Executive functions - what they are, how they work and why they evolved

#adhd #russell barkley #cbt #executive functions #psychiatry #book

Chapter: 8
Sentence: Without a coherent theory of EF, constructs have multiplied to the extent that 33 or more have been claimed to be involved in this “metaconstruct” or umbrella term (Eslinger, 1996).
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Chapter: 8
Sentence: Executive functions refer to a collection of interrelated cognitive and behavioral skills that are responsible for purposeful, goal-directed activity, and include the highest level of human functioning, such as intellect, thought, self-control, and social interaction (Lezak, 1995, p. 42).
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Chapter: 9
Sentence: A second aim of this book is to bridge this gap between these psychometric versus ethological methods of assessing EF to show how this state of affairs could arise, what it means for conceptualizing EF, and how to resolve it.
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Chapter: 11
Sentence: Both Bekhterev (1905–1907) and later Pavlov (see Luria, 1966, p. 222) observed that damaging the prefrontal lobes resulted in a disintegration of goal-directed behavior, which they saw as the principal function of the PFC.
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Chapter: 11
Sentence: Cross-temporal synthesis is based on three PFC components: (1) working memory, which is a temporally retrospective function; (2) anticipatory set (planning), which is a temporally prospective function; and (3) interference control (a form of attention that involves resistance to distraction), which inhibits the disruption of goal-directed behavior by events or behavior that are irrelevant to or incompatible with the goal.
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Chapter: 11
Sentence: Eslinger (1996) in particular would later take up this call for the importance of EF (the PFC) in managing the social conduct of the individual.
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Chapter: 11
Sentence: He argued that EF contains “social executors” that each serve certain social functions: (1) social self-regulation: processes needed to manage the initiation, rate, intensity, and duration of social interactions; (2) social self-awareness: knowledge and insight about oneself and the impact of one’s behavior on others in social settings; (3) social sensitivity: the ability to understand another’s perspective, point of view, or emotional state (similar to empathy); and (4) social salience: regulation of somatic and emotional states that impart a sense of meaningfulness to social situations and to specific individuals within that situation (p. 390).
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Chapter: 11
Sentence: He lists the following as some of the social deficits arising from PFC (hence EF) damage: demanding and self-centered behavior, lack of social tact and restraint, impulsive speech and actions, disinhibition (of immediate self-interests), apathy and indifference, and lack of empathy, among others.
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Chapter: 11
Sentence: It is axiomatic that we do not live alone—humans are a group-living social species.
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Chapter: 11
Sentence: Perhaps this neglect arises because computers do not have emotions that need self-regulating and do not have to self-motivate.
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Chapter: 11
Sentence: The supposedly “cool” EF brain networks, such as working memory, planning, problem solving, and foresight, may provide for the “what, where, and when” of goal-directed action, but it is the “hot” EF brain network (Castellanos et al., 2006; Nigg & Casey, 2005) that provides the “why” or basis for choosing to pursue that goal in the first place and the motivation that will be needed to get there.
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Chapter: 11
Sentence: This is a very passive view of the organism, devoid of what makes living things unique—they are self-interested agents!
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Chapter: 11
Sentence: Computers are not self-interested, do not self-assemble, do not compete with other computers for resources or mating rights, and do not concern themselves with the source of their own fuel or the integrity of their hardware.
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Chapter: 11
Sentence: And we have ample evidence that this sense of ourselves as an active, thinking–choosing agent can be diminished by brain injuries, especially to the PFC.
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Chapter: 11
Sentence: One chooses what he or she will do and ought to do using one’s self-awareness and sense of the future—the longer-term consequences that are likely to ensue for one’s self and for others given the various choices under consideration.
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Chapter: 13
Sentence: Vicarious learning is a particularly useful adaptation when it comes to learning from the mistakes made by others, some of which can be injurious or even lethal.
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Chapter: 13
Sentence: There may be other social problems that the EF system has evolved to solve (Rossano, 2011).
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Chapter: 13
Sentence: These may include theory of mind (anticipating that another also has a mind and especially an EF system and acting accordingly) and empathy (Grattan, Bloomer, Archambault, & Eslinger, 1994).
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Chapter: 46
Sentence: The components of EF are essential in directing and sustaining human action toward a goal.
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Chapter: 46
Sentence: Such foresight, choice, and the calculated actions to which they lead are therefore the starting point for the study of economics.
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Chapter: 46
Sentence: The location for such market exchanges eventually may become a common, specific setting or place, then known as a marketplace, but this should not disguise the fact that a market is a process, not a location (Mises, 1990).
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Chapter: 47
Sentence: Evolutionary psychology, however, has shown that other species have evolved prototypical forms of morality such as reciprocity.
