SELF-RATED EXECUTIVE FUNCTION: DEVELOPMENT OF THE EXECUTIVE FUNCTION INDEX

Barkley Deficits in Executive Functioning Scale (BDEFS): Validation in a Large Multisite College Sample

Despite the importance of daily life executive functioning (EF) for college students' success, few measures exist that have been validated in college students specifically. This study examined the factor structure of the Barkley Deficits in Executive Functioning Scale (BDEFS) in college students. Participants were 1,311 students (ages 18-28 years, 65% female) from five universities in the United States. Additionally, the study examined invariance across sex, age, and attention-deficit/hyperactivity disorder symptoms. Exploratory structural equation modeling provided strong support for the BDEFS five-factor structure though some items had high cross-loadings on multiple factors. Findings generally supported invariance across sex and age; however, loadings, thresholds, and factor means differed based on attention-deficit/hyperactivity disorder symptoms. Stronger support for invariance across sex emerged for a reduced item version that eliminated cross-loading items. Overall, findings provide support for the validity and utility of the BDEFS in college students.

Error monitoring and daily life executive functioning

Error monitoring during task execution is reflected in post-error slowing (PES), which refers to the tendency to slow down performance after making an error in order to prevent future mistakes. The key question of the present study is whether poor error monitoring (reduced magnitude of PES) has negative consequences for daily life executive function skills, as well as functioning in different life settings such as work, family, social, and academic settings. Eighty-five university students performed a lexical decision task and completed The Executive Function Index Scale (EFI), and the Weiss Functional Impairments Rating Scale (WFIRS). Individual academic achievement was measured using the Grade Point Average. Statistical analysis revealed that a decreased magnitude of PES was weakly associated with less efficient planning (one of the executive functions). Results suggest that error monitoring, as measured by PES, was not associated with functioning in a naturalistic environment, but could be interpreted to some extent as an experimental marker of planning in daily life executive functioning.

Which features of psychopathy and impulsivity matter most for prison violence? New evidence among female prisoners

Prison violence is a complex and multifaceted phenomenon. While a great deal of research has been conducted in male samples, very few studies are dedicated to understanding violence committed by female offenders. Two constructs that have emerged as important predictors of violence are psychopathy and impulsivity. These constructs may be an important line of inquiry due to the close association between psychopathy, impulsivity, and violence. In a sample of 166 female offenders, we used the 3-facet model of psychopathy and 3-factor model of trait impulsivity with the goal to statistically explain two types of prison violence: official reports of violent misconducts over a 12-month period, and self-report of deliberately instigating a violent altercation. We conducted three separate regression models to test the independent contribution of psychopathy and impulsivity, as well as accounting for the overlap between psychopathy and impulsivity. When impulsivity and psychopathy were not competing within the same model, affective and behavioral psychopathic traits, and nonplanning impulsiveness predicted violent misconducts. However, when accounting for impulsivity and psychopathy within the same model, only affective psychopathic traits remained significant. When predicting if an offender deliberately started a violent altercation, separate statistical models showed affective and interpersonal psychopathic traits, and nonplanning impulsiveness were significant. When competing for variance within the same statistical model, only affective and interpersonal psychopathic traits remained as significant predictors. This suggests an overlap between psychopathic traits and nonplanning impulsivity when understanding violent misconducts in female offenders, while affective psychopathic explains female prison violence, regardless of impulsivity.

Traumatic Brain Injury in the General Population: Incidence, Mental Health Comorbidity, and Functional Impact

Traumatic brain injury (TBI) is a relatively prevalent and burdensome condition with significant public health cost; however, epidemiological studies of TBI in the United States have rarely used nationally representative samples or included measures of functioning. Data were obtained from the third wave of the National Epidemiological Survey on Alcohol and Related Conditions. Of the 36,309 individuals surveyed, 193 (0.53% weighted) reported a past-year TBI. Results from weighted logistic regression modeling indicated that prior active duty military status, mood disorders, posttraumatic stress disorder, and nicotine use disorders were associated with greater odds of TBI. Annual household income greater than $20,000 was associated with lower odds of TBI. Regarding functioning, TBI was associated with greater impairment on SF-12 scales measuring mental and physical health and the organization subscale of the Executive Function Index. Results suggest that many individuals in the US population experience TBI each year and that such injuries are associated with impairment across multiple domains.

The roles of delay and probability discounting in texting while driving: Toward the development of a translational scientific program

A sample of 109 college students completed a survey to assess how frequently they send or read text messages while driving. In a novel discounting task with a hypothetical scenario in which participants receive a text message while driving, they rated the likelihood of replying to a text message immediately versus waiting to reply until arriving at a destination. The scenario presented several delays to a destination and probabilities of a motor vehicle crash. The likelihood of waiting to reply decreased as a function of both the delay until the destination and the probability of a motor vehicle crash. Self-reported higher frequencies of texting while driving were associated with greater rates of both delay and probability discounting. The degree of delay discounting was altered as a function of the probability of a motor vehicle crash and vice versa. These results suggest that both delay and probability discounting are important underlying mechanisms of drivers' decision to text while driving.

