The goal-control model: An integrated neuropsychological framework to explain impaired performance of everyday activities.

Abstract

Objective: This review describes the relatively small body of neuropsychological and cognitive research conducted over the past 100 years focused on theoretical models explaining the neurocognitive processes that support everyday functioning and the breakdown of functional abilities in the face of neurological damage or disease. Method: The historical roots of the theories of everyday activities based on direct observation of behavior in neurology and diary reports of everyday errors in cognitive psychology are presented, followed by a review of the empirical findings and resulting theoretical conceptualizations from case studies and group studies of various clinical populations in neuropsychology. Results: We conclude with a new framework (the goal-control model) that integrates the most recent empirical findings in neuropsychology with mechanisms proposed by cognitive models. Conclusions: The goal-control model offers empirically supported solutions to understanding and predicting functioning in the real world. This new model generates testable predictions for future research and provides guidance for clinical assessment and interventions.

Capturing Cognitive Aging in Vivo: Application of a Neuropsychological Framework for Emerging Digital Tools

“…An alternative framework from which to interpret early patterns of inefficiency and variability, particularly in the absence of executive function deficits, is the resource theory [ 116 ], which originates from the cognitive rehabilitation literature. This theory posits that early damage to any nonspecific brain region depletes overall cognitive resources and leads to errors in task performance and that the level—not the type—of cognitive impairment is critical in determining functioning [ 109 ]. As a result of mild resource depletion, compensatory strategies are engaged to allow the system to function, but at a cost (ie, inefficiently, slowly, and inconsistently).…”

“…The term "graceful degradation" is used to characterize the way in which complex systems maintain functionality in the face of mild damage or problematic changes in the environment [108]. From a neuropsychological perspective, increased inefficiency and variability in the early stage of decline may stem from faulty executive control mechanisms governed by the prefrontal cortex and associated white matter projections, which, according to a framework proposed by Giovannetti and colleagues [109], are essential to modulate goal activations, enable smooth transitions between goals, and inhibit inappropriate activations from internal or external distractors during everyday tasks. Reductions in extrastriatal dopaminergic neuromodulation required for consistent cognitive control in early stages of dementia support this framework [110][111][112].…”

Similarities between Cognitive Models of Language Production and Everyday Functioning: Implications for Development of Interventions for Functional Difficulties

“…The goal‐control model of everyday action builds on prior theories of action in the cognitive (Cooper & Shallice, 2006; Cooper, Ruh, & Mareschal, 2014; Norman & Shallice, 1986) and clinical dementia (Giovannetti et al., 2008) literatures to explain errors in everyday activities across the spectrum from healthy aging to moderate‐level dementia (Giovannetti, Mis, Hackett, Simone, & Ungrady, 2021). Similar to existing models, the goal‐control model represents everyday activities as goal hierarchies, with intentions (i.e., higher level goals, such as “make coffee”) at the highest level of the goal hierarchy, followed by lower‐level goals (e.g., “add coffee grinds”) at intermediate levels, and manual gestures (e.g., “grab spoon”) at the lowest levels.…”

“…Uniquely, the goal‐control model was developed to account for errors in everyday action in individuals with neurologic cognitive impairment and thus emphasizes error mechanisms . There are many potential sources of errors during everyday task execution, but two distinct mechanisms are suggested based on prior empirical data from clinical populations (Giovannetti et al., 2021). First, failure of control mechanisms leads to interference from competing goals or objects in the environment, resulting in inappropriate reaching movements (e.g., microerrors––reaching for an ice cream scoop in place of a spoon) and inefficient action performance (e.g., commission errors––mis‐sequencing task steps).…”

Introduction to the special issue on the neuropsychology of daily life.

“…For example, few theories and conceptual models have been available to guide research in this complex area (see Marcotte & Grant, 2010). To that end, this special issue includes a thought-provoking article from Giovannetti et al (2021) that provides a conceptual roadmap for studying the neuropsychology of everyday actions, as well as an article from Kraal et al (2021) that proposes an interesting framework for examining functional reserve, which extends the already influential concept of cognitive reserve (Stern, 2009).…”