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Understanding the Basics: Executive Function and Dysfunction

Updated: Jun 27

Explore the basics of executive function and dysfunction in this informative blog. Understand the cognitive skills, related conditions, and treatment options.


Written by Sarah Talarico and reviewed by Shawn Horn PsyD, PS


An Asian woman chews on her pencil, looking frustrated at a laptop/computer. This image shows the challenges of executive dysfunction.

What is Executive Function?


Due to the executive function's complex and multifaceted nature, theoretical perspectives, different research focuses, and methodologies, there is no operational definition nor official theory on the concept of executive function. However, it’s generally understood that executive function (EF) refers to a set of cognitive skills that help us make decisions and manage our behavior to fulfill our goals and navigate life successfully. 


Many skills fall into executive function, such as emotional regulation, time management, planning, self-awareness, and task initiation, but the core components of EF are categorized as working memory, inhibition, and cognitive flexibility


Working Memory


Working memory is how we remember and manipulate information. There are two types of working memory: nonverbal (visual-spatial) and verbal (auditory) working memory. Working memory involves reasoning, language, the ability to do math, comprehension, and problem-solving. 


Inhibition


Inhibition, also known as self-control or impulse control, is the ability to manage our impulses to do what’s needed or appropriate despite having a strong internal predisposition or external lure (Diamond, 2013). 


Cognitive Flexibility


Cognitive flexibility helps us shift and adapt to the world around us. This skill allows us to multitask, switch perspectives, pivot our attention, and be flexible with change. Interpersonally, cognitive flexibility allows us to perspective-take, meaning we can see from other people’s points of view. 


Signs of Executive Dysfunction


  • Struggling to focus and often daydreaming or easily distracted

  • Difficulty planning and following through

  • Thinks before acting or speaking, often makes hasty decisions

  • Struggles with multitasking

  • Having trouble organizing and prioritizing

  • Struggle to get or stay motivated

  • Having trouble managing time

  • Having a hard time managing emotions and solving conflict

  • Can't articulate thoughts or feelings

  • Difficulty remembering details or instructions

  • Forgets important dates or deadlines

  • Difficulty estimating time or one's abilities

  • Inflexible with change

  • Ridgid thinking, unable to adapt

  • Unable to understand other's perspective

  • Often misplacing items and forgetting where things are

  • Interrupting others or blurting out during inappropriate times

  • Lack of self-awareness and impact on others

  • Has frequent emotional outbursts or mood swings

  • Difficulty calming down after being upset

  • Socially awkward or inappropriate, not understanding social cues or norms

  • Often procrastinates


Causes of Executive Dysfunction


Anyone can experience challenges with executive function; however, experts have linked executive dysfunction to several conditions, including:

  • Neurodevelopmental disorders:

    • Attention-deficit hyperactivity disorder (ADHD)

    • Autism spectrum disorder (ASD)

    • Schizophrenia

    • Obsessive-compulsive disorder (OCD)

  • Developmental and genetic conditions:

    • Learning disabilities

    • Genetic syndromes such as Down syndrome and fragile X syndrome (FXS)

  • Psychological or psychiatric conditions:

    • Depression

    • Anxiety disorders

    • Bipolar disorder

  • Neurological conditions and neurodegenerative diseases:

    • Traumatic brain injury (TBI)

    • Parkinson's disease

    • Huntington's disease

    • Alzheimer's disease

    • Multiple sclerosis (MS)

    • Stroke

    • Dementia

  • Substance abuse

  • Sleep disorders

  • Chronic stress


Does Executive Dysfunction Ever Go Away?


Treatment largely depends on the underlying cause of executive dysfunction and the varying degrees of severity. For example, treating chronic conditions such as ADHD will only minimize symptoms, but challenges with executive dysfunction are often lifelong. Whereas temporary conditions like depression or anxiety, symptoms of executive dysfunction will eventually diminish with the proper treatment. Brain damage and neurodegenerative diseases are harder to treat, and sometimes the damage may be permanent.


Care and Treatment


Care and treatment options may include:

  • Therapeutic interventions

    • Occupational therapy

    • Psychotherapy such as cognitive behavioral therapy (CBT) and behavioral therapy

    • Coaching such as executive function coaching, ADHD coaching, and organizational coaching

  • Medication

    • Simulant medications for ADHD

    • Antidepressants

    • Antipsychotics

  • Life modifications:

    • Exercise and diet

    • Sleep hygiene


Remember, each individual may express different symptoms, and it’s always best to speak with a healthcare provider so they can devise a treatment plan that is best suited for your needs.


If you have ADHD and are looking for more guidance on how to get your treatment started, read this blog: Empower Yourself: 10 Ways to Advocate for Your ADHD Healthcare Needs


 

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Disclaimer for Inspired Living Blog


The information on the Inspired Living Blog is intended for educational and informational purposes only. It is not meant to replace professional psychological advice, diagnosis, or treatment. While the content on this blog is provided with the utmost care and accuracy regarding mental health and psychological topics, it is not a substitute for professional consultation with a qualified psychologist or healthcare provider.

Readers are advised that the understanding and interpretation of mental health issues are complex and highly individualized. Therefore, the insights and guidance provided on this blog should not be used to diagnose or treat any mental health condition independently. If you are struggling with mental health issues, it is crucial to seek the advice of a licensed professional who can provide you with personalized care and support.


 

References


Barkley, R. A. (2020). Executive functions: What they are, how they work, and why they evolved. Guilford Press.


Cowan, N. (2014). Working memory underpins cognitive development, learning, and education. Educational Psychology Review, 26(2), 197–223. https://doi.org/10.1007/s10648-013-9246-y


Diamond, A. (2013). Executive functions. Annual Review of Psychology, 64, 135–168. https://doi.org/10.1146/annurev-psych-113011-143750


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