Validation of the Portuguese Version of Impulsive-Premeditated Aggression Scale in an Inmate Population

Aggression is one of the core symptoms of antisocial personality disorder (ASPD) with therapeutic and prognostic relevance. ASPD is highly prevalent among inmates, being responsible for adverse events and elevated direct and indirect economic costs for the criminal justice system. The Impulsive/Premeditated Aggression Scale (IPAS) is a self-report instrument that characterizes aggression as either predominately impulsive or premeditated. This study aims to determine the validity and reliability of the IPAS in a sample of Portuguese inmates. A total of 240 inmates were included in the study. A principal component factor analysis was performed so as to obtain the construct validity of the IPAS impulsive aggression (IA) and premeditated aggression (PM) subscales; internal consistency was determined by Cronbach's alpha coefficient; convergent and divergent validity of the subscales were determined analyzing correlations with the Barratt Impulsiveness scale, 11th version (BIS-11), and the Psychopathic Checklist Revised (PCL-R). The rotated matrix with two factors accounted for 49.9% of total variance. IA subscale had 11 items and PM subscale had 10 items. The IA and PM subscales had a good Cronbach's alpha values of 0.89 and 0.88, respectively. The IA subscale is correlated with BIS-11 attentional, motor, and non-planning impulsiveness dimensions (p < 0.05). The PM subscale is correlated with BIS-11 attentional, motor impulsiveness dimensions (p < 0.05). The PM subscale is correlated with PCL-R interpersonal, lifestyle, and antisocial dimensions (p < 0.05). The IA subscale is not correlated with PCL-R. The Portuguese translated version of IPAS has adequate psychometric properties, allowing the measurement of impulsive and premeditated dimensions of aggression.

Executive function and dangerous driving behaviors in young drivers

The purpose of the present study was to investigate the behavioral and cognitive processes underlying dangerous driving behaviors. We used a survey to assess levels of executive function in college students. The sample consisted of 59 males and 77 females and their age ranged from 18 to 24. We stratified the students into two groups based on executive function scores and compared the extent to which each group engaged in four dangerous driving behaviors (texting while driving, driving without a seat belt, driving while intoxicated, and speeding) as well as how often they experienced three negative driving outcomes (crashes, pulled over, and ticketed). We also investigated how these driving behaviors and outcomes are correlated with subcategories of executive function. The results show that students with a low level of executive function were more likely to engage in dangerous driving behaviors and more likely to experience negative driving outcomes. The results also show that texting while driving, driving while intoxicated, and speeding were most strongly correlated with the executive function subcategory of Impulse Control, whereas driving without a seat belt was most strongly correlated with the executive function subcategory of Strategic Planning. These results suggest that different behavioral or cognitive processes are involved in different dangerous driving behaviors and different interventions may be needed to target each underlying process.

Self-reported cognitive scales in a US National Survey: reliability, validity, and preliminary evidence for associations with alcohol and drug use

AIMS

To evaluate relationships between measures of cognitive functioning and alcohol or drug use among adults (≥ 18 years) in the US general population.

DESIGN

Two cognitive scales were created based on dimensionality and reliability of self-reported Executive Function Index items. Relationships between the two scales and validators were evaluated. Associations between the cognitive scales and past-year frequency of alcohol or drug use were estimated with adjusted odds ratios (aOR).

SETTING

United States, using the 2012-13 National Epidemiologic Survey on Alcohol and Related Conditions-III, a nationally representative adult sample selected by multi-stage probability sampling.

PARTICIPANTS

36 085 respondents.

MEASUREMENTS

Past-year substance use outcome variables categorized binge drinking, marijuana, cocaine, opioid, sedative/tranquilizer and stimulant use as frequent (at least weekly to daily), infrequent (any to two to three times/month) or no use, assessed by the Alcohol Use Disorder and Associated Disabilities Interview Schedule-5. Key predictors were the two cognitive scales. Construct validators included education and functional impairment. Covariates included age, gender, income and race/ethnicity.

FINDINGS

Nine cognitive items fitted a two-factor model (comparative fit index = 0.973): attention (five items) and executive functioning (four items). Both scales were associated positively with higher education (Ps < 0.001) and negatively with functional impairment (Ps < 0.001), demonstrating construct validity. Poorer attention was associated with frequent and infrequent binge drinking and use of drugs [aOR range = 1.07 (binge drinking) to 1.72 (stimulants), Ps ≤ 0.01]. Poorer executive functioning was associated with frequent binge drinking and use of drugs [aOR range = 1.22 (binge drinking) to 2.03 (cocaine), Ps < 0.001] and infrequent use of all drugs [aOR range = 1.19 (marijuana) to 1.63 (cocaine), Ps < 0.001].

