Attentional bias toward emotional faces in cognitive disengagement syndrome

Introduction Given the conceptual overlap yet increasing distinction between cognitive disengagement syndrome (CDS) and Attention Deficit/Hyperactivity Disorder (ADHD), this study examined attentional bias toward emotional faces in adults with CDS and compared their patterns with those of individuals with ADHD to clarify distinct attentional processing profiles. Methods Following an initial screening of 1,098 adults using the Barkley Adult ADHD Rating Scale and the Adult Concentration Inventory, 96 participants were recruited and categorized into four groups: CDS only ( n = 35), ADHD only ( n = 21), comorbid CDS and ADHD ( n = 17), and a control group with neither condition ( n = 23). Participants completed a free-viewing eye-tracking task in which pairs of emotional and neutral faces (angry–neutral, sad–neutral, happy–neutral) were presented. Attentional bias was analyzed by distinguishing early orienting (proportion of first fixation) and later attentional maintenance (total dwell time). Results Results indicated that individuals with CDS (CDS only and CDS+ADHD groups) showed a trend toward a lower proportion of first fixations toward angry faces as compared to those without CDS. In addition, individuals with CDS exhibited longer dwell times for all emotional faces. In contrast, individuals with ADHD symptoms (ADHD only and CDS+ADHD groups) demonstrated greater dwell time specifically for angry faces as compared to those without ADHD symptoms. Discussion These findings suggest that CDS may be associated with difficulty detecting angry faces at the early stage of attentional processing and with generalized difficulty disengaging from emotional faces at the later stage. By contrast, ADHD symptoms may be selectively associated with anger-specific attentional bias at the later stage. Overall, the present study suggests that CDS and ADHD may be characterized by distinct patterns of attentional processing in response to emotional faces.