Cognitive Disengagement Syndrome: Changes in Severity, Comorbid Conditions, and Impairment from Childhood to Adolescence.

An international Cognitive Disengagement Syndrome (CDS) Work Group noted it remains unclear whether CDS worsens or becomes more impairing with age, which we tested in community and referred samples. Mothers rated their children on the Pediatric Behavior Scale (assessing CDS, ADHD, autism, oppositional defiant disorder, conduct problems, anxiety, depression, social impairment, and academic impairment) in a community sample (N = 376, 6-12 years at baseline re-evaluated a mean of 8 years later) and a referred sample with autism and/or ADHD (N = 1,601, 6-17 years). In the community sample (Study 1), CDS mean scores decreased from childhood to adolescence in youth with childhood CDS, yet were still clinically elevated in adolescence. At the individual level, 70% improved, 26% worsened, and 4% were unchanged. Mean psychopathology/impairment scores also improved in youth with childhood CDS. For youth without childhood CDS, change in CDS scores was nonsignificant. All psychopathology/impairment scores in childhood and in adolescence were above the population mean for youth with childhood CDS and were below the mean for youth without childhood CDS. In the referred ADHD/autism sample (Study 2), CDS was also associated with increased psychopathology/impairment. Adolescents had higher CDS scores than children, but effect sizes were small, as were correlations with age. In conclusion, CDS was associated with psychopathology/impairment in the community and referred ADHD/autism samples. Mean CDS and psychopathology/impairment scores improved over time for youth with childhood CDS, but were still clinically elevated in adolescence, underscoring the need for ongoing monitoring and support.