“Spaced Out”? It Could Be Cognitive Disengagement Syndrome

Cognitive disengagement syndrome (CDS), a condition characterized by excessive daydreaming, sluggishness, and difficulty concentrating.¹ While everyone daydreams occasionally, CDS involves a persistent pattern of disengagement that can significantly disrupt daily life, academic performance, and social interactions.

Cognitive disengagement syndrome first emerged in the psychology literature during the 1960s and 1970s when researchers saw that some people displayed persistent patterns of daydreaming, sluggishness, and difficulty focusing.² Initially, it was considered a “sluggish cognitive tempo,” but the term CDS gained traction as researchers recognized the significant impact these symptoms could have on daily functioning.³

Despite growing research, cognitive disengagement syndrome is not yet a formally recognized disorder in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the standard classification of mental disorders used by professionals in the United States.⁴ It shares symptoms similar to attention deficit hyperactivity disorder (ADHD), but accumulating evidence suggests that it is different from ADHD and needs further investigation and clinical attention.¹

CDS versus ADHD

Cognitive disengagement syndrome is often confused with ADHD, but there are key differences. While ADHD involves hyperactivity, impulsivity, and distractibility, cognitive disengagement syndrome is characterized by slow processing speed, making it challenging to engage with information and complete tasks efficiently.⁴

The key difference lies in the starting point of attention. Someone with ADHD can initially focus but is easily distracted and shifts their attention. Someone with cognitive disengagement syndrome struggles to focus from the very beginning. This difficulty engaging with the present can manifest in several ways:^1-6

• Mental fog: Individuals with cognitive disengagement syndrome often describe feeling spaced out, mentally fuzzy, or as if they’re in a dreamlike state. This can make it hard to follow conversations, absorb information, or even just stay aware of their surroundings.
• Sluggishness: This goes beyond just feeling tired. People with the syndrome experience a slowness in their mental and physical processes, leading to difficulty initiating tasks, slow reaction times, and a general sense of lethargy.
• Daydreaming: While everyone daydreams, people with cognitive disengagement syndrome experience excessive and intrusive daydreams that interfere with their daily life. These daydreams can be vivid and elaborate, making it hard to disengage from them and return to reality.
• Difficulty with working memory: This affects the ability to hold information in mind while using it, making it challenging to follow multi-step instructions, solve problems, or engage in complex tasks.

It’s important to note that cognitive disengagement syndrome and ADHD can sometimes co-occur, making diagnosis and treatment more complex.

Recognizing cognitive disengagement syndrome

Although not yet officially recognized as a distinct disorder, research suggests CDS may be as prevalent as ADHD, which affects about 5-7% of children.⁵ Diagnosis typically involves questionnaires and behavioral observations, as there are no official diagnostic criteria.

Treatment options are still evolving, but cognitive behavioral therapy (CBT) is often used to help individuals develop coping strategies and improve focus.⁶ Lifestyle adjustments, such as prioritizing sleep and regular exercise, can also be beneficial.

Raising awareness about this condition is crucial to combat stigma and ensure that individuals receive appropriate support and treatment. If you suspect you or someone you know may be experiencing it, it’s important to consult with a healthcare professional for proper evaluation and guidance.

References

1. Fredrick JW, Jacobson LA, Peterson RK, Becker SP. Cognitive disengagement syndrome (sluggish cognitive tempo) and medical conditions: a systematic review and call for future research. Child Neuropsychol. 2024 Jul;30(5):783-817. doi: 10.1080/09297049.2023.2256052. Epub 2023 Sep 15. PMID: 37712631; PMCID: PMC10940202.
2. Becker, S.P., Marshall, S.A. and McBurnett, K. (2013) ‘Sluggish cognitive tempo in abnormal child psychology: An historical overview and introduction to the special section’, Journal of Abnormal Child Psychology, 42(1), pp. 1–6. doi:10.1007/s10802-013-9825-x. 
3. Fredrick JW, Becker SP. Cognitive Disengagement Syndrome (Sluggish Cognitive Tempo) and Social Withdrawal: Advancing a Conceptual Model to Guide Future Research. J Atten Disord. 2023 Jan;27(1):38-45. doi: 10.1177/10870547221114602. Epub 2022 Aug 4. PMID: 35927980.
4. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders [Preprint]. doi:10.1176/appi.books.9780890425596. Fredrick JW, Becker SP. Personality Traits in Relation to Cognitive Disengagement Syndrome and ADHD Inattention in Two Samples of Children. J Clin Child Adolesc Psychol. 2024;53(3):460-472. doi:10.1080/15374416.2024.2316707
5. Cortese S, Song M, Farhat LC, Yon DK, Lee SW, Kim MS, Park S, Oh JW, Lee S, Cheon KA, Smith L, Gosling CJ, Polanczyk GV, Larsson H, Rohde LA, Faraone SV, Koyanagi A, Dragioti E, Radua J, Carvalho AF, Il Shin J, Solmi M. Incidence, prevalence, and global burden of ADHD from 1990 to 2019 across 204 countries: data, with critical re-analysis, from the Global Burden of Disease study. Mol Psychiatry. 2023 Nov;28(11):4823-4830. doi: 10.1038/s41380-023-02228-3. Epub 2023 Sep 8. PMID: 37684322.
6. Lopez PL, Torrente FM, Ciapponi A, et al. Cognitive-behavioural interventions for attention deficit hyperactivity disorder (ADHD) in adults. Cochrane Database Syst Rev. 2018;3(3):CD010840. Published 2018 Mar 23. doi:10.1002/14651858.CD010840.pub2