CONCLUSIONS

Impairments in attention and executive functioning are positively associated with substance use in the US general population.

Self-reported executive functioning competencies and lifetime aggression

Neuropsychological research can be advanced through a better understanding of relationships between executive functioning (EF) behavioral competencies and the expression of aggressive behavior. While performance-based EF measures have been widely examined, links between self-report indices and practical real-life outcomes have not yet been established. Executive Functioning Index subscale scores in this sample (N = 579) were linked to trait hostility (Buss-Perry Aggression Questionnaire), aggression in the natural environment (Lifetime Acts of Violence Assessment), and conduct disorder symptoms prior to age 15. Significant associations were found between all of the EFI subscales (Motivational Drive, Organization, Strategic Planning, Impulse Control, and Empathy), trait aggression, and conduct disturbance. Lifetime acts of aggression were predicted by all but Organization scores. Physical injuries inflicted on other(s) were 2 to 4 times more likely to occur among respondents generating low (z < -1) EFI subscale scores. While these EFI relationships were modest in size, they are pervasive in scope. These findings provide support for the potential role of perceived EF deficits in moderating lifetime aggression.

Texting while driving, executive function, and impulsivity in college students

The purpose of the present study was to investigate the cognitive processes underlying texting while driving. A sample of 120 college students completed a survey to assess how frequently they send and read a text message while driving. Based on this information, students were assigned to one of two groups: 20 students who frequently text while driving and 20 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they differed in self-reported measures of executive function and impulsivity. The groups were also compared on a behavioral measure of impulsivity: the extent to which they discounted hypothetical monetary rewards as a function of the delay. For this measure, the students made repeated choices between smaller monetary rewards available immediately and larger rewards available after delays ranging from 1 week to 6 months. The results show that the group of students who frequently text while driving showed (a) significantly lower levels of executive function and (b) higher levels of self-reported impulsivity, although the groups did not differ significantly on the behavioral measure of impulsivity. These results support a general conclusion that drivers with lower levels of executive function and higher levels of impulsivity are more likely to text while driving.

Executive Function Index (EFI) performance in nonclinical individuals with high levels of autistic traits

This study examined the ability of the Executive Function Index (EFI) to detect differences in executive functioning amongst participants with varying levels of subclinical autistic symptoms as quantified by the Autism Spectrum Quotient (ASQ). Participants were a nonclinical college subject sample classified as displaying either Low (0-15 ASQ score, n = 182) ASQ traits or High (16 or higher ASQ score, n = 91) ASQ traits. Participants were given the ASQ (Baron-Cohen et al., 2001) and the EFI (Spinella, 2005 ). High ASQ subjects were significantly impaired (p's < .04) on the Motivation/Drive (EFI-1) and Organization (EFI-4) subscales of the EFI, as compared to the Low ASQ subjects. However, no High/Low ASQ group differences were observed for EFI-2 (Impulse Control), EFI-3 (Empathy), EFI-5 (Planning) subscales or the EFI-Total Score (p's > .12), although these differences were in the predicted direction (High ASQ < Low ASQ). Use of the EFI as a measure of executive function performance in nonclinical ASQ trait individuals requires further study and may not be sensitive enough of an instrument to assess EF in nonclinical populations with autistic traits.

Texting Dependence, iPod Dependence, and Delay Discounting

We gave 127 undergraduates questionnaires about their iPod and texting dependence and 2 hypothetical delay discounting scenarios related to free downloaded songs and free texting for life. Using regression analyses we found that when iPod dependence was the dependent variable, Text2-excessive use, Text4-psychological and behavioral symptoms, iPod2-excessive use, and iPod3-relationship disruption were significant predictors of discounting. When texting dependence was the dependent variable, Text4-psychological and behavioral symptoms and iPod3-relationship disruption were significant predictors of discounting. These are the first data to show that delay discounting relates to certain aspects of social media, namely iPod and texting dependence. These data also show that across these 2 dependencies, both psychological and behavioral symptoms and relationship disruptions are affected.

Trait impulsivity and body mass index: A cross-sectional investigation in 3073 individuals reveals positive, but very small relationships

Impulsivity has been suggested to be associated with obesity. However, findings are fairly inconsistent and it appears that only specific facets of impulsivity are related to overeating and body mass. In this study, relationships between scores on a short form of the Barratt Impulsiveness Scale and body mass index were examined in a heterogeneous sample (N = 3073). After controlling for age and sex, only scores on attentional and motor impulsivity, but not non-planning impulsivity, were predictive of higher body mass index. The magnitude of these relationships, however, was very small. Thus, future research needs to address possible mediators and moderators of the relationship between impulsivity and body mass in order to explain why only specific facets of impulsivity appear to play a role in obesity and under which circumstances heightened impulsivity levels are associated with higher body weight.

