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Avunduk S, Aksoy Avunduk S, Güleç A. Sluggish cognitive tempo in children and adolescents: circadian preference and digital gaming addiction. Child Neuropsychol 2025:1-15. [PMID: 40195750 DOI: 10.1080/09297049.2025.2488816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2024] [Accepted: 03/31/2025] [Indexed: 04/09/2025]
Abstract
This study investigates the relationship between Sluggish Cognitive Tempo (SCT) and circadian preferences in children and adolescents. We also aimed to assess the relationship between digital game addiction and SCT, as existing literature is insufficient, particularly given the similarities between SCT and Attention Deficit Hyperactivity Disorder (ADHD) in relation to internalizing symptoms and comorbidity. This study involved 72 children and adolescents with SCT and 77 healthy controls, aged 11-16 years, who were referred to the Child and Adolescent Psychiatry outpatient clinic. We used Sociodemographic Data Form, Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime Version- Turkish Version (K-SADS-PL), Turgay's DSM-IV Based Screening and Assessment Scale for Disruptive Behavior Disorders in Children and Adolescents (T-DSM-IV-S), Child and Adolescent Behavior Inventory-SCT (CABI-SCT), Children's Chronotype Questionnaire (CCQ), Digital Game Addiction Scale (DGAS). In the group with SCT, we found that eveningness preference and digital game addiction were statistically significant. Correlation analyses revealed a moderate positive relationship between chronotype scores (eveningness preferences higher scores) and digital game addiction. Additionally, a strong positive correlation was found between chronotype and SCT scale scores, as well as between digital game addiction and SCT scale scores. These findings highlight the potential role of digital game addiction and circadian preferences in shaping profile of SCT, providing valuable insights into the understanding of SCT symptoms.
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Affiliation(s)
- Serdar Avunduk
- Child and Adolescent Psychiatry, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Sena Aksoy Avunduk
- Child and Adolescent Psychiatry, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
| | - Ahmet Güleç
- Child and Adolescent Psychiatry, Balıkesir Atatürk City Hospital, Balıkesir, Turkey
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Gul H, Gul A, Murat N. Exploring the link between sleep and cognitive disengagement syndrome (CDS) in young adults: Integrating the role of ADHD. RESEARCH IN DEVELOPMENTAL DISABILITIES 2025; 161:105000. [PMID: 40158348 DOI: 10.1016/j.ridd.2025.105000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/26/2024] [Revised: 02/20/2025] [Accepted: 03/20/2025] [Indexed: 04/02/2025]
Abstract
OBJECTIVE This study aimed to: (1) compare sleep quality and sleep-related parameters in a Turkish adult population with and without CDS and ADHD symptoms; and (2) re-examine the relationship between CDS and sleep by exploring potential associations between sleep problems and CDS symptoms, while also examining the separate roles of sluggishness and daydreaming, as well as possible gender differences. METHOD The study included 274 participants (age:18-35, 70.4 % female). The Adult CDS Ratings Scale, the Adult ADHD Self-Report Scale (ASRS), and the Pittsburgh Sleep Quality Index were used. The data were analyzed using SPSS 22 and AMOS 23. Statistical analyses included ANOVA with post-hoc Tamhane's test, Mann-Whitney U test, Spearman Correlation Analysis, and structural equation modeling with path analysis. Linear regression analysis was conducted to identify factors influencing daydreaming. RESULTS The study yielded four key findings: CONCLUSIONS: This study is among the first to explore the relationship between CDS symptoms and sleep problems in young adults, accounting for ADHD. Our findings highlight the significant association of hyperactivity/impulsivity and daydreaming with sleep quality, as well as the relationship between poor sleep quality and increased daydreaming and sluggishness, though to a lesser extent than ADHD symptoms. Notably, gender differences emerged, with poor sleep quality affecting CDS symptoms primarily in women, while sluggishness decreased with age in men. These results underscore the importance of considering sleep issues in the context of CDS and ADHD, particularly with attention to gender-specific patterns.
