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Keywords = cognitive disengagement syndrome (CDS)

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16 pages, 729 KiB  
Article
Cross-Sectional and Quasi-Longitudinal Examination of Childhood and Adult Cognitive Disengagement Syndrome, Depression, Anxiety, Stress, and Insomnia
by Dena Sadeghi-Bahmani, Larina Eisenhut, Thorsten Mikoteit, Nico Helfenstein, Annette Beatrix Brühl, Kenneth M. Dürsteler, Jean-Marie Bizimana, Stephen P. Becker and Serge Brand
J. Clin. Med. 2025, 14(14), 5165; https://doi.org/10.3390/jcm14145165 - 21 Jul 2025
Viewed by 273
Abstract
Background: Longitudinal studies on cognitive disengagement syndrome (CDS) are scarce, and only one study has investigated the trajectory of CDS from childhood to early adulthood. Given this, the aims of the present study were to explore, with a quasi-longitudinal design, (1) whether scores [...] Read more.
Background: Longitudinal studies on cognitive disengagement syndrome (CDS) are scarce, and only one study has investigated the trajectory of CDS from childhood to early adulthood. Given this, the aims of the present study were to explore, with a quasi-longitudinal design, (1) whether scores for childhood CDS were associated with scores for CDS during early adulthood; (2) whether childhood CDS scores were associated with childhood and adult scores for depression, anxiety, stress, and insomnia; (3) whether childhood CDS, depression, anxiety, stress, and insomnia and adult depression, anxiety, stress, and insomnia were independently associated with adult scores for CDS, and (4) whether childhood CDS scores were directly and indirectly associated with adult CDS scores via adult depression and stress in two conditional effect models. Methods: A total of 246 young adult students (mean age = 22.62; 56.3% females) participated in a cross-sectional and quasi-longitudinal study. The participants completed questionnaires assessing CDS (Adult Concentration Inventory; ACI), depression, anxiety, stress, and insomnia for the following two developmental periods: for the present time point as young adults and for a past time point, when they were about eight years old. To enable retrospective past recall, the participants undertook a standardized imagination exercise. Results: Childhood scores for CDS, depression, anxiety, stress, and insomnia were highly associated with adult scores for CDS, depression, anxiety, stress, and insomnia. In the regression model, higher childhood scores for CDS, depression, and anxiety and higher adult scores for depression, stress, and insomnia, but not adult anxiety, were strongly and independently associated with adult scores for CDS. In the two conditional effects models, childhood CDS was associated with adult CDS directly and indirectly via adult depression and adult stress. Conclusions: In this quasi-longitudinal study, childhood scores for CDS were associated with adult scores for CDS, suggesting a potentially stable trajectory of CDS from childhood to early adulthood. Further, the two conditional effects models suggested that childhood and adult CDS were both directly and indirectly associated via adult depression and stress. As such, symptoms of depression, anxiety, stress, and insomnia should be considered in conceptualizations of adult CDS. Next, given that standardized psychotherapeutic interventions for depression, stress, and insomnia are available, such interventions might also favorably impact CDS symptoms. These findings further underscore the importance of prospective longitudinal and intervention studies on adult CDS. Full article
(This article belongs to the Section Mental Health)
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16 pages, 2457 KiB  
Article
Neural Correlates of Cognitive Disengagement Syndrome Symptoms in Children: A Magnetoencephalography Study
by Xiaoqian Yu, Jing Xiang, Jeffery N. Epstein, Leanne Tamm, Josalyn A. Foster and Stephen P. Becker
Brain Sci. 2025, 15(6), 624; https://doi.org/10.3390/brainsci15060624 - 10 Jun 2025
Viewed by 621
Abstract
Background/Objectives: Despite the growing recognition of cognitive disengagement syndrome (CDS), previously termed sluggish cognitive tempo, as a distinct dimension of psychopathology, the neural correlates of CDS remain largely unknown. We investigated the neural correlates of CDS in children using whole-head magnetoencephalography (MEG). Methods [...] Read more.
