March 10, 2026

554. ADHD, Sluggish Cognitive Tempo, and Cognitive Disengagement Syndrome

49 minutes

Would you rather read the transcript? Click here.

In this episode, I dive into the evolving understanding of Cognitive Disengagement Syndrome (CDS), formerly known as sluggish cognitive tempo. I explain why we are moving away from the older terminology toward a label that more accurately describes the internal mechanisms of the brain. We explore the neurobiological differences between CDS and traditional ADHD, specifically looking at the posterior attention system and the default mode network. I share how these differences manifest in clinical testing, such as the slow and accurate profile on processing speed tasks, and offer concrete tips for adjusting your assessment battery. We also touch on why traditional stimulant medications might not be the first line of defense for these individuals and what environmental primers might work better to wake up their attention systems.

Main Topics Discussed

00:01 Introduction to the transition from sluggish cognitive tempo to Cognitive Disengagement Syndrome.

02:28 Defining CDS as a mental disengagement from the external environment.

04:54 Analyzing the 2022 Becker meta-analysis and the distinction between CDS and ADHD symptoms.

06:30 Neurobiology: Frontal-striatal circuits versus the posterior attention system and default mode network.

07:20 Differentiating CDS from predominantly inattentive and combined ADHD presentations.

08:45 The orienting network versus the executive control network in cognitive profiles.

09:38 Identifying the slow and accurate pattern in cognitive testing data.

11:15 Clinical recommendations: Rating scales, environmental primers, and medication considerations.

Cool Things Mentioned

The Testing Psychologist mastermind groups and business consulting

Reverb: the premier AI-powered report-writing platform for testing psychologists

Featured Resources

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About Dr. Jeremy Sharp

I’m a licensed psychologist and Clinical Director at the Colorado Center for Assessment & Counseling, a private practice that I founded in 2009 and have grown to over 20 clinicians. I earned my undergraduate degree in Experimental Psychology from the University of South Carolina before getting my Master’s and PhD in Counseling Psychology from Colorado State University. These days, I specialize in psychological and neuropsychological evaluation with kids and adolescents.

As the host of the Testing Psychologist Podcast, I provide private practice consulting for psychologists and other mental health professionals who want to start or grow psychological testing services in their practices. I live in Fort Collins, Colorado with my wife (also a therapist) and two young kids.

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