How do cognitive disengagement syndrom symptoms in ADHD affect executive functions while reducing psychological flexibility?

Abstract

Objective: This study aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) symptoms and executive functioning, cognitive flexibility, and psychological flexibility in adolescents diagnosed with Attention-Deficit/Hyperactivity Disorder (ADHD). Method: A total of 101 adolescents with ADHD were recruited and divided into two groups based on CDS symptom presence, evaluated using the Barkley Child Attention Scale. Participants completed the Cognitive Flexibility Scale and the Psychological Flexibility Scale, while executive functions were assessed using the Stroop TBAG test. Results: Adolescents with CDS symptoms demonstrated significantly lower psychological flexibility compared to those without CDS (p =.022), although cognitive flexibility levels did not differ significantly between groups. Regression analyses revealed that specific sub-dimensions of psychological flexibility—such as Values and Defusion—significantly predicted cognitive flexibility in both groups, but different components stood out across groups. Additionally, mediation analyses showed that cognitive flexibility did not significantly mediate the relationship between CDS status and Stroop 5 performance indicators (errors, corrections, time). However, in the CDS(+) group, higher psychological flexibility was associated with fewer Stroop 5 errors, suggesting a potential protective role in executive functioning. Conclusion: These findings highlight the differential impact of CDS symptoms on psychological flexibility and executive functioning in adolescents with ADHD. They suggest that tailored interventions aimed at enhancing psychological flexibility may improve cognitive outcomes, particularly in individuals exhibiting CDS traits.