Post-error adjustments and ADHD symptoms in adults: The effect of laterality and state regulation

Evidence is accumulating that individuals with Attention-Deficit/Hyperactivity Disorder (ADHD) do not adjust their responses after committing errors. Post-error response adjustments are taken to reflect, among others, error monitoring that is essential for learning, flexible behavioural adaptation, and achieving future goals. Many behavioural studies have suggested that atypical lateral brain functions and difficulties in allocating effort to protect performance against stressors (i.e., state regulation) are key factors in ADHD. Whether these factors contribute to the absence of post-error response adjustments in ADHD is unknown. The aim of the present study is to investigate the contribution of the left and right hemispheres and the deficiency in effort allocation to deviant post-error processing in adults with high ADHD symptoms. From a pool of 87 university students, two groups were formed: a group with higher (n=30) and a group with lower (n=26) scores on the ADHD index subscale of the Conners' Adult ADHD Rating Scales. The groups performed a lateralized lexical decision task with a fast and slower stimulus presentation rate. Post-error slowing and post-error response accuracy to stimuli presented in the left and right visual field were measured in each stimulus presentation rate. Results indicated that subjects with the lower ADHD scores slowed down and improved their response accuracy after errors, especially when stimuli were presented in the right visual field at the slower rate. In contrast, subjects with the higher ADHD scores showed no post-error adjustments. Results suggest that during lexical decision performance, impaired error processing in adults with ADHD is associated with affected ability of the left hemisphere to compensate for errors, especially when extra effort allocation is needed to meet task demands.

Why We Don't "Just Do It": Understanding the Intention-Behavior Gap in Lifestyle Medicine

Intention can be a poor predictor of actual health behavior change-now termed the intention-behavior gap. In other words, although patients intend to change and maintain their behavior, the data suggest that many will not follow through with their intention. This review introduces 5 factors that could help the practitioner understand the patient intention-behavior gap: (1) the motivation, (2) the trigger, (3) the response, (4) the capacity, and (4) the process. These key factors allow the lifestyle medicine practitioner to (1) understand the difficulties in changing patient behavior and (2) apply strategies to encourage successful change and maintenance of healthy lifestyle behavior in their patients.

Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-Language Version in a community sample of puerto rican adults

Performance-based measures have shown some limitation in the assessment of executive functioning (EF) and rating scales have been proposed as an alternative. Our aim was to conduct a comprehensive psychometric evaluation of the Barkley Deficits in Executive Functioning Scale (BDEFS), as administered in 452 Latino community adults (65.5% female). The BDEFS was back-translated into Spanish. We performed exploratory factor analysis (EFA) to assess the structure of the translated BDEFS and to compare it with the original five-factor structure based on the English-language version. Confirmatory factor analysis (CFA) was performed to test the original language structure of the instrument, and also a modified version with items that loaded equally in both versions. The Adult Self-Report Scale was used to screen for ADHD symptoms. We assessed invariance on the latent factor's mean by age and gender, and to estimate associations with ADHD symptom dimensions. The five-factor structure of the BDEFS was partially supported by EFA/CFA, in which 78 out of 89 items loaded similar to the original English-language structure. Factor scores were significantly associated with ADHD symptom dimensions. Model-based contrasts revealed that inattention was primarily associated with disorganization, time-management and motivational aspects of EF; hyperactivity was predominantly related to self-restraint and self-regulation factors. The BDEFS seemingly assesses similar dimensions of the EF construct in English and in the present Spanish-language versions. Factor scores were differentially associated with ADHD subtypes. Replication and confirmation of the Spanish-language BDEFS in a larger sample is advised. (PsycINFO Database Record

Relationships between Dimensions of Impulsivity and Prospective Memory

Prospective memory refers to the ability to plan and execute future intentions. A burgeoning body of research indicates that a significant proportion of the variability in prospective memory performance can be accounted for by personality traits, with two recent studies revealing that the various dimensions of impulsivity measured by the Barratt Impulsivity Scale–11 (BIS–11) are related to prospective memory failures. The present study was conducted to examine which dimensions of impulsivity indexed by the BIS–11 and UPPS–P relate to prospective memory failures and which dimensions of impulsivity contribute unique variance in the prediction of prospective memory failures. A large sample ( N = 662) of students completed the BIS–11, UPPS–P, Prospective Memory Questionnaire and a habitual prospective memory test. Consistent correlations between six of the seven measures of impulsivity and prospective memory failures were found. Regression analyses further revealed that lack of perseverance, emotional urgency and attentional impulsivity were reliable and unique predictors of prospective memory failures. Thus, difficulty remaining focused on tasks (especially long, boring or difficult tasks); lack of forethought, planning and distaste for challenging tasks; and tendencies to behave impulsively under conditions of strong affect relate most strongly to prospective memory failures. Copyright © 2015 European Association of Personality Psychology

Boredom proneness predicts quality of life in outpatients diagnosed with schizophrenia-spectrum disorders

BACKGROUND

There is increasing recognition of the clinical significance of boredom associated with functional impairments in schizophrenia. Previous work has highlighted the importance of motivational deficits more broadly, although no study has yet explored the unique effects of boredom on community outcomes.

