Objective To conduct the first meta-analysis evaluating the internal and external validity of the sluggish cognitive tempo (SCT) construct as related to or distinct from attention-deficit/hyperactivity disorder (ADHD) and as associated with functional impairment and neuropsychological functioning. Method Electronic databases were searched through September 2015 for studies examining the factor structure and/or correlates of SCT in children or adults. The search procedures identified 73 papers. The core SCT behaviors included across studies, as well as factor loadings and reliability estimates, were reviewed to evaluate internal validity. Pooled correlation effect sizes using random effects models were used to evaluate SCT in relation to external validity domains (i.e., demographics, other psychopathologies, functional impairment, and neuropsychological functioning). Results Strong support was found for the internal validity of the SCT construct. Specifically, across factor analytic studies including over 19,000 individuals, 13 SCT items loaded consistently on an SCT factor as opposed to an ADHD factor. Findings also support the reliability (i.e., internal consistency, test-retest reliability, inter-rater reliability) of SCT. In terms of external validity, there is some indication that SCT may increase with age (r = 0.11) and be associated with lower socioeconomic status (r = 0.10). Modest (potentially negligible) support was found for SCT symptoms being higher in males than females in children (r = 0.05) but not adults. SCT is more strongly associated with ADHD inattention (r = 0.63 in children, r = 0.72 in adults) than with ADHD hyperactivity-impulsivity (r = 0.32 in children, r = 0.46 in adults), and it likewise appears that SCT is more strongly associated with internalizing symptoms than with externalizing symptoms. SCT is associated with significant global, social, and academic impairment (rs = 0.38–0.44). Effects for neuropsychological functioning are mixed, although there is initial support for SCT being associated with processing speed, sustained attention, and metacognitive deficits. Conclusion This meta-analytic review provides strong support for the internal validity of SCT and preliminary support for the external validity of SCT. In terms of diagnostic validity, there is not currently enough evidence to describe SCT in diagnostic terms. Key directions for future research are discussed, including evaluating the conceptualization of SCT as a transdiagnostic construct and the need for longitudinal research.

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Objective The purpose of the research study was to examine the manifestation of variability in reaction times (RT) in children with Attention Deficit Hyperactivity Disorder (ADHD) and to examine whether RT variability presented differently across a variety of neuropsychological tasks, was present across the two most common ADHD subtypes, and whether it was affected by reward and event rate (ER) manipulations. Method Children with ADHD-Combined Type (n=51), ADHD-Predominantly Inattentive Type (n=53) and 47 controls completed five neuropsychological tasks (Choice Discrimination Task, Child Attentional Network Task, Go/No-Go task, Stop Signal Task, and N-back task), each allowing trial-by-trial assessment of reaction times. Multiple indicators of RT variability including RT standard deviation, coefficient of variation and ex-Gaussian tau were used. Results Children with ADHD demonstrated greater RT variability than controls across all five tasks as measured by the ex-Gaussian indicator tau. There were minimal differences in RT variability across the ADHD subtypes. Children with ADHD also had poorer task accuracy than controls across all tasks except the Choice Discrimination task. Although ER and reward manipulations did affect children’s RT variability and task accuracy, these manipulations largely did not differentially affect children with ADHD compared to controls. RT variability and task accuracy were highly correlated across tasks. Removing variance attributable to RT variability from task accuracy did not appreciably affect between-group differences in task accuracy. Conclusions High RT variability is a ubiquitous and robust phenomenon in children with ADHD.

Background The impact of chronic stressors like the COVID‐19 pandemic is likely to be magnified in adolescents with pre‐existing mental health risk, such as attention‐deficit/hyperactivity disorder (ADHD). This study examined changes in and predictors of adolescent mental health from before to during the COVID‐19 pandemic in the Southeastern and Midwestern United States. Methods Participants include 238 adolescents (132 males; ages 15–17; 118 with ADHD). Parents and adolescents provided ratings of mental health symptoms shortly before the COVID‐19 pandemic and in spring and summer 2020. Results Adolescents on average experienced an increase in depression, anxiety, sluggish cognitive tempo, inattentive, and oppositional/defiant symptoms from pre‐COVID‐19 to spring 2020; however, with the exception of inattention, these symptoms decreased from spring to summer 2020. Adolescents with ADHD were more likely than adolescents without ADHD to experience an increase in inattentive, hyperactive/impulsive, and oppositional/defiant symptoms. Adolescents with poorer pre‐COVID‐19 emotion regulation abilities were at‐risk for experiencing increases in all mental health symptoms relative to adolescents with better pre‐COVID‐19 emotion regulation abilities. Interactive risk based on ADHD status and pre‐COVID‐19 emotion regulation abilities was found for inattention and hyperactivity/impulsivity, such that adolescents with ADHD and poor pre‐COVID‐19 emotion regulation displayed the highest symptomatology across timepoints. Lower family income related to increases in inattention but higher family income related to increases in oppositional/defiant symptoms. Conclusions The early observed increases in adolescent mental health symptoms during the COVID‐19 pandemic do not on average appear to be sustained following the lift of stay‐at‐home orders, though studies evaluating mental health across longer periods of time are needed. Emotion dysregulation and ADHD increase risk for sustained negative mental health functioning and highlight the need for interventions for these populations during chronic stressors. Results and clinical implications should be considered within the context of our predominately White, middle class sample.

ED is associated with ADHD among young adolescents, does not differ based on ADHD subtype or ODD status, and is associated with social impairment.

Sleep problems in adolescence have been identified as an international public health issue. Over the past few decades, notable advances have been made in our understanding of the patterns and consequences of sleep in adolescence. Despite these important gains, there is much about the role of sleep in adolescence that remains to be understood. This Special Issue brings together studies that examine sleep as it specifically pertains to adolescent development and adjustment. In this introductory article, we argue for the importance of grounding the study of sleep and adolescence in developmental science and a developmental psychopathology framework. First, a review of the literature is used to outline a biopsychosocial and contextual model of sleep in adolescence. Second, attention-deficit/hyperactivity disorder (ADHD) is used as an exemplar of the proposed model given the pervasiveness of sleep problems among youth with ADHD and the likelihood that sleep problems and ADHD symptoms are interconnected in complex ways. Finally, a brief introduction to the empirical articles included in the Special Issue is provided, with particular attention given to how these articles fit within the proposed biopsychosocial and contextual model. Along with the framework proposed in this article, the studies included in this Special Issue advance the current literature and point to critical directions for future research.

These results fill an important gap in the literature by (a) confirming SCT to be distinct from ADHD in emerging adulthood, (b) demonstrating SCT to be strongly linked to college student adjustment, and (c) providing support for the hypothesis that SCT is associated with psychosocial functioning in both individuals with and without ADHD.

Children with attention-deficit/hyperactivity disorder (ADHD) exhibit significant academic impairments, as evidenced by poor academic achievement, grade retention, and school dropout. Deficits in organization skills may contribute to these academic impairments, as children with ADHD frequently lose assignments, misplace their completed work, and have difficulty planning for tests. The present study examined the pilot efficacy of an 8-week organization skills intervention for children with ADHD. Thirty-seven children were randomly assigned to receive the intervention immediately or to a wait-list control. Participants made significant improvements in organization and homework management skills during the intervention and these gains were maintained at 8-week follow-up. Parents of children in the intervention group reported decreased homework problems. Children in the intervention group also demonstrated pre-post gains on teacher ratings of academic impairment and GPA. This study suggests that targeted academic skills interventions have the potential to improve overall academic performance among children with ADHD.