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Affiliation(s)
- Hesna Gul
- Ufuk University, School of Medicine, Child and Adolescent Psychiatry, Ankara, Turkey.
| | - Ahmet Gul
- Ufuk University, School of Medicine, Psychiatry, Ankara, Turkey
| | - Naci Murat
- Doctor Lecturer, Ondokuz Mayis University, Department of Industrial Engineering, Samsun, Turkey
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Zhang X, Qian W. The effect of social support on academic performance among adolescents: The chain mediating roles of self-efficacy and learning engagement. PLoS One 2024; 19:e0311597. [PMID: 39739649 DOI: 10.1371/journal.pone.0311597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 09/20/2024] [Indexed: 01/02/2025] Open
Abstract
PURPOSE While the impact of social support on academic performance is acknowledged, the specific mechanisms by which social support affects academic performance, particularly through self-efficacy and learning engagement, remain poorly understood. This study aims to examine the correlation between social support and academic achievement among Chinese middle school students, framed within the Social Cognitive Theory. It also seeks to explore the mediating roles of self-efficacy and learning engagement in this relationship. METHOD Data was collected from 265 individuals (mean age = 13.47 years, SD = 0.5) in four middle schools in Shandong Province, China in June 2023, using the simple random sample technique. Participants completed the questionnaires independently, and the data was analyzed using the structural equation model (SEM) in AMOS 24.0 and SPSS 24.0. RESULTS Social support and academic performance have a direct and significant relationship with the SCT among middle school students. In addition, social support indirectly and positively affects academic performance through self-efficacy and learning engagement. The results also highlight self-efficacy as a key factor linking social support with academic performance. PRACTICAL IMPLICATIONS This study offers valuable insights into the role of social support in Chinese middle school students' academic achievement, particularly by examining the impact of self-efficacy and learning engagement. These valuable findings may guide policymakers in creating a supportive educational environment both inside and outside the classroom, enhancing adolescents' self-confidence and engagement in learning. ORIGINALITY This study contributes to the theoretical understanding of social support by investigating the mechanisms through which it impacts academic achievement. It clarifies the complex interactions among social support, self-efficacy, learning engagement, and academic achievement, with particular emphasis on the mediating roles of self-efficacy and learning engagement within the Chinese context.
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Affiliation(s)
- Xiangping Zhang
- Faculty of Education, Qufu Normal University, Qufu, Shandong, China
- Faculty of Tourism and Art, Xiangyang Polytechnic, Xiangyang, China
| | - Wensheng Qian
- Faculty of Architecture and Engineering, Xiangyang Polytechnic, Xiangyang, China
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Cano-Crespo A, Moreno-García I, Servera M, Morales-Ortiz M. Cognitive Disengagement Syndrome and Child Sleep Problems in ADHD, Anxiety and Depression. Healthcare (Basel) 2023; 11:2022. [PMID: 37510463 PMCID: PMC10378907 DOI: 10.3390/healthcare11142022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The main objective of this study was to analyse the relationship and differential contribution of Cognitive Disengagement Syndrome (CDS) and sleep problems in children in different psychopathological measures. A total of 1133 participants (612 fathers/mothers and 521 children aged 7-13 years in Years 3-6 of Primary Education) completed the scales on CDS, sleep problems, depression (DEP), anxiety (ANX) and attention deficit and hyperactivity disorder (ADHD). Similar and significant correlations were identified in the measures of CDS and sleep problems between fathers and mothers, obtaining a high coefficient between the two parents. However, weak correlations were found between fathers/mothers and children. The scores of CDS and the sleep disturbance scale for children (SDSC) significantly predicted the internalising measures and ADHD, especially between SDSC and DEP. It was confirmed that sleep problems had a greater presence in the group of children with the highest ADHD scores, and especially in CDS and ADHD jointly. To conclude, the data indicate the importance of sleep problems in understanding CDS and its relationship with other psychopathological measures, especially ADHD, although to a greater extent with internalising symptoms, especially DEP.
