“Sluggish Cognitive Tempo” is the New ADHD

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“Some powerful figures in mental health,” according to today’s New York Times, “are claiming to have identified a new disorder that could vastly expand the ranks of young children treated for attention problems.” Sluggish Cognitive Tempo (SCT) – characterized by lethargy, daydreaming, and slow mental processing – was the subject of 131 pages in the January issue of the Journal of Abnormal Child Psychology. The lead paper claims that the question of the disorder’s existence “seems to be laid to rest as of this issue,” with other papers claiming “exciting findings” of pharmaceutical treatment for the disorder. Eli Lilly promises to study the disorder as part of its mission to “help satisfy unmet medical needs around the world.”

Idea of New Attention Disorder Spurs Research, and Debate (NY Times)

See also:
Should Sluggish Cognitive Tempo Symptoms Be Included in the Diagnosis of Attention-Deficit/Hyperactivity Disorder? (Journal of the American Academy of Child & Adolescent Psychiatry)

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Kermit Cole
Kermit Cole, MFT, founding editor of Mad in America, works in Santa Fe, New Mexico as a couples and family therapist. Inspired by Open Dialogue, he works as part of a team and consults with couples and families that have members identified as patients. His work in residential treatment — largely with severely traumatized and/or "psychotic" clients — led to an appreciation of the power and beauty of systemic philosophy and practice, as the alternative to the prevailing focus on individual pathology. A former film-maker, he has undergraduate and master's degrees in psychology from Harvard University, as well as an MFT degree from the Council for Relationships in Philadelphia. He is a doctoral candidate with the Taos Institute and the Free University of Brussels. You can reach him at [email protected].

51 COMMENTS

  1. It couldn’t possibly have anything to do with not getting adequate sleep ord consuming too many empty carbs and excess sugars, or of children not being taught how to regulate their attention, or children being bored, or anything, really, except a drug deficiency.

    I’m guessing Nemeroff and/or Biederman.

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    • Since sleep apnea is frequently misdiagnosed as ADHD with obvious cognitive issues, that is exactly what I thought of. So if psychiatrists want to really prove they are medical doctors, they need to show their skills in screening for sleep disorders and nutritional problems before they sentence patients to a lifetime of drugs.

      Gosh, there is no end to this cr——-p.

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    • Sleep may be the problem, especially in the era of artificial light, TV and computers (it can really screw up your day/night cycle – I know it from my own experience). However sugar right diet isn’t related to behavioural problems or at least I couldn’t find a study to confirm it, I only found one that didn’t:
      http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3133757/
      So sounds like a myth to me. However, one should take into account that kids who eat a lot of snacks likely don’t eat much of fruit/veggies and may have some vitamin and microelement deficiencies.
      Another thing is: when you put all kids in a school setting with some kids being more energetic or less interested in certain topics or maybe having some personal problems etc. you’re likely to have behavioural issues which have nothing to do with kid’s health. The sheer stats on ADHD show that this may be responsible for most of the “diagnosis” – more boys have it, more kids from poor backgrounds, more kids with history of trauma.

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      • That’s what I was thinking. If anyone’s diet is mostly sugar and carbs, they aren’t likely to be healthy enough to be sharp. This looks like another situation in which judging a child to be lacking sufficient “tempo” could be subjective.

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      • Sorry, but bogus studies supposedly proving bad diets with lots of sugar and refined carbs don’t cause behavioral and other acting out issues with children are total bunk. Any parent knows that this is garbage and will come to see that feeding her kids a lot of sugar and similar foods can make their children act like they are on speed. There have been many experts recommending diets for children that can alleviate these issues.

        I agree with you about some of the other issues contributing to these bogus child stigmas to scapegoat children so the psychopaths in power can continue to profit from their original suffering and trauma and the retraumatization these vampires inflict to push their evil, lucrative, fascist agenda.

        This latest ploy to push ADHD drugs with the usual drug company shills making no secret about it is totally disgusting and vile.

