ADHD-I / SCT
Sluggish Cognitive Tempo (SCT) is a descriptive term which is used to better identify what appears to be a homogeneous group within the ADHD predominantly inattentive (ADHD-I or ADHD-PI). It has been 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. 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 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.
Since the symptoms of SCT are not recognized in any standard medical manuals, those who have significant SCT symptoms would likely receive a ADHD/PI diagnosis. Currently they are considering the inclusion of SCT in the DSM-V which is scheduled to be released 2011.
Far less is known about this group yet the impairments seem to indicate the prefrontal cortex region of the brain and difficulties with working memory. The 7-repeat allele polymorphism of the DRD4 gene is also linked more strongly to this group than to ADHD/C and ADHD/PHI subgroups.
It is thought that SCT and ADHD are due to deficienceies of dopamine and norepinephrine. This would explain the efficiacy of stimulants such as amphetamines on the treatment of ADHD and SCT.
Selective attention difficulties of those with SCT manifests itself academically, in that they are prone to making more mistakes while working. Those with classic ADHD do not have this difficulty. Those with SCT have difficulty with verbal retrieval from long term memory, and also have greater visual spatial deficits. They have deficits in working memory which has been described as the ability to keep multiple things in mind for manipulation, while simultaneously keeping this information free from internal distraction. Consequently, mental skills such as calculation, reading, and abstract reasoning are often more challenging for those with SCT. They also have a more disorganized thought process, a greater degree of sloppiness, and lose things more easily. They tend to have a greater degree of comorbid learning disabilities.
Studies indicate that Comorbid psychiatric problems are more often of the internalizing variety with SCT, such as anxiety, depression, and social withdrawal.
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. 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 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.
Since the symptoms of SCT are not recognized in any standard medical manuals, those who have significant SCT symptoms would likely receive a ADHD/PI diagnosis. Currently they are considering the inclusion of SCT in the DSM-V which is scheduled to be released 2011.
Far less is known about this group yet the impairments seem to indicate the prefrontal cortex region of the brain and difficulties with working memory. The 7-repeat allele polymorphism of the DRD4 gene is also linked more strongly to this group than to ADHD/C and ADHD/PHI subgroups.
It is thought that SCT and ADHD are due to deficienceies of dopamine and norepinephrine. This would explain the efficiacy of stimulants such as amphetamines on the treatment of ADHD and SCT.
Selective attention difficulties of those with SCT manifests itself academically, in that they are prone to making more mistakes while working. Those with classic ADHD do not have this difficulty. Those with SCT have difficulty with verbal retrieval from long term memory, and also have greater visual spatial deficits. They have deficits in working memory which has been described as the ability to keep multiple things in mind for manipulation, while simultaneously keeping this information free from internal distraction. Consequently, mental skills such as calculation, reading, and abstract reasoning are often more challenging for those with SCT. They also have a more disorganized thought process, a greater degree of sloppiness, and lose things more easily. They tend to have a greater degree of comorbid learning disabilities.
Studies indicate that Comorbid psychiatric problems are more often of the internalizing variety with SCT, such as anxiety, depression, and social withdrawal.