Executive functioning is a form of cognitive control. It involves planning, prioritizing, impulse control, and other high-level forms of cognition. Like an executive running a business, executive functioning allows a person to coordinate their resources in order to achieve a goal. When one’s executive functioning skills are impaired, a person is said to have executive dysfunction.
Many learning disorders and cognitive disabilities undermine executive functioning. For example, people with dementias such as Alzheimer’s may have trouble with keeping track of recent information. People with ADHD may struggle to organize their thoughts or control their impulses. A licensed therapist can help individuals manage executive dysfunction symptoms and treat any underlying issues.
What is Executive Functioning?
Researchers have developed several different (and occasionally competing) models of executive functioning. Mental health experts do not rely on a single definition of executive functioning. In general, executive functioning refers to high-level cognitive processes such as:
- Directing one’s attention. This control includes prioritizing attention and shifting attention from one task to another.
- Regulating emotions. For instance, someone with high executive function may continue to work in spite of anxiety.
- Controlling one’s impulses. For example, people with poor executive functioning may struggle to sit still or resist the temptation to speak over others.
- Utilizing working memory. This is the ability to keep track of information necessary to complete a task. Reading, putting together a puzzle, and following directions all involve working memory.
- Planning and organization. Prioritizing daily tasks, following a schedule, or gathering supplies for a project all rely on executive functioning.
- Self-monitoring. This is the ability to assess one’s own performance as compared to a specific standard. For example, a person might assess whether they are talking too little or too much in a conversation.
Executive functioning plays a key role in almost all skills, from studying for a test to having a conversation with a loved one. Executive dysfunction can undermine daily functioning and make it difficult to master new concepts and skills. Executive functioning is also a skill in its own right. People who struggle with executive function are often able to improve their performance with practice, cognitive management strategies, and the right working environment.
Signs of Executive Dysfunction
Most people experience executive dysfunction from time to time, often due to stress, boredom, or fatigue. The frustrating experience of “losing” one’s keys, only to find they’ve been in one’s hands all along, is a common experience. It is common to have occasional interruptions to executive functioning. These moments don’t necessarily mean a person has an underlying mental health or neurological condition.
Executive dysfunction becomes a clinical issue when it affects daily life. Some signs of clinical executive dysfunction include:
- Chronic trouble multi-tasking.
- Frequent loss of concentration.
- Immense difficulty with planning and organization, such as never being able to leave the house with everything one needs on the first exit.
- Impulsive behavior.
- Difficulty assessing one’s own behavior, or a tendency to deviate from social norms. For instance, a person who shares excessively personal details to acquaintances may struggle with executive function.
- Difficulties with decision-making.
- Chronic procrastination or low motivation.
- Trouble remaining on task. For example, a person writing a paper may have numerous windows open on their web browser and continually switch back and forth between dozens of screens.
- Difficulty regaining focus after a distraction. For example, a person might take 20 minutes to get back to their work after a sudden phone call.
A person is more likely to have clinical executive dysfunction if these symptoms frequently appear, significantly intrude upon daily functioning, or don’t get better with rest and focus.
A wide range of tests can assess for executive dysfunction, as well as the conditions that are most likely to cause it. The right test depends on the type of executive dysfunction a person has and whether a doctor suspects a specific underlying diagnosis. For example, a clock-drawing test is one of the first tests doctors use to assess for dementia. This test measures executive functioning and memory, as well as other cognitive impairments.
What Causes Executive Dysfunction?
Executive dysfunction is not a diagnosis. Instead, it is a symptom that may signal a host of mental health or neurological conditions. Some common causes of executive dysfunction include:
- Traumatic brain injuries, tumors, and other forms of brain damage. Imaging scans suggest damage to the basal ganglia and/or frontal cortex often affects executive functioning
- Dementias such as Alzheimer’s, frontotemporal dementia, and vascular dementia
- Drug addiction
- Attention deficit hyperactivity (ADHD) and other developmental disabilities
- Obsessive Compulsive Disorder (OCD)
Executive functioning can also be context dependent. Distraction, exhaustion, boredom, and stress can all undermine executive functioning. For example, a harried parent rushing a child to school may struggle to remember schedules and control their own behavior than a person having a relaxing, low-stress morning. If a person already has executive dysfunction issues, stress can make their symptoms worse.
A number of strategies can help with executive dysfunction, including medication and therapy. Some people find that organizational aids, mindfulness, and assistive devices can help. If you experience executive dysfunction, a licensed therapist can help you determine which strategies would suit you best.
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