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Chapter: 47
Sentence: In short, it is not always in the best interests of a self-interested creature to always maximize short-term interests; it is possible to derive a greater payoff by reciprocating on some occasions with others.
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Chapter: 47
Sentence: When humans live in groups and repeatedly intersect with each other as they each pursue their own goals, there is also the repeated likelihood that their paths and goals will conflict.
My notes: - need for ethics

Chapter: 47
Sentence: Ethics are like the rules we adopt for driving so that all drivers can get to their destinations more efficiently and effectively while interacting with other drivers.
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Chapter: 47
Sentence: It includes a capacity to contemplate the welfare of or consequences to others as well as one’s self as a result of the actions and goals being contemplated.
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Chapter: 47
Sentence: Research indicates that the PFC and hence the EF system participates in a person’s efforts to confront and resolve just such moral dilemmas (Hauser, 2006; Wright, 1994).
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Chapter: 47
Sentence: To reiterate, EF/SR extends outward as a phenotype to become essential to social exchange (reciprocity) and trading, as well as to ethics and economics.
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Chapter: 47
Sentence: That is because it provides the means by which (1) we perceive and conceive of the future or the longer term and so of the greater payoffs that these social activities can provide to us; (2) we are able to construct and follow rules to guide our choices and commensurate actions over that time period; (3) we rapidly calculate the costs-benefits (subjective value) of those choices (means and ends) over time beforehand; (4) we restrain or otherwise subordinate our immediate short-term interests to our longer-term interests so as to obtain greater mediate or longer-term consequences; (5) we activate, manage, and otherwise regulate emotional and motivational states in the service of these goals in the context of the actions and motivations of others; and (6) we self-organize the environment and others within it so as to be more likely to attain our goals and to attain larger goals than by acting in isolation, independently, or parasitically.
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Chapter: 48
Sentence: The relationship of EF/SR to social relations may also be bidirectional.
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Chapter: 48
Sentence: As Carver and Scheier (2011) noted, self-regulation (or EF) can be thought of as a four-step process in which one engages in goal setting and initiation (goal choice), goal operation (the course of action being pursued toward the goal), goal monitoring (feedback on the current state relative to the desired goal), and effective outputs (using the feedback to adjust actions, rate of progress, and even to reprioritize goals).
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Chapter: 51
Sentence: In this instance, that social means is reciprocity—mutual exchange of resources, goods, and services that yields a greater longer-term payoff for participants than had either party acted alone or tried to parasitize the other.
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Chapter: 52
Sentence: Third, the individual finds that EF tactics being employed for a goal can become a submeans to attain larger, longer-term ones.
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Chapter: 53
Sentence: EF has been shown to be an important contributor to cooperative social behavior in children (Best et al., 2009; Ciariano et al., 2007; Mischel et al., 1989; Mischel, Shoda, & Rodriguez, 1989).
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Chapter: 53
Sentence: It has arisen multiple times at significant transitions in biological evolution as when genes combined to create chromosomes, cells combined to create eukaryotes, eukaryotic cells combined to create multicellular bodies, and when those individual bodies combine to create a social cooperative (Maynard Smith & Szathmary, 1999; Michod, 1999).
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Chapter: 54
Sentence: This may account for why some of the earliest forms of human cooperative action arose within genetically related families.
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Chapter: 56
Sentence: The existence of culture means that each individual or cooperative does not have to start again from scratch to discover useful means to various goals.
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Chapter: 56
Sentence: For example, this Strategic–Cooperative level of EF may include EF abilities such as self-management across time, self-organization and problem solving, self-discipline, self-motivation, and self-regulation of emotions as employed over weeks, months, and even years to attain one’s long-term goals and to see to one’s longer-term welfare at these durations (Barkley, 2011a).
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Chapter: 56
Sentence: When it is no longer in someone’s self-interest to engage in division of labor and trade with particular others, he or she will not continue to do so.
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Chapter: 56
Sentence: Such an analysis makes it evident that people do not pursue a group-living, cooperative, existence because of some innate need to bond or cooperate with others.
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Chapter: 56
Sentence: Cooperative action is situational and group specific.
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Chapter: 56
Sentence: Nor do they do so because of some spiritual quest for oneness of humanity or because of some utopian vision to perfect humankind.
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Chapter: 56
Sentence: They have foresight and so can realize that each is far better off and can achieve more goals more efficiently (Brown & Vincent, 2008) and more likely by engaging in a division of labor with trade (Mises, 1990; Ridley, Matt, 2010).
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Chapter: 57
Sentence: All members of the group have come to understand that over the long term the self-interests of any individual nearly always converge with the long-term self-interests of others.
