Adults with Sluggish Cognitive Tempo

Sluggish Cognitive Tempo "Daydreamy and Lethargic"
Adults with Sluggish Cognitive Tempo (SCT) and no other ADHD symptoms are more likely to fare worse in school and at work than people with just ADHD or people with ADHD and some SCT symptoms. People with SCT and people with SCT and ADHD symptoms have more problems with organization and problem solving than people without ADHD or people with just ADHD and no SCT symptoms. These are the findings of a study just published in the Journal of Abnormal Psychology that was performed by Russell Barkley.

Barkley reports that people with SCT differ from people with all types of ADHD in that they are more "day-dreamy, mentally confused, lethargic and much more markedly hypo-active". Some folks consider Russell Barkley to be the U.S. authority on ADHD.  Barkley is one of the first ADHD experts who suggested that ADHD Inattentive might not be ADHD at all. He has, in past reports, speculated that people with ADHD Inattentive (ADHD-PI) are really people who should be diagnosed with Sluggish Cognitive tempo.

I have disagreed with that assessment as both my son and I are inattentive but normally active. Not hypo-active or hyperactive and I have argued that there are a subset of people with ADHD Inattentive (ADHD-I)that are not sluggish or mentally confused though they are day-dreamy.

This new study, I think, is Barkley's attempt to sort this all out. The findings are interesting in that it appears that having SCT symptoms means that you will be less able to resolve problems and organize your life and in turn you will tend to do worse at school, at work and at home.

The only area where people with ADHD without SCT fared worse than their SCT cousins was in the area of driving. It appears, from Barkley's study, that people with just ADHD symptoms had poorer driving records than people with SCT and ADHD symptoms or people with just SCT symptoms.

I had thought that Russell Barkley had abandoned study of the ADHD Inattentive and Sluggish Cogntive Tempo subgroup of patients all together. He seemed to be focused on his model of ADHD as a disease of Emotional dysregulation and his descriptions of ADHD did not resonate with me as it failed to describe people with ADHD Inattentive type. I am thrilled to see that his studies are still trying to work out the subtleties of SCT. This condition is terribly disabling and deserves more attention than it has received in the past.

Many more studies need to be done to determine how the symptoms of  ADHD-PI differs from Combined type ADHD and from SCT but I am happy to see that Russell Barkley is still attempting to sort out this wide array of ADHD Executive Function disabilities.


  1. Your topics are always interesting, and thoughtfully discussed...enjoyed reading. Thank you. I have thought myself, many times, that someday ADHD will probably be broken down into more categories or that certain kinds of ADHD will someday be identified as something else. There do seem to be "types" that simply don't belong under the same umbrella...but until then we'll all remain puzzled but searching ;)

  2. Thanks, I wish more was written and studied about SCT.

  3. "This condition is terribly disabling and deserves more attention than it has received in the past."

    Indeed. While some of us have learned how to "hold it together" a little better, with SCT every day is another battle, but also another opportunity to achieve a victory.

    BTW you've done a phenomenal job with the site Tess. Your content is both valuable and highly relevant and this site has become a great resource.

    Keep up the great work. No one can question your commitment to this project ... and with regards to inattentives, that's pretty much the highest compliment anyone can give =)

  4. Yeah, it seems that this is the main thing that remains to be worked out: is there such a thing as ADHD-REALLY inattentive, NOT hyperactive (which has been proposed as a "restrictive inattentive" type, defined by inattention and a maximum of 2 hyperactive symptoms) without SCT? (Which seems to be how you describe yourself and your son.) And what does that mean for our diagnostic categories? Is it the same disorder as ADHD-C, but just less severe (as some researchers have argued the inattentive type in general is)? Or could it be that you have SCT, not ADHD, and it's just that the SCT symptoms are less pronounced compared to the inattentive symptoms (the inattentive symptoms being perhaps as characteristic of the as-yet unrecognized disorder SCT as they are of ADHD)? If you have SCT + inattention, and no trace of hyperactivity/impulsivity (like me), is that pure SCT? Or is it a case of co-morbid SCT and inattentive ADHD?

    Interestingly, my mom has ADHD-C, and my dad has never been diagnosed with anything, but he seems to have some SCT tendencies, especially in the way he interacts with people (but he seems to be generally able to manage his life without much difficulty--much better than me at least). Of course, my case is a single anecdote, which may not be representative of anything.

  5. Interesting!! Yea, the SCT puzzle is not yet clear but what is clear is that those with sluggish symptoms are also inattentive.

    It is my belief that the APA did not designate yet another "Subtype" of ADHD by recognizing SCT because they are losing confidence in the subtypes they have currently designated.

    Many folks in the ADHD Research community, however, are coming to the conclusion that ADHD is a disorder with "many faces" but that inattentiveness is the disabling symptom that runs through all the different presentations.

    Thanks so much for your insightful comment!

  6. I have been doing some research and found this page. I have had adhd as a child. I was never diagnosed until 23, but i know i had it. I was always fidgeting, hyper, excessive talking, If a subject interested me. On the other hand if I was not interested I was the opposite innatentive, very daydreamy, stuck in my own head. I am finding now as I am older I am completely ADHD innattentive type. I am now 29 pregnant and cannot take my adderall so I am extrememly daydreamy, tired, lethargic, Stuck in my head and unorganized. All doctors want to do is put me on more meds so now that I am pregnant I am on none. Trying to find a correct diagnosis and treatment options. Glad I am not alone...


  7. Very interesting! I had never heard of this until recently. I've always called myself organizationally challenged but it goes deeper than that. I've never really fit into the adhd category but I've always known something isn't right. It sucks and I struggle every single day!


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