Executive Functioning and Gambling: Performance on the Trail Making Test is Associated with Gambling Problems in Older Adult Gamblers

ABSTRACT

Rates of gambling problems in older adults have risen with increased accessibility of gambling venues. One possible contributor to problem gambling among older adults is decreased self-control brought about by diminished executive functioning. Consistent with this possibility, Study 1 revealed that older adults recruited from gambling venues reported greater gambling problems if they also experienced deficits in executive functioning, measured via the Trail Making Test. Study 2 replicated this finding and demonstrated that problem gambling is associated with increased depression among older adults, mediated by increased financial distress. These studies provide support for the hypothesis that older adult gamblers who have executive functioning problems are also likely to have gambling problems.     

Executive dysfunctions across adulthood: measurement properties and correlates of the DEX self-report questionnaire

Difficulties in executive processes can disturb daily life functioning. Using data obtained from two independent community-dwelling samples (n(1) = 468, n(2) = 669, 18-97 years), we examined the factor structure of the Dysexecutive Functioning Questionnaire (DEX) and explored the frequencies and potential correlates of self-reported executive difficulties. Our results revealed that executive problems are parsimoniously described with one underlying factor. Everyday executive dysfunctions were moderately frequent throughout adulthood. Reports of executive problems were associated with individual difference characteristics including age, subjective health, personality, affect, and cognition. We also found that, although executive functions are known to decline with advancing adult age, younger age groups reported more problems than older groups, an effect that was partially mediated by a negative affect factor. We discuss implications for the validity of the instrument as well as directions for future research on executive functioning difficulties in everyday life.     

Intact theory of mind in TBI with behavioural disturbance

Behavioural disturbance following TBI is common. Theory of mind(ToM) deficits have been noted in autism where difficulties with social interaction and communication are evident. It was hypothesised that TBI patients with behavioural disturbance would show deficits on ToM tasks independent of executive function. Twenty TBI patients with behavioural disturbance and 20 TBI patients without were assessed on verbal (stories) and non-verbal (cartoons) ToM tasks,standard psychometry, and measures of executive function.TBI patients were unimpaired on the ToM tasks. Both groups were unimpaired on standard tests of executive function (verbal fluency and trail making test) but were impaired on the Behavioural Assessment of Dysexecutive Syndrome (BADS). Groups did not differ significantly on these tests.It is concluded that ToM ability does not predict behavioural disturbance and may be independent of executive functioning.     

Behavioral dysexecutive symptoms in normal aging

Executive deficits of normal aging such as deficits in planning, organization or decision making are likely to affect elderly individuals in their daily life functioning. Therefore, executive functioning in aging seems to be interesting to study not only in cognitive terms but also in relation to the behavioral area. This pilot study aimed to investigate the nature of behavioral dysexecutive problems in a sample of normal elderly adults as measured by the Dysexecutive Questionnaire. Factor analysis showed that five interpretable factors could be derived from the DEX: intentionality (factor 1), interference management (factor 2), inhibition (factor 3), planning (factor 4), and social regulation (factor 5), suggesting that different components may underlie the behavioral dysexecutive symptoms of normal aging. The relationship between these factors and neuropsychological measures of Executive Functions were also briefly explored.     

The influence of functional social support on executive functioning in middle-aged African Americans

Social support has a positive influence on cognitive functioning and buffers cognitive decline in older adults. This study examined the relations between social support and executive functioning in middle-aged adults. A community-based sample of African Americans completed the Interpersonal Support Evaluation List, a measure of functions of social support, and two measures of executive functioning, the Stroop Color and Word Test and the Wisconsin Card Sorting Test (WCST). Hierarchical regression analyses were used to explore the hypothesis that different facets of perceived social support influence performance on measures of executive functioning. After controlling for age, gender, and education, social support facets including belonging support, self-esteem support, appraisal support, and tangible support were significant predictors of Stroop performance. In addition, tangible support significantly predicted WCST performance. These findings add to previous literature on social support and cognition; however, findings for middle-aged adults are unique and suggest that social support has a positive influence on some executive functions in African Americans prior to old age.     