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Chapter: 59
Sentence: EF is self-regulation across time to direct and sustain goal-directed action in the context of others, often relying on social means.
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Chapter: 59
Sentence: Yet given what has transpired to produce this higher level of the EF phenotype, we can now amend the definition yet again: the use of self-directed actions so as to choose goals and to select, enact, and sustain actions across time toward those goals usually in the context of others, often relying on social and cultural means.
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Chapter: 60
Sentence: If EF/SR had failed to achieve any benefit for the individual, it would not have become a stable trait in the human genotype or phenotype.
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Chapter: 61
Sentence: EF is directly related to that dimension of personality known as conscientiousness—an aspect of personality reflecting how likely one is to consider the consequences of one’s actions for self and others before acting.
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Chapter: 61
Sentence: Lower levels of conscientiousness have been linked repeatedly to health problems and even to life expectancy (Friedman et al., 1995).
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Chapter: 61
Sentence: Swensen and colleagues (2004) have found that adults with ADHD who have substantial deficits in EF (Barkley & Murphy, 2010) are more than twice as likely to die prematurely from misadventures compared to control cases.
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Chapter: 61
Sentence: The follow-up study indicated that the most significant childhood personality characteristic predictive of reduced life expectancy by all causes was related to the impulsive, undercontrolled personality characteristics of low conscientiousness.
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Chapter: 61
Sentence: My colleagues and I also found adult women with ADHD to be less likely to be married (Barkley et al., 2008).
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Chapter: 64
Sentence: I then specified that each component of EF (types of self-regulation) arise out of two developmental processes: the self-direction of actions and their internalization.
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Chapter: 64
Sentence: It is done to alter the likelihood of future consequences for the individual (to attain various ends or goals).
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Chapter: 64
Sentence: EF was therefore concluded to be the use of self-directed actions so as to choose goals and to select, enact, and sustain actions across time toward those goals usually in the context of others often relying on social and cultural means for the maximization of one’s longer-term welfare as the person defines that to be.
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Chapter: 65
Sentence: From this arises self-awareness, inhibition, nonverbal and verbal working memory, emotional and motivational self-regulation, and planning and problem solving, which are each conceptualized here as actions-to-the-self.
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Chapter: 65
Sentence: In this last level, Strategic–Cooperative, a second stage may emerge among some cooperatives that extend their activities over sufficient lengths of time and develop sufficient cultural scaffolding to achieve it, and that is the Principled–Mutualistic stage.
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Chapter: 65
Sentence: In it, like-minded individuals pursue their mutual longer term self-interests by putting the self-interests of others initially on an equal footing, if not ahead of their own near-term and midterm self-interests.
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Chapter: 65
Sentence: First, such injuries or disorders can devastate the two developmental processes that give rise to EF itself: the self-direction of human actions for self-regulation across time to attain goals and the internalization of those self-directed actions.
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Chapter: 65
Sentence: Even if these basic processes are spared, or developed normally, later injuries or disorders can still have direct adverse effects on any or all of the six Instrumental EF components: self-awareness; self-restraint; self-directed sensory–motor actions for mental simulation and ideation; self-directed speech and verbal thinking; self-regulation of emotion along with self-regulation of motivational states needed to pursue goals; and self-play or the creative component of goal-directed problem solving and innovation.
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Chapter: 65
Sentence: Deficits in EF produce a nearsightedness to the future (a temporal myopia), making the individual relatively time blind and thus more focused on the now or near-term than should be the case for that individual’s developmental stage.
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Chapter: 65
Sentence: The individual with EF deficits is therefore likely to be governed more by external events within their immediate sensory fields than by mental (internal) representations concerning hindsight/foresight and the future more generally.
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Chapter: 65
Sentence: • An abstract to concrete rule contraction—with injury to the EF system, the capacity for the individual to use more abstract rules for self-governance contracts such that higher-level rules, such as ethics, laws, and regulations, may no longer have any governing influence over behavior.
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Chapter: 65
Sentence: The result is a highly selfish, impulsive, hedonistic, and even socially callous or psychopathic nature to the individual’s conduct.
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Chapter: 65
Sentence: Less able to regulate their behavior by internal representations concerning the future and their goals, and thus they are subject to being controlled more by external representations in the temporal now.
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Chapter: 69
Sentence: In contrast, observations and rating scales of EF collected in ecologically naturalistic settings are more likely to be evaluating the Methodical (adaptive), Tactical, and Strategic levels of EF.
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Chapter: 69
Sentence: For clinical evaluations in which the goal of the assessment is to ascertain EF in daily life activities in natural settings and to predict impairments that may arise therefrom, the evidence and the hierarchical model of EF make it clear that observations, ratings, the reports of others, and archival records of extended EF effects in natural settings will prove superior to tests of EF in accomplishing this goal.
