Subjective executive difficulties – a study using the Dysexecutive Questionnaire
Ewa Małgorzata Szepietowska1, Anna Kuzaka2,3
Introduction: Subjective executive difficulties, understood as a sense of disruption of planning, control and correction of one’s own activity, is often reported by healthy as well as clinical individuals. Self-report measures such as the Dysexecutive Questionnaire (DEX-S) are used to assess the severity of this feeling. The diagnostic value of this method is debated due to the numerous factors affecting the beliefs on executive deficits. Aim of the study: With reference to inconclusive data concerning the underlying factors of subjective executive deficits and the value of self-report measures the following aims of the present study were established: a) determination of the demographic, clinical and cognitive characteristics of individuals with various levels of subjective executive difficulties, b) finding which of these variables contribute to the risk of subjective executive difficulties increase. Material and methods: The study included 213 adult individuals. DEX-S as well as measures of cognitive assessment (Montreal Cognitive Assessment, MoCA; subtests of the Wechsler Adult Intelligence Scale-Revised, WAIS-R) and depressive mood assessment [Geriatric Depression Scale (Short Form), GDS-15] were used. Demographic variables (age, gender and educational level) as well as clinical variables (lack of/presence of central nervous system disease history, including lateralised brain pathology) were also taken into consideration. Based on DEX-S results a cluster analysis was performed and two groups of subjects with a different level of subjective executive difficulties were identified: low-severity group (individuals reporting no complaints regarding executive deficits) and high-severity group (individuals with complaints). Group comparisons demonstrated that individuals complaining about executive deficits have a higher depressive mood index and lower scores on some subtests used to assess cognitive functions. The results of logistic regression analysis suggest that the risk of executive difficulties complaints increases with the severity of depressive mood. In contrast, higher attentional performance reduces the possibility of complaints. No interaction effect was observed between these two factors. Conclusions: Based on the results it can be assumed that there are independent protective mechanisms against subjective executive difficulties as well as mechanisms that exacerbate them, which indicates the need for psychological intervention (e.g. cognitive training and/or psychotherapy) adjusted to the mechanism of the complaint.