The relationship between theory of mind and sluggish cognitive tempo in school-age children with attention deficit and hyperactivity disorder

Clin Child Psychol Psychiatry. 2021 Oct;26(4):1137-1152. doi: 10.1177/13591045211030665. Epub 2021 Jul 8.

Abstract

Sluggish cognitive tempo (SCT) is considered as a cognitive-emotional style. Theory of mind (ToM) skills form the basis of human cognition and social behavior. The aim of this study is to contribute to SCT literature by examining the relationship between SCT and cognitive and affective ToM in school-age children with attention deficit and hyperactivity disorder (ADHD). Fifty school-age children with ADHD (43 boys and seven girls) and 40 typically developing children (34 boys and six girls) were assessed using Parent-rated Barkley Child Attention Scale and Child Behavior Checklist/6-18, cognitive (first- and second-order ToM) and affective ToM (Reading Mind in the Eyes Test and Unexpected Outcomes Test (UOT)) tests. Multiple linear regression analysis was performed to determine the variables that may predict SCT levels in children with ADHD. Attention deficit and hyperactivity disorder-inattention (Exp(B) = .334, p = .027), internalization (Exp(B) = .305, p = .006), and UOT scores (Exp(B) = .933, p = .015) significantly predicted SCT severity in children with ADHD. SCT severity was significantly associated with impaired cognitive ToM skills as measured by second-order ToM (Exp(B) = 1.933, p = .045). Our findings may indicate that affective ToM developing with age, and impaired cognitive ToM skills are associated with increasing SCT severity.

Keywords: affective theory of mind; attention deficit and hyperactivity disorder; children; cognitive theory of mind; sluggish cognitive tempo; theory of mind.

MeSH terms

  • Attention Deficit Disorder with Hyperactivity*
  • Child
  • Cognition
  • Cognitive Dysfunction*
  • Female
  • Humans
  • Male
  • Schools
  • Theory of Mind*