Auditory processing and attention profiles in adolescents with cognitive disengagement syndrome and attention-deficit/hyperactivity disorder.

This study examined auditory processing (AP) and selective attention in adolescents with cognitive disengagement syndrome (CDS), attention-deficit/hyperactivity disorder (ADHD), and controls. Participants were 61 adolescents (CDS: n = 20; ADHD: n = 20; ages 12-18) recruited from a child psychiatry clinic, and 21 controls recruited from other hospital outpatient clinics. AP was assessed with the experimental Auditory Selective Attention Task, which included monaural and dichotic listening trials measuring accuracy and reaction time (RT). Executive and attentional symptoms were evaluated with the Barkley Deficits in Executive Functioning Scale; the Swanson, Nolan, and Pelham, Version IV; and the Barkley Child Attention Scale. Both CDS and ADHD groups showed significantly lower AP accuracy than controls (e.g., dichotic percent correct: H = 18.54, p < .001), with no differences between the clinical groups. However, adolescents with CDS exhibited greater executive dysfunction and inattention than those with ADHD (all ps < .05). Regression analyses controlling for gender and diagnostic group identified significant associations only for dichotic listening: higher inattention and poorer self-restraint predicted lower accuracy and slower RTs. No significant relationships were found for monaural tasks. Preliminary findings suggest that CDS does not involve additional basic AP deficits beyond ADHD but is characterized by broader executive and emotional difficulties. Overall, results support a dimensional view, indicating that difficulties in complex auditory contexts reflect higher-order executive control rather than sensory processing.