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. 2025 Feb;53(2):151-161.
doi: 10.1007/s10802-024-01281-y. Epub 2025 Jan 9.

Cognitive Disengagement Syndrome and Autism Traits are Empirically Distinct from each Other and from Other Psychopathology Dimensions

Susan D Mayes  1 , Stephen P Becker  2 , Daniel A Waschbusch  3
Affiliations

Cognitive Disengagement Syndrome and Autism Traits are Empirically Distinct from each Other and from Other Psychopathology Dimensions

Susan D Mayes et al. Res Child Adolesc Psychopathol. 2025 Feb.

Abstract

Recently, an association between cognitive disengagement syndrome (CDS), formerly sluggish cognitive tempo, and autism has been documented, but it is not known if the association is due to overlapping autism and CDS traits or if CDS is empirically distinct from autism. Mothers rated 2,209 children 4-17 years (1,177 with autism, 725 with ADHD-Combined type, and 307 with ADHD-Inattentive type) on the Pediatric Behavior Scale. Factor analysis of the Pediatric Behavior Scale items indicated that CDS and autism traits are empirically distinct from each other without cross-loading and are distinct from eight other factors (attention deficit, impulsivity, hyperactivity, oppositional behavior, irritability/anger, conduct problems, depression, and anxiety). CDS total scores were significantly higher in the autism + ADHD-Inattentive and autism + ADHD-Combined groups than in the autism, ADHD-Combined, and ADHD-Inattentive only groups with a nonsignificant difference between the latter three groups. CDS and autism are empirically distinct from each other and from other psychopathology dimensions. Overlapping traits do not explain the association between autism and CDS. Autism in combination with ADHD-Combined or ADHD-Inattentive increases the likelihood of CDS relative to youth who have autism, ADHD-Combined, or ADHD-Inattentive only. Because of the known associations between autism, CDS, and ADHD, both autism and ADHD must be assessed in CDS research and clinically to better understand and explain research findings and provide targeted clinical intervention.

Keywords: ADHD; Autism; Cognitive disengagement syndrome; Psychopathology dimensions; Sluggish cognitive tempo.

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Conflict of interest statement

Declarations. Research Involving Human Participants: The research was conducted in accordance with the ethical standards of the authors’ Institutional Review Board and with the 1964 Helsinki Declaration and its later amendments. Ethics Approval: The study was approved by the Penn State College of Medicine Institutional Review Board. Informed Consent: Out study is a retrospective analysis of existing clinical data. The Institutional Review Board waived informed consent for this retrospective analysis. Conflicts of Interest: The authors declare they have no conflicts of interest.

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