Symptoms of cognitive disengagement syndrome in youth diagnosed with ADHD, mood disorders, and comorbid presentations.

Abstract

Cognitive Disengagement Syndrome (CDS) is characterized by symptoms such as daydreaming, slowed behavior, and mental confusion, but remains understudied outside of ADHD populations. CDS has recently emerged as a potential transdiagnostic construct, yet most investigations have been limited to ADHD samples. To further clarify the clinical profile of CDS, research is needed in pediatric mood disorder populations and comorbid presentations. This study examined predictors of caregiver-reported CDS symptoms in a racially and socioeconomically diverse sample of treatment-seeking outpatient youth (N = 697), with attention to psychiatric diagnoses (ADHD and mood disorders), youth demographics, caregiver education, and number of other psychiatric diagnoses. A 5-item CBCL-based CDS index demonstrated acceptable psychometric performance and was used to capture youth CDS levels. Hierarchical regression revealed that mood disorder diagnosis was the strongest and most unique predictor of elevated CDS symptoms, followed by ADHD diagnosis, with the comorbid group (ADHD+Mood) showing the highest CDS levels. Clinical and structural factors, including mood and ADHD diagnoses, number of other psychiatric diagnoses, Black racial identity, lower caregiver education, and older age, each independently predicted CDS severity. These findings support CDS as a clinically meaningful construct extending beyond ADHD and underscore the importance of contextually informed, transdiagnostic assessment. Implications are discussed through a developmental psychopathology framework, emphasizing equifinality.