Beyond birth status: Psychopathological factors associated with cognitive disengagement syndrome in preterm school-aged children

OBJECTIVE: This study aims to examine psychopathological factors associated with Cognitive Disengagement Syndrome (CDS) in preterm school-aged children, while controlling for the potential confounding effects of inattention, emotional problems, and peer difficulties. METHODS: A comparative cross-sectional design was utilized with 181 children (89 preterm, 92 full-term). Assessment tools included the Turgay DSM-IV-Based Screening Scale, the Barkley Child Attention Scale, and the Strengths and Difficulties Questionnaire (SDQ). Group differences were analyzed using t-tests. A univariate ANCOVA was conducted to assess the effect of prematurity on CDS symptom scores after adjusting for birth weight, age, gender, and psychopathological covariates. RESULTS: The preterm group had significantly lower birth weight and gestational age (p < .001). While no significant difference was found in raw CDS symptom scores between groups (p = .603), preterm children scored significantly higher on the SDQ Peer Problems subscale (p = .002). The ANCOVA model revealed that prematurity status was not independently associated with CDS severity after adjusting for covariates (p = .432). Instead, ADHD-inattention (p < .001), emotional problems (p = .001), and peer problems (p = .004) emerged as significant predictors of CDS severity. CONCLUSION: Prematurity status is not an independent risk factor for CDS in school-aged children. The variance in CDS severity is primarily accounted for by co-occurring psychopathological vulnerabilities, particularly inattention and internalizing social challenges. Clinical evaluations of preterm children should prioritize screening for these associated factors to better manage the risk of cognitive disengagement.