Executive Functions - Adele Diamond

1 PS64CH06-DiamondARI12 November 20128:45 Executive FunctionsAdele DiamondDepartment of Psychiatry, University of British Columbia and BC Children s Hospital,Vancouver, BC V6T 2A1 Canada; email: Rev. Psychol. 2013. 64:135 68 First published online as a Review in Advance onSeptember 27, 2012 TheAnnual Review of Psychologyis online article s 2013 by Annual rights reservedKeywordscognitive control, self-regulation, creativity, attention, reasoning,working memory, fluid intelligence, inhibitory control, task switching,mental flexibilityAbstractExecutive Functions (EFs) make possible mentally playing with ideas;taking the time to think before acting; meeting novel, unanticipatedchallenges; resisting temptations; and staying focused. Core EFs areinhibition [response inhibition (self-control resisting temptationsand resisting acting impulsively) and interference control (selectiveattention and cognitive inhibition)], working memory, and cognitiveflexibility (including creatively thinking outside the box, seeinganything from different perspectives, and quickly and flexibly adaptingto changed circumstances).

2 The developmental progression and repre-sentative measures of each are discussed. Controversies are addressed( , the relation between EFs and fluid intelligence, self-regulation, Executive attention, and effortful control, and the relation betweenworking memory and inhibition and attention). The importance ofsocial, emotional, and physical health for cognitive health is discussedbecause stress, lack of sleep, loneliness, or lack of exercise each impairEFs. That EFs are trainable and can be improved with practice isaddressed, including diverse methods tried thus Rev. Psychol. :135-168. Downloaded from Prof. Adele Diamond on 01/07/13. For personal use November 20128 136 INHIBITORY CONTROL .. 137 Representative PsychologicalTasks Used to AssessInhibitory Control .. 139 Commonalities and DifferencesAmong Diverse Forms ofInhibitory Control .. 141 Development of 141 WORKING MEMORY .. 142 Working Memory 143 Relations Between WorkingMemory and 143 Working Memory andSelective, FocusedAttention.

3 147 Representative PsychologicalTasks Used to AssessWorking Memory .. 147 Development of 148 COGNITIVE FLEXIBILITY .. 149 Representative PsychologicalTasks Used to AssessCognitive Flexibility .. 149 Development of CognitiveFlexibility .. 151A HIGHER-ORDEREXECUTIVE FUNCTION:RELATIONALREASONING/LOGICALREAS ONING/FLUIDINTELLIGENCE .. 151 DIFFERENCES ANDSIMILARITIES BETWEENEXECUTIVE FUNCTIONSAND RELATED TERMS .. 152IT ISNOTALWAYSBENEFICIAL TO EXERTEXECUTIVE FUNCTIONSOR 153 CANARY IN THE COAL MINE: Executive FUNCTIONSAS AN EARLY 153 TRAINING AND PRACTICEIMPROVE 154 Executive Functions (EFs):a collection oftop-down controlprocesses used whengoing on automatic orrelying on instinct orintuition would beill-advised, insufficient,or impossibleInhibition (inhibitorycontrol):controllingone s attention,behavior, thoughts,and/or emotions tooverride a stronginternal predispositionor external lureINTRODUCTIONE xecutive Functions (EFs; also called executivecontrol or cognitive control) refer to a family oftop-down mental processes needed when youhave to concentrate and pay attention, whengoing on automatic or relying on instinct or in-tuition would be ill-advised, insufficient, or im-possible (Burgess & Simons 2005, Espy 2004,Miller & Cohen 2001).

4 Using EFs is effortful; itis easier to continue doing what you have beendoing than to change, it is easier to give intotemptation than to resist it, and it is easier to goon automatic pilot than to consider what to donext. There is general agreement that there arethree core EFs ( , Lehto et al. 2003, Miyakeet al. 2000): inhibition [inhibitory control, in-cluding self-control (behavioral inhibition) andinterference control (selective attention andcognitive inhibition)], working memory (WM),and cognitive flexibility (also called set shift-ing, mental flexibility, or mental set shifting andclosely linked to creativity). From these, higher-order EFs are built such as reasoning, prob-lem solving, and planning (Collins & Koechlin2012, Lunt et al. 2012). EFs are skills essentialfor mental and physical health; success in schooland in life; and cognitive, social, and psycholog-ical development (seeTable 1).136 DiamondAnnu. Rev. Psychol. :135-168.

5 Downloaded from Prof. Adele Diamond on 01/07/13. For personal use November 20128:45 Table 1 Executive Functions (EFs) are important to just about every aspect of lifeAspects of lifeThe ways in which EFs are relevant to that aspect of lifeReferencesMental healthEFs are impaired in many mental disorders, including:- AddictionsBaler & Volkow 2006- Attention deficit hyperactivity (ADHD) Diamond 2005, Lui & Tannock 2007- Conduct disorderFairchild et al. 2009- DepressionTaylor-Tavares et al. 2007- Obsessive compulsive disorder (OCD)Penad es et al. 2007- SchizophreniaBarch 2005 Physical healthPoorer EFs are associated with obesity, overeating, substanceabuse, and poor treatment adherenceCrescioni et al. 2011, Miller et al. 2011,Riggs et al. 2010 Quality of lifePeople with better EFs enjoy a better quality of lifeBrown & Landgraf 2010, Davis et al. 2010 School readinessEFs are more important for school readiness than are IQ orentry-level reading or mathBlair & Razza 2007, Morrison et al.

