Clinical distinction between cognitive disengagement syndrome and ADHD presentations in a nationally representative sample of Spanish children and adolescents

G Leonard Burns; Stephen P Becker; Juan José Montaño; Mateu Servera

doi:10.1111/jcpp.14005

Clinical distinction between cognitive disengagement syndrome and ADHD presentations in a nationally representative sample of Spanish children and adolescents

J Child Psychol Psychiatry. 2024 May 15. doi: 10.1111/jcpp.14005. Online ahead of print.

Authors

G Leonard Burns¹, Stephen P Becker², Juan José Montaño³, Mateu Servera⁴

Affiliations

¹ Department of Psychology, Washington State University, Pullman, WA, USA.
² Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
³ Department of Psychology, Universty of the Balearic Islands & Health Research Institute of the Balearic Islands, Palma de Mallorca, Illes Balears, Spain.
⁴ Department of Psychology, University of the Balearic Islands, Health Research Institute of the Balearic Islands & University Institute of Health Sciences Research, Palma de Mallorca, Illes Balears, Spain.

PMID: 38747554
DOI: 10.1111/jcpp.14005

Abstract

Background: This study sought to determine whether cognitive disengagement syndrome (CDS, formerly sluggish cognitive tempo) has different external correlates relative to ADHD-inattentive presentation (INP), ADHD-hyperactive/impulsive presentation (HIP), and ADHD-combined presentation (CP).

Methods: Parents of a nationally representative sample of 5,525 Spanish youth (ages: 5-16, 56.1% boys) completed measures of CDS, ADHD-inattention (IN), and ADHD-hyperactivity/impulsivity (HI) and other measures. Scores greater/less than the top 5% on CDS, ADHD-IN, and ADHD-HI were used to create control (n = 5,013, 90.73%), CDS-only (n = 131, 2.37%), ADHD-INP-only (n = 83, 1.50%), ADHD-HIP-only (n = 113, 2.05%), ADHD-CP-only (n = 48, 0.97%), CDS + ADHD-INP (n = 44, 0.80%), CDS + ADHD-HIP (n = 25, 0.45%), and CDS + ADHD-CP (n = 68, 1.23%) groups.

Results: Forty-nine percent of youth with clinically elevated CDS did not qualify for any ADHD presentation, whereas 64% of youth with clinically elevated ADHD did not qualify for CDS. The CDS-only group was higher than the ADHD-INP-only, ADHD-HIP-only, and ADHD-CP-only groups on anxiety, depression, somatization, daytime sleep-related impairment, nighttime sleep disturbance, and peer withdrawal, whereas the CDS-only and ADHD-INP-only groups did not differ on ODD (ADHD-HIP-only and ADHD-CP-only higher) and academic impairment (ADHD-CP-only higher than CDS-only and ADHD-HIP-only lower than CDS-only). The CDS-only group also had higher rates of anxiety, depression, and bipolar disorder diagnoses than the ADHD-only group.

Conclusions: A distinction was found between CDS and each ADHD presentation, thus providing support for CDS as a syndrome that frequently co-occurs with yet is distinct from each ADHD presentation.

Keywords: Attention‐deficit/hyperactivity disorder; cognitive disengagement syndrome; comorbidity; sluggish cognitive tempo; transdiagnostic.

Grants and funding

This research was supported by grant PID2020-118309RB-100 funded by MCIN/AEI/10.13039/501100011033