The influence of functional social support on executive functioning in middle-aged African Americans

ABSTRACT

Social support has a positive influence on cognitive functioning and buffers cognitive decline in older adults. This study examined the relations between social support and executive functioning in middle-aged adults. A community-based sample of African Americans completed the Interpersonal Support Evaluation List, a measure of functions of social support, and two measures of executive functioning, the Stroop Color and Word Test and the Wisconsin Card Sorting Test (WCST). Hierarchical regression analyses were used to explore the hypothesis that different facets of perceived social support influence performance on measures of executive functioning. After controlling for age, gender, and education, social support facets including belonging support, selfesteem support, appraisal support, and tangible support were significant predictors of Stroop performance. In addition, tangible support significantly predicted WCST performance. These findings add to previous literature on social support and cognition; however, findings for middle-aged adults are unique and suggest that social support has a positive influence on some executive functions in African Americans prior to old age.     

Theory of mind in spina bifida: Relationship with intellectual and executive functioning

This article investigates emotion recognition ability, a central aspect of Theory of Mind (ToM), in a group of individuals with spina bifida myelomeningocele (SBM) experiencing executive function deficits, and examine associations between emotion recognition, and intellectual and executive functioning. A total of 38 adult subjects with SBM were included in this study, participating in a randomized controlled trial evaluating the effects of a cognitive rehabilitation intervention for executive dysfunction. Reading the Mind in the Eyes Test (RMET) was used as a measure of emotion recognition, and neuropsychological tests and questionnaires were utilized as executive function measures. One third of the participants performed poorer on the emotion recognition task compared to normative data. Emotion recognition may represent an area being affected in adults with SBM, and it is related to verbal IQ. Findings also suggest that executive functions and emotion recognition ability in adults with SBM are independent.     

Dysexecutive syndrome in schizophrenia: A cross-cultural comparison between Japanese and British patients

This study tested the hypothesis that the dysexecutive syndrome of schizophrenia is impervious to cultural differences. 18 Japanese and 22 British patients and 14 Japanese and 19 British control subjects were compared on the BADS (Behavioural Assessment of Dysexecutive Syndrome), a comprehensive neuropsychological assessment battery, designed for 'ecological validity', and other measures of frontal executive functions (EFs). Both cultural groups of schizophrenic patients showed equally severe impairment in most executive tests including the BADS (verbal fluency and intelligence were less impaired). Irrespective of cultural origin, similar neuropsychological deficits were found in patients with minimal intellectual deterioration. Our study suggests that socio-cultural background does not affect the dysexecutive profile of schizophrenia very much, and that neuropsychological assessment may possibly provide added clinical information relevant to the management and rehabilitation of schizophrenic patients across different cultures.     

Disentangling executive functions and memory processes in event‐based prospective remembering after brain damage: A neuropsychological study

Successful prospective remembering (PR) comprises at least two components: one retrospective component that refers to the encoding and retrieval of the content of the intention and a second prospective component that involves the retrieval of the intended action at the appropriate moment. Whereas the retrospective component is very similar to memory skills like learning and retention of new information, the prospective component is thought to rely mainly on executive function. Head injuries can disturb PR during both of these stages. To disentangle the relative impact of executive functions and retrospective memory processes on PR we embedded a PR task in a 2‐back verbal working memory paradigm. Fifty‐six neurological patients with brain damage of various aetiologies were divided pre‐experimentally into four groups on the basis of their delayed recall Index in the Wechsler Memory Scale‐Revised (WMS‐R, indicating absence or presence of deficits in retrospective memory functions) and their age‐corrected score in the Behavioural Assessment of the Dysexecutive Syndrome (BADS, indicating absence or presence of deficits in executive functions). Additionally, 19 controls matched for age and education were examined. We found that patients with deficits in executive functions detected fewer cues than any other group irrespective of their retrospective memory performance. However, eight patients with severe anterograde memory deficits could retain neither the intention nor its content. Thus, intactness of the retrospective component seems to be a necessary but not sufficient prerequisite for successful prospective remembering. For the execution of the intended action itself executive functions play a critical role.     