Background/Objectives: Despite the growing recognition of cognitive disengagement syndrome (CDS), previously termed sluggish cognitive tempo, as a distinct dimension of psychopathology, the neural correlates of CDS remain largely unknown. We investigated the neural correlates of CDS in children using whole-head magnetoencephalography (MEG). Methods: A community-based sample of children (N = 43, ages 8–12 years) was recruited and completed self-report ratings of CDS. MEG was recorded while the children completed an adapted version of the attention network test (ANT). Results: The results indicated that higher levels of self-reported CDS symptoms were associated with larger changes in the root-mean square (ΔRMS) (incongruent—congruent trials) in M2 and M3, suggesting children with higher levels of CDS symptoms might require greater mental effort to overcome distractors during incongruent trials. The source localization analysis initially revealed a negative correlation between child self-reported CDS symptoms and ΔM2 power (incongruent—congruent trials) in the medial prefrontal cortex (mPFC), suggesting insufficient power allocation in a region critical for attentional processing. However, this association was no longer significant after controlling for ADHD status. No significant correlation was found between self-reported CDS symptoms and alerting or orienting. Conclusions: These findings provide initial evidence of the disrupted attentional processing associated with CDS in children. Further replication and extension with larger samples are warranted. Full article
(This article belongs to the Section Cognitive, Social and Affective Neuroscience)
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17 pages, 696 KiB  
Review
Emotional Dysregulation and Cognitive Disengagement Syndrome: Exploring Their Relationship Through the Lens of Twin Studies
by Gaia De Giuli, Cecilia Amico, Stefano De Francesco, Ludovica Giani, Gülşah Tüzün, Federico Galli, Marcella Caputi, Barbara Forresi and Simona Scaini
Appl. Sci. 2025, 15(11), 6067; https://doi.org/10.3390/app15116067 - 28 May 2025
Viewed by 504
Abstract
Cognitive Disengagement Syndrome (CDS) is a clinical construct characterized by symptoms such as excessive daydreaming, mental confusion, slowed behavior, and reduced cognitive and motor activity. Increasing evidence suggests a potential overlap between CDS and Emotional Dysregulation (ED), a transdiagnostic construct associated with difficulties [...] Read more.
Cognitive Disengagement Syndrome (CDS) is a clinical construct characterized by symptoms such as excessive daydreaming, mental confusion, slowed behavior, and reduced cognitive and motor activity. Increasing evidence suggests a potential overlap between CDS and Emotional Dysregulation (ED), a transdiagnostic construct associated with difficulties in regulating emotional responses. This narrative review synthesizes current empirical findings and theoretical perspectives on the co-occurrence of CDS and ED, with a particular focus on insights provided by behavioral genetics—especially twin studies. We describe the core principles and models used in twin research and evaluate how they have been applied to disentangle genetic and environmental contributions to these phenotypes and their overlap. While some studies support a shared etiology between CDS and ED, particularly through non-shared environmental influences, research in this area remains limited and conceptually fragmented. The review identifies critical knowledge gaps, including the lack of longitudinal studies, inconsistent definitions of ED, and limited exploration of developmental trajectories. We argue that future twin studies are essential for clarifying these unresolved issues. Nonetheless, limitations include the scarcity of twin-based studies directly examining the CDS–ED association and methodological inconsistencies across the existing literature. Full article
(This article belongs to the Special Issue Feature Review Papers in Theoretical and Applied Neuroscience)
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17 pages, 615 KiB  
Article
Cognitive Disengagement Syndrome (CDS) and Psychological Ill-Being in Young Adults Using the Adult Concentration Inventory (ACI)
by Dena Sadeghi-Bahmani, Larina Eisenhut, Thorsten Mikoteit, Nico Helfenstein, Annette Beatrix Brühl, Kenneth M. Dürsteler, Stephen P. Becker and Serge Brand
J. Clin. Med. 2025, 14(7), 2362; https://doi.org/10.3390/jcm14072362 - 29 Mar 2025
Cited by 1 | Viewed by 1285
Abstract
Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement [...] Read more.
