Slow Cognitive Tempo: Causes and Related Disorders

Although slow cognitive tempo (SCT) was previously thought to be a subtype of disorder by attention deficit hyperactivity disorder (ADHD) with a predominance of inattention symptoms, it is currently known that it is a differentiated syndrome that also manifests itself in other psychopathological alterations.

In this article we will describe the clinical characteristics, the causes of slow cognitive tempo and its relationship with other disorders. The research around this set of symptoms is in the initial stage, but it has been advancing at a significant speed for some years.

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What is Slow Cognitive Tempo?

The concept "slow cognitive tempo" refers to a cognitive-emotional style that is characterized mainly by the continued presence of a state of confusion, staring off into space, daydreaming, lack of motivation and slowness or laziness If these manifestations are understood as symptoms, we can conceptualize TCL as a syndrome.

In addition to these five cardinal signs, it is common for the following to be detected in people with slow cognitive tempo:

• Low precision and speed in information processing.
• Frequent appearance of feelings of fatigue, or chronic fatigue.
• Relatively low energy and activity levels.
• Sleepiness during the day.
• Difficulty maintaining alertness or wakefulness in unstimulating situations.
• Withdrawal, decreased interest and participation in activities.
• Difficulty turning thoughts into words.
• Loss of train of thought, blocks due to forgetfulness when speaking.

Initially it was believed that the slow cognitive tempo was a subtype of Attention Deficit Hyperactivity Disorder in which the symptoms of inattention predominated. The progress of scientific research has shown that it actually constitutes an independent clinical category, although there is no agreement as to whether it is a disorder or not.

In this sense, the clinical characteristics of slow cognitive tempo appear in the context of various psychological disorders and psychiatric, among which major depression, generalized anxiety, intellectual functional diversity or different learning-related disorders stand out, in addition to ADHD.

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Causes of this syndrome

The causes of slow cognitive tempo are not fully understood at this time. It is believed, however, that the neural networks associated with attention in the back of the brain, in the parietal lobes, are associated to a greater extent with this syndrome than the frontal lobes, as is the case with ADHD.

On the other hand, it has been discovered that exposure to high amounts of alcohol during fetal development favors the appearance of these neurocognitive signs.

The slow cognitive tempo appears to have a biological basis similar to that of Attention Deficit Hyperactivity Disorder. However, the heritability of ADHD is higher in the subtype in which hyperactivity symptoms predominate.

On the contrary, the cases of ADHD that are related to the presence of slow cognitive tempo are those that have a lower weight of genetic inheritance. It has been hypothesized that this style of thought and emotion arises as a consequence of changes in environmental influences caused by the very presence of inattention symptoms.

Relationship with other disorders

There is currently an unresolved debate about the clinical nature of slow cognitive tempo. Its correlation with other psychological disorders may shed some light in this regard.

1. attention deficit hyperactivity disorder

Research indicates that between 30 and 50% of children diagnosed with ADHD show the characteristic syndrome of slow cognitive tempo. The clinical similarities between this pattern and inattention-predominant ADHD are significant, but the two constructs differ in some neurological and cognitive features.

For many experts, the increase in interest in slow cognitive tempo represents an opportunity to question the very diagnosis of ADHD, which encompasses very diverse manifestations and became restrictive in the area of ​​inattention in the transition from DSM-III to DSM-IV, but it gains explanatory power if TCL is included among the criteria.

2. major depression

Has been found a clear association between slow cognitive tempo and the presence of internalizing symptoms, particularly those that are typical of mood and anxiety disorders.

Although this relationship is modestly strong, it is somewhat more powerful in the case of depression than in anxiety. In addition, some authors defend that slow cognitive tempo is associated to a greater extent with internalization than with ADHD.

3. Anxiety disorders

Regarding the category of anxiety disorders, comorbidities have been found between slow cognitive time and alterations such as social phobia, obsessive thoughts and especially the generalized anxiety disorder, which is closely connected to depression from a biological point of view.

Signs of inattention mediate the relationship between anxiety disorders and slow cognitive tempo: difficulties in attention characteristic of the LCT are increased by the effects of anxiety, which in itself entails alterations in this function psychological.

4. Behavioral disorders

Children and adolescents with attention deficit hyperactivity disorder have a greater likelihood of developing conduct problems, such as conduct disorder, oppositional-defiant, or he substance abuse. However, in cases with a slow cognitive tempo, this relationship is reduced; therefore, TCL acts as a protection factor.

5. Learning difficulties

Slow cognitive tempo interferes with learning through the appearance of deficits in self-organization and problem solvingas well as other executive functions. The severity of the associated difficulties depends on the intensity of the symptoms in each specific case.

Bibliographic references:

• Camprodon, E., Duñó, L., Batlle, S., Estrada, X., Aceña, M., Marrón, M., Torrubia, R., Pujals, E., Martín, L. m. & Ribas-Fito, N. (2013). Slow cognitive time: review of a construct. Journal of Psychopathology and Clinical Psychology, 18(2): 151-168.

• Muller, A. K., Tucha, L., Koerts, J., Groen, T., Lange, K. W. & Tucha, O. (2014). Sluggish cognitive tempo and its neurocognitive, social and emotional correlates: a systematic review of the current literature. Journal of Molecular Psychiatry, 2: 5.