Does Cognitive Disengagement Syndrome Affect the Cognitive Flexibility of Children with Attention Deficit Hyperactivity Disorder?

Background: Cognitive flexibility (CF) is an ability to adapt to a changing environment, which is a prominent skill in children at school age. ADHD is a common disorder of childhood and can be accompanied by cognitivedisengagement syndrome (CDS, previously referred to as “sluggish cognitive tempo”). This study aimed to assess CDS’s effect on CF in children with ADHD by using neuropsychological tests.

Methods: The study sample consisted of 100 ADHD children aged between 6 and 12 years, including 2groups: 60 ADHD-only and 40 CDS+ADHD. ADHD diagnosis and CDS symptoms in participants wereassessed by Diagnostic and Statistical Manual of Mental Disorder Fifth Edition Text Revision (DSM-5-TR)based psychiatric interviews and rating scales. The Neuropsychological Battery, consisting of 4 different tests,Wisconsin Card Sorting Test (WCST), Stroop Color–Word Test, Verbal Fluency Test (VFT), and Color TrailTest, was applied to participants to compare CF of the ADHD-only group to CDS+ADHD.

Results: It was found that the CDS+ADHD group showed lower performance than the ADHD-only groupin the WCST and the Semantic Fluency Test—a subtest of the VFT. However, no significant performancedifferences were found between the groups in other tests.

Conclusion: It was revealed that CDS co-occurrence causes lower CF performance in ADHD-diagnosedchildren. A more comprehensive approach is required to understand the nature of this difficulty.

Cite this article as: Adak İ, Varan E., Ekinci ., et al. Does cognitive disengagement syndrome affectthe cognitive flexibility of children with ADHD?Eurasian J Med. 2025, 57(4), 1160, doi: 10.5152/eurasianjmed.2025.251160.