Term
| The dilemmas of pre-frontal function and dysfunction |
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Definition
| "Higher" cognitive functions are often implicit - background processes. They are not directly observable or measurable out of context with other processes, and dysfunction is often associated with forms of acquired injuries or developmental issues. Dysfunction is very context dependent, few good validity studies, minimal normative data, no reliability studies. |
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Term
| The importance of studying pre-frontal function and dysfunction |
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Definition
| High prevalence of developmental disorders, congenital, or acquired disorders, and other medical or toxic conditions effect this area, its essential for all forms of functioning, its difficult to recognized and assess meaningfully and is often undetected, and the degree and type of rehabilitation needs to be specific to type of disruption. |
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Term
| Errors in detection of pre-frontal dysfunction |
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Definition
| Often misconstrued as "attitude" problem, can present as "ignorant", "naive", "stupid", "inappropriate", or "impulsive", can look like and test like amnesia, Axis II, motivation loss, rigidity, indifference, etc., history is key in these cases. |
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Term
| What are the main executive functions? |
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Definition
| Planning, organizing, problem solving, self-monitoring, initiation, inhibition, set shifting. These all underlie and depend upon attention and working memory. |
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Term
| What are the executive functions core abilities? |
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Definition
| Paying attention despite external distraction = selective or focused attention. Sustaining attention despite internal or external distraction, boredom, affect, etc. = discipline. Inhibiting action, controlling impulses, resisting jumping to conclusions, etc. = self-control. |
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Term
| What do all actions require a balance of? |
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Definition
| Topographically organized: Energization; initiation and attention. Executive; decision making/problem solving. Regulation; emotional and behavioral control. Metacognition; thinking and experiencing. |
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Term
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Definition
| Functional divisions include dorsolateral, ventrolateral, orbital medial, and the "frontal poles". |
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Term
| Dysfunction seen in initiation... |
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Definition
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Term
| Dysfunction seen in planning... |
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Definition
| disorganization, poor foresight |
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Term
| Dysfunction seen in sequencing... |
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Definition
| priorities, time management, values |
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Term
| Dysfunction seen in inhibition... |
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Definition
| impulsivity, reactivity (most obvious change) |
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Term
| Dysfunction seen in flexibility... |
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Definition
| literality, poor shifting of set, rigidity |
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Term
| Dysfunction seen in self-monitoring... |
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Definition
| poor insight, limited self-correction, poor hygiene |
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Term
| New ideas about pre-frontal function and dysfunction |
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Definition
| Consider concept of "Supervisory Attentional System" rather than "Executive", fragmented into a group of general control process, most forms of pre-frontal injury produce some form of attentional control and dysfunction. |
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Term
| How to assess pre-frontal dysfunction |
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Definition
| Clinical observation; maintaining, directing, focusing, and switching attention problems are the most obvious, internal vs. external attentional processes need to be differentiated: how are you feeling? vs. how are you doing? |
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Term
| Energization definition and location |
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Definition
| The process of initiating and sustaining responses. The most obvious deficits here stem from superior medial and anterior cingulate injury. |
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Term
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Definition
| Motor speed and reaction time tests, continuous performance tests, distraction tests, rapid choice tests. |
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Term
| Task Setting definition and location |
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Definition
| The ability to establish a stimulus-response relationship requiring formation of a response criterion, defining specific targets, and organizing schema for acting. Most obvious deficits here are seen after ventro-lateral damage. |
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Term
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Definition
| Hypothesis generation and testing, go-no go tasks, categorization, complex problem solving, over-learned task suppression. |
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Term
| Monitoring definition and location |
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Definition
| The process of checking the task over time for "quality control" and the adjustment of subsequent/consequent behavior. Deficits here are seen after right lateral damage. |
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Term
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Definition
| Recognition, forced-choice, checking performance, following rules. |
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Term
| Metacognition definition and location |
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Definition
| The process of working with information, conceptualizing, abstracting, imagining, thinking "outside of the box", awareness. Issues here arise out of damage to the pre-frontal poles. |
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Term
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Definition
| Similarities, proverbs tests, problem-solving tests, 20-Questions test, social comprehension. |
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Term
| Behavioral and Emotional self-regulation definition and location |
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Definition
| The ability to control actions and affective responses on the basis of context (including rules/laws), history, and culture. Issues here arise from the orbital and ventromedial prefrontal cortex. |
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Term
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Definition
| Behavioral observations, self-statements and demonstrations of anger, frustration, or excessive emotionality. Impulsivity, interruption, impatience, and intrusions can reflect dysfunction - but can also be attitudinal or characterological. |
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Term
| Poor learning across repeated trials? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Relatively clear onset of signs and symptoms with detailed complaints of loss of abilities? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Poor performance despite good effort? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
| Cortical, subcortical, amnestic |
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Term
| Poor recognition with almost no recall? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Prior to dementia, depression appeared without psychosocial precipitants. Patients only complaints were weakness and a tendency to drop things and trip? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Cueing can help recall? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Poor performance despite giving patient strategies? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Interference (both forms) is strong? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Numerous false positives on recognition? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Numerous deficits in memory without vegetative signs? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
| amnestic, subcortical, cortical |
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Term
| Immediate and delayed recall are relatively good? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Intrusions occur with delay? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Reliance on serial clustering over semantic clustering? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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Term
| Recognition worse than recall? Is it a cortical, subcortical, amnestic, or depressive disorder? |
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Definition
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