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Affiliation(s)
- Almudena Cano-Crespo
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain
| | - Inmaculada Moreno-García
- Department of Personality, Assessment and Psychological Treatment, Faculty of Psychology, University of Seville, 41018 Seville, Spain
| | - Mateu Servera
- Institut Universitari d'Investigació en Ciències de la Salut, Fundación Instituto de Investigación Sanitaria Islas Baleares, University of Illes Balears, 07122 Palma, Spain
| | - Manuel Morales-Ortiz
- Department of Experimental Psychology, Faculty of Psychology, University of Seville, 41018 Seville, Spain
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Becker SP, Willcutt EG, Leopold DR, Fredrick JW, Smith ZR, Jacobson LA, Burns GL, Mayes SD, Waschbusch DA, Froehlich TE, McBurnett K, Servera M, Barkley RA. Report of a Work Group on Sluggish Cognitive Tempo: Key Research Directions and a Consensus Change in Terminology to Cognitive Disengagement Syndrome. J Am Acad Child Adolesc Psychiatry 2023; 62:629-645. [PMID: 36007816 PMCID: PMC9943858 DOI: 10.1016/j.jaac.2022.07.821] [Citation(s) in RCA: 78] [Impact Index Per Article: 39.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 06/28/2022] [Accepted: 08/15/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this work was 2-fold: (1) to evaluate current knowledge and identify key directions in the study of sluggish cognitive tempo (SCT); and (2) to arrive at a consensus change in terminology for the construct that reflects the current science and may be more acceptable to researchers, clinicians, caregivers, and patients. METHOD An international Work Group was convened that, in early 2021, compiled an online archive of all research studies on SCT and summarized the current state of knowledge, noted methodological issues, and highlighted future directions, and met virtually on 10 occasions in 2021 to discuss these topics and terminology. RESULTS Major progress has been made over the last decade in advancing our understanding of SCT across the following domains of inquiry: construct measurement and stability; genetic, environmental, pathophysiologic, and neuropsychological correlates; comorbid conditions; functional impairments; and psychosocial and medication interventions. Findings across these domains are summarized, and potential avenues to pursue in the next generation of SCT-related research are proposed. Following repeated discussions on terminology, the Work Group selected "cognitive disengagement syndrome" (CDS) to replace "SCT" as the name for this construct. This term was deemed to best satisfy considerations that should apply when selecting terms for a condition or syndrome, as it does not overlap with established terms for other constructs, is not offensive, and reflects the current state of the science. CONCLUSION It is evident that CDS (SCT) has reached the threshold of recognition as a distinct syndrome. Much work remains to further clarify its nature (eg, transdiagnostic factor, separate disorder, diagnostic specifier), etiologies, demographic factors, relations to other psychopathologies, and linkages to specific domains of functional impairment. Investigators are needed with interests and expertise spanning basic, clinical, and translational research to advance our understanding and to improve the lives of individuals with this unique syndrome.
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Affiliation(s)
- Stephen P Becker
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio.