        Also, now that the child bipolar fad fraud has been exposed, the victims must be redistributed to the other predatory child stigmas like autism, ADHD, conduct disorder and the rest to scapegoat and destroy children’s lives with these horrible stigmas and brain/body damaging drugs. If they reduce adult lives by 25 years on average, just think what they are doing to children. Further, it doesn’t really matter what bogus stigma kids get given that neuroleptic poisons will most likely be forced on most if not all.

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        • Well, but that may not be the fault of sugar per se, but rather the fact that feeding kids with snacks means they don’t get the necessary nutrients. No kid is going to want an apple after two mars bars.

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    • When I was in the 4th grade many years ago , when teachers actually did wield rulers to get the attention of the disruptive student or what was often discribed by the teacher to my parents as “he’s a little slow and can’t pay attention.” This is the relentless legacy handed down to millions of children by the custodians of sociaty that are hard to corral. If you wish to put your families well being in the hands of scientist, teachers, police, bankers, media and religon you will reap the society you presently have. I learned a great deal in the forth grade.

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  2. Oops. The prize goes to:

    “‘The psychologist Russell Barkley of the Medical University of South Carolina, for 30 years one of A.D.H.D.’s most influential and visible proponents, has claimed in research papers and lectures that sluggish cognitive tempo “has become the new attention disorder.’”

    Is there any indication, whatsoever, that the people who name these disorders give the slightest bit of consideration to the people they expect to carry these labels around? “Hi. I have Sluggish Cognitive Tempo Disorder. What’s your problem?”

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  3. I just cant help but to think… “oh what a bunch of silly monkeys!”

    They still haven’t even proven the existence of their first ADHD and now they’re already off creating another. Reckless and irrational are words that come to mind. But my mind is just blown. How could anyone continue to think that psychiatrists are real doctors, practicing real medicine, based on science. It’s getting so ridiculous that it’s going even beyond what the worst of their critics ever even imagined.

    And then to add up all the harm they’re recklessly causing in this money-making endeavor… And the many lives ruined by irreparable brain damage. Brains never allowed to naturally develop and be healthy. The children they inflict with brain damage and movement disorders. Not to mention the ones they downright literally kill…

    Something seriously needs to be done about this… even tomorrow would have been way too late to hinder this atrocity.

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  4. Eli Lilly promises to study the disorder as part of its mission to “help satisfy unmet medical needs around the world.”

    or rather:

    Eli Lilly promises to study the factitious disorder as part of its mission to “help satisfy our need to make profits by creating fake medical needs around the world.”

    I wonder if David Harvey would see this as the 18th contradiction of capitalism? http://davidharvey.org/2014/03/new-book-seventeen-contradictions-end-capitalism/

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  5. “In an interview, Keith McBurnett, a professor of psychiatry at the University of California, San Francisco, and co-author of several papers on sluggish cognitive tempo, said: “When you start talking about things like daydreaming, mind-wandering, those types of behaviors, someone who has a son or daughter who does this excessively says, ‘I know about this from my own experience.’ They know what you’re talking about.”

    Oh golly…such insight(?) from a supposedly highly qualified professional!

    Has he or the school or the parents ever considered that perhaps the child/adolescent is
    1) bored out of its brain by uninspiring curriculum and teaching
    2) frankly more interested in what the birds or the clouds are doing outside the classroom
    3) enjoying flights of creative fancy
    4) tired, hungry, cold, living in fear of domestic violence,
    5)living in poverty
    6)being bullied
    or any number of other reasons why (s)he is not engaging in the way that THEY would like him to???
    This is not the child’s problem, it is a problem that rests purely in the heads of psychiatrists, drug companies, teachers and parents who wish the child to be something other than what (s)he is.
    It will be a very sad day when children are drugged for daydreaming or for not sufficiently paying attention to stuff that is neither relevant nor interesting to them….or, heaven forbid, for skipping problems on a work sheet or not doing their homework!

