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Slow Cognitive Tempo: causes and related disorders

Slow Cognitive Tempo: causes and related disorders

January 25, 2022

Although it was previously believed that the slow cognitive tempo (TCL) was a subtype of attention deficit hyperactivity disorder (ADHD) with predominance of inattention symptoms, it is now known that it is a differentiated syndrome that manifests itself in other psychopathological alterations.

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

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What is the 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, lost eyesight, daydreaming, lack of motivation and slowness or laziness. If these manifestations are understood as symptoms, we can conceptualize the LCL as a syndrome.


In addition to these five cardinal signs, it is usual to also detect the following in people with slow cognitive tempo:

  • Low accuracy and speed in information processing.
  • Frequent appearance of fatigue sensations, or chronic fatigue.
  • Relatively low levels of energy and activity.
  • Drowsiness during the day.
  • Difficulties to maintain the alert or the wakefulness in little stimulating situations.
  • Withdrawal, lower interest and participation in activities.
  • Difficulties to transform thoughts into words.
  • Loss of the thread of thought, blocks by forgetting 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 advance of scientific research has shown that it is in fact 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 the slow cognitive tempo appear in the context of various psychological disorders and psychiatric, among which are major depression, generalized anxiety, intellectual functional diversity or different disorders related to learning, in addition to ADHD.

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Causes of this syndrome

The causes of the slow cognitive tempo are not known in depth at the moment. It is believed, however, that the nerve networks associated with the attention of the back of the brain , in the parietal lobes, they are more associated to this syndrome than the frontal lobes, as in the case of 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 seems to have a biological basis similar to that of Attention Deficit Hyperactivity Disorder . However, the heritability of ADHD is greater in the subtype in which the symptoms of hyperactivity predominate.

In contrast, 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 result of changes in environmental influences caused by the very presence of inattentive symptoms.

Relationship with other disorders

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

1. Attention deficit hyperactivity disorder

The investigations indicate 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 ADHD with predominance of inattention are significant, but both constructs differ in some neurological and cognitive characteristics.

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

2. Major depression

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

Although this relationship has a modest intensity, it is somewhat more powerful in the case of depression than in that of anxiety. In addition, some authors argue that the 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 like social phobia, obsessive thoughts and especially generalized anxiety disorder, which is closely connected to depression from a biological point of view.

The signs of inattention mediate the relationship between anxiety disorders and the slow cognitive tempo: the difficulties in attending to the TCL are increased by the effects of anxiety, which itself involves alterations in this psychological function.

4. Behavioral disorders

Children and adolescents with attention deficit hyperactivity disorder are more likely to develop behavioral problems, such as conduct disorder, negative-defiant disorder or substance abuse. However, in the cases that occur with slow cognitive tempo this relationship is reduced; so, the TCL acts as a protection factor .

5. Learning difficulties

The slow cognitive tempo interferes with learning through the appearance of Deficits in self-organization and problem solving , as well as in 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., Brown, M., Torrubia, R., Pujals, E., Martin, LM & Ribas-Fitó, N. (2013). Slow cognitive time: revision of a construct. Journal of Psychopathology and Clinical Psychology, 18 (2): 151-168.
  • Mueller, A. K., Tucha, L., Koerts, J., Groen, T., Lange, K. W. & Tucha, O. (2014). Sluggish cognitive tempo and its neurocognitive, social and emotive correlates: a systematic review of the current literature. Journal of Molecular Psychiatry, 2: 5.

Attention Disorders Q&A (January 2022).


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