Concentration Deficit Disorder (Sluggish Cognitive Tempo)

This Fact Sheet is based on a chapter to appear in the next edition of Dr. Barkley's textbook, Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment (4 th edition). New York: Guilford Press. In press; expected publication date – December 2014. This chapter reviews the evidence for a second attention disorder that is distinct from yet overlaps with ADHD. Although this condition has been called Sluggish Cognitive Tempo (SCT) since the 1980s, I have recently recommended that the name be changed to Concentration Deficit Disorder (CDD) for various reasons, not the least of which is that it can be viewed by the public as pejorative, derogatory, or frankly offensive (Barkley, 2014; Saxbe & Barkley, 2014). While some prior reviewers of the evidence have suggested that the disorder be called attention deficit disorder, or ADD (Diamond, 2005; Milich & Roberts, 2012), and many clinicians have adopted this term for people who are primarily inattentive and have little or no evidence of hyperactive or impulsive behavior, it is not advisable to do so. Not the least reason for which is that ADD is the older term for ADHD dating back to DSM-III in 1980 and so resurrecting it as the name for a second attention disorder merely unnecessary creates confusion between these conditions which, as will be shown below, are quite different in a number of important features. The term SCT also implies that the neurocognitive dysfunction underlying the condition is well-known and supported by empirical evidence, and this is very far from the case at the moment. The same criticism can be applied to other terms suggested for this condition, such as Primary Disorder of, although that term was asserted to be an alternative to ADHD and not just the identification of another attention disorder. Obviously, if vigilance is defined as " alertness " and " sustained attention " (Wikipedia) then, by definition, ADHD can be automatically redefined as representing PDV, with the former now relegated to mythical status by those authors (Weinberg & Brumback, 1992). Toss into the definition as they did problems with wakefulness and focus of attention and you pretty much cover both disorders under discussion here without having to do anything more scholarly than pontification. Or do anything more scientific than dredging up five clinical cases out of one's practice while summarily dispensing with 200 years of medical commentary and CDD seems to be a …