| | | | | | - Joseph W Fredrick
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio
| | | | - Lisa A Jacobson
- Kennedy Krieger Institute, Johns Hopkins School of Medicine, Baltimore, Maryland
| | | | - Susan D Mayes
- Waschbusch are with Penn State College of Medicine, Hershey, Pennsylvania
| | | | - Tanya E Froehlich
- Cincinnati Children's Hospital Medical Center, Ohio, and the University of Cincinnati College of Medicine, Ohio
| | - Keith McBurnett
- University of California San Francisco, San Francisco, California
| | - Mateu Servera
- IDISBA Institute, University of the Balearic Islands, Palma, Spain
| | - Russell A Barkley
- Virginia Commonwealth University, School of Medicine, Richmond, Virginia
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Luo Y, Smith DM, Moosbrugger M, France TJ, Wang K, Cheng Y, Sha Y, Wang D, Si S. Dynamics and moderating factors of esport participation and loneliness: A daily diary study. PSYCHOLOGY OF SPORT AND EXERCISE 2023; 66:102384. [PMID: 37665849 DOI: 10.1016/j.psychsport.2023.102384] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/20/2022] [Accepted: 01/06/2023] [Indexed: 09/06/2023]
Abstract
The purpose of this study was to examine the association between esport participation and loneliness, as well as its moderating factors. Chinese college students (N = 216) self-reported their esport playing time and degree of loneliness each day immediately before bedtime for four consecutive weeks. The findings revealed that as playing time increased, students did not experience reduced sense of loneliness during playing esport, but they experienced a temporary and intensified feeling of loneliness the same day following gameplay. Students with higher general loneliness tended to feel more after-game loneliness associated with increased esport participation. Students with higher obsessive passion about esport tended to experience more loneliness (both in-game and after-game) associated with increased esport participation. Students with greater coping motivation about esport tended to experience more in-game loneliness associated with previous increased esport participation. Students who played esport less often with friends in person, or with more escape motivation toward esport, tended to increase esport participation time more following previous increased after-game loneliness. The findings suggested that college students should avoid utilizing esport to achieve a sense of belonging and should be cautious of the loneliness-inducing effect after gameplay. A healthy level of loneliness can be maintained by playing esport more with friends in person, learning strategies to avoid obsessive passion, coping motivation, and escape motivation towards esport.
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Affiliation(s)
- Yan Luo
- Department of Physical Education and Health Education, Springfield College, Springfield, 01109, MA, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, 61801, IL, USA.
| | - Daniel M Smith
- Department of Physical Education and Health Education, Springfield College, Springfield, 01109, MA, USA.
| | - Michelle Moosbrugger
- Department of Physical Education and Health Education, Springfield College, Springfield, 01109, MA, USA
| | - Thaddeus J France
- Department of Physical Education and Health Education, Springfield College, Springfield, 01109, MA, USA
| | - Ke Wang
- Physical Education Department of Northwestern Polytechnic University, Xi'an, 710072, Shaanxi, China
| | - Yafei Cheng
- Institute of Sports Science, Zhengzhou Normal University, Zhengzhou, 450044, Henan, China
| | - Yanru Sha
- Institute of Physical Education, Ningxia University, Yinchuan, 750021, Ningxia, China
| | - Dan Wang
- Institute of Physical Education, Ningxia University, Yinchuan, 750021, Ningxia, China
| | - Shumei Si
- Institute of Physical Education, Ningxia University, Yinchuan, 750021, Ningxia, China
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Öğütlü H, Karatekin Ş, Sürücü Kara İ, McNicholas F. Sluggish cognitive tempo, eating habits, and daytime sleepiness in obese adolescents. Clin Child Psychol Psychiatry 2023; 28:595-609. [PMID: 35638558 DOI: 10.1177/13591045221105194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Rates of obesity have risen steeply in the western world in all age groups. Sluggish Cognitive Tempo (SCT) is characterized by a cluster of symptoms. Daytime sleepiness, commonly seen in obesity, may share a similar origin with sleepiness and daydreaming symptoms of SCT. This study aims to investigate the relationship between obesity, SCT, daytime sleepiness, and eating habits. METHOD Adolescents, aged between 10-17 years, with a BMI >95th centile, were recruited to the study. Clinical interviews were supplemented with standardized questionnaires. RESULTS Of the 35 adolescents, more than one quarter (N = 10, 28.6%) had SCT. Emotional overeating and food enjoyment subscale scores showed moderate correlations with the SCT scores, though these associations were not significant when controlling for ADHD symptoms. Daytime sleepiness score in adolescents with SCT was found to be significantly higher than those without. CONCLUSION Sluggish Cognitive Tempo is frequently present in adolescents with obesity and associated with higher levels of emotional overeating, food enjoyment, and daytime sleepiness. Targeting aspects of SCT might offer additional avenues to assist in weight management programs for youth.
