(PS3-98) Cognitive Disengagement Syndrome Symptoms and ADHD Dimensions in Relation to Children’s Daily Life Executive Functioning Deficits

Abstract Text: Cognitive disengagement syndrome (CDS) is a set of behaviors including mental confusion, excessive daydreaming, and slowed behavior and thinking that are strongly related to but distinct from ADHD symptoms (Becker et al., 2023). There is clear evidence that ADHD dimensions are robustly associated with executive functioning (EF) deficits, including daily life EF (Antshel et al., 2014; Barkley & Murphy, 2011). It remains unknown whether, and to what extent, CDS symptoms are associated with EF deficits, which may guide theory in understanding the differentiation and overlap of CDS and ADHD. A small body of research suggests that CDS may be associated with specific daily EF deficits in children including organization and problem-solving, above and beyond ADHD symptoms (Barkley, 2013; Becker & Langberg, 2014; Jimenez et al., 2015). However, findings remain mixed, partially due to smaller and ADHD-defined samples, mono-informant designs, and non-optimal measures of CDS. To address these limitations, the current study examines multi-informant CDS symptoms and ADHD dimensions in relation to daily life EF in a large sample of children recruited to include a full range of CDS symptom severity. Participants were 263 children (ages 8-12 years; 57.8% male; 75.3% White, 14.1% Black, 6.5% Multiracial, 1.1% Asian; 3.0% Hispanic). Caregivers and teachers completed a validated scale assessing CDS, ADHD inattentive (ADHD-IN), and ADHD hyperactive-impulsive (ADHD-HI) symptoms and the Behavior Rating Inventory of Executive Function (BRIEF). The BRIEF consists of three behavioral regulation subscales (inhibit, shift, and emotional control) and five metacognitive subscales (initiate, working memory, plan/organize, organization of materials, and monitor). Multivariate regression models were estimated to determine whether caregiver and teacher ratings of ADHD-IN, ADHD-HI and CDS symptoms dimensions were independently associated with daily life EF ratings, with separate models conducted for the behavioral and metacognitive EF subscales. Medication status (yes/no), sex, age, and family income were included as covariates. Missing data was minimal and handled via maximum likelihood. Behavioral regulation model results showed caregiver (β = 0.28, p < .001) and teacher (β = 0.35, p < .01) ratings of CDS were significantly independently associated with higher shift deficits, but not with inhibit or emotional control deficits. Metacognitive model results showed caregiver ratings of CDS were significantly independently associated with higher initiate (β = 0.24, p < .001), working memory (β = 0.13, p < .01), plan/organize (β = 0.12, p < .05) deficits; the same pattern was found when using teacher ratings (βs = 0.16-0.35, ps < .05). Across informants, ADHD-HI and ADHD-IN symptoms were most consistently and strongly associated with behavioral and metacognitive EF domains, respectively. These findings are consistent with ADHD dimensions being strongly associated with daily life EF deficits and point to specific domains where CDS symptoms predict additional variance in EF. CDS symptoms may be important to incorporate in models of EF, and future studies are needed to examine the interrelations of CDS and EF over time and in response to treatment.