Sluggish Cognitive Tempo: A Separate Disorder from ADHD?

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No, I didn't start the thread
http://www.addforums.com/forums/showthread.php?t=63290

ADHD expert Dr. Russell Barkley talks about it in about 30 minof the 1st video.

I think this applies to me. I'm not the sterfeotypical ADHD'er.
It may or may not make it to the DSM-V.

This is about SCT which was taken from the first post which in turn was taken from Wikipedia:

Sluggish Cognitive Tempo (SCT) is an unformalized descriptive term which is used to better identify what appears to be a homogeneous sub-subgroup within the formal subgroup ADHD predominantly inattentive (ADHD-I or ADHD-PI) classification in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition. It has been roughly estimated that the SCT population may make up 30-50% of the ADHD-PI population.
In many ways, those who have an SCT profile have the opposite symptoms of those with classic ADHD: Instead of being hyperactive, extroverted, obtrusive, and risk takers, those with SCT are passive, daydreamy, shy, and "HYPO"-active in both a mental and physical way. They also don't have the same risk factors and outcomes. Their demeanor is sluggish, as if "in a fog" and logically they also process information more slowly. A key behavioural characteristic of those with SCT symptoms is that they are more likely to appear to be lacking motivation. They lack energy to deal with mundane tasks and will consequently seek things that are mentally stimulating because of their underaroused state. Those with SCT symptoms show a qualitatively different kind of attention deficit that is more typical of a true information input-output problem, such as memory retrieval and active working memory. Conversely, those with the other two subtypes of ADHD are characteristically excessively energetic and have no difficulty processing information.[1]

This describes me. This leads to a lot of self esteem issues when you've grown up feeling stupid and lazy. Everything is exhausting.

this sounds just like me! I have troubles concentrating but i've never thought it could be ADHD because i'm not hyperactive. In the contrary: i'm ALWAYS tired.

What I find strange about SCT, (which by the way also describes me very well) is that it is not yet an official diagnosis, yet some practitioners are apparently diagnosing patients with it. Is that not a bit irresponsible?

I had an idle minded speculation regarding this yesterday and was thinking about bringing it up here; could SCT describe the point where something like Autism/Asperger's and AD(H)D become indistinguishable? That this is the point at which they merge without appearing as two relatively distinct 'conditions'?

Again, this is just my own speculation based on informal reading around.

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Agree with you. SCT (Sluggish Cognitive Tempo) is not one of the four ADHDs (2010).

It's an invention by someone.

There are several very high profile ADHD persons / so called experts who regularly run around the country with their own privately invented diagnostic list which does not match the DSM 2010.

SCT is one of the non-official diagnoses.

Another very high profile doctor has six or so ADHD diagnoses - again - non-official diagnoses which do not match the DSM 2010.

From what I've seen the powers-that-be simply wink at what these doctors do even though it fails to match current DSM 2010 categories / standards.

Is it irresponsible to allow these doctors to make money off of privately invented, non-official diagnoses?

Many believe so.

If these doctors want to use their own privately invented categories, they should disclose that up front and say that these diagnostic categories are invented by them and not official categories at all - however - from what I've seen - these doctors often on mute on the subject.

Wikipedia has an article about Sluggish Cognitive Tempo (2010).

Doctors who invent their own categories are often controversial.

In the recent past there were doctors who said all of autism is caused by vaccinations, food additives cause everything from polio to Parkinson's, and neurological challenges are simply due to a lack of megadoses of Vitamin C or fluoride in the water.

These doctors are regularly sources of incorrect information and the public should be protected from such irresponsible persons (my view).

Last edited by pgd on 09 Nov 2010, 12:30 pm, edited 1 time in total.

I had never heard of SCT before this thread, but I am diagnosed with Inattentive ADHD and those are the things I experience. Why do you need an unofficial diagnosis of SCT when you have ADHD-PI? Are there differences?

@pdg - I think we have to tread a little carefully here because there is a sense to which all disorders/conditions are 'made up' by someone at some point. The difference is that some of the 'made up' ones get officially sanctioned by a body of professionals such as the APA, based on thorough studies and clinical observations. The practices of independent doctors and therapists, in terms of 'inventing' new disorders/conditions, is an adaptive process which may help those who do not fit the categories of the DSM or other diagnostic tool, based more on anecdotal cases.

BUT the lack of consensus between the independents and those who operate under the proviso of the APA (for example) is where the danger lies, rather than an assumed blanket of irresponsibility. Independent practitioners therefore seem to represent something of a double edged sword in offering geniune help and possibly more flexibility of approach on the one hand, but lacking the 'authority' and sense of credibility on the other.