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Affiliation(s)
- Hakan Öğütlü
- Department of Child and Adolescent Psychiatry, 536164Ankara City Hospital, Ankara, Turkey
| | - Şeyma Karatekin
- Department of Pediatrics, 375269Samsun Training and Research Hospital, Samsun, Turkey
| | - İlknur Sürücü Kara
- Division of Pediatric Metabolism, Department of Pediatrics, 37504Ankara University, Ankara, Turkey
| | - Fiona McNicholas
- Child and Adolescent Psychiatry Department, 8797University College of Dublin, Dublin, Ireland.,Children Hospital Ireland, Crumlin, Dublin, Ireland.,SJOG C AMHS, Lucena Rathgar, Dublin, Ireland
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Fredrick JW, Becker SP. Sluggish Cognitive Tempo (Cognitive Disengagement Syndrome) and Academic Functioning: A Systematic Review and Agenda for Future Research. Clin Child Fam Psychol Rev 2023; 26:82-120. [PMID: 36117226 DOI: 10.1007/s10567-022-00411-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2022] [Indexed: 02/01/2023]
Abstract
The past two decades have witnessed substantial interest in sluggish cognitive tempo (SCT), a set of symptoms (e.g., excessive daydreaming, mental confusion, slowed behavior) distinct from attention-deficit/hyperactivity disorder (ADHD) and other psychopathology symptoms. Despite evidence linking SCT to a range of functional outcomes, findings for academic functioning are unclear. The current review summarizes the literature on SCT and academic functioning and offers an agenda for future research. A systematic review was conducted to identify studies assessing SCT and academic outcomes, including academic impairments and performance, in childhood, adolescence, and young adulthood. Sixty studies were retained (53 cross-sectional, 7 longitudinal) from 44 separate samples, with the majority (n = 32, 53%) assessing global ratings of academic impairment and fewer measuring specific academic domains or standardized achievement test scores. Findings were generally consistent in showing SCT to be correlated with global ratings of academic impairment, lower grades, and inconsistently associated with poorer math and reading scores. Findings were more mixed when controlling for ADHD symptoms, intelligence, and/or demographic factors. Overall, SCT is associated with poorer academic functioning, although inconsistencies and key limitations are common across studies. Ten directions for future research are offered to advance understanding of how SCT may be associated with or impact academic functioning.
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Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA.
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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Yeo H, Lee J, Jeon S, Lee S, Hwang Y, Kim J, Kim SJ. Sleep disturbances, depressive symptoms, and cognitive efficiency as determinants of mistakes at work in shift and non-shift workers. Front Public Health 2022; 10:1030710. [PMID: 36589934 PMCID: PMC9794856 DOI: 10.3389/fpubh.2022.1030710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 11/21/2022] [Indexed: 12/15/2022] Open
Abstract
Introduction Shift work is known to reduce productivity and safety at work. Previous studies have suggested that a variety of interrelated factors, such as mood, cognition, and sleep, can affect the performance of shift workers. This study aimed to identify potential pathways from depression, sleep, and cognition to work performance in shift and non-shift workers. Material and methods Online survey including the Center for Epidemiologic Studies Depression Scale (CES-D), Cognitive Failure Questionnaire (CFQ), and Pittsburgh Sleep Quality Index (PSQI), as well as two items representing work mistakes were administered to 4,561 shift workers and 2,093 non-shift workers. A multi-group structural equation model (SEM) was used to explore differences in the paths to work mistakes between shift and non-shift workers. Results Shift workers had higher PSQI, CES-D, and CFQ scores, and made more mistakes at work than non-shift workers. The SEM revealed that PSQI, CES-D, and CFQ scores were significantly related to mistakes at work, with the CFQ being a mediating variable. There were significant differences in the path coefficients of the PSQI and CES-D between shift and non-shift workers. The direct effects of sleep disturbances on mistakes at work were greater in shift workers, while direct effects of depressive symptoms were found only in non-shift workers. Discussion The present study found that shift workers made more mistakes at work than non-shift workers, probably because of depressed mood, poor sleep quality, and cognitive inefficiency. Sleep influences work performance in shift workers more directly compared to non-shift workers.
