Cognitive disengagement syndrome and alexisomia: examining the moderating role of anxiety-depression symptoms, stress, and insomnia symptoms among a sample of Lebanese adults

BACKGROUND: The interplay between body and mind is at the heart of processing bodily states. Alexisomia refers to the lack of somatic awareness, whereas cognitive disengagement syndrome (CDS) is a cluster of symptoms that reflect mental sluggishness, daydreaming, and hypoactivity. Given that interoceptive accuracy relies on attention to internal signals, the hypoactive characteristics of CDS may attenuate interoceptive processing; therefore, individuals with higher CDS traits might show diminished awareness of bodily states. This study investigates the association between CDS and alexisomia, as well as the moderating effect of anxiety-depression symptoms, stress, and insomnia symptoms. METHOD: A cross-sectional study was conducted among 877 Lebanese adults aged 18-70 years, recruited through snowball sampling. Data were collected using a Google Forms questionnaire that included the Adult Concentration Inventory, the Shitsu Taikan Sho Scale, the Stress Numerical Rating Scale, the Patient Health Questionnaire-4, and the Insomnia Severity Index. Of the participants, 64.3% were female, and 35.7% were male. RESULTS: The interaction models were adjusted over the following variables: marital status, education, and living situation. The CDS × anxiety-depression (B = -0.04, p = .011) and CDS × insomnia (B = -0.03, p = .002) interactions were significantly associated with alexisomia, whereas the CDS × stress interaction (B = -0.03, p = .076) was not statistically significant after applying heteroscedasticity-consistent standard errors. At low (-1 SD), mean, and high (+1 SD) levels of anxiety - depression and insomnia, higher CDS levels were significantly associated with higher levels of alexisomia. Additionally, higher levels of anxiety-depression and insomnia symptoms attenuated the positive association between CDS traits and alexisomia. CONCLUSION: Findings highlight an interplay between symptoms of cognitive disengagement and reduced somatic awareness, while emphasizing the importance of accounting for psychological distress and sleep disturbance when studying this relationship. Understanding these interactions provides a foundation for future longitudinal research to further clarify the nature and temporal relationships among these constructs.