AIMS

This study aims to measure boredom proneness among outpatients diagnosed with schizophrenia to determine whether it is elevated in this population and to determine its relation to quality-of-life outcomes.

METHODS

A self-report measure of boredom proneness along with standard measures of symptoms and functional status was administered to a community-dwelling sample of schizophrenia outpatients.

RESULTS

Boredom proneness was found to be elevated in this population and was associated with reduced quality of life, specifically with leisure activity dissatisfaction and reduced sense of financial well-being. Negative symptoms were determined to be associated with reduced work and school functioning.

CONCLUSION

This pattern of unique effects on quality of life highlights the clinical relevance of identifying a subjective state of boredom and has theoretical importance in distinguishing boredom proneness specifically from more general avolitional and amotivational conditions that have tended to be the focus of clinical observation and previous research.

Texting while driving as impulsive choice: A behavioral economic analysis

The goal of the present study was to examine the utility of a behavioral economic analysis to investigate the role of delay discounting in texting while driving. A sample of 147 college students completed a survey to assess how frequently they send and read text messages while driving. Based on this information, students were assigned to one of two groups: 19 students who frequently text while driving and 19 matched-control students who infrequently text while driving but were similar in gender, age, years of education, and years driving. The groups were compared on the extent to which they discounted, or devalued, delayed hypothetical monetary rewards using a delay-discounting task. In this task, students made repeated choices between $1000 available after a delay (ranging from 1 week to 10 years) and an equal or lesser amount of money available immediately. The results show that the students who frequently text while driving discounted delayed rewards at a greater rate than the matched control students. The study supports the conclusions that texting while driving is fundamentally an impulsive choice made by drivers, and that a behavioral economic approach may be a useful research tool for investigating the decision-making processes underlying risky behaviors.

Do Old Errors Always Lead to New Truths? A Randomized Controlled Trial of Errorless Goal Management Training in Brain-Injured Patients

Both errorless learning (EL) and Goal Management Training (GMT) have been shown effective cognitive rehabilitation methods aimed at optimizing the performance on everyday skills after brain injury. We examine whether a combination of EL and GMT is superior to traditional GMT for training complex daily tasks in brain-injured patients with executive dysfunction. This was an assessor-blinded randomized controlled trial conducted in 67 patients with executive impairments due to brain injury of non-progressive nature (minimal post-onset time: 3 months), referred for outpatient rehabilitation. Individually selected everyday tasks were trained using 8 sessions of an experimental combination of EL and GMT or via conventional GMT, which follows a trial-and-error approach. Primary outcome measure was everyday task performance assessed after treatment compared to baseline. Goal attainment scaling, rated by both trainers and patients, was used as secondary outcome measure. EL-GMT improved everyday task performance significantly more than conventional GMT (adjusted difference 15.43, 95% confidence interval [CI] [4.52, 26.35]; Cohen's d=0.74). Goal attainment, as scored by the trainers, was significantly higher after EL-GMT compared to conventional GMT (mean difference 7.34, 95% CI [2.99, 11.68]; Cohen's d=0.87). The patients' goal attainment scores did not differ between the two treatment arms (mean difference 3.51, 95% CI [-1.41, 8.44]). Our study is the first to show that preventing the occurrence of errors during executive strategy training enhances the acquisition of everyday activities. A combined EL-GMT intervention is a valuable contribution to cognitive rehabilitation in clinical practice.

Reliability of an Adapted Version of the Modified Six Elements Test as a Measure of Executive Function

The Modified Six Elements Test (MSET) is used to examine executive deficits-more specifically, planning deficits. This study investigates the reliability of an adapted version of the MSET and proposes a novel scoring method. Two parallel versions of the adapted MSET were administered in 60 healthy participants in a counterbalanced order. Test-retest and parallel-form reliability were examined using intraclass correlation coefficients, Bland-Altman analyses, standard errors of measurement, and smallest real differences, representing clinically relevant changes over time. Moreover, the ecological validity of the adapted MSET was evaluated using the Executive Function Index, a self-rating questionnaire measuring everyday executive performance. No systematic differences between the test occasions were present, and the adapted MSET including the proposed scoring method was capable of detecting real clinical changes. Intraclass correlations for the test-retest and parallel-form reliability were modest, and the variability between the test scores was high. The nonsignificant correlations with the Executive Function Index did not confirm the previously established ecological validity of the MSET. We show that both parallel versions of the test are clinically equivalent and can be used to measure executive function over the course of time without task-specific learning effects.

