Reference
Guide | Reference

40  Cognitive Control and Executive Function

40.1 Summary

  • A dimensional construct describing attention regulation, planning, impulse control, and task persistence.

40.2 Core Construct

  • Capacity to initiate, organize, sustain, and complete goal-directed behavior.

40.3 Subdimensions

  • Attention and distractibility.
  • Planning, organization, and working memory.
  • Impulse control and inhibition.

40.4 Severity Anchors (0-4)

  • 0: No clinically meaningful executive dysfunction.
  • 1: Mild, situational, manageable.
  • 2: Moderate, recurring, impacts function.
  • 3: Severe, persistent, with clear impairment.
  • 4: Extreme, disabling or unsafe.

40.5 Time-Course Patterns

  • Early-onset and stable.
  • Worsening under stress or sleep loss.

40.6 Functional Impact

  • Work/school: missed deadlines, inconsistent performance.
  • Relationships: forgetfulness or follow-through strain.
  • Self-care: routine instability.

40.7 Developmental Expression

  • Childhood: attention and behavior challenges.
  • Adolescence: organizational strain with increased demands.
  • Adulthood: executive overload and burnout.

40.8 Cultural / Context Notes

  • Expectations for structure vary by context.
  • Environmental supports can mask or reveal impairment.

40.9 Differential and Rule-Outs

  • Mood or anxiety-related inattention.
  • Sleep deprivation or substance effects.
  • Neurologic or medical contributors.

40.10 Measurement Prompts

  • Brief attention/executive screening.
  • Collateral or rating scales.

40.11 Treatment-Relevant Correlates (non-prescriptive)

  • Executive strain often amplifies functional impairment.

40.13 Documentation Snippet (1-2 lines)

  • “Executive dysfunction with distractibility and poor follow-through; Cognitive Control 3; chronic course.”