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Study finds sluggish cognitive tempo in early life predicts depression and inattention in adulthood

by Eric W. Dolan
April 10, 2021
in Mental Health

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Children and adolescents who suffer from sluggish cognitive tempo are at increased risk of suffering from inattention and depressive symptoms in adulthood, according to new research published in the Journal of Abnormal Child Psychology. The findings shed light on a relatively understudied syndrome that is linked to academic and functional impairment.

“I have always been interested in supporting and learning more about children and adolescents who are often lost in our school system as most systems are not built to help these students,” explained study author Zoe R. Smith (@DrZoeRSmith), a postdoctoral research fellow at Loyola University Chicago

“I work with adolescents and their parents who are often not disruptive in class, but are still struggling in school. I wanted to learn more about how to support these students and how symptoms of sluggish cognitive tempo may affect later outcomes in adulthood.”

Previous research has provided evidence that sluggish cognitive tempo, which is characterized by excessive daydreaming, slowed thinking, lethargy, and confusion, is concurrently associated with other mental health issues. But because of a lack of longitudinal research, it has been unclear whether sluggish cognitive tempo in childhood predicts psychopathology in adulthood.

“Sluggish cognitive tempo is a relatively new construct, so there has not been a chance to examine how sluggish cognitive tempo in childhood affects adulthood psychopathology,” Smith said. “We also know that sluggish cognitive tempo is impairing and is associated with multiple psychological disorders, including ADHD, depression, and anxiety. What I have found particularly interesting as research continues to explore sluggish cognitive tempo is the connection between it and internalizing psychopathology (e.g., depression, anxiety).”

Using longitudinal data from 449 twins who completed two waves of the Tennessee Twin Study, the researchers found that symptoms of sluggish cognitive tempo and depression were closely related in childhood and adolescence. Importantly, sluggish cognitive tempo in childhood and adolescence also predicted psychopathology in adulthood.

“If a child or adolescent is exhibiting higher levels of sluggish cognitive tempo, they are more likely to have higher levels of depression in adulthood than someone without high levels of sluggish cognitive tempo. As prior work has shown, children and adolescents who experience depression in childhood have a higher likelihood of experiencing depression in adulthood,” Smith told PsyPost.

Additionally, “higher levels of sluggish cognitive tempo in childhood predicted higher rates of inattention in adulthood. Thus, having higher rates of sluggish cognitive tempo in childhood and adolescence is a risk factor for higher rates of inattention and depression in adulthood.”

The twin pairs were initially assessed for psychopathological symptoms at ages 6 to 17. They completed similar assessments again in adulthood when they were ages 23 to 31.

The findings provide new insight into the relationship between sluggish cognitive tempo and mental health outcomes. But Smith noted that there are still many questions that need to be addressed, “as this is the first study to examine sluggish cognitive tempo in childhood and later associations with adulthood depression and inattention.”

For example, “questions include further understanding of the etiology of sluggish cognitive tempo, examining impairment from a prospective perspective, and the prevention and treatment of sluggish cognitive tempo,” she explained. “We need more longitudinal research on sluggish cognitive tempo to understand how sluggish cognitive tempo changes over time and what leads to further impairment.”

And the study — like all research — includes some limitations.

“It needs to be replicated with other participants,” Smith said. “This was a large sample, but it was a twin sample, which may not generalize to the general population.”

“I will be working on developing a new intervention that will help adolescents with ADHD and sluggish cognitive tempo, using this study, lived experiences of adolescents with ADHD and sluggish cognitive tempo, and other prior studies to help guide this intervention,” she added. “As this study found that sluggish cognitive tempo and depression are closely linked, it is likely that aspects of cognitive behavioral therapy will be beneficial.”

The study, “Sluggish Cognitive Tempo and Depressive Symptoms in Children and Adolescents Predict Adulthood Psychopathology“, was authored by Zoe R. Smith, David H. Zald, and Benjamin B. Lahey.

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