Background: Young adulthood is a demanding developmental stage, in that individuals are often faced with making major and long-lasting decisions related to career and family. This is also a heightened time of mental health difficulties. There is recent evidence that cognitive disengagement syndrome (CDS; previously sluggish cognitive tempo) may also be more prevalent in young adults and associated with poorer functioning. However, the relation between CDS symptoms and anxiety, depression, stress, and insomnia remains insufficiently investigated among young adults. Given this, the aims of the present study were as follows: (1) to investigate the associations between CDS and symptoms of depression, anxiety, stress, and insomnia; (2) to investigate if and which dimensions of ill-being were more robustly related to higher CDS scores; (3) to explore if stress scores moderated the associations between CDS symptoms and insomnia; and (4) to explore if higher insomnia categories were associated with higher CDS scores. Methods: A total of 246 young adult students in Switzerland (mean age = 22.62; 56.3% females) completed a booklet of questionnaires covering socio-demographic information, cognitive disengagement syndrome (Adult Concentration Inventory; ACI), and symptoms of depression, anxiety, stress, and insomnia as part of this cross-sectional study. Results: Higher CDS scores on the ACI were associated with higher scores for depression, anxiety, stress, and insomnia. Depression, anxiety, stress, and insomnia were independently associated with higher scores for CDS. Higher categories of stress moderated the associations between higher CDS scores and higher insomnia. Higher insomnia categories were related to higher CDS scores. Conclusions: The present data showed that among a small sample of young adult students, higher CDS scores were associated with higher psychological ill-being (depression, anxiety, stress, and insomnia). If we consider CDS as a trait, specific performance-enhancing medication or psychotherapeutic interventions might favorably influence dimensions of psychological ill-being such as depression, anxiety, stress, and insomnia. Full article
(This article belongs to the Section Mental Health)
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11 pages, 726 KiB  
Article
Women with Symptoms Suggestive of ADHD Are More Likely to Report Symptoms of Iron Deficiency and Heavy Menstrual Bleeding
by Beth MacLean, Paige Buissink, Vernon Louw, Wai Chen and Toby Richards
Nutrients 2025, 17(5), 785; https://doi.org/10.3390/nu17050785 - 24 Feb 2025
Viewed by 2814
Abstract
Background/Objectives: Iron deficiency has been suggested as a potential mechanism for attention-deficit hyperactivity disorder (ADHD) development due to involvement in neurotransmitter synthesis and transporter expression. As iron deficiency is particularly common in women of reproductive age, often due to heavy menstrual bleeding (HMB), [...] Read more.
Background/Objectives: Iron deficiency has been suggested as a potential mechanism for attention-deficit hyperactivity disorder (ADHD) development due to involvement in neurotransmitter synthesis and transporter expression. As iron deficiency is particularly common in women of reproductive age, often due to heavy menstrual bleeding (HMB), we aimed to explore the relationship between iron deficiency, HMB and ADHD in women. Methods: We screened women (18–49 years) at university and local sporting events in Western Australia. To screen for ADHD, section A of the Adult ADHD Self-Report Scale-V1.1 (ASRS-V1.1) and the Adult Concentration Inventory were used to assess cognitive disengagement syndrome (CDS) symptoms. Risk factors for iron deficiency, such as HMB, commonly reported symptoms and a fingerpick haemoglobin concentration (Hb) (Hemocue Hb801) were recorded. Results: Of the 405 completed questionnaires, the mean age was 24.8 ± 10.1 years, the mean Hb was 136.8 ± 12.4 g/L and 6.4% of women were anaemic. Symptoms suggestive of ADHD were reported by 174/405 (43%) women, and 128/405 (32%) women reported HMB. There was a greater prevalence of HMB reported in those experiencing symptoms suggestive of ADHD (39% vs. 26%, p = 0.01). Symptoms of fatigue, dizziness, brain fog, anxiety, heart palpitations, headaches, restless legs and depression were more common in patients with symptoms suggestive of ADHD (p ≤ 0.01) and HMB (p < 0.05). Anaemia status did not influence ADHD status (p = 0.87) nor CDS scores (15.7 ± 7.0 vs. 13.8 ± 6.1, p = 0.17). Conclusions: There is an apparent relationship between those with symptoms reported in ADHD, HMB and iron deficiency. Further exploration is required to determine whether there is a causative relationship. Full article
(This article belongs to the Special Issue Iron and Brain and Cognitive Function Across the Lifespan)
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10 pages, 284 KiB  
Article
Cognitive Disengagement Syndrome and Child Sleep Problems in ADHD, Anxiety and Depression
by Almudena Cano-Crespo, Inmaculada Moreno-García, Mateu Servera and Manuel Morales-Ortiz
Healthcare 2023, 11(14), 2022; https://doi.org/10.3390/healthcare11142022 - 14 Jul 2023
Viewed by 2657
Abstract
The main objective of this study was to analyse the relationship and differential contribution of Cognitive Disengagement Syndrome (CDS) and sleep problems in children in different psychopathological measures. A total of 1133 participants (612 fathers/mothers and 521 children aged 7–13 years in Years [...] Read more.
The main objective of this study was to analyse the relationship and differential contribution of Cognitive Disengagement Syndrome (CDS) and sleep problems in children in different psychopathological measures. A total of 1133 participants (612 fathers/mothers and 521 children aged 7–13 years in Years 3–6 of Primary Education) completed the scales on CDS, sleep problems, depression (DEP), anxiety (ANX) and attention deficit and hyperactivity disorder (ADHD). Similar and significant correlations were identified in the measures of CDS and sleep problems between fathers and mothers, obtaining a high coefficient between the two parents. However, weak correlations were found between fathers/mothers and children. The scores of CDS and the sleep disturbance scale for children (SDSC) significantly predicted the internalising measures and ADHD, especially between SDSC and DEP. It was confirmed that sleep problems had a greater presence in the group of children with the highest ADHD scores, and especially in CDS and ADHD jointly. To conclude, the data indicate the importance of sleep problems in understanding CDS and its relationship with other psychopathological measures, especially ADHD, although to a greater extent with internalising symptoms, especially DEP. Full article
(This article belongs to the Section School Health)
14 pages, 314 KiB  
Article
Validation of the Farsi Version of the Adult Concentration Inventory for Assessing Cognitive Disengagement Syndrome
by Dena Sadeghi-Bahmani, Hadi Parhoon, Maryam Esmaeili, Kamal Parhoon, Laleh Sadeghi Bahmani, Habibolah Khazaie, Stephen P. Becker, G. Leonard Burns and Serge Brand
J. Clin. Med. 2023, 12(14), 4607; https://doi.org/10.3390/jcm12144607 - 11 Jul 2023
Cited by 7 | Viewed by 2258
Abstract
The internal and external validity of cognitive disengagement syndrome (CDS) relative to attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated herein with Farsi-speaking adults. A total of 837 Iranian adults assessed throughout the whole country (54.72% women, Mage = 23.85; SD = 7.05; age range [...] Read more.
