What to know about executive function disorder

Mental Health
Executive function is a broad group of mental skills that enable people to complete tasks and interact with others. An executive function disorder can impair a person’s ability to organize themselves and control their behavior.

However, executive function disorder is not a specific, standalone diagnosis or condition. Instead, neurological, mental health, and behavioral disorders, such as depression and attention deficit hyperactivity disorder (ADHD), can affect a person’s executive function.

What is executive function disorder?

Woman with executive function disorder working on laptop looking bored.
Executive function disorder can affect a person’s ability to concentrate and manage time.

Executive function skills help people complete tasks and interact with others. They include a range of skills, such as:

  • planning and organization
  • concentrating and controlling mental focus
  • analyzing and processing information
  • controlling emotions and behavior
  • remembering details
  • managing time
  • multitasking
  • problem-solving

An executive function disorder impairs some of these skills, which can affect a person’s ability to manage and organize themselves to achieve goals.

However, the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not recognize executive function disorder as a specific mental health condition. Instead, executive function issues are symptomatic of other neurological, mental health, and behavioral disorders.

For example, depression may affect certain executive functions, such as memory, attention, and control of inhibitions. Alzheimer’s can sometimes severely impair executive function, and a person may no longer be able to drive, get dressed, or behave appropriately in social situations.


Symptoms

People with executive function issues may have the following symptoms:

  • trouble controlling emotions or impulses
  • problems with starting, organizing, planning, or completing tasks
  • trouble listening or paying attention
  • short-term memory issues
  • inability to multitask or balance tasks
  • socially inappropriate behavior
  • inability to learn from past consequences
  • difficulty solving problems
  • difficulty learning or processing new information

Problems with executive function may lead to:

  • poor performance at work or school
  • problems forming or maintaining relationships
  • mood issues
  • low self-esteem
  • avoidance of difficult tasks
  • low motivation or loss of interest in activities

Executive function takes time to develop, so many of these behaviors are completely normal in young children. However, if these behaviors persist, they may indicate that the child has executive function issues.

How does it relate to ADHD?

It is more common for a person to receive a diagnosis of ADHD during childhood than as an adult.
It is more common for a person to receive a diagnosis of ADHD during childhood than as an adult.

ADHD is a developmental impairment of executive function that can cause hyperactivity, impulsivity, and inattention.

Symptoms of ADHD can vary in type and severity but may include:

  • fidgeting, restlessness, being unable to sit still, and talking excessively
  • acting without thinking and behaving in socially inappropriate ways
  • often interrupting other people’s conversations or activities
  • being prone to distraction or having a short attention span
  • making careless mistakes at work or in schoolwork
  • having difficulty organizing, completing, or focusing on tasks
  • general forgetfulness

People with executive function issues may have ADHD. However, ADHD is not the only condition that can affect executive function.


Causes

Conditions that can cause executive function issues include:

Temporary causes of executive function issues can include:

  • exhaustion
  • severe pain
  • stress
  • distracting environments
  • drug use
  • alcohol
  • severe boredom

Diagnosis

Doctors can use a variety of tests to help assess a person’s executive function.

In the Stroop task, for example, a person looks at the names of colors that appear in different colored inks. So, the word “red” may appear in green ink, and the word “yellow” may appear in blue ink. For each word, the person has to say what the ink color is, rather than the written color name. The Stroop task can help evaluate a person’s mental control and selective attention.

Other tests that a doctor may use to assess executive function include:

  • trail making tests
  • clock drawing tests
  • verbal fluency tests
  • card sorting tests

If a doctor suspects a specific disorder, such as ADHD, they may skip executive functioning tests and instead compare the person’s symptoms with standard diagnostic criteria for that disorder.

A doctor may sometimes also recommend additional testing to rule out other causes. For example, they may order an MRI scan to rule out a stroke or brain tumor in people with signs of dementia.


Treatment

A doctor may prescribe medication to treat the cause of executive function disorder.
A doctor may prescribe medication to treat the cause of executive function disorder.

The type of treatment will depend on the condition causing the executive function issues.

Some neurological disorders, particularly dementia, are progressive. Although some treatments may help slow the disease, symptoms may continue to get worse over time. Many causes of executive function issues, however, are highly treatable.

Treatment options may include:

Summary

Executive function is a set of mental skills that help people plan, organize, manage their time, pay attention, process information, and control their behavior. Executive function issues can affect everything from how a person interacts with other people to their ability to learn and work.

A common cause of executive function problems is ADHD, but other causes can include dementia, depression, schizophrenia, autism, and traumatic injuries to the brain.

Diagnosing the cause of executive function issues can help identify treatment options, such as medications and therapy. Signs of executive function issues include chronic disorganization, lack of focus, memory problems, and socially inappropriate behavior.

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