Long-term executive function deficits in children with traumatic brain injuries: assessment using the Behavior Rating Inventory of Executive Function (BRIEF).

Long-term deficits in executive functions following childhood traumatic brain injuries (TBI) were examined using the Behavior Rating Inventory of Executive Function (BRIEF). Parents completed the BRIEF approximately 5 years postinjury as part of a prospective study of children injured between the ages of 6 and 12. The children were between 10 and 19 years of age at the time of the assessment, and included 33 with severe TBI, 31 with moderate TBI, and 34 with orthopedic injuries. Parents also rated children's adaptive functioning and completed several other measures of parent and family functioning. Children were administered a neuropsychological test battery that included several measures of executive functions. The groups displayed a significant linear trend in BRIEF scores, with the largest deficits in executive functions reported in children with severe TBI. BRIEF scores were related consistently across groups to a test of working memory, but not to other neuropsychological measures. BRIEF scores also predicted children's adaptive functioning and behavioral adjustment, as well as parent psychological distress, perceived family burden, and general family functioning. The findings indicate that TBI results in long-term deficits in executive functions that are related to children's psychosocial outcomes, as well as to parent and family functioning.     

Long-Term Executive Function Deficits in Children With Traumatic Brain Injuries: Assessment Using the Behavior Rating Inventory of Executive Function (BRIEF)

Long-term deficits in executive functions following childhood traumatic brain injuries (TBI) were examined using the Behavior Rating Inventory of Executive Function (BRIEF). Parents completed the BRIEF approximately 5 years postinjury as part of a prospective study of children injured between the ages of 6 and 12. The children were between 10 and 19 years of age at the time of the assessment, and included 33 with severe TBI, 31 with moderate TBI, and 34 with orthopedic injuries. Parents also rated children's adaptive functioning and completed several other measures of parent and family functioning. Children were administered a neuropsychological test battery that included several measures of executive functions. The groups displayed a significant linear trend in BRIEF scores, with the largest deficits in executive functions reported in children with severe TBI. BRIEF scores were related consistently across groups to a test of working memory, but not to other neuropsychological measures. BRIEF scores also predicted children's adaptive functioning and behavioral adjustment, as well as parent psychological distress, perceived family burden, and general family functioning. The findings indicate that TBI results in long-term deficits in executive functions that are related to children's psychosocial outcomes, as well as to parent and family functioning.     

Executive Dysfunctions Across Adulthood: Measurement Properties and Correlates of the DEX Self-Report Questionnaire

ABSTRACT

Difficulties in executive processes can disturb daily life functioning. Using data obtained from two independent community-dwelling samples (n ₁?=?468, n ₂?=?669, 18–97 years), we examined the factor structure of the Dysexecutive Functioning Questionnaire (DEX) and explored the frequencies and potential correlates of self-reported executive difficulties. Our results revealed that executive problems are parsimoniously described with one underlying factor. Everyday executive dysfunctions were moderately frequent throughout adulthood. Reports of executive problems were associated with individual difference characteristics including age, subjective health, personality, affect, and cognition. We also found that, although executive functions are known to decline with advancing adult age, younger age groups reported more problems than older groups, an effect that was partially mediated by a negative affect factor. We discuss implications for the validity of the instrument as well as directions for future research on executive functioning difficulties in everyday life.     

Planning and realization of complex intentions in traumatic brain injury and normal aging

The realization of delayed intentions (i.e., prospective memory) is a highly complex process composed of four phases: intention formation, retention, re-instantiation, and execution. The aim of this study was to investigate if executive functioning impairments are related to problems in the formation, re-instantiation, and execution of a delayed complex intention. In this context, it was another aim of the study to investigate the executive functioning hypothesis of cognitive aging in prospective memory performance. It was, therefore, explored if age-related prospective memory decline leads to similar decrements in the process of prospective remembering as executive functioning-related decline in young patients with traumatic brain injury. A group of patients with traumatic brain injury with retrospective memory within normal limits but impaired executive functions, a group of healthy older and a group of healthy younger adults completed a complex prospective memory task that allows for the separate assessment of the four phases of the prospective memory process. All groups showed a similarly high performance in the intention retention phase, whereas the patients with deficits in executive functioning and the older participants performed worse than the healthy young participants in the intention formation, re-instantiation and execution phases. The importance of executive functioning for prospective remembering in traumatic brain injury and normal aging is discussed.     

