Executive Function Challenges and Anger

9/2/2016

David A. Perna, PhD
Licensed Psychologist
Lecturer in Psychology
Department of Psychiatry
Harvard Medical School

"Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts."

Many children with anger issues suffer from executive function deficits. These deficits impact their ability to make effective academic progress in school in addition to impacting their functioning in a variety of other social-learning contexts. Executive functions are viewed to be primary learning challenges that impact functioning across a variety of learning contexts. Unlike a specific learning disability, such as dyslexia, which is viewed to impact a specific learning category, such as reading, an executive function deficit generally, impacts multiple categories of learning.

For example, an attention deficit disorder would impact an individual’s ability to make progress in many learning categories, whether they are academic or social. The inability to pay attention in class can impact the ability to learn history as well as the ability to drive a car safely. Organizational deficits are pervasive as well. For example, the inability to organize one’s assignment pad would impact school performance, while it could also impact the ability to socialize with friends (calling friends to get together too late on a friday night rather than earlier in the week).

"Cognitive flexibility allows kids to adjust to the curve balls that life throws at them."

Common Executive Function Deficits
Associated with Anger Management Disorders:

1. Causal Linking Challenges:
The inability to understand that one event causes the other. An example would be a patient who thinks that his probation officer is causing him to have a limited social life, forgetting the fact that the probation officer was assigned to work with him because he had made the poor choice of assaulting another person. In this situation the patient loses track of his own behavior as the primary reason why he has lost many age-appropriate freedoms. Within school it might include the lack of understanding that completing homework will increase one’s understanding of the class material and subsequent performance on tests.

2. Organizational Deficits:
Difficulties with the ability to keep track of details that allow the patient to successfully negotiate a myriad of social interactions and learning opportunities. An adolescent might be upset that she has misplaced her homework assignment and cannot complete her homework. However, within her social interactions she might become angry at a parents when she misplaces a slip of paper that contained a phone number that she felt was essential to her social life.

3. Sequencing Challenges:
Difficulties with the ability to keep track of sequences of events that are needed to facilitate a positive outcome in a learning situation. The inability to follow a given sequence to solve a math problem will generally result in the wrong answer. In a job situation, an adolescent might sanitize the counters of a fast-food establishment and then place a package with raw chicken onto the cleaned counter in front of his boss just prior to being terminated. A hard-working kid would have lost a job over the likelihood that his sequencing challenge could result in someone going to the hospital.

4. Time Management Issues:
Difficulties with allocating time to complete/attend events and activities that are of meaning to the patient or other people in his/her environment. An example would include having an adolescent plan on completing a major project for school on a weekend when relatives were visiting from out of town resulting in a huge family fight. Within the social realm it might include being bombarded by complaints from peers as a result of being late for a movie.

5. Transition Issues:
Difficulties with the ability to transition between two activities. Examples of these difficulties range from obvious difficult transitions, such as ending summer and starting school in September to less clear transitions, such as the movement from a sleeping state to a waking state each morning. The resulting morning tirades can be overwhelming for parents. Within a middle school environment the process by which kids constantly move from class to class could prompt a student with this challenge to feel unsettled throughout the school day. As soon as he feels settled in class the bell rings and he has to head off to the next one. As the day progresses the sense of stress increases to the point where an explosion can occur in the last period of the day.

6. Cognitive Flexibility:
The ability to learn new ways of coping with ever-changing stressors in a fluid manner. This issue is many times referred to as the ability to be prepared for all of the “Curve balls” that life throws one’s way. A child who was taught one way of solving a math problem using long division in 5th grade becomes enraged when her 6th grade teacher introduces a new method. Or in social settings it might represent the ability to quickly respond to the fickle interests of a peer group who wanted to go to the mall on Friday night when plans were made earlier that day during school lunch, to the movies when plans were made at 6PM Friday night, and out for food at 9PM when all the peers at the theater realized that the popular kids were having dinner at a nearby Shake Shack. For the average teen popularity always tops planning, however, for the teen with cognitive flexibility issues the plan is written in stone. This skill challenge is closely tied to transitioning challenges and challenges in understanding other people’s perspectives (theory of mind).

7. Memory:
The ability to remember information in a manner that allows it to be readily available for quick and efficient access. For example, a child might erupt at the thought that he had to get his hair cut when in fact both parents informed him of the hair cut days earlier. In school it might include the embarrassment of walking into class on a Monday morning and being handed a test by the teacher after forgetting to study over the weekend.

8. Generalization:
The ability to generalize from one situation to the other. For example, a student is told not to write on his desk at school, which he agrees not to do, but is then caught writing on a table in the cafeteria. In such a situation the child may be incredibly frustrated that the teacher did not clarify this issue to a greater extent and may become highly focused on the fact that he has not written on his desk since the teacher asked him to stop. The connection between the two situations is simply not apparent to the student, while the teacher may start to feel that the student is playing him/her. In reality the student is simply clueless to the connection between the two contexts.