Coffee for Life, Inattentive ADD and Sluggish Cognitive Tempo

Coffee for Life, Inattentive ADD and Sluggish Cognitive tEMPO

Regular readers of this blog know that I am a big coffee drinker.  I drink at least two cups a day and, depending on what my day holds in store, I may drink up to four cups a day.  Coffee helps my Inattentive ADHD symptoms so I was very happy to see the recent New England Journal of Medicine report showing that several cups of coffee a day promote longevity.

The New England Journal article researchers were quick to point out that they are uncertain which of the thousands of chemicals in coffee brings about these life enhancing properties. It is likely not just the caffeine but rather the result of the combination of antioxidants and other chemicals that combine to promote health and, in my case, attention.

I have written several posts about why and how caffeine helps people with Inattentive ADHD.  I believe that coffee's mild stimulant is very helpful for the Inattentive type of ADHD but I also recognize that the vast majority of kids will not drink coffee and I am NOT a believer in Mountain Dew, Coca-Cola or other soda drink.

The South American and European scientific community have continued to study the ADHD benefits of caffeine and there have been two animals studies recently published that have demonstrated that caffeine improves ADHD by mainly improving memory and attention while not improving or having a lesser affect on hyperactivity.  The fact that people with Inattentive ADHD sometimes react badly to strong stimulants makes coffee a good alternative that is worth trying as treatment.  I do not recommend more than two cups a day as too much caffeine can cause jitters and anxiety.

Summer is coming and blending a cup of espresso with some fat free milk and ice is a pretty good treat.  I recently tasted an espresso aioli which was served with Italian sausage and some really good Manchego cheese that was to die for.  It would have never have occurred to me to mix mayo and espresso but it absolutely works.

Eur Neuropsychopharmacol. 2012 May 4. [Epub ahead of print]
Caffeine regulates frontocorticostriatal dopamine transporter density and improves attention and cognitive deficits in an animal model of attention deficithyperactivity disorder.
Pandolfo P, Machado NJ, Köfalvi A, Takahashi RN, Cunha RA.


Neurosci Lett. 2011 Apr 20;494(1):44-8. Epub 2011 Mar 6.
Caffeine improves attention deficit in neonatal 6-OHDA lesioned rats, an animal model of attention deficit hyperactivity disorder (ADHD).
Caballero M, Núñez F, Ahern S, Cuffí ML, Carbonell L, Sánchez S, Fernández-Dueñas V, Ciruela F.

Source

Not Much News for Defining Sluggish Cognitive Tempo

Not Much News for Defining Sluggish Cognitive Tempo 

If Sluggish Cognitive Tempo (SCT) is to get a "place at the table" in the DSM V (the diagnostic manual that psychiatrists use to diagnose mental health conditions) a complete and accurate definition and description of the symptoms are necessary.

A group of researchers has developed a 14 point scale of SCT symptoms that aim to distinguish SCT from ADHD and from Inattentive ADHD.

A study, just published, in the Journal of Abnormal Child Psychology has tested this scale and identified three distinct traits that correspond with SCT and/or Inattentive ADHD symptoms and a trait, that when it is present, significantly impair individuals with SCT above and beyond the impairments related to sluggishness or inattentiveness.

The three traits are Sleepy/Sluggish, Slow/Daydreamy, and Low Initiation/Persistence.   The low initiaion/persistence scale contributes to significantly greater academic impairment but I would argue, as I did in the post on ADHD being a persistence deficit, that  this trait can be found in everyone with a diagnosis of ADHD regardless of subtype.

I hate to be a kill joy but I honestly do not see how a study that tells us that people with Sluggish Cognitive Tempo are more sluggish or more sleepy (or that a lack of persistence contribute to greater academic impairment) adds much to our knowledge of SCT.

The abstract is below.


J Abnorm Child Psychol. 2012 May 8.
Factor Structure of a Sluggish Cognitive Tempo Scale in Clinically-Referred Children.
Jacobson LA, Murphy-Bowman SC, Pritchard AE, Tart-Zelvin A, Zabel TA, Mahone EM.


Abstract

"Sluggish cognitive tempo" (SCT) is a construct hypothesized to describe a constellation of behaviors that includes daydreaming, lethargy, drowsiness, difficulty sustaining attention, and underactivity. Although the construct has been inconsistently defined, measures of SCT have shown associations with symptoms of attention-deficit/hyperactivity disorder (ADHD), particularly inattention. Thus, better characterization of SCT symptoms may help to better predict specific areas of functional difficulty in children with ADHD. The present study examined psychometric characteristics of a recently developed 14-item scale of SCT (Penny et al., Psychological Assessment 21:380-389, 2009), completed by teachers on children referred for outpatient neuropsychological assessment. Exploratory factor analysis identified three factors in the clinical sample: Sleepy/Sluggish, Slow/Daydreamy, and Low Initiation/Persistence. Additionally, SCT symptoms, especially those loading on the Sleepy/Sluggish and Slow/Daydreamy factors, correlated more strongly with inattentive than with hyperactive/impulsive symptoms, while Low Initiation/Persistence symptoms added significant unique variance (over and above symptoms of inattention) to the predictions of impairment in academic progress.