Executive Dysfunction Treatment
Intro
Executive Functioning is the ability to make decisions, solve problems, and manage emotions. Strong executive functioning skills make it more likely that you will have a better quality of life, both mentally and physically.
Deficiencies in executive functioning can cause long-term problems. Executive dysfunction or Executive functioning disorders impact the brain’s command center, disrupting the mental skills that help us plan, organize, focus, and manage daily responsibilities.[1]
Key Points
- Executive functioning disorders disrupt the brain’s ability to plan, organize, and manage daily responsibilities, often co-occurring with conditions like ADHD, anxiety, and depression.
- Executive function disorder and executive processing disorder are interchangeable terms describing the same challenges with cognitive tasks and daily functioning.
- There are three main kinds of executive functioning skills: working memory, cognitive flexibility, and inhibition control.
Types of Executive Functioning Skills
There are three main kinds of executive functioning skills: working memory, cognitive flexibility, and inhibition control.
Working Memory: Working memory is the type of memory that stores information while a person is working with it. Working memory can also help organize thoughts for storage in long-term memory. For example, if someone dictates a grocery list to you, working memory allows you to temporarily remember the items the person is naming so that you can write them down. This memory may not exist in 10 minutes, but it is sufficient for the task at hand.
Cognitive Flexibility: Cognitive flexibility refers to the ability to switch gears when thinking about something. This can be seen when multitasking or understanding two different meanings a word can have. Empathy is another form of cognitive flexibility, as you can see things from another person’s point of view.
Inhibition Control: Inhibition control is the ability to focus on one thing rather than another, as when you block out noises to focus on the task at hand. This function also helps you decide which impulses to act on, keeping you (hopefully) from lashing out with aggression any time you get angry.
Causes of Executive Function Disorder in Adults
Executive functioning skills start developing in infants as they learn to remember faces and regulate their emotions with help from their caregivers. As people develop, their executive functioning skills get better, peaking when adults are in their 30s. At this stage, adults should be able to plan ahead, solve problems, and think critically.
Sometimes people experience deficiencies in executive functioning. These deficiencies can be caused by factors like brain chemistry or structure, mental health disorders, or brain damage.
Brain Chemistry/Structure: Irregular brain structures or slower brain growth can result in executive functioning deficiencies, especially in the parts of the brain that deal with memory and decision-making, like the amygdala and prefrontal cortex. Irregularities in neurotransmitters like serotonin and dopamine are also associated with executive dysfunction.
Mental Health: Executive dysfunction is often associated with conditions like ADHD, autism, addictions, depression, and anxiety. All these mental health disorders connect to the way a person’s brain works.
Brain Damage: Brain damage can also cause executive function problems. This might be due to traumatic injury, but it can also be caused by degenerative diseases that affect the brain, like Alzheimer’s.
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Symptoms of Executive Dysfunction
Executive functioning deficiency or executive dysfunction can be exhibited by the following symptoms:
- Trouble planning ahead.
- Difficulty with time management.
- Excessive distractibility.
- Difficulty memorizing things.
- Trouble starting tasks.
- Trouble switching tasks.
- Inability to motivate oneself to do uninteresting tasks.
- Daydreaming.
- Forgetting things.
- Speaking without thinking first.
Effects of Executive Functioning Deficiency
Executive functioning deficiency can greatly affect a person’s daily life. Without the ability to concentrate or focus, a person may have difficulty completing even simple daily tasks, especially if they struggle with motivation. If a person is unable to manage their time or plan ahead, they may have trouble with working certain kinds of jobs.
These issues can also affect relationships, as having a partner, parent, or child who continually forgets things or speaks without thinking can be frustrating.
Diagnosis of Executive Dysfunction
There are several tests that can help a medical practitioner assess whether you have executive dysfunction.
Barkley Deficits in Executive Functioning Scale: This test measures things like organization, self-restraint, motivation, emotional control, and time management. It is based on both a self-reported questionnaire as well as a questionnaire someone close to you fills out.
The Conners Comprehensive Behavior Rating Scale (CBRS): This multiple-choice rating scale helps screen children for ADHD symptoms, which include executive functioning deficiencies. The child, parent, and teacher will all fill out separate questionnaires.[2]
Comprehensive Executive Function Inventory: This scale also measures executive functioning skills in children 5-18. The child, parent, and teacher will all fill out separate questionnaires.
Stroop Color and Word Test: This test measures inhibition control and things that might affect reading ability in both children and adults.
Executive Dysfunction Treatment
Treatment for executive dysfunction depends on the causes of it. In general, if the executive function deficiency is caused by a mental health disorder, treating the disorder with medication and/or therapy will solve the executive function problems.
If you have a chronic condition that needs management like ADHD, a therapist might help you learn specific coping strategies like making lists or breaking large tasks into small ones.
Frequently Asked Questions About Executive Function Disorder
How does executive dysfunction contribute to addiction, and what are the signs I should look for?
Executive dysfunction significantly increases addiction risk because it impairs the brain’s ability to make sound decisions, control impulses, and learn from consequences. In people with substance use disorders, you might notice impulsivity around substance use, inability to prioritize recovery goals, difficulty following through on treatment plans, or problems with self-monitoring behaviors. These symptoms often stem from impaired functioning in the frontal lobe, which controls decision-making and impulse control.
Can ADHD and other mental health conditions make executive function problems worse during treatment?
Yes, attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, learning disabilities, and other mental health conditions can significantly complicate executive function during treatment. People with ADHD often struggle with working memory, flexible thinking, and inhibition, making it harder to complete tasks, follow treatment schedules, or use coping strategies effectively. Other conditions like obsessive-compulsive disorder, traumatic brain injury (TBI), or even Alzheimer’s disease can create additional executive function deficits. A neuropsychological evaluation using tools like executive functioning scales and questionnaires helps identify the underlying cause and develop appropriate treatment options.
What treatment approaches work best for executive dysfunction in addiction recovery?
Effective executive dysfunction treatment typically combines psychotherapies like Cognitive-Behavioral therapy (CBT) with practical interventions and sometimes medication. CBT helps improve problem-solving skills, emotional regulation, and cognitive flexibility while addressing negative thought patterns.
Practical tools include planners, checklists, timers, and apps to support day-to-day functioning and help people multitask more effectively.
How can I improve my executive function skills to enhance my quality of life?
Building executive function skills requires consistent practice and the right support systems. Focus on developing self-care routines, using organizational tools like planners and apps, and breaking complex tasks into smaller, manageable steps. Practice self-monitoring techniques to become more aware of your cognitive patterns and emotional responses. Work on time management by setting realistic goals and using timers to stay focused. Social skills training can improve your ability to navigate relationships and maintain accountability. Healthcare providers often recommend specific interventions based on your executive function inventory results and individual needs.
Is executive function disorder treatable, and how long does improvement take?
Executive function disorder is highly treatable, though improvement timelines vary based on the underlying cause and individual factors. People with conditions like ADHD may see benefits from medication within weeks, while those addressing trauma-related executive deficits might need months of consistent therapy. The brain’s neuroplasticity allows for significant improvement in executive function skills throughout life, including in adolescents and adults.
Success depends on consistent use of interventions, addressing any co-occurring mental health conditions, and developing sustainable day-to-day strategies. Most people notice improvements in their overall well-being and ability to manage daily life within three to six months of starting treatment.
Sources
[1] Cleveland Clinic. (2022, June 5). Executive Dysfunction: What It Is, Symptoms & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/23224-executive-dysfunction
[2] Anderson, H. (2021, June 29). What is the Conners Rating Scale? Healthline.
https://www.healthline.com/health/adhd/conners-scale#scoring