Executive Function Index (EFI) performance and risk factors for disordered eating

We examined Executive Function Index (EFI) performance in individuals at risk (n=22) for an eating disorder, based on the SCANS criteria. In comparison to those not at risk (n=104; also based on the SCANS criteria), those at risk on SCANS were more likely to be depressed, anxious, and showed deficits in many components of EFI performance, including EFI impulse control and EFI total score. These results support previous work on executive function in those at risk for an eating disorder and highlight the use of the EFI as a tool for such investigation in this population.

Quick to Act, Quick to Forget: The Link between Impulsiveness and Prospective Memory

Several traits of impulsiveness (e.g. lack of planning and perseverance, difficulty focusing attention) seem intimately connected to the skills required for successful prospective memory performance. This is the first study to examine whether the various inter–correlated dimensions of impulsiveness are related to problems with prospective memory. Undergraduate students (N = 184) completed the Barratt Impulsiveness Scale 11, the Prospective Memory Questionnaire, the Prospective and Retrospective Memory Questionnaire, and two objective prospective memory tests. Results revealed consistent correlations between the various dimensions of impulsiveness (attentional, motor, non–planning) and self–reported problems with prospective memory. Subsequent regression analyses indicated that attentional impulsiveness is a unique predictor of self–reported problems with internally cued prospective memory, and non–planning impulsiveness is a unique predictor of self–reported problems with episodic and overall prospective memory. Similarly, findings from the objective prospective tests showed that non–planning impulsiveness was related to worse performance on the two prospective memory tests. Whereas non–planning impulsiveness was also related to using fewer prospective memory–aiding strategies, mediation analyses showed that use of these strategies does not account for any of the detected relationships. Because the findings suggest that a failure to plan does not underlie the detected effects, other potential explanations for the relationships are discussed. Copyright © 2013 European Association of Personality Psychology

A randomized controlled trial on errorless learning in goal management training: study rationale and protocol

Background

Many brain-injured patients referred for outpatient rehabilitation have executive deficits, notably difficulties with planning, problem-solving and goal directed behaviour. Goal Management Training (GMT) has proven to be an efficacious cognitive treatment for these problems. GMT entails learning and applying an algorithm, in which daily tasks are subdivided into multiple steps. Main aim of the present study is to examine whether using an errorless learning approach (preventing the occurrence of errors during the acquisition phase of learning) contributes to the efficacy of Goal Management Training in the performance of complex daily tasks.

Methods/Design

The study is a double blind randomized controlled trial, in which the efficacy of Goal Management Training with an errorless learning approach will be compared with conventional Goal Management Training, based on trial and error learning. In both conditions 32 patients with acquired brain injury of mixed etiology will be examined. Main outcome measure will be the performance on two individually chosen everyday-tasks before and after treatment, using a standardized observation scale and goal attainment scaling.

Discussion

This is the first study that introduces errorless learning in Goal Management Training. It is expected that the GMT-errorless learning approach will improve the execution of complex daily tasks in brain-injured patients with executive deficits. The study can contribute to a better treatment of executive deficits in cognitive rehabilitation.

Trial registration

(Dutch Trial Register): http://NTR3567

Practitioner review: do performance-based measures and ratings of executive function assess the same construct?

BACKGROUND

Both performance-based and rating measures are commonly used to index executive function in clinical and neuropsychological assessments. They are intended to index the same broad underlying mental construct of executive function. The association between these two types of measures was investigated in the current article.

METHOD AND RESULTS

We examined the association between performance-based and rating measures of executive function in 20 studies. These studies included 13 child and 7 adult samples, which were derived from 7 clinical, 2 nonclinical, and 11 combined clinical and nonclinical samples. Only 68 (24%) of the 286 relevant correlations reported in these studies were statistically significant, and the overall median correlation was only .19.

CONCLUSIONS

It was concluded that performance-based and rating measures of executive function assess different underlying mental constructs. We discuss how these two types of measures appear to capture different levels of cognition, namely, the efficiency of cognitive abilities and success in goal pursuit. Clinical implications of using performance-based and rating measures of executive function are discussed, including the use of these measures in assessing ADHD.

Self-reported differences on measures of executive function in a patient sample of pathological gamblers

Patients seeking help for pathological gambling often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with gambling. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive deficits. Evidence of executive deficits have been confirmed in pathological gamblers using objective neurocognitive tests, however, it remains to be seen if such findings will emerge in self-report measures of executive control. These observations led to the current investigation of differences between a group of pathological gamblers (n = 62) and a comparison group (n = 64) using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A). Significant differences between the groups emerged over all nine subscales of executive functioning with the most dramatic differences on BRIEF-A subscales Inhibit, Plan/Organize, Shift, Emotion Control, Self-Monitor, and Initiate among the pathological gamblers. These results provide evidence that support findings among pathological gamblers using objective neuropsychological measures and suggest that the BRIEF-A may be an appropriate instrument to assess possible problems with executive control in this population.

