Food insecurity is associated with cognitive disengagement in adolescents

Adolescents who live in food-insecure households may be more likely to experience symptoms of cognitive disengagement, such as excessive daydreaming, confusion, and sluggish thinking, according to new research published in Research on Child and Adolescent Psychopathology. In contrast, the study found no clear relationship between food insecurity and symptoms of attention-deficit/hyperactivity disorder (ADHD), despite some previous studies suggesting a link. These findings suggest food insecurity may affect mental health in subtle and under-recognized ways, particularly through its relationship with cognitive disengagement syndrome, a condition closely related to but distinct from ADHD.

ADHD is one of the most common mental health conditions in childhood, typically involving high levels of inattention, impulsivity, and hyperactivity. Researchers have long studied how environmental stressors might contribute to these symptoms, and nutrition has emerged as a key area of interest. Food insecurity — defined as limited or uncertain access to adequate food — is one such stressor, affecting nearly 14 million households in the United States.

More than half of these households include children. Although earlier studies have linked food insecurity to behavioral and emotional problems in children, few have investigated how it relates to ADHD. Even fewer have looked at how food insecurity might relate to symptoms of cognitive disengagement syndrome, a condition marked by mental confusion, hypoactivity, and persistent daydreaming. This study aimed to address these gaps.

Researchers at Cincinnati Children’s Hospital Medical Center conducted the study with a group of 136 adolescents between the ages of 10 and 12. Participants and their caregivers were recruited through social media, community postings, and hospital networks. Roughly half of the participants had a formal diagnosis of ADHD. To be included in the study, children had to meet basic criteria including a minimum score on a vocabulary test and the ability to complete study tasks in English. Adolescents with more severe developmental or psychiatric disorders were excluded.

To measure food insecurity, parents answered two questions from a national screening tool assessing whether their household had worried about running out of food or had experienced food shortages over the past year. These responses were combined into a single score, with higher scores indicating more severe food insecurity. About 15 percent of the sample met the criteria for experiencing food insecurity, a rate nearly identical to national averages.

To measure symptoms of ADHD and cognitive disengagement syndrome, the researchers used standardized questionnaires filled out by three informants: parents, teachers, and the adolescents themselves. These surveys asked about specific behaviors related to attention problems, hyperactivity, and cognitive disengagement symptoms like frequent daydreaming, getting lost in thought, or seeming mentally confused. The team also accounted for factors like age, sex, race, ethnicity, psychiatric medication use, and family income.

Initial statistical analyses showed that food insecurity was significantly related to higher levels of cognitive disengagement symptoms across all three reporting sources: parents, teachers, and the adolescents themselves. These associations held up even after accounting for differences in age, sex, race, ethnicity, and medication use. However, once family income was included in the models, only the teacher- and adolescent-reported cognitive disengagement symptoms remained significantly associated with food insecurity. Parent-reported symptoms no longer showed a unique association.

Importantly, none of the ADHD symptom scores were significantly linked to food insecurity when all other factors were taken into account. This held true for both dimensions of ADHD: inattentiveness and hyperactivity/impulsivity. The only exception was a modest correlation between teacher-reported inattention and food insecurity, which did not hold up in the full statistical models. Similarly, food insecurity was not associated with symptoms of anxiety or depression reported by any informant.

These results suggest that food insecurity may be more strongly associated with internal, withdrawn forms of mental disengagement than with the outwardly visible behaviors typical of ADHD. One possibility is that food insecurity, through its effects on diet quality and stress, may impair cognitive functions like focus and attention in subtle ways that manifest as daydreaming or mental fog. Research shows that proper nutrition is important for brain development and cognitive functioning, and hunger or poor diet could contribute to the kinds of slow, internally focused thinking seen in cognitive disengagement syndrome.

Another explanation may involve how children psychologically respond to the stress of food insecurity. Adolescents are more aware of family hardships than younger children and may cope with distress by turning inward. Qualitative research suggests that some children respond to hunger by retreating into imagination, even creating imaginary friends or fantasizing about food to comfort themselves. Such coping strategies could increase the likelihood of behaviors that resemble the symptoms of cognitive disengagement.

Sleep could also be an important link. Studies in adults and young children have found that food insecurity can disrupt sleep, and other research has shown that poor sleep quality is associated with more pronounced symptoms of cognitive disengagement. In this view, food insecurity may impact adolescents’ mental functioning by interfering with sleep, which in turn contributes to greater cognitive sluggishness and disconnection from the external world.

Despite these insights, the study had several limitations. The research design was cross-sectional, meaning that all data were collected at one time. This limits the ability to determine whether food insecurity causes cognitive disengagement symptoms or whether another underlying factor explains both. The food insecurity measure was brief and based solely on caregiver reports, which may differ from how adolescents themselves perceive and are affected by food-related hardship. Moreover, the study sample came from relatively well-educated and higher-income families, with only a small proportion reporting food insecurity. This means the findings might not fully apply to more economically vulnerable populations, where the effects of food insecurity may be more pronounced.

Even so, the study makes an important contribution by identifying a potential relationship between food insecurity and a form of mental disengagement that has received little attention in the context of socioeconomic hardship. The findings suggest that cognitive disengagement syndrome may be especially sensitive to environmental stressors like food insecurity, even when accounting for family income and ADHD symptoms.

The study, “Examining ADHD and Cognitive Disengagement Syndrome Symptoms in Relation to Food Insecurity in Early Adolescents,” was authored by Cathrin D. Green, Andrew C. Martinez, and Stephen P. Becker.