@Aimless - I think the main difference (and grounds for recognising SCT as a distinct disorder) is the complete lack of any hyperactivity throughout the person's life, whereas ADHD-PI people may have been hyper as children.

In the videos I've seen of Russell Barkley, he does seem to say there is an observable neurological difference too, although the specifics escape me at the present moment.

This is so me. I haven't been diagnosed with ADHD or known to have ADHD, but I reckon I have ADD, because I just cannot focus on anything. My mind gets distracted onto objects, noise and people. My special interest is the weather around the world, and I'm often finding myself on the BBC weather site typing in different places around Britain, Europe, and the rest of the world, to see what the weather is - but even then I get very distracted. If there are people talking in my house and I can hear them, my mind switches right away from ''my favourite website'', and I walk out of my room and start seeing what they're talking about. Then when the telly is on I get drawn to that - then any little movement of someone else in the room and I'm drawn onto them. This is why I can't do shopping - I'm too distracted by all the people and the noise.
Lights, smells and tastes are things I don't get drawn to (unless I'm interested in a particular light, smell or taste, which everyone is like that), and when people touch me I hardly notice them touching me, so none of those bother me. But other things I just cannot focus my attention on. Most Aspies go to libraries and borrow books - but me, no way. I start reading a book and it probably won't get finished 'til about 6 months later, even a 10 year old's book. I can focus on films if I enjoy them, which is good for me because it helps take my mind off of things.

Another thing is this sluggish cognitive tempo. I don't really know what it means but I assume it means ''difficulty in getting motivated with things'', and it by all means does not mean laziness. In fact, laziness doesn't come into it. With ADD, although to other people it looks like you're being lazy - you are not. It's an unrelated thing. I'm somebody who stresses and gets anxious over lots of things, and I don't always know how to overcome it, like most NTs do. It's probably because I look at some things in a different way, and then think that everything's against me. It's caused by poor self esteem too. I get 10 hours of sleep a night, because my mind gets too over flooded with too many things going on in the day, ie, too many people, noise, and responsibilities. Also, a lot of the time, I don't always know where or when to start with things, especially things what causes stress for me, like looking for jobs. I'm trying to look for part time work (which I will be able to afford to do), because I need plenty of time to myself, and I find it more harder to adapt to big changes, like full time work, but the job centre thinks I should do full time work - even though I'm an individual at the end of the day, and I want to do what's best for me. I think I'll rather work less and have more time to myself to relax and sleep off life's pressure (yes, I sleep in the day too), rather than working full time and get a bit more money. Nobody is going to change my mind, and criticism don't change minds - criticism causes more anxiety, I don't care what people say.

Let's get one thing straight. SCT is a part of ADHD. It is a more severe type of ADHD - PI (predominantly inattentive).
I have PI with a bit of hyperactivity. I think at times I feel SCT.
Brain fog exists in PI too.
SCT to me is a very low energy, very foggy brain. I used to refer to it as 'sloth syndrome.'

Hopefully, it will be added the DSM V. I think because there is very little treatment for it they are struggling to get it added. People with SCT don't always benefit from medications.

Anyone who says these people are lazy or this disorder is made up is going to get a swift kick up the butt from me.

I will just repeat that I still have no comprehension of ADHD, including this sluggish cognitive type. Certainly ADHD exists but as for it in congruence with autism; I think autism can better explain it most of the time. So trying to apply this sluggish cognitive tempo label to myself is impossible.

This describes me so much

I think that, for all practical effects, "SCT" is the name that the doctors who think that ADHD-PI is unrelated to the others ADHDs gave to ADHD-PI.

Why is this being called SCT? These are basically the symptoms of ADD.

I suspect that the idea is rebranding ADD to make it different from ADHD

Sorry, I didn't catch that.

What's there to not understand? SCT is a more severe version of ADHD-PI. There is no hyperactivity/ impulsiveness at all.
Oh those poor people.

Parts of that describe me incredibly well.

I'm disappointed though. I expected sluggish cognitive tempo to be three words that were simply descriptive. Instead, they're one of those phrases that has a particular meaning, almost like a brand name but not quite. I hate running into such phrases, especially when I wanted to respond.

But hey, I'll respond anyway. So I expected it to refer to the fact that my brain tends to run on a much slower wavelength than other people, in a way that I have in common with many other autistic people. It means that I may hear something at one time and understand it years later. Or hear something in a conversation and then respond to it twenty minutes (four topic changes) later (and possibly be seen as not even aware of things because of stuff like that).

Oh well.