    That
    “Eli Lilly promises to study the disorder as part of its mission to “help satisfy unmet medical needs around the world.”
    is code for “we are, with the assistance of our hired help in psychiatry and massive advertising campaigns, going to CREATE demand for our highly addictive and damaging psychoactive drugs. We estimate that in the pursuit of profits we can create another 2 million brain damaged child addicts who will remain loyal customers for the term of their natural (albeit shortened and impoverished) lives. We will do this with no scientific proof that the disorder the drugs purport to cure even exists! And so confident are we in our complete control of the marketplace and loyalty of psychiatry, we have even given clear notice of our intentions IN ADVANCE of any scientific research being carried out. That way, psychiatrists can start diagnosing and prescribing immediately!”

    Their tactical brilliance is quite astounding, really…a new disease almost overnight. Shame about the ethics.

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    • When you start talking about things like …, those types of behaviors, someone who has a son or daughter who does this excessively says, ‘I know about this from my own experience.’ They know what you’re talking about.”
      … can be also substituted by “playing with dolls and talking to them”, “drawing bizarre pictures” “telling imaginary stories”, “being afraid of monsters under their beds” etc. etc.
      There soon will be a disorder for every aspect of being a kid.

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  6. How they define “real doctor” is screwed up. Getting people to take drugs does not make one a doctor. Skillfully, correctly figuring out what is going on with a person, and making the solution accurately fit the problem, and behaving ethically, including avoiding unnecessary or harmful treatments, is more like it. Diagnosing incorrectly, and prescribing, is not medical practice.

    Legitimate diagnosis in all other fields of medicine, includes an assessment of mechanism of injury or mechanism of onset. Psychiatrists don’t even care about that- all they care about is symptoms. Imagine if an orthopedist behaved like that. They would lose their license pretty quickly.

    Are psychiatrists doctors? Not in the slightest. They are drug pushers, not much different from the person in the street trying to convince you that you would feel better if you took heroin or cocaine or whatever else. In fact there’s not much difference between ADHD and cocaine.

    Sluggish Cognitive Tempo could be a new iatrogenic disease that happens as a result of taking all these other drugs.

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  7. I have a good friend who actually is a real doctor, an orthopedist. He always listens closely to the patient, and adapts his advice to what the patient values and enjoys in life. He helps the patient understand their condition and the various options for healing it, so that the patient can make good decisions about it. Often, he tells patients they can fix their problem by doing a certain exercise every day, or avoiding a certain activity for awhile. He almost never prescribes a drug, and he is very careful not to do any unnecessary invasive procedures. Oh yeah- and his diagnosis process includes finding out what happened that created the problem, as well as performing whatever tests are needed. And he knows how to say, “I don’t know” when that is true. That is what a doctor is. He happens to be very bothered by the field of psychiatry in that they don’t follow anything resembling the ethics of medicine.

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    • One would hope. I think people are starting to wake up to it. The moment they introduced such idiocies like Caffeine Withdrawal Disorder (not that this isn’t real it’s just not a mental illness for christ’s sake) some people are starting to openly mock them. On the other hand many are willing to swallow any bullshit easily without thinking 2s about it…

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    • This is no laughing matter, Francesca! Many of us are acronymonious— suffering from too many acronyms. You can only have so many before it starts to show up outside the offices of specialists and requires real doctors with real prescription pads and other purveyors of destigmatization to address those labels.

      Be concerned, be very concerned! Any day now, there will be acronyms with five, maybe six letters and cocktails won’t be enough— we’ll need something like a pharmaceutical wedding cake with many layers of drugs that we can eat communally in school and at work. If if gets any worse than that, they’ll just have to gas us en masse to keep our attention affixed and our feelings irrelevant.

      Someday, someone might come up with an acronym remover, but they’re going to have to have one hell of a lawyer.

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      • Good point, wileywitch. I hadn’t even noticed that psych acronyms have been slowly expanding from 3 to 4 letters. My math is a bit rusty but doesn’t that give us 26 x 26 x 26 x 26 = 456,976 possible diseases? That’s going to be one hell of a DSM-6!

