Executive Functions in Parents With ADHD

Dr. Timothy G. Lesaca Psychiatrist Bethel Park, Pennsylvania

Dr. Timothy Lesaca is a psychiatrist practicing in Pittsburgh, PA. Dr. Lesaca is a medical doctor specializing in the care of mental health patients. As a psychiatrist, Dr. Lesaca diagnoses and treats mental illnesses. Dr. Lesaca may treat patients through a variety of methods including medications, psychotherapy or talk... more

Over the past two decades, there has been considerable progress in understanding the functions of the prefrontal cortex of the brain and its regulation of mental activities that allow for self-control and goal-directed behaviors. These mental activities are unified under the term executive functions. Executive functions are thought to enable a person to successfully engage in independent, purposeful, and self-serving behaviors. The major executive functions include response inhibition, which permits impulse control, resistance to distraction, and delay of gratification; nonverbal working memory, which permits the holding of events in the mind and allows self-awareness across time; verbal working memory, which comprises the internalization of speech and permits self-description, questioning and reading comprehension; and self-regulation of emotion and motivation, which permits motivation, persistence toward a goal and emotional self-control.

Executive functions are thus a collection of varying abilities that involve regulatory control over thought and behavior in the service of goal-directed or intentional action, problem-solving, and flexible shifting of actions to meet task demands. Besides formal neuropsychological testing, clinical data about executive function can be obtained by observing an individual's ability to problem-solve in the natural environment and assessing how flexible a person is when faced with a changing routine. In recent years, executive functions have been applied as a concept to help explain attention-deficit/hyperactivity disorder (ADHD) pathophysiology. Although the importance of executive functions in understanding ADHD seems clear, a less obvious, yet important, correlation is the relationship between executive functions and the management of families with children who have ADHD. This relationship is significant since one-quarter of children presenting with ADHD will have at least one parent who also has ADHD. The fact that parents with ADHD probably suffer from impairments in executive functions creates challenges in the treatment of their children.