6 2010 School successEFs predict both math and reading competence throughout theschool yearsBorella et al. 2010, Duncan et al. 2007,Gathercole et al. 2004 Job successPoor EFs lead to poor productivity and difficulty finding andkeeping a jobBailey 2007 Marital harmonyA partner with poor EFs can be more difficult to get along with,less dependable, and/or more likely to act on impulseEakin et al. 2004 Public safetyPoor EFs lead to social problems (including crime, recklessbehavior, violence, and emotional outbursts)Broidy et al. 2003, Denson et al. 2011 INHIBITORY CONTROLI nhibitory control (one of the core EFs) in-volves being able to control one s attention,behavior, thoughts, and/or emotions to over-ride a strong internal predisposition or exter-nal lure, and instead do what s more appropri-ate or needed. Without inhibitory control wewould be at the mercy of impulses, old habitsof thought or action (conditioned responses),and/or stimuli in the environment that pull usthis way or that.

7 Thus, inhibitory control makesit possible for us to change and for us to choosehow we react and how we behave rather thanbeing unthinking creatures of habit. It doesn tmake it easy. Indeed, we usually are creaturesof habit and our behavior is under the con-trol of environmental stimuli far more than weusually realize, but having the ability to exer-cise inhibitory control creates the possibility ofchange and choice. It can also save us from mak-ing fools of control of attention (interferencecontrol at the level of perception) enables us toSelf-control:theaspect of inhibitorycontrol that involvesresisting temptationsand not actingimpulsively orprematurelyWorking memory(WM):holdinginformation in mindand mentally workingwith it ( , relatingone thing to another,using information tosolve a problem)Cognitive flexibility:changing perspectivesor approaches to aproblem, flexiblyadjusting to newdemands, rules, orpriorities (as inswitching betweentasks)selectively attend, focusing on what we chooseand suppressing attention to other stimuli.

8 Weneed such selective attention at a cocktail partywhen we want to screen out all but one voice. Asalient stimulus such as visual motion or a loudnoise attracts our attention whether we want itto or not. That is called exogenous, bottom-up, automatic, stimulus-driven, or involuntaryattention and is driven by properties of stim-uli themselves (Posner & DiGirolamo 1998,Theeuwes 1991). We can also choose voluntar-ily to ignore (or inhibit attention to) particularstimuli and attend to others based on our goalor intention. Besides being called selective orfocused attention, this has been termed atten-tional control or attentional inhibition, endoge-nous, top-down, active, goal-driven, voluntary,volitional, or Executive attention (Posner &DiGirolamo 1998, Theeuwes 2010).Another aspect of interference control issuppressing prepotent mental representations(cognitive inhibition). This involves resistingextraneous or unwanted thoughts or memories,including intentional forgetting (Anderson & Executive Functions 137 Annu.)

9 Rev. Psychol. :135-168. Downloaded from Prof. Adele Diamond on 01/07/13. For personal use November 20128:45 Levy 2009), resisting proactive interferencefrom information acquired earlier (Postle et ), and resisting retroactive interferencefrom items presented later. Cognitive inhibi-tion is usually in the service of aiding WM andis discussed in the section Inhibitory ControlSupports Working Memory. It tends to coheremore with WM measures than with measuresof other types of is the aspect of inhibitory con-trol that involves control over one s behaviorand control over one s emotions in the serviceof controlling one s behavior. Self-control isabout resisting temptations and not acting im-pulsively. The temptation resisted might be toindulge in pleasures when one should not ( ,to indulge in a romantic fling if you are mar-ried or to eat sweets if you are trying to loseweight), to overindulge, or to stray from thestraight and narrow ( , to cheat or steal).

10 Orthe temptation might be to impulsively react( , reflexively striking back at someone whohas hurt your feelings) or to do or take whatyou want without regard for social norms ( ,butting in line or grabbing another child s toy).Another aspect of self-control is having thediscipline to stay on task despite distractionsand completing a task despite temptations togive up, to move on to more interesting work,or to have a good time instead. This involvesmaking yourself do something or keep at some-thing though you would rather be doing some-thing else. It is related to the final aspect of self-control delaying gratification (Mischel et ) making yourself forgo an immediatepleasure for a greater reward later (often termeddelay discounting by neuroscientists and learn-ing theorists; Louie & Glimcher 2010, Rachlinet al. 1991). Without the discipline to completewhat one started and delay gratification, no onewould ever complete a long, time-consumingtask such as writing a dissertation, running amarathon, or starting a new the above examples typically in-volve a tug-of-war between a part of you thatwants to doxand another part of you that wantsto doy(Hofmann et al.)