The internal and external validity of cognitive disengagement syndrome (CDS) relative to attention-deficit/hyperactivity disorder-inattention (ADHD-IN) was evaluated herein with Farsi-speaking adults. A total of 837 Iranian adults assessed throughout the whole country (54.72% women, Mage = 23.85; SD = 7.05; age range = 18 to 58 years; 75% between 18 and 24 years old; reporting higher educational training) completed self-report measures of CDS, ADHD-IN, ADHD-hyperactivity/impulsivity (HI), depression, anxiety, and stress. Seven of the fifteen CDS symptoms showed a good convergent (high loadings on the CDS factor) and discriminant (higher loadings on the CDS factor than the ADHD-IN factor) validity. CDS also showed stronger first-order and unique associations with depression than ADHD-IN, whereas ADHD-IN showed stronger first-order and unique associations with ADHD-HI and anxiety than CDS. The first-order and unique associations of CDS and ADHD-IN did not differ in relation to stress. This study is the first to support the validity of the self-report of assessing CDS symptoms with the Adult Concentration Inventory with Farsi-speaking individuals residing in Iran, thus further strengthening the transcultural validity of the CDS, and paving the way for further transcultural research in the field of CDS among adults. Full article
(This article belongs to the Section Mental Health)
15 pages, 295 KiB  
Article
Sluggish Cognitive Tempo among Iranian Children and Adolescents: A Validation Study of the Farsi Child and Adolescent Behavior Inventory (CABI)–Parent Version
by Dena Sadeghi-Bahmani, Youkhabeh Mohammadian, Mohammad Ghasemi, Laleh Sadeghi Bahmani, Nahid Piri, Annette Beatrix Brühl, Stephen P. Becker, G. Leonard Burns and Serge Brand
J. Clin. Med. 2022, 11(21), 6346; https://doi.org/10.3390/jcm11216346 - 27 Oct 2022
Cited by 19 | Viewed by 2969
Abstract
Background: Sluggish cognitive tempo (SCT), recently renamed cognitive disengagement syndrome (CDS), is a set of behavioral symptoms that includes excessive daydreaming, mental confusion and fogginess, being lost in one’s thoughts, and slowed behavior and thinking. Symptoms of SCT show overlap with a broad [...] Read more.
Background: Sluggish cognitive tempo (SCT), recently renamed cognitive disengagement syndrome (CDS), is a set of behavioral symptoms that includes excessive daydreaming, mental confusion and fogginess, being lost in one’s thoughts, and slowed behavior and thinking. Symptoms of SCT show overlap with a broad range of other symptoms such as attention-deficit/hyperactivity disorder inattention, anxiety, and depression, or oppositional defiant disorder (ODD). To measure SCT, one of the optimal measures is the Child and Adolescent Behavior Inventory (CABI). Here, we report the psychometric properties of the Farsi version of the CABI Parent Version, including the CABI SCT scale and its subscales. Methods: The participants were the parents of 209 children and adolescents (53.9% girls; ages 8–19 years; Mage = 14.23, SDage = 2.72). Parents completed the SCT, ADHD inattention (ADHD-IN), ADHD-hyperactivity/impulsivity (ADHD-HI), oppositional defiant disorder (ODD), limited prosocial emotions (callous-unemotional (CU) traits), anxiety, depression, social impairment, and academic impairment scales of the Child and Adolescent Behavior Inventory (CABI). Parents also completed four dimensions of the Strengths and Difficulties Questionnaire (SDQ: emotional problems; conduct problems; peer problems; prosocial behavior), and five dimensions of the Kidscreen questionnaire (physical health; psychological well-being; autonomy and parental well-being; peers and social support; school environment). Results: SCT symptoms demonstrated strong discriminant validity from the ADHD-IN symptoms. SCT showed stronger first-order and unique associations than ADHD-IN with anxiety, depression, and ODD, whereas ADHD-IN showed stronger first-order and unique associations than SCT with ADHD-HI, CU, and social and academic impairment. Further, SCT showed stronger first-order and unique associations than ADHD-IN with more emotional problems, peer problems, and with lower prosocial behavior, as assessed with the SDQ. Higher scores for SCT were associated with lower psychological well-being, autonomy and parental relations, and lower peer and social support, as assessed with the Kidscreen. Higher ADHD-IN scores were associated with lower peer and social support, and a lower school environment. Conclusions: The Farsi version of the CABI–Parent Version has very good psychometric properties for assessing SCT and other dimensions of psychopathology/impairment and replicates the findings from similar studies with children and adolescents from South Korea, Spain, Turkey, and the United States. Accordingly, the present study provides further support of the transcultural validity of the sluggish cognitive tempo construct. Full article
(This article belongs to the Section Mental Health)
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