How Much Do We Know About Our Own Cognitive Control?

The paper investigates whether self-report and performance measures of executive control yield comparable results. We report an empirical study in which the answers to a self-report questionnaire on executive control were compared with the results of three computerized tests of cognitive control. Both the questionnaire and the computerized tests covered three dimensions of executive control, namely, prepotent response inhibition, task switching, and goal monitoring (goal maintenance). The results are rather surprising and negative: The relationships between performance and self-report measures of executive control were either weak or insignificant. Moreover, they tended to disappear when age of participants was controlled. We conclude that people are basically unable to assess the strength of their own cognitive control. However, the two types of assessment tool might analyze different aspects of individual differences in executive control and should therefore be considered in research and practical applications.

Can't stop the craving: the effect of impulsivity on cue-elicited craving for alcohol in heavy and light social drinkers

RATIONALE

A robust finding in the alcohol literature is that heavy and alcohol-dependent drinkers show stronger reactions to alcohol-related cues than light drinkers. However, there are individual differences in the degree of cue-elicited craving. Personality factors appear to be involved in cue reactivity and impulsivity is a possible candidate.

OBJECTIVES

The aim of the present study was to examine the role of different aspects of impulsivity in heavy drinking and alcohol cue reactivity in social drinkers.

METHODS

Participants were heavy (n = 13) and light (n = 29) social drinkers who were exposed to neutral and alcohol-related stimuli during a single laboratory session. Trait impulsivity, response inhibition, and sensitivity to reward were assessed with the Barratt Impulsiveness Scale (BIS-11), the Stop Signal Task, and the Card-Arranging Reward Responsivity Objective Test, respectively.

RESULTS

Heavy drinkers scored higher on trait impulsivity (BIS-11) than light drinkers. In addition, heavy drinkers reported elevated levels of craving for alcohol, but both in light and heavy drinkers, craving increased equally after exposure to alcohol cues. Impulsivity appeared to moderate this relation: heavy drinkers with ineffective response inhibition showed more craving to alcohol cues, compared to heavy drinkers with adequate response inhibition. In light drinkers, response inhibition did not influence craving to alcohol cues.

CONCLUSIONS

Different aspects of impulsivity are involved in heavy drinking and perhaps motivate alcohol consumption in a variety of ways. Having a deficient response inhibition appears to be a risk factor for heavy drinkers because it is associated with increased craving to alcohol cues.

Impaired goal-directed behavioural control in human impulsivity

Two dissociable learning processes underlie instrumental behaviour. Whereas goal-directed behaviour is controlled by knowledge of the consequences, habitual behaviour is elicited directly by antecedent Pavlovian stimuli without knowledge of the consequences. Predominance of habitual control is thought to underlie psychopathological conditions associated with corticostriatal abnormalities, such as impulsivity and drug dependence. To explore this claim, smokers were assessed for nicotine dependence, impulsivity, and capacity for goal-directed control over instrumental performance in an outcome devaluation procedure. Reduced goal-directed control was selectively associated with the Motor Impulsivity factor of Barrett's Impulsivity Scale (BIS), which reflects propensity for action without thought. These data support the claim that human impulsivity is marked by impaired use of causal knowledge to make adaptive decisions. The predominance of habit learning may play a role in psychopathological conditions that are associated with trait impulsivity.

Executive functioning and positive psychological characteristics: a replication and extension

Positive psychological characteristics and executive function are correlated with gratitude, satisfaction with life, and forgiveness. The goal of this study was to replicate these findings while examining two additional constructs, namely, hope and optimism. 113 students (25 men, 88 women) between the ages of 17 to 24 years (M = 19.4, SD = 1.5) volunteered to participate. Positive correlations between executive function and gratitude were found but mixed results were obtained for forgiveness and satisfaction with life. Hope and optimism correlated positively with executive function and hierarchical multiple regression analysis indicated that they contributed significantly to the explanation of executive functioning. Further investigation into relationships between executive functioning, its neurobiological substrates, and positive psychological attributes is recommended.

A surprising finding related to executive control in a patient sample of hypersexual men

INTRODUCTION

Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, and poor judgment as well as deficits in emotion regulation and excessive preoccupation with sex. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive dysfunction. Exploring relationships between dysregulated sexual behavior and executive deficits will enhance our understanding of hypersexuality.

AIM

This study sought to assess whether patients seeking help for hypersexual behavior exhibit executive deficits as measured by standardized neuropsychological tests of executive functioning when compared with healthy controls.

METHODS

Executive deficits were assessed in a sample of male patients (N = 30) seeking help for hypersexual behavior compared with a nonhypersexual community sample of men (N = 30) using neuropsychological tests of executive functioning. Using multivariate statistics, differences between the groups were examined.

