Advancing understanding of executive function impairments and psychopathology: bridging the gap between clinical and cognitive approaches

Abstract

Executive function (EF) is essential for successfully navigating nearly all of our daily activities. Of critical importance for clinical psychological science, EF impairments are associated with most forms of psychopathology. However, despite the proliferation of research on EF in clinical populations, with notable exceptions clinical and cognitive approaches to EF have remained largely independent, leading to failures to apply theoretical and methodological advances in one field to the other field and hindering progress. First, we review the current state of knowledge of EF impairments associated with psychopathology and limitations to the previous research in light of recent advances in understanding and measuring EF. Next, we offer concrete suggestions for improving EF assessment. Last, we suggest future directions, including integrating modern models of EF with state of the art, hierarchical models of dimensional psychopathology as well as translational implications of EF-informed research on clinical science.

Getting “Stuck” in the Future or the Past: Relationships between Dimensions of Time Perspective, Executive Functions, and Repetitive Negative Thinking in Anxiety

“…How the relationships between these variables vary over time is a topic that remains to be addressed by studies using longitudinal study designs. Another limitation concerns the use of a mixed sample of anxiety disorders, which potentially masked differences in effects for different disorders [3, 45]. Unfortunately, there were too few participants in each anxiety disorder category to examine whether the results differed between different disorders.…”

“…It is a version of the classical Stroop task, which has been widely used in research of executive functioning in both normal [35] and various clinical populations [3]. In this task, subjects are first asked to as quickly as possible name the color (blue, red, green, and yellow) of a number of colored x s, which are placed randomly in 10 rows of 10 stimuli for each row.…”

“…For instance, Joorman et al [32] argued that problems with inhibition may underlie rumination, in the sense that inhibition deficits lead to problems with redirecting attention and disengaging from negative thought material, which in turn causes a vicious circle of recurring negative thoughts or images (i.e., rumination). Given commonalities between worry and rumination (i.e., intrusive, repetitive, and relatively uncontrollable thoughts), the same line of reasoning can also be applied in explaining the relationship between worry and deficits in executive functioning [for a review, see 3]. …”

“…Anxiety disorders can persist for several years and are associated with a significant decrease in quality of life and impaired psychosocial functioning [2]. Anxiety disorders are complex and associated with a broad range of cognitive impairments, such as impairments in executive functions [3], distortions in temporal information processing [4], and repetitive negative thinking (i.e., worry and rumination [5]). Here we wanted to shed more light on the complexities of anxiety by studying interrelationships between executive functions, temporal information processing (specifically time perspective), and repetitive negative thinking in psychiatric patients with anxiety disorders and healthy controls.…”

Ecological validity of the five digit test and the oral trails test

“…also be investigated in clinical populations since alterations in the attentional-executive system if often present 25 .…”