What Is Executive Dysfunction?

Sherri Gordon
·7 min read
<p>Maskot / Getty Images</p>

Maskot / Getty Images

Medically reviewed by Kathleen Daly, MD

Executive dysfunction is a phrase used to describe the challenges someone has with their executive functioning, such as difficulties with with memory, thinking, planning, and organizing. Executive dysfunction is not an official diagnosis, but instead it's a symptom of another condition like depression, attention deficit hyperactivity disorder (ADHD), traumatic brain injury, Alzheimer's, and more.

While everyone experiences varying degrees of executive dysfunction, it is not uncommon for people to experience trouble remembering things, sticking to a schedule, or controlling their thoughts and behaviors. Usually, the diagnosis and treatment for executive dysfunction is included in the treatment plan for the condition or disease that is causing the issues with executive functioning.

Keep reading if you want to learn more about executive dysfunction and its symptoms, causes, diagnosis, treatment, and prevention.

Symptoms of Executive Dysfunction

If you have executive dysfunction, you may display a range of behavioral symptoms, many of which could interfere with your quality of life. These symptoms change how you regulate your feelings, thoughts, and actions.

Here are some of the symptoms associated with executive dysfunction:

  • Having trouble planning or organizing activities

  • Failing to meet deadlines

  • Struggling to follow steps needed to complete a task

  • Having trouble staying focused

  • Not being on time for appointments, work, school, and more

  • Trouble regulating emotions

  • Losing track of belongings

  • Struggling to remember things

  • Finding it hard to switch between tasks

  • Struggling to stay motivated

  • Not being able to multitask

  • Appearing inflexible

  • Struggling to solve problems

What Causes Executive Dysfunction?

It is important to remember that executive function is not a diagnosis. Instead, it is often a symptom of another condition, disease, or disorder. If your healthcare provider notices that you are struggling with executive dysfunction, they will likely look for an underlying cause.

Executive dysfunction is frequently caused by a neurological issue. This could be from an injury, a mental health condition, or a disease. However, there are times when executive dysfunction can be the result of your environment. For instance, if you abuse alcohol or drugs, this could impact your executive functioning. Even stress, exhaustion, or boredom can cause executive dysfunction.

Risk Factors

Having certain diseases or mental health conditions put you at risk for executive dysfunction—especially neurological disorders. While not everyone will experience issues in the same way, there is a risk for issues with executive functioning if you have one or more of the following conditions:

How Is Executive Dysfunction Diagnosed?

Because executive dysfunction is not listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), a healthcare provider or mental health professional will not diagnose you with executive dysfunction. Instead, they will note the challenges you are having with executive functioning and look for an underlying cause.

That said, there are instruments and tests that can be used to assess executive functioning and cognitive skills such as planning, organization, inhibition, mental agility, and distractibility. Some of the tools used to asses these skills include Word Fluency Task, Stroop Test, Wisconsin Card Sorting Test, and the Trail Making Test.

Here is a closer look at each test:

  • Word Fluency Task: During this test, you will be given one minute to produce as many unique words as possible within a category or starting with a given letter. You score is the number of correct words you produce.

  • Stroop Test: This neuropsychological test assesses your attention capacity and processing skills. During the test, you might be asked to read the name of a color that is printed in a different color. In other words, you might be asked to read the word "red," but the letters are printed in yellow.

  • Wisconsin Card Sorting Test: With this neuropsychological test, you will be given cards and then asked to match the cards. You will not be told how to match the cards, but will be given feedback when the matches are right or wrong.

  • Trail Making Test: As a timed neuropsychological test, this two-part assessment evaluates visual scanning capabilities and working memory. Using a pencil and paper, you will be asked to connect randomly placed circles in ascending order. Then, you will be asked to connect randomly placed circles in ascending order alternating between numbers and letters.

Treatments for Executive Dysfunction

Typically, the treatment options for executive dysfunction are dictated by the condition that is causing your issues with executive functioning. That said, there are a number ways that neurological disorders are addressed. Here are some of the common treatments that may impact executive dysfunction.

  • Therapy: Depending on your needs, your healthcare provider may recommend cognitive behavioral therapy or occupational therapy with a mental health professional who can give you tools and strategies for dealing with your challenges.

  • Medications: If the condition you have can be treated with a medication, you may be given a prescription. Sometimes people with executive dysfunction may be treated with antidepressants, stimulants, or antipsychotic medications.

How to Prevent Executive Dysfunction

Because executive dysfunction often co-occurs with another condition like ADHD, depression, schizophrenia, mood disorders, or Alzheimer's, there is no way to prevent it from occurring. But you can reduce the severity of the symptoms by following the treatment plan created by your healthcare provider.

Sometimes, though, executive dysfunction is caused by a traumatic brain injury. In those situations, you may be able reduce the likelihood of experiencing a brain injury. One way to do that is by following safety guidelines.

For instance, you should wear a helmet when cycling, put a seatbelt on when riding in a car, and never drive under the influence. And while taking the proper precautions will certainly reduce your risk, accidents still happen.

Complications of Executive Dysfunction

Because your executive function plays a vital role in your ability to function as expected, having executive dysfunction can cause you to struggle with different areas of your life. This can result in issues with with school, work, family, and relationships.

For instance, you may forget important dates or deadlines, promise to do something and then not follow through, or have trouble controlling your emotions. This can strain your interactions and damage both personal and professional relationships.

There also is evidence that having executive dysfunction may make you more prone to complications later in life, particularly with depression. In fact, research indicates that having executive dysfunction may lead to a poor response to antidepressants later in life.

A Quick Review

When someone experiences challenges with their executive functioning such as trouble with memory, thinking, planning, and organizing, they have executive dysfunction. Typically, this condition is caused by neurological issues like ADHD, dementia, depression, traumatic brain injury, and more.

For this reason, it is not an official diagnosis but instead a symptom of something else. Consequently, executive dysfunction is treated alongside the condition causing the difficulties. There also is no way to prevent executive dysfunction from occurring.

If you are experiencing challenges with your executive functioning, it is important to talk to a healthcare provider. They can let you know what is at the root of the challenges you are experiencing and recommend a treatment plan.

Frequently Asked Questions

Is ADHD the same as executive dysfunction?

Executive dysfunction and ADHD are not the same thing. Although executive dysfunction can be a symptom of of ADHD, it is not an official diagnosis like ADHD is. Additionally, executive dysfunction can be a symptom of many other conditions like traumatic brain injury, depression, and dementia.

What’s the difference between executive dysfunction and procrastination?

While executive dysfunction and procrastination may seem similar at first glance, they are actually different. For instance executive dysfunction occurs when someone has difficulty managing, planning, and executing their tasks due to challenges with their executive function. Meanwhile, procrastination is the conscious decision to put off completing a task.

Is executive dysfunction preventable?

Executive dysfunction is usually not preventable because it often co-occurs with another condition like ADHD, depression, or Alzheimer's. That said, sometimes executive dysfunction is caused by a traumatic brain injury. In those situations, you can reduce the likelihood of getting a brain injury by following safety guidelines like wearing a helmet when cycling, putting a seatbelt on in a car, and wearing a hard hat in construction zones. Of course, accidents can still happen even when you are careful, but taking the proper precautions can certainly reduce your risk.

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