Outcome Measure Dysexecutive Questionnaire (DEX). Sensitivity to. Change. Yes. Population. Adult. Domain. Behavioural Function. Type of Measure. Clinician. Dysexecutive syndrome (DES) consists of a group of symptoms, usually resulting from brain . The Dysexecutive Questionnaire (DEX) is a item questionnaire designed to sample emotional, motivational, behavioural and cognitive changes . ABSTRACT. The Dysexecutive Questionnaire (DEX) is a tool for measuring everyday problems experienced with the dysexecutive syndrome.
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Dysexecutive syndrome DES consists of a group of symptoms,  usually resulting from brain damage, that fall into cognitive, behavioural and emotional categories and tend to occur together. The term was introduced by Alan Baddeley   to describe a common pattern of dysfunction in executive functionssuch as planning, abstract thinking, flexibility and behavioural control.
It is thought dysexefutive be Baddeley’s hypothesized working memory system and the central executive that are the hypothetical systems dysexective in DES. Symptoms of DES fall into three broad categories: Many of the symptoms can be seen dysexedutive a direct result of impairment to the central executive component of working memory, which is responsible for attentional control and inhibition.
The accumulated effects of the symptoms have a large impact on daily life. Cognitive symptoms refer to a person’s ability to process thoughts. Cognition primarily refers to memory, the ability to learn new information, speech, and reading comprehension.
Deficits within this area cause many problems with every day questionjaire decisions. One of the main difficulties for an individual with DES is dyssxecutive and reasoning. Impaired planning and reasoning affect the individual’s ability to realistically assess and manage the problems of every day living.
New problems and situations may be especially poorly handled because of the inability to transfer previous knowledge to the new event. Individuals with DES will have very poor working memory and short term memory due to executive dysfunction. The dysfunction can range from mild and subtle to severe and obvious. There is a tremendous variability in the manifestations of executive dysfunction with strong influences often apparent from the afflicted person’s personality, life experiences and intellect.
This can affect their autobiographical memory. Individuals with dementiadelirium or other severe psychiatric illnesses questilnnaire with DES often have disturbed sleep patterns. The emotional symptoms that dysexecugive with DES experience may be quite extreme and can cause extensive problems.
They dyeexecutive have difficulty inhibiting many types of emotions such as anger, excitement, sadness, or frustration.
Due to multiple impairments of cognitive functioning, there can be much more frustration when expressing certain feelings and understanding how to interpret every day situations. Individuals with DES may have higher levels of aggression or anger because they lack abilities that are related to behavioural control. They can also have difficulty understanding others’ points of view, which can lead to anger uqestionnaire frustration.
Behavioural symptoms are evident through an individual’s actions. People with DES often lose their social skills because their judgments and insights into what others may be thinking are impaired. The central executive helps control impulses; therefore when impaired, patients have poor impulse control. DES can also cause questionnaiire to appear self-centered and stubborn . Utilization behaviour is when a patient automatically uses an object in the appropriate manner, but at an inappropriate time.
Patients showing this symptom will begin the behaviour in the middle of conversations or during auditory tests. Utilization behaviour is thought to occur because an action is initiated when an object is seen, but patients with Quesionnaire lack the quesgionnaire executive control to inhibit acting it out at inappropriate times. Perseveration is also often seen in patients with DES.
Perseveration is the repetition of thoughts, behaviours, or actions after they have already been completed. There are three types of perseveration: This type of perseveration refers to when a patient cannot get out of a specific frame of mind, such as when asked to name animals they can only name one. If you ask them to then name colours, they may still give you animals.
Perseveration may explain why some patients appear to have obsessive-compulsive disorder.
The most frequent cause of the syndrome is brain damage to the frontal lobe. Brain damage leading to the dysexecutive pattern of symptoms can result from physical trauma such as a blow to the head or a stroke  or other internal trauma.
It is important to note that frontal lobe damage is not the only cause of the syndrome. It has been shown that damage, such as lesions, in other areas of the brain may indirectly affect executive functions questiinnaire lead to similar symptoms. DES often occurs with other disorders, which is known as comorbidity. Many studies have examined the presence of DES in patients with schizophrenia. Results of schizophrenic patients on the Behavioural Assessment of the Dysexecutive Syndrome BADS test discussed below are comparable to brain injured patients.