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Affiliation(s)
- Hyewon Yeo
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Jooyoung Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Sehyun Jeon
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Somi Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Yunjee Hwang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea,Department of Brain and Cognitive Engineering, Korea University, Seoul, South Korea
| | - Jichul Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea
| | - Seog Ju Kim
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, South Korea,*Correspondence: Seog Ju Kim
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Orihuela CA, Mrug S, Evans RR. Associations between sleepiness, sleep duration, and academic outcomes in early adolescence. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Catheryn A. Orihuela
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Sylvie Mrug
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
| | - Retta R. Evans
- Departments of Human Studies and Psychology University of Alabama at Birmingham Birmingham Alabama USA
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Fredrick JW, Yeaman KM, Yu X, Langberg JM, Becker SP. A multi-method examination of sluggish cognitive tempo in relation to adolescent sleep, daytime sleepiness, and circadian preference. J Child Psychol Psychiatry 2022; 63:1658-1667. [PMID: 35045192 DOI: 10.1111/jcpp.13568] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND The field's understanding of the association between sluggish cognitive tempo (SCT) and sleep is severely limited by the lack of multi-method and multi-informant research designs that move beyond global ratings, often focused on a limited number of sleep-related domains, such as daytime sleepiness. The current study begins to address these limitations by using actigraphy, daily sleep diary, and self- and parent-report global ratings of sleep in adolescents, a developmental period marked by changes in SCT, sleep, and circadian function. As SCT and sleep are also associated with ADHD symptoms, we tested these associations in a sample of adolescents with and without ADHD. METHODS Adolescents (N = 302; M age = 13.17 years, 44.7% female) with (n = 162) and without ADHD (n = 140) and parents completed global ratings of sleep and daytime sleepiness, and adolescents completed a measure of circadian preference. Adolescents also wore actigraphs for approximately two weeks, during which daily diaries were completed. RESULTS Above and beyond demographic characteristics (i.e., sex, race, and family income), pubertal development, medication use, and ADHD group status, adolescents' self-reported SCT symptoms were uniquely associated with shorter sleep duration and later sleep onset per both actigraphy and daily diary. SCT symptoms were also uniquely associated with longer sleep onset latency and poorer overall sleep (per daily diary), more sleep/wake problems and daytime sleepiness (per adolescent rating), more difficulties initiating and maintaining sleep (per parent rating), and later eveningness preference (per adolescent rating). Nearly all significant effects remained in sensitivity analyses controlling for adolescent- or parent-reported ADHD symptom dimensions. CONCLUSIONS Findings provide the strongest evidence to date for SCT being uniquely linked to poorer sleep, greater daytime sleepiness, and a later evening circadian preference across subjective and objective measures. Longitudinal studies are needed to evaluate predictive and bidirectional associations.