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        • Think bigger, Francesca— Infinite Acronymonious Treatment Resistant Disorder Disorder might tie it all together so that only one label would be required, but with infinite dimensional details. IATRDD, IATRDD +1, IATRDD + 3…

          There could be any number of committees on the DSM task force to elaborate on the many manifestations of infinite mental illness.

          Start with an antidepressant, add an antipsychotic, add an adjunct, then add drugs to treat the symptoms of one or more of the first three drugs or any combination of them. Then a person could be on their way to swallowing 8 or more psyche drugs a day, being debilitated, and being unable to figure out what’s wrong with them because they’re stoned out of their mind on so many different drugs that the drugs themselves don’t know who they are anymore.

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          • You can always have co-morbid disorders which the drugs are so good at “unmasking” so that expands the spectrum of new awesome diagnosis.
            Oppositional Defiant Disorder with symptoms of enhanced combined Sluggish Cognitive Tempo Disorder and Thinking Everything Your Psychiatrist Says is Bullshit Disorder followed by short bursts of Leave Me Alone I Don’t Want Your Drugs Disorder.
            Welcome to the Brave New Wold.

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  8. Alan Schwarz, of the NYT’s, deserves some credit for pointing out obvious conflicts of interest and business ties. Regarding Shire, he says “because the new condition shares so many symptoms with ADHD, these products might easily be repositioned to serve the new market”.
    There’s no “might” , maybe, or possibly about it. Schwarz, and most everyone else, knows the game plan. “Reposition” for S.C.T.D. Grab 5 million more who are slipping past the criteria of “hyperactive”.

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  9. “When are the patents running out?” Some have already, not sure on all of them though. But I’m hoping psychiatry’s shameless assault on children will end some day soon. And drugs going off patent may help?

    Another thought, there have been quite a few mainstream attacks on the validity of ADHD, maybe this is alternative diagnosis for those who already know ADHD is an invalid disorder?

    Psychiatry makes up “diseases,” creates epidemics of iatrogenic harm, then moves to new “disease” names. What an evil scam.

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  10. I think instead of giving kids the drugs we should prepare curriculums that accommodate students of different types. I do not think we should put too much force into making kids meet any rigid tempo. I think we should stretch out the amount of years that people can go to school so they have more time to learn what they need to learn .
    There are things I never understood in high school that I am ready to learn now or have since been ready to learn, but now I have to pay thousands of dollars to go to school. I think we should make learning and education as affordable and conveniently accessible as possible so people can learn at their own rates. To drug a child (or an adult for that matter) and risk the side effects so that they can fit within some construct of normalcy or some rushed time frame is wrong and unhealthy.

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    • A lot of children who are recommended for adhd drugging and analyses are simply the youngest children in the class. There is a lot of difference between a child who just turned seven, and one who is four months shy of their eighth birthday. Milestones of development weren’t intended to be deadlines. Besides how old they really are, there are differences in maturity for many reasons, and children have their own schedule for development in which windows of development, so to speak, open and close when they’re ready— not when some arbitrary cut-off arrives.

      The only advantage to rating and judging and grading children by age is the ability to convince oneself that half of the children are stupid and not worth much investment and that’s not really advantageous. Academic ability is just one kind of intelligence, it certainly isn’t the only kind required for human survival, and it’s often quite limited— especially when people with advanced degrees still don’t understand the difference between knowledge and intelligence.

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      • True, I can’t find the specific article now but I’ve seen stats showing that the kids born in December are much more likely to “have ADHD”. It’s just one more piece of evidence next to gender and socioeconomic status which shows how much nonsense is going on. Or are psychiatrists also astrologists?

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    • I agree with you 100%. This is exactly what I’ve been thinking about. The sequence of grades and their content serves agendas other than the best interests of the diversity of children’s needs.

      For example: Teachers’ unions and institutions of learning comprise huge economic engines.

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  11. I must say, it warms my heart to know that Eli Lily is so concerned with “helping satisfy unmet medical needs around the world.” They are so sweet to be so concerned about our children! But perhaps we would better phrase it “helping satisfy unmet financial needs around the world, by creating new ‘medical needs’ they can pretend to satisfy.”

