Overview
This lecture introduces Cognitive Disengagement Syndrome (CDS), formerly known as Sluggish Cognitive Tempo (SCT), describing its symptoms, history, diagnostic challenges, and how it differs from ADHD and other disorders.
Introduction to Cognitive Disengagement Syndrome (CDS)
- CDS is a distinct attention disorder, previously called Sluggish Cognitive Tempo (SCT).
- The term was changed to reduce negative stigma and better reflect the condition's characteristics.
- CDS is sometimes misdiagnosed as ADHD or ADD, but differs in key symptoms and presentation.
Main Symptoms of CDS
- CDS involves mental confusion, frequent daydreaming, and a "spacey" appearance.
- Individuals may appear drowsy, mentally foggy, or disconnected from their surroundings.
- Episodes include low motor activity, sluggish responses, passivity, and lethargy.
- CDS symptoms are episodic, typically occurring during disengagement from the environment.
History and Research
- Early descriptions date back to the 1700s and 1800s, with scientific research starting in the 1980s.
- CDS symptoms were identified as a separate construct from ADHD in research studies.
- Earlier terms like "ADD without hyperactivity" have been abandoned.
Diagnostic Challenges and DSM Issues
- CDS is not officially recognized in the DSM, leading clinicians to classify it under the inattentive presentation of ADHD or use outdated terms.
- About 30–50% of those diagnosed with inattentive ADHD may actually have CDS.
- ADHD presentations include hyperactive, inattentive, and combined, but CDS does not fit well in these categories.
Criteria for Identifying a New Disorder
- Key criteria include a distinct symptom set, unique comorbidity patterns, different demographics, cognitive deficits, developmental course, etiologies, family history, biological markers, and treatment responses.
- Research shows that CDS meets many of these criteria, supporting its identity as a distinct disorder.
Symptom Structure and Differentiation
- CDS symptoms form two dimensions: cognitive (daydreaming, confusion) and motor (hypoactivity).
- Symptoms are stable over time and differ from those of ADHD and other disorders like depression, anxiety, or conduct disorder.
- CDS is somewhat correlated with inward, ruminative thinking typical of depression but remains a distinct syndrome.
Relation to Other Disorders
- CDS overlaps slightly with disorders involving pathological daydreaming but is distinct from depression based on network analysis studies.
Key Terms & Definitions
- Cognitive Disengagement Syndrome (CDS) — An attention disorder marked by daydreaming, mental confusion, and low motor activity.
- Sluggish Cognitive Tempo (SCT) — Former name for CDS, now avoided due to stigma.
- DSM (Diagnostic and Statistical Manual of Mental Disorders) — Guide for diagnosing mental disorders.
- Inattentive Presentation — A subtype of ADHD with predominant inattention symptoms.
Action Items / Next Steps
- Review the full research article on CDS in the Journal of the American Academy of Child and Adolescent Psychiatry.
- Prepare for the next lecture on cognitive differences between CDS and ADHD.