Aging and self-reported internal and external memory strategy uses: The role of executive functioning

The aim of this study was to investigate the effect of advanced age on self-reported internal and external memory strategy uses, and whether this effect can be predicted by executive functioning. A sample of 194 participants aged 21 to 80 divided into three age groups (21-40, 41-60, 61-80) completed the two strategy scales of the Metamemory in Adulthood (MIA) questionnaire, differentiating between internal and external everyday memory strategy uses, and three tests of executive functioning. The results showed that: (1) the use of external memory strategies increased with age, whereas use of internal memory strategy decreased; (2) executive functioning appeared to be related only to internal strategies, the participants who reported the greatest use of internal strategies having the highest executive level; and (3) executive functioning accounted for a sizeable proportion of the age-related variance in internal strategy use. These findings suggest that older adults preferentially use external memory strategies to cope with everyday memory impairment due to aging. They also support the view that the age-related decrease in the implementation of internal memory strategies can be explained by the executive hypothesis of cognitive aging. This result parallels those observed using objective laboratory memory strategy measures and then supports the validity of self-reported memory strategy questionnaire.     

Modeling a cascade of effects: the role of speed and executive functioning in preterm/full-term differences in academic achievement

This study identified deficits in executive functioning in pre-adolescent preterms and modeled their role, along with processing speed, in explaining preterm/full-term differences in reading and mathematics. Preterms (< 1750 g) showed deficits at 11 years on a battery of tasks tapping the three basic executive functions identified by Miyake - updating/working memory, inhibition, and shifting. Confirmatory factor analysis showed that these executive functions, though correlated, were distinct from one another and from processing speed, which later proved to account for much of the intercorrelation among executive functions. In the best-fitting structural equation model, the negative effects of prematurity on achievement were completely mediated by the three executive functions and speed in a cascade of effects: prematurity → slower processing speed → poorer executive functioning (working memory) → lower achievement in math and reading.     

The role of white matter hyperintensities and medial temporal lobe atrophy in age-related executive dysfunctioning

Various studies support an association between white matter hyperintensities (WMH) and deficits in executive function in nondemented ageing. Studies examining executive functions and WMH have generally adopted executive function as a phrase including various functions such as flexibility, inhibition, and working memory. However, these functions include distinctive cognitive processes and not all may be affected as a result of WMH. Furthermore, atrophy of the medial temporal lobe (MTA) is frequently observed in ageing. Nevertheless, in previous studies of nondemented ageing MTA was not considered when examining a relationship between white matter and executive function. The goal of the present study was to examine how WMH and MTA relate to a variety of executive functions, including flexibility, fluency, inhibition, planning, set shifting, and working memory. Strong correlations were observed between WMH and MTA and most of the executive functions. However, only MTA was related to flexibility and set shifting performance. Regression analysis furthermore showed that MTA was the strongest predictor of working memory, after which no further significant association with WMH was noted. Alternatively, both MTA and periventricular hyperintensities independently predicted inhibition performance. These findings emphasize the importance of MTA when examining age-related decline in executive functioning.     

ADHD outside the laboratory: boys' executive function performance on tasks in videogame play and on a visit to the zoo

One current theory of attention-deficit/hyperactivity disorder (ADHD) proposes that a primary deficit in behavioral inhibition gives rise to secondary deficits in 4 executive functions and motor control. To date, empirical support for this model is based primarily on laboratory-based cognitive methods. This study assessed behavioral inhibition and executive functioning in children with ADHD in 2 real-life contexts: videogames (motor-skill target game, cognitively demanding adventure game) and an outing at the zoo (route tasks). Participants were a community sample of 57 boys diagnosed with ADHD (20 inattentive, 37 combined type) and 57 normally developing control boys, matched individually for age and nonverbal IQ. Operationally defined measures of behavioral inhibition and specific executive functions were derived from these activities and assessed under contrasting conditions of low or high working memory and distractor loads. There were no group differences in basic motor skills on the target game, nor in terms of the ability to inhibit a prepotent or ongoing response in the adventure videogame. However, boys with ADHD exhibited more self-talk, more effortful response preparation, and completed fewer challenges in the latter videogame. Also, they manifested inhibition deficits in terms of interference control during the route task at the zoo and took longer to complete the tasks. Typically, these differences were greatest under conditions of high working memory and distractor loads. Findings from this study suggest that cognitive difficulties in ADHD may be context dependent and that ADHD is associated with deficits in some but not all aspects of behavioral inhibition.     

