensitivity Index-3. Journal of Psychopathological Behavior Assessment, 36, 452-464.
21.
FarrellA. D. (1999). Statistical methods in clinical research. In KendallP. C.ButcherJ. N.HolmbeckG. N. (Eds.), Handbook of research methods in clinical psychology (2nd ed., pp. 72-106). New York, NY: Wiley.
22.
Fenollar CortésJ.ServeraM.BeckerS. P.BurnsG. L. (2014). External validity of ADHD inattention and Sluggish Cognitive Tempo dimensions in Spanish children with ADHD. Journal of Attention Disorder. Advance online publication. doi:10.1177/1087054714548033
23.
FloydF. J.WidamanK. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7, 286-299.
24.
FristadM. A.TeareM.WellerE. B.WellerR. A.SalmonP. (1998). Study III: Development and concurrent validity of the Children’s Interview for Psychiatric Syndromes–Parent version (P-ChIPS). Journal of Child and Adolescent Psychopharmacology, 8, 221-226.
25.
GarnerA. A.MarceauxJ. C.MrugS.PattersonC.HodgensB. (2010). Dimensions and correlates of Attention Deficit/Hyperactivity Disorder and Sluggish Cognitive Tempo. Journal of Abnormal Child Psychology, 38, 1097-1107.
26.
GarnerA. A.PeughJ.BeckerS. P.KingeryK. M.TammL.VaughnA. J.. . . EpsteinJ. N. (2014). Does sluggish cognitive tempo fit within a bi-factor model of ADHD?Journal of Attention Disorders. Advance online publication. doi:10.1177/1087054714539995
27.
HartmanC. A.WillcuttE. G.RheeS. H.PenningtonB. F. (2004). The relation between sluggish cognitive tempo and DSM-IV ADHD. Journal of Abnormal Child Psychology, 32, 491-503.
28.
HuL.BentlerP. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1-55.
29.
JacobsonL. A.Murphy-BowmanS. C.PritchardA. E.Tart-ZelvinA.ZabelT. A.MahoneE. M. (2012). Factor structure of a sluggish cognitive tempo scale in clinically-referred children. Journal of Abnormal Child Psychology, 40, 1327-1337.
30.
KleinD. N.DoughertyL. R.OlinoT. M. (2005). Towards guidelines for evidence-based assessment of depression in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 412-432.
31.
KlineR. B. (2011). Principles and practice of structural equation modeling (3rd ed.). New York, NY: Guildford Press.
32.
LangbergJ. M.BeckerS. P.DvorskyM. R. (2014). The association between Sluggish Cognitive Tempo and academic functioning in youth with Attention-Deficit/Hyperactivity Disorder (ADHD). Journal of Abnormal Child Psychology, 42, 91-103.
33.
LeeS.BurnsG. L.BeauchaineT. P.BeckerS. P. (2015). Bifactor latent structure of attention-deficit/hyperactivity disorder (ADHD)/oppositional defiant disorder (ODD) symptoms and first-order latent structure of sluggish cognitive tempo symptoms. Psychological Assessment. Advance online publication. doi:10.1037/pas0000232
34.
LeeS.BurnsG. L.SnellJ.McBurnettK. (2014). Validity of sluggish cognitive tempo symptom dimension in children: Sluggish cognitive tempo and ADHD-inattention as distinct symptom dimensions. Journal of Abnormal Child Psychology, 42, 7-19.
35.
LefflerJ. M.RiebelJ.HughesH. M. (2015). A review of child and adolescent diagnostic interviews for clinical practitioners. Assessment, 22, 690-703. doi:10.1177/1073191114561253
36.
LeopoldD. R.ChristopherM. E.BurnsG. L.BeckerS. P.OlsonR. K.WillcuttE. G. (2016). ADHD and sluggish cognitive tempo throughout childhood: Temporal invariance and stability from preschool through ninth grade. Journal of Child Psychology and Psychiatry. Advance online publication. doi:10.1111/jcpp.12505
37.
LittleD. (2013). Longitudinal structural equation modeling. New York, NY: Guilford Press.
38.
MarshallS. A.EvansS. W.EiraldiR. B.BeckerS. P.PowerT. J. (2014). Social and academic impairment in youth with ADHD, predominately inattentive type and sluggish cognitive tempo. Journal of Abnormal Child Psychology, 42, 77-90.
39.