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Chapter: 69
Sentence: The extended phenotype model of EF indicates that the assessment of EF must be as multimethod and multilevel as the construct itself and as the concerns of a particular case may warrant.
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Chapter: 69
Sentence: Evaluating EF from the vantage point of the extended phenotype model means collecting information on as many of the EF levels of the model as may be relevant to the particular individual.
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Chapter: 69
Sentence: Likewise, individuals with delayed motor development and coordination are likely to experience problems in their mental simulations of the same motor actions (Maruff, Wilson, Trebilcock, & Currie, 1999), again given that the latter self-directed action is based on the former pre-executive function.
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Chapter: 69
Sentence: This zone of the extended phenotype model is actually a zone of impairments arising from extended EF deficits and reflects the proximal, intermediate, and longer term over which EF has had effects at a distance.
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Chapter: 69
Sentence: Impairment refers to functional ineffectiveness, not to symptoms per se (Barkley, 2011b).
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Chapter: 70
Sentence: This view would encourage individuals wishing to further develop or rehabilitate their EF/SR to repeatedly practice: self-monitoring, self-stopping, seeing the future, saying the future, feeling the future, and playing with the future so as to effectively “plan and go” toward that future.
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Chapter: 70
Sentence: In short, information is not self-regulation.
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Chapter: 70
Sentence: Since covert or private information is weak as a source of stimulus control, making that information overt and public may help strengthen control of behavior by that information.
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Chapter: 70
Sentence: Make it physical outside of the individual, as it has to have been in earlier development.
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Chapter: 70
Sentence: The organization of the individual’s behavior both within and across time is one of the ultimate disabilities rendered by PFC injuries and other EF disorders.
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Chapter: 70
Sentence: Many techniques exist within this form of treatment that can be applied to children and adults with EF deficits.
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Chapter: 70
Sentence: What first needs to be recognized, as this model of EF stipulates, is that (1) internalized, self-generated forms of motivation are weak at initiating and sustaining goal-directed behavior; (2) externalized sources of motivation, often artificial, must be arranged within the context at the point of performance; and (3) these compensatory, prosthetic forms of motivation must be sustained for long periods.
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Chapter: 70
Sentence: Research also indicates what factors may serve to more rapidly replenish the resource pool.
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Chapter: 70
Sentence: These include:
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Chapter: 70
Sentence: Routine physical exercise.
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Chapter: 70
Sentence: Taking 10-minute breaks periodically during SR strenuous situations.
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Chapter: 70
Sentence: Relaxing or meditating for at least 3 minutes after such SR-exerting activities.
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Chapter: 70
Sentence: Visualizing the rewards or outcomes while involved in EF/SR tasks.
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Chapter: 70
Sentence: Arranging for periodic small rewards throughout the tasks for SR-demanding settings.
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Chapter: 70
Sentence: Engaging in self-affirming statements of self-efficacy prior to and during such tasks.
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Chapter: 70
Sentence: Generating positive emotions.
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Chapter: 70
Sentence: Consuming glucose-rich beverages during the task.
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Chapter: 70
Sentence: Some research further suggests that the actual capacity of the resource pool may be boosted by routine physical exercise and by routine practicing of tasks involving self-regulation daily for two weeks.
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Chapter: 70
Sentence: Given the above listed considerations, clinicians should likely reject most approaches to intervention for adults with EF deficits that do not involve helping patients with an active intervention at the point of performance and across the extended EF phenotypic levels that are impaired.
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Chapter: 70
Sentence: Evidence to date suggests that this improvement or normalization in ADHD-related EF deficits may occur as a temporary consequence of active treatment with stimulant medication, yet only during the time course the medication remains within the brain.
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Chapter: 70
Sentence: Diabetes is an analogous condition to many forms of EF deficits.
My notes: adhd as chronic disorder

Chapter: 70
Sentence: Behavioral and other technologies used to assist people with EF deficits are akin to artificial limbs, hearing aids, wheelchairs, ramps, and other prostheses that reduce the handicapping impact of a disability and allow the individual greater access to and better performance of their major life activities.
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Chapter: 70

Chapter: 70
Sentence: Of further importance to intervention is the multileveled nature of EF/SR proposed here and the need to intervene at those levels most disrupted or adversely affected by damage or disorder.
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Chapter: 70
Sentence: Adverse effects at the Methodical–Self-Reliant level may need to focus more on helping individuals to reorganize their external environment to facilitate performance of EF, self-care, and general adaptive functioning at this level.
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