The involvement of executive functions in prospective memory performance of adults

The present study examines the relationship between prospective memory performance and executive functioning. The four phases of the prospective memory process—intention formation, intention retention, reinstantiation of the intention, and intention execution—are assumed to require different amounts of executive processing, most of which is demanded in the phases of intention formation and intention execution. At present, though, it is still unclear whether, and to what extent, prefrontal executive systems are involved in different kinds of prospective memory tasks, as some findings suggest that prospective memory might rather rely on nonstrategic processes that are unlikely to depend on prefrontal executive systems. Therefore, this study focuses on the following questions: (1) to what degree does executive functioning predict prospective memory performance in different standard prospective memory tasks and, furthermore, are certain executive measures better predictors than others; (2) are age‐related effects in different prospective memory measures due to individual differences in executive functioning; and (3) do age‐related differences in prospective memory exist that are not explained by individual differences in executive functioning. In a sample of 80 adults (20‐80 years), we applied four instruments to measure prospective memory: a traditional single‐task paradigm, two more complex tasks—one time‐based and one event‐based—and a highly complex multi‐task paradigm. We further assessed a broadly defined construct of executive functioning using several standard neuropsychological tests. Results showed that executive functioning did not predict performance in the simple single‐task paradigm. However, executive functioning, but not age, predicted performance in the two more complex standard tests of prospective remembering, and both executive functioning and age predicted performance in the most complex paradigm. In sum, the obtained data underline the assumption that frontal/ executive functions are related to prospective memory performance across a range of prospective paradigms. It also seems clear that age differences in prospective memory performance partially depend on age‐related individual differences in frontal/executive functions.     

Metaphor comprehension in Alzheimer's disease: novelty matters

The comprehension of non-literal language was investigated in 20 probable Alzheimer's disease (pAD) patients by comparing their performance to that of 20 matched control subjects. pAD patients were unimpaired in the comprehension of conventional metaphors and idioms. However, their performance was significantly lower in the case of non-conventional (novel) metaphor comprehension. This ability was not related to global cognitive deterioration or to deficits in the cognitive domains of attention, memory and language comprehension. On the other hand, the impairment in verbal reasoning appeared to be relevant for both novel and conventional metaphor comprehension. The relationship between novel metaphor comprehension and performance in the visual-spatial planning task of the Behavioral Assessment of the Dysexecutive Syndrome (BADS) suggests that executive impairment, possibly related to prefrontal dysfunction, may be responsible for the pAD patients' poor performance in novel metaphor comprehension. The present findings suggest a role of the prefrontal cortex in novel metaphor comprehension.     

Sense of Time and Executive Functioning in Children and Adults

A number of patient studies suggest that impairments in frontal lobe functions are associated with disorders in temporal information processing. One implication of these findings is that subjective experience of time should be related to executive functions regardless of etiology. In two experiments, we examined sense of time in relation to components of executive functioning in healthy children and adults. In Experiment 1, children between 8 to 12 years completed six experimental tasks that tapped three components of executive functioning: inhibition, updating, and mental shifting. Sense of time was examined in a duration judgment task in which participants reproduced stimulus durations between 4 to 32 s. In Experiment 2, adult participants completed the time reproduction task under varying concurrent task demands. Both experiments showed selective effects in that time reproduction errors were related to the inhibition and updating, but not to the shifting, components of executive functioning. However, the observed effects were modulated by task demands and age-related differences in cognitive competence. We conclude that individual differences in executive functioning are only weakly related to time reproduction performance in healthy children and adults.