MAIN OUTCOME MEASURES

Sexual activity measured by the Hypersexual Behavior Inventory and the Compulsive Sexual Behavior Inventory. Executive functions measured through neuropsychological testing using several subtests of Delis-Kaplan Executive Function System: Color-Word Interference Test, the Tower Test, the Trail Making Test, the Verbal Fluency Test, as well as the Wisconsin Card Sorting Test. Psychopathology was assessed using the Mini International Neuropsychiatric Interview, and cognitive ability was assessed using the Wechsler Adult Intelligence Scale.

RESULTS

Significant differences on measures of hypersexuality were observed. However, the groups failed to exhibit significant differences across neuropsychological tests of executive functioning even after controlling for cognitive ability.

CONCLUSIONS

These results contradict a previous finding of executive deficits among hypersexual men measured by self-report. The lack of executive deficits suggests that this population may exhibit domain-specific aspects of impulsivity, poor judgment, and risky behavior that are not generalizable to other domains of life. Furthermore, our findings fail to support a conceptualization of the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, proposed hypersexual disorder based on models of executive dysfunction. .

Questionnaire of executive function for dancers: an ecological approach

There is a current debate about the ecological validity of executive function (EF) tests. Consistent with the verisimilitude approach, this research proposes the ballet executive scale (BES), a self-rating questionnaire that assimilates idiosyncratic executive behaviors of classical dance community. The BES was administrated to 149 adolescents, students of the Cuban Ballet School. Results present a Cronbach's alpha coefficient of .80 and a split-half Spearman-Brown coefficient r (SB) = .81. An exploratory factor analysis describes a bifactorial pattern of EF dimensions, with a self-regulation component, which explains more than 40% of variance, and a Developmental component, which accounts for more than 20% of variance. The questionnaire's total scores fit linear regression models with two external criteria of academic records, confirming concurrent validity. These findings support the hypothesis that the internalization of specific contextual cultural meanings has a mediating influence in the development of EF.

Assessing executive performance during cognitive rehabilitation

Executive functioning influences a host of other cognitive processes and people who attend neuropsychological services are more likely to display executive dysfunction than any other cognitive deficit (Stuss & Levine, 2002). Impairment in executive functioning disrupts a person's ability to effectively employ their intact areas of functioning, and undermines effective self-management of other areas of dysfunction, hampering attempts to employ compensatory strategies. Therefore, assessment of a person's executive functioning is a high priority as part of a comprehensive neurorehabilitation plan. Guided by the International Classification of Functioning, Disability, and Health model (ICF model; Peterson, 2005), we suggest that an important development in the field is moving to formal assessment of executive performance in functional contexts, in addition to more traditional assessment of executive impairment. We outline a number of existing studies in this area, review current measures that can provide clinicians with useful information on these issues, and discuss how this research could be further advanced.

Self-reported differences on measures of executive function and hypersexual behavior in a patient and community sample of men

Patients seeking help for hypersexual behavior often exhibit features of impulsivity, cognitive rigidity, poor judgment, deficits in emotion regulation, and excessive preoccupation with sex. Some of these characteristics are also common among patients presenting with neurological pathology associated with executive dysfunction. These observations led to the current investigation of differences between a group of hypersexual patients (n = 87) and a non-hypersexual community sample (n = 92) of men using the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Hypersexual Behavior Inventory (HBI). Significant differences between the groups emerged on eight subscales and all of the general indices of executive functioning with the most dramatic differences on BRIEF-A's Shift, Emotional Control, Initiate, and Plan/Organize subscales. Hypersexual behavior was positively correlated (r = .37, p < .01) with global indices of executive dysfunction and several subscales of the BRIEF-A. These findings provide preliminary evidence supporting the hypothesis that executive dysfunction may be implicated in hypersexual behavior.

Executive functioning in college students: evaluation of the Dutch executive function index (EFI-NL)

The Executive Function Index (EFI) is a short self-report questionnaire for the assessment of executive functions (EF) as encountered in daily life. The aim of the present study is to examine the psychometric properties of the Dutch version of the EFI (EFI-NL) in a college student sample (N = 376). Internal structure was analyzed using a principal components analysis with varimax rotation, followed by parallel analysis. This resulted in a five-factor solution accounting for 44.3% of the variance. Cronbach's alpha was acceptable for the EFI total score (alpha = 0.73), but internal scale consistencies were lower, ranging from 0.41 to 0.69. In comparison with the original United States sample both similarities and differences emerged. Although the five-factor structure as found in the U.S. sample did not provide a completely adequate fit for the present data, several equivalent factors were found. The (cross-cultural) differences were discussed against the background of possible disturbing factors, such as gender, age, and educational level. In general, the results lend support for the use of the EFI-NL as a self-report measure. However, replication of the factor structure and scale results in different samples is needed to disentangle the differential effects of age, gender, and item translation.