Subjective executive difficulties – a study using the Dysexecutive Questionnaire

• Authors: Ewa Małgorzata Szepietowska , Anna Kuzaka

Title variants

PL

Poczucie trudności wykonawczych – badania z wykorzystaniem Dysexecutive Questionnaire

• Languages of publication: EN PL

Abstracts

EN

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.

PL

Wstęp: Poczucie trudności wykonawczych, rozumiane jako subiektywne odczuwanie zakłóceń w planowaniu, kontroli i korygowaniu własnej aktywności, jest często zgłaszane przez osoby zdrowe i z różnych grup klinicznych. Do oceny nasilenia poczucia tych trudności służą techniki samoopisowe, m.in. Dysexecutive Questionnaire (DEX-S). Wartość diagnostyczna metody jest dyskutowana ze względu na liczne uwarunkowania przekonań o deficytach wykonawczych. Cel: W nawiązaniu do niekonkluzywnych danych dotyczących zarówno uwarunkowań poczucia deficytów wykonawczych, jak i wartości narzędzi samoopisowych sformułowano następujące cele badań własnych: a) charakterystyka demograficzna, kliniczna i poznawcza osób o różnym nasileniu poczucia trudności wykonawczych, b) określenie, które z tych zmiennych zwiększają ryzyko wzrostu poczucia trudności wykonawczych. Materiał i metody: W badaniach uczestniczyło 213 osób dorosłych. Zastosowano DEX-S oraz narzędzia oceniające funkcje poznawcze (Montrealską Skalę Oceny Funkcji Poznawczych – Montreal Cognitive Assessment, MoCA; podtesty Skali Inteligencji D. Wechslera dla Dorosłych, wersji zrewidowanej – Wechsler Adult Intelligence Scale-Revised, WAIS-R) i nasilenie nastroju depresyjnego [Geriatryczną Skalę Depresji – Geriatric Depression Scale (Short Form), GDS-15]. Uwzględniono także zmienne demograficzne (wiek, płeć, poziom wykształcenia) i kliniczne (brak/obecność obciążeń ośrodkowego układu nerwowego, w tym lateralizację patologii mózgowej). Na bazie wyników DEX-S wykonano analizę skupień i wyodrębniono dwie grupy uczestników o różnym nasileniu poczucia trudności wykonawczych: niskim (osoby nieskarżące się na deficyty wykonawcze) i wyższym (osoby skarżące się). Porównania grup wykazały, iż osoby skarżące się na deficyty wykonawcze uzyskują wyższy wskaźnik nastroju depresyjnego i niższe wyniki w niektórych podtestach służących do oceny funkcji poznawczych. Wyniki analizy regresji logistycznej sugerują, że ryzyko wystąpienia skarg na trudności wykonawcze rośnie w przypadku nasilonego nastroju depresyjnego. Z kolei wyższa sprawność procesów uwagowych zmniejsza prawdopodobieństwo formułowania skarg. Nie odnotowano efektu interakcji między tymi dwoma czynnikami. Wnioski: Na podstawie uzyskanych wyników można przyjąć, że istnieją niezależne mechanizmy protekcyjne względem poczucia deficytów wykonawczych oraz nasilające to poczucie, co wskazuje na konieczność podejmowania oddziaływań psychologicznych (np. treningów poznawczych i/lub psychoterapii) dopasowanych do mechanizmu skarg.

Keywords

EN

DEX-S; cognitive functions; depressive mood; subjective executive difficulties

Discipline

• MEDICINE: MEDICINE

• Publisher: Medical Communications
• Journal: Psychiatria i Psychologia Kliniczna
• Year: 2018
• Volume: 18
• Issue: 1
• Pages: 25–34

Contributors

author

Ewa Małgorzata Szepietowska

• Department of Clinical Psychology and Neuropsychology, Institute of Psychology, Maria Curie-Skłodowska University, Lublin, Poland

author

Anna Kuzaka

• Provincial Specialist Hospital, Biała Podlaska, Poland; Faculty of Tourism and Health, Józef Piłsudski University of Physical Education in Warsaw, Branch in Biała Podlaska, Biała Podlaska, Poland

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• Document Type: article