Exploring the impact of trauma exposure on cognitive disengagement syndrome (CDS) in Black and/or Latiné youth with ADHD: a multilevel investigation

Youth with cognitive disengagement syndrome (CDS) report experiencing a decoupling or disengagement of effortful mental process from their external environment and hypoactivity. To many familiar with trauma, these symptoms are similar to post-traumatic dissociation, yet there is limited research on CDS and trauma experiences. Black and/or Latiné youth are often excluded from research despite experiencing higher levels of trauma than peers. Thus, the present study examined how CDS is associated with trauma for Black and/or Latiné youth with attention-deficit/hyperactivity disorder (ADHD). This is the first study to examine individual (e.g. PTSD, perceived stress, developmental trauma), community (i.e. community violence, COVID19), and systemic level trauma (i.e. discrimination) and their associations with CDS. Participants were 50 Black and/or Latiné adolescents with ADHD. Path analyses were conducted to assess how different aspects of trauma affected CDS symptom severity. One hundred percent of youth reported at least one trauma exposure. 20% of the sample had PTSD and 7 participants were provided a diagnosis of developmental trauma disorder (DTD) on their integrated report (14%). ADHD inattention, perceived stress, daily and lifetime discrimination, COVID19, and PTSD were moderately associated with CDS. The second path analysis only included the six factors of DTD, with affect regulation and physiological factors being moderately, positively associated with CDS and attachment factor being moderately, negatively associated with CDS. It is necessary to assess for trauma at the individual symptom level, community level, and systems level in Black and/or Latiné youth with ADHD who also experience high levels of CDS.