Rethinking the Assessment and Diagnosis of ADHD

The aim of this symposium is to provide data to encourage reflection on how to conduct and interpret the diagnosis of ADHD, based on the consolidation of the “Cognitive Disengagement Syndrome” (CDS) dimension across all developmental stages, including adulthood. First, the similarities and differences between CDS and ADHD measures will be presented, not only in childhood and adolescence but also in adulthood. In recent years, intensive research on CDS has made it quite clear that, on the one hand, when CDS and inattentive ADHD are assessed using parent, teacher, and self-report scales, both dimensions significantly overlap. However, on the other hand, it is equally true that they present different clinical validity.  

In other words, their impact on children’s behavior and daily life is not the same. The attentional difficulties characteristic of children with CDS include a tendency to daydream, appear drowsy, confused, and mentally scattered. These difficulties are also associated with a noticeably slowed motor and cognitive pace, yet they do not involve behavioral problems. CDS is linked to symptoms of anxiety and depression: these children (and adults) tend to be withdrawn and shy, do not disrupt or interrupt, but carry a future risk factor for emotional disorders. Thus, although CDS is not a recognized diagnosis—and it is unclear whether it should be—it has proven to be a relevant psychopathological dimension that also deserves analysis in the search for more specific and effective treatments.