MartelM. M.RobertsB.GremillionM.von EyeA.NiggJ. T. (2011). External validation of bifactor model of ADHD: Explaining heterogeneity in psychiatric comorbidity, cognitive control, and personality trait profiles within DSM-IV ADHD. Journal of Abnormal Child Psychology, 39, 1111-1123.
40.
McBurnettK.PfiffnerL. J.FrickP. J. (2001). Symptom properties as a function of ADHD type: An argument for continued study of Sluggish Cognitive Tempo. Journal of Abnormal Child Psychology, 29, 207-213.
41.
McBurnettK.VillodasM.BurnsG. L.HinshawS. P.BeaulieuA.PfiffnerL. J. (2014). Structure and validity of Sluggish Cognitive Tempo using an expanded item pool in children with Attention-Deficit/Hyperactivity Disorder. Journal of Abnormal Child Psychology, 42, 37-48.
42.
MuthénL. K.MuthénB. O. (1998-2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Author.
43.
PelhamW. E.FabianoG. A.MassettiG. M. (2005). Evidence-based assessment of attention deficit hyperactivity disorder in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 449-476.
44.
PennyA. M.WaschbuschD. A.KleinR. M.CorkumP.EskesG. (2009). Developing a measure of sluggish cognitive tempo for children: Content validity, factor structure, and reliability. Psychological Assessment, 21, 380-389.
45.
ReiseS. P. (2012). The rediscovery of bifactor measurement models. Multivariate Behavioral Research, 47, 667-696.
46.
ReiseS. P.BonifayW.HavilandM. G. (2013). Scoring and modeling psychological measures in the presence of multidimensionality. Journal of Personality Assessment, 95, 129-140.
47.
ReiseS. P.MooreT. M.HavilandM. G. (2010). Bifactor models and rotations: Exploring the extent to which multidimensional data yield univocal scale scores. Journal of Personality Assessment, 92, 544-559.
48.
ReynoldsC. R.KamphausR. W. (2004). Behavior assessment system for children (2nd ed.). Circle Pines, MN: AGS.
49.
RiosJ.WellsC. (2014). Validity evidence based on internal structure. Psicothema, 26, 108-116.
50.
Salbach-AndraeH.LenzK.LehmkuhlU. (2009). Patterns of agreement among parent, teacher, and youth ratings in a referred sample. European Psychiatry, 24, 345-351.
51.
SaxbeC.BarkleyR. A. (2014). The second attention disorder? Sluggish cognitive tempo vs. attention-deficit/hyperactivity disorder: Update for clinicians. Journal of Psychiatric Practice, 20, 38-49.
52.
SilvermanW. K.OllendickT. H. (2005). Evidence-based assessment of anxiety and its disorders in children and adolescents. Journal of Clinical Child and Adolescent Psychology, 34, 380-411.
53.
UllebøA. K.BreivikK.GillbergC.LundervoldA. J.PosserudM. (2012). The factor structure of ADHD in general population of primary school children. Journal of Child Psychology and Psychiatry, 53, 927-936.
54.
WechslerD. (2003). Wechsler Intelligence Scale for Children (4th ed.). San Antonio, TX: Psychological Corporation.
55.
WechslerD. (2009). Wechsler Individual Achievement Test (3rd ed.). San Antonio, TX: Psychological Corporation.
56.
WellerE. B.WellerR. A.FristadM. A.RooneyM. T.SchecterJ. (2000). Children’s interview for psychiatric syndromes (ChIPS). Journal of the American Academy of Child & Adolescent Psychiatry, 39, 76-84.
57.
WillcuttE. G.ChhabildasN.KinnearM.DeFriesJ. C.OlsonR. K.LeopoldD. R.. . . PenningtonB. F. (2014). The internal and external validity of sluggish cognitive tempo and its relation with DSM-IV ADHD. Journal of Abnormal Child Psychology, 42, 21-35.
58.
WolraichM. L.LambertE. W.DoffingM. A.BickmanL.SimmonsT.WorleyK. (2003). Psychometric properties of the Vanderbilt ADHD Diagnostic Parent Rating Scale in a referred population. Journal of Pediatric Psychology, 28, 559-568.
59.
YuC.-Y. (2002). Evaluating cutoff criteria of model fit indices for latent variable models with binary and continuous outcomes (Unpublished doctoral dissertation). University of California, Los Angeles.
