Early adversity, executive function, and the development of cognitive disengagement syndrome: a sex-specific...

Despite growing recognition of cognitive disengagement syndrome (CDS), the developmental mechanisms linking early adversity to CDS symptoms remain largely unknown. This study addresses this gap by examining whether executive function (EF) serves as a cognitive mechanism linking cumulative adverse childhood experiences (ACEs) to later CDS symptoms and whether this mediational chain differs by adolescent sex.

Data were drawn from the prospective longitudinal Adolescent Brain Cognitive Development (ABCD) Study®. The final analytic sample included 4,678 adolescents (52.5% male) identifying primarily as White (72.5%), Hispanic/Latino (13.6%), and Black (13.1%). A moderated mediation model was tested using cumulative ACEs score (ages 9-11) as the predictor, EF deficits (ages 12-13) as the mediator, CDS symptoms (ages 13-14) as the outcome, and adolescent sex as moderator.

Results indicate cumulative ACEs predict later CDS symptoms above and beyond baseline levels. EF deficits partially mediated the ACEs-CDS link (accounting for 30% of the effect). Notably, adolescent sex moderated the EF-CDS pathway; while adversity impacted EF similarly across sexes, the association between EF deficits and CDS symptoms was significantly stronger for female adolescents.

These findings provide the first prospective evidence that early adversity accelerates CDS development via disruptions in executive functioning. The results support a developmental psychopathology model of CDS and identify EF as a potentially modifiable intervention target, particularly for female adolescents exposed to early adversity.