A Comparison of Cognitive Disengagement Syndrome in Children with Major Depression Versus Attention Deficit and Hyperactivity Disorder

Abstract

Objective: There is growing evidence that Cognitive Disengagement Syndrome (CDS) is a distinct construct, supported by both empirical research and clinical differentiation. CDS demonstrates a stronger association with the inattentive type of Attention Deficit Hyperactivity Disorder (ADHD-IA), compared to its correlation with hyperactivity/impulsivity symptoms. Several studies have identified a significant positive relationship between CDS and internalizing symptoms such as anxiety and depression. To our knowledge, no study has explored CDS in children with major depression (MD). In the present study, we compared children with MD but without ADHD to children with ADHD but without depression in terms of CDS. We examined whether children with MD would have greater CDS when compared to children with ADHD. Methods: Thirty-six adolescents with ADHD, and twenty-five adolescents with MD, aged 12 to 18 years old, were administered the Barkley Child Attention Scale (BCAS), Turgay's DSM-IV Based ADHD and Disruptive Behavior Disorders Screening Scale, and the Children’s Depression Rating Scale-Revised (CDRS-R). Results: The majority of the ADHD and MD groups were boys. The MD group had significantly higher BCAS scores than the ADHD group (U=287.0, p=0.016). In the ADHD group, the severity of BCAS scores was inversely correlated with ADHD-Hyperactivity/impulsivity scores (r=-0.681, p<0.001). In the MD group, there was a significant positive relationship between BCAS and CDRS scores (r= 0.493, p=0.012). Conclusions: The findings of this study highlight the transdiagnostic relevance of CDS by demonstrating its association with depression, independent of ADHD. This underscores the importance of considering CDS in the assessment and treatment of depression across various clinical contexts.