A look at “Cognitive-behavioral and mindfulness-based cognitive therapies for adults with attention-deficit/hyperactivity disorder and cognitive disengagement syndrome: a randomized controlled trial” by Leila Kamran, Seyed Mousa Golestaneh, Ali Pakizeh and Sooran Rajabi (2026)
In “Head in the Clouds: Cognitive Disengagement, ADHD and Knowing What You Feel”, we met cognitive disengagement syndrome (CDS): the dreamy, foggy, slowed-down pattern of attention that often overlaps with ADHD. Most ADHD research focuses on the restless, impulsive side, so the foggy-headed daydreamers can get overlooked. This Iranian trial asked whether two talking therapies might help with both.
What they found
The researchers screened 690 university students and selected 60 who met criteria for ADHD traits along with signs of CDS. They randomly assigned them to one of three groups of 20.
- CBT (cognitive behavioural therapy), focusing on organisation, time management, problem-solving and challenging unhelpful thoughts.
- MBCT (mindfulness-based cognitive therapy), combining mindfulness practice with cognitive techniques to notice and gently redirect attention.
- A waiting list, which received no treatment during the study.
The headlines:
- Both therapies helped compared with waiting. People in both therapy groups reported greater reductions in ADHD and CDS traits.
- The clearest gains were in inattention and the “fog” of CDS, and these were largely maintained two months later.
- Effects on hyperactivity and impulsivity were smaller.
- No clear winner. There were no significant differences between CBT and MBCT, though the authors are careful to say this doesn’t prove they’re equally effective.
A grain of glitter ✨
It’s encouraging to see a randomised trial that takes CDS seriously, and the authors are admirably cautious in their conclusions. But this is very much a small, preliminary study.
With only 20 people per group, the trial was too small to detect anything but large differences. Participants were university students identified through a screening questionnaire rather than a full clinical diagnostic assessment, which may not reflect the wider adult ADHD population. All outcomes were self-reported, and since participants knew which group they were in, expectations could have influenced their answers. Comparing therapy with a waiting list tends to make therapies look better than comparing them with another active treatment would. And two months is a short follow-up.
Why this matters
If you’re an ADHDer who identifies more with the foggy daydreamer than the bouncing-off-the-walls stereotype, there’s growing recognition of your experience, and early evidence that therapy can help. Both structured CBT and mindfulness-based approaches may make a difference, so you can choose what feels like the better fit for you. A therapist familiar with ADHD can help tailor either approach.
Even the cloudiest unicorn can learn to find its way through the mist, one mindful hoofstep at a time.