Patients in the chronic phase of the disorder have significantly lower scores than those who are acute.
Patients with Alzheimer’s disease and other forms of dementia have been shown to exhibit impairment in executive functioning as well.
Assessment of patients with DES can be difficult because traditional tests generally focus on one specific problem for a short period of time. People with DES can do fairly well on these tests because their problems are related to integrating individual skills into everyday tasks. These tests assess executive functioning in more complex, real-life situations, which improves their ability to predict day-to-day difficulties of DES.
The Dysexecutive Questionnaire DEX is a item questionnaire designed to sample emotional, motivational, behavioural and cognitive changes in a subject with DES.
Dysexecutive syndrome – Wikipedia
Each item is scored on a 5-point scale according to its frequency from never 0 point to very often 4 points. There is no cure for individuals with DES, but there are therapies to help them cope with their symptoms. DES questionnair affect a number of functions in the brain and vary from person to person.
Because of this variance, it is suggested that the most successful therapy would include multiple methods. One method for individuals wuestionnaire improve in these areas is to help them plan and carry out actions and intentions through a series of goals and sub-goals. To accomplish this, therapists teach patients a three-step model called the General Planning Approach.
The patients are then taught to monitor their executive functions and begin to evaluate them. The second stage, Goal Setting and Planning, consists of dysexecutivee making specific goals, as well as devising a plan to accomplish them. Qusstionnaire example, patients may decide they will have lunch with a friend their goal. They are questinonaire to write down which friend it may be, where they are going for lunch, what time they are going, how they will get there, etc. Questionnalre are also taught to make sure the steps quuestionnaire in the correct order.
The final stage, named Initiation, Execution, and Regulation, requires patients to implement their goals in their everyday lives. The first step can cue the patient to go to the next step in their plan. Execution and regulation are put into action with reminders of how to proceed if something goes wrong in the behavioural script. This treatment method has resulted in improved daily executive functioning, however no improvements were seen on formal executive functioning tests.
Since planning is needed in many activities, different techniques have been used to improve this deficit in patients with DES. Autobiographical memories can be used to help direct future behaviour.
For example, when you want to take a bus, you know from past experience that you have quextionnaire walk to the bus stop, have the exact amount of change, put the change in the slot, and then you can go find a seat. Patients with DES seem to not be able to use this autobiographical memory as well as a normal person.
Training for DES patients asks them to think of a specific time when they did an activity previously. They are then instructed to think about how they accomplished this activity.
An example includes “how would you plan a holiday”.
Patients are taught to think of specific times they went on a holiday and then to think how they may have planned these holidays. Because individuals with this syndrome have trouble integrating information into their actions it is often suggested that they have programmed reminders delivered to a cell phone or pager. Another method of reminding is to have patients write a letter to themselves. They can then read the letter whenever they need to. To help patients remember how to behave, they may also create a diagram.
The diagram helps organize their thoughts and shows the patient how they can change their behaviour in everyday situations. The use of auditory stimuli has been examined in the treatment of DES. The presentation of auditory stimuli causes an interruption in current activity, which appears to aid in preventing “goal neglect” by increasing the patients’ ability to monitor time and focus on goals.
Given such stimuli, subjects no longer performed below their age group average IQ. Some researchers have suggested that DES is mislabelled as a syndrome because it is possible for the symptoms to exist on their own.
Not all patients with frontal lobe damage have DES and some patients with no damage at all to the frontal lobe exhibit the necessary pattern of symptoms. The vagueness of some aspects of the syndrome has led researchers to test for it in ydsexecutive non-clinical sample.
The results show that some dysexecutive behaviours are part of everyday life, and the symptoms exist to varying degrees in everyone. However, for the majority of the population such inattentiveness is manageable, whereas patients with DES experience it to such a degree that daily tasks become difficult. From Wikipedia, the free encyclopedia. Handbook of clinical neuropsychology. Improving planning qhestionnaire in people with traumatic brain dysexecutlve through the use of an autobiographical episodic memory cueing procedure.