The relationship between functional impairment and reward sensitivity, metacognition, psychological resilience, and self-compassion in children and adolescents with sluggish cognitive tempo symptoms

Aim: This study aimed to examine the unique contribution of Cognitive Disengagement Syndrome (CDS) symptoms to functional impairment in children and adolescents. It also investigated whether self-compassion, resilience, reinforcement sensitivity, and metacognitive functioning moderate this association. Material and Method: A total of 221 participants aged 8 to 18 were included in the study, categorized into four groups: CDS, ADHD, CDS+ADHD, and controls. Data were collected using standardized parent- and self-report instruments, including the Barkley Child Attention Scale, Turgay DSM-IV Based Disruptive Behavior Disorders Rating Scale, Weiss Functional Impairment Rating Scale, Revised Children's Anxiety and Depression Scale, Self-Compassion Scale, Reinforcement Sensitivity Theory-Personality Questionnaire–Children, Metacognition Questionnaire for Children and Adolescents, and the Child and Youth Resilience Measure. Results: The highest level of functional impairment was observed in the comorbid CDS+ADHD group. CDS symptoms showed weak to moderate negative correlations with self-compassion, psychological resilience, reward sensitivity, and metacognitive functioning, while no significant association was found with punishment sensitivity. When comorbid psychopathology and individual psychological variables were controlled for, the specific contribution of CDS to functional impairment was either attenuated or no longer statistically significant. Nonetheless, self-compassion, resilience, and reward sensitivity demonstrated a modest yet significant buffering effect on the relationship between CDS symptoms and functional impairment. Conclusion: Although CDS symptoms are associated with clinically meaningful difficulties in various domains of functioning in children and adolescents, their specific and independent effects appear to be generally limited. A multidimensional, integrative approach that considers both psychopathological comorbidity and psychological resources may enhance the clinical understanding and assessment of CDS-related functional outcomes. Key Words: Cognitive Disengagement Syndrome, Functional Impairment, Self-Compassion, Resilience, Reinforcement Sensitivity