    This one takes the cake! But we can’t assume everyone will laugh it off. After all, people have accepted “Oppositional Defiant Disorder” and “Intermittent Explosive Disorder,” so people will believe almost anything if spoken in somber terms by a person of sufficient “authority” to convince them they should listen.

    Bottom line (ha, ha) , they will continue to pull this crap as long as we (the people of the world) allow them to get away with it.

    —- Steve

    —- Steve

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  12. Finally!! I’m so happy that this extremely painful disorder will now be seen as the mental illness that it is. My poor child has suffered from it for years. We thoght at first it was Excessive Grumpiness Disorder (EGD) but these reserchers have finally nailed it. So far we haven’t been able to get doctor prescribed medication for her “SCT” but now I am hoping that my 5 year old will receive Provigil. We have had to medicate her ourselves…first with double shots of espresso, now with IM Methamphetamine, and the fog finally is lifting. But I would prefer a doctor prescribes the meds than to have to buy drugs from “Snakes”- the guy down on the corner.

    I feel like I can see some hope for my little one today. Thank God!

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  13. This sounds so misguided that I first thought that this could not be anything other than veiled eugenics. Psychotropics will only debilitate, marginalize, and curtail the pursuit of happiness of the targeted individuals. I would expect a new epidemic of mania among children given stimulants.

    No one should be surprised that many school children exhibit sluggish cognitive tempo and daydreaming in the current conditions of the public schools. Many children are suffering from poor quality sleep due to school schedules that exacerbate that , as well as social-emotional difficulties, and nutritional problems.. However, lately research on sleep hygiene is getting more attention and awareness is growing of the link between sleep disorders and poor school performance, which leads me to consider a second possibility, i.e, that this alleged newly discovered disorder with its need for pharmacological assistance sounds like a desperate move to neutralize the growing momentum for the use of natural means to address perceived needs, thus protecting the economic interests of the pharmacological companies.

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  14. Surely rather than have the difficulty of choosing one (or several) of the multitude of child disorders now available it would be far more cost effective to have done with all the current nonsense and simply introduce BCD (Being a Child Disorder). Think of the ease and speed of diagnosis, the endless supply of new patients and the profits once a suitably toxic and innefective drug is brought to market. It would be a double whammy by dealing with the pensions crisis at the same time – no-one would live long enough to draw one.

    I wait with eager anticipation for my own disorder to be identified – DNPD. Deck the Nearest Psychiatrist Disorder.

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    • How about “EYD” – “Excessive Youth Disorder,” unequivocally caused by not being old enough to have matured yet. The market is almost endless…

      Or we could also have “BWSD” – “Bored with School Disorder” – I know I would have qualified! If daydreaming had been outlawed, I probably would have slashed my wrists – it was the only thing that kept me sane through 7 years of elementary school torture.

      Next thing you know, they’ll diagnose doodling as a mental disorder.

      —- Steve

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      • You’ve just reminded me of what one of my friends recently told me about the pre-maturely born kids: that they are a higher risk of having ADHD. One would expect that a kid born few weeks or even months early could be behind in normal childhood development which would cause him/her to be diagnosed with a disorder instead of just helping them to catch up.

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  15. Btw, a recent study on the long-term effect of stimulants: seems that the use of stimulants in kids is actually correlated with greater risk for obesity later in life:
    http://www.medpagetoday.com/Psychiatry/ADHD-ADD/44828?xid-NL_UBM_daily&hr=UBM&utm_content=&utm_medium=email&utm_campaign=DailyHeadlines&utm_source=WC?GUID=2321B16C-CAA6-4CEE-A922-D8B3AFDCD984&rememberme=1&ts=11042014
    Original article:
    Schwartz BS, et al “Attention deficit disorder, stimulant use, and childhood body mass index trajectory” Pediatrics 2014; DOI: 10.1542/peds.2013-3427.

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