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Can PTSD cause executive dysfunction?


Is it the same to say that PTSD causes problems in the executive functions than to say that it causes executive dysfunction? I think the difference could be enormous since our executive functions rule our most elevated existence.


Executive Function

Executive function (EF) is essential for successfully navigating nearly all of our daily activities. Executive functions include processes by which important information like words, objects, task goals, contextual information, abstraction, etc., generated via perception or thought influence processing.

Executive functions emerge from a number of regions in the brain’s frontal lobes working in coordination with several subcortical structures.

The term executive functions refers to a diverse set of skills that serve two primary goals:

  • to enable us to manage ourselves and

  • to engage with the environment.

Executive function abilities, including working memory, inhibitory control, and the flexible volitional shifting of the focus of attention provide a foundation for reflection on experience, reasoning, and the purposeful regulation of behavior and emotion.

Having executive functions is what make us humans.


Executive Dysfunction

Executive dysfunction is a term that refers to the range of cognitive, emotional, and behavioral difficulties that often occur after injury to the frontal lobes of the brain. The impairment of executive functions has a profound effect on many aspects of everyday life and on our emotional experience.

The importance of executive functions is shown by the difficulties caused when they don't work properly. Since the executive functions are involved in even the most routine activities, frontal lobe injuries can lead to deficits in cognitive (thinking) skills, personality, and social behavior and our relationship with higher-order experiences like love, faith, imagination, morality, etc.


PTSD and Executive Dysfunction

It’s been said that 60 to 70% of us will experience a traumatic event in our lives. It’s been also affirmed that only 5 to 10% of those individuals would meet the criteria for PTSD.

Most studies believe that once PTSD develops, executive dysfunction occurs regardless of PTSD severity. Previous researchers believe executive dysfunction can either be a risk factor or a consequence of PTSD.


Most recent studies (Wang et al, 2019) show that PTSD and executive dysfunction symptoms co-occur and share comparable underlying causes. This implies that PTSD and executive dysfunction could represent different aspects of a general pathological response following trauma exposure.


Another study showed that trauma-exposed people present weaknesses in executive functioning as soon as PTSD developed but that they were not necessarily a long-term consequence of PTSD. Still, children with severe PTSD symptoms might have more impairments in executive function.


Conclusion

The word “dysfunction” sounds too deterministic to me, like a death sentence. When clinicians talk about executive dysfunction, they almost always refer to physical damage, as in traumatic brain injury. Individuals with physical damage will have clear and probably severe impairment in their executive functions. They will never be the same person again.

Even when PTSD affects the frontal lobes and creates problems in the executives functions, the dysfunction is not permanent and can be reversed as most of the alterations suffered by PTSD. When the trauma happens while the brain is still developing, then the damage can be more permanent, and those kids could present executive dysfunction. But that’s the case mostly with C-PTSD and not with a single event type of traumatization.

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