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Affiliation(s)
- Joseph W Fredrick
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Kiley M Yeaman
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Xiaoqian Yu
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Joshua M Langberg
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Stephen P Becker
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA
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12
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Olsthoorn IM, Holland AA, Hawkins RC, Cornelius AE, Baig MU, Yang G, Holland DC, Zaky W, Stavinoha PL. Sleep Disturbance and Its Association With Sluggish Cognitive Tempo and Attention in Pediatric Brain Tumor Survivors. Front Neurosci 2022; 16:918800. [PMID: 35812214 PMCID: PMC9259867 DOI: 10.3389/fnins.2022.918800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 06/07/2022] [Indexed: 11/15/2022] Open
Abstract
Background Pediatric brain tumor (PBT) survivors are at risk for developing sleep disturbances. While in other pediatric populations sleep disturbance has been associated with worse cognitive functioning, it is unclear to what extent this relationship generalizes to PBT survivors. The aim of the current study was to assess the relationship between sleep disturbance and aspects of cognition, including sluggish cognitive tempo (SCT) as well as attention and working memory. Materials and Methods Eighty-three PBT survivors 6–18 years of age who were at least 3 months post-treatment were included in the present cross-sectional study. Level of sleep disturbance was measured as a composite score reflecting various sleep problems as rated by caregivers. Cognitive measures included caregiver-ratings of sluggish cognitive tempo and attention problems, as well as performance-based cognitive measures assessing attention and executive functioning. Hierarchical regression analysis was used to assess associations between sleep and cognition. Results Of all caregivers, 32.5% reported one or more sleep disturbances as “very/often true” and over 68% of caregivers rated at least one sleep-related item as “somewhat true.” Of all cognitive variables, scores were most frequently impaired for SCT (30%). A higher level of sleep disturbance was associated with worse SCT and parent-rated attention problems. Associations between sleep and performance-based cognitive measures assessing attention and working memory were not statistically significant. Conclusion Findings of the current study highlight the importance of further investigation into the relationship between sleep and cognition in PBT survivors, which may assist efforts to maximize cognitive outcome and health-related quality of life in PBT survivors. The current study additionally suggests further investigation of SCT in this population is warranted, as it may be more sensitive to detecting possible associations with sleep disturbance relative to discrete measures that assess cognitive performance under ideal circumstances.
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Affiliation(s)
- Ineke M. Olsthoorn
- Department of Neurology, McGovern Medical School, University of Texas Health Science Center at Houston (UT Health), Houston, TX, United States
| | - Alice Ann Holland
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, United States
- Department of Psychiatry, Children’s Medical Center of Dallas, Dallas, TX, United States
| | - Raymond C. Hawkins
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
| | - Allen E. Cornelius
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
| | - Muhammad Usman Baig
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Grace Yang
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Daniel C. Holland
- School of Psychology, Fielding Graduate University, Santa Barbara, CA, United States
| | - Wafik Zaky
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
| | - Peter L. Stavinoha
- Department of Pediatrics, University of Texas MD Anderson Cancer Center, Houston, TX, United States
- *Correspondence: Peter L. Stavinoha,
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Becker SP, Fredrick JW, Foster JA, Yeaman KM, Epstein JN, Froehlich TE, Mitchell JT. "My mom calls it Annaland": A Qualitative Study of Phenomenology, Daily Life Impacts, and Treatment Considerations of Sluggish Cognitive Tempo. J Atten Disord 2022; 26:915-931. [PMID: 34623188 DOI: 10.1177/10870547211050946] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To conduct qualitative analysis of interviews to understand phenomenology, daily life impact, and treatment considerations of sluggish cognitive tempo (SCT) behaviors in children and adolescents. Method: Youth with elevated SCT symptoms (N = 15, ages 9-16 years) and their parents completed interviews focused on their perception and daily life impact of SCT behaviors. Parents were also asked about intervention targets. Results: Parents and youth had both negative and positive perceptions of SCT, with SCT fostering creativity/imagination and a break from stressors while also negatively impacting daily functioning. The domains most frequently selected by parents as SCT intervention targets were academics, emotions, mind wandering, morning routines, and self-esteem. Conclusion: Children and their parents share negative and positive views of SCT behaviors, while also detailing specific ways that SCT negatively impacts day-to-day functioning. This study offers insights into possible intervention targets as provided by youth and parents directly impacted by SCT.
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Affiliation(s)
- Stephen P Becker
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
| | | | - Josalyn A Foster
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati, OH, USA
| | | | - Jeffery N Epstein
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
| | - Tanya E Froehlich
- Cincinnati Children's Hospital Medical Center, OH, USA
- University of Cincinnati College of Medicine, OH, USA
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