Impairments to Executive Functions in Children with Emotional and Behavioral Dysregulation
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Impairments to Executive Functions in Children with Emotional and Behavioral Dysregulation L. S. Chutko, S. Yu. Surushkina, E. A. Yakovenko, T. I. Anisimova, A. V. Sergeev, and M. D. Didur
Translated from Zhurnal Nevrologii i Psikhiatrii imeni S. S. Korsakova, Vol. 120, No. 4, Iss. 1, pp. 23–28, April, 2020. Original article submitted February 18, 2020. Accepted February 29, 2020. Objective. To study the role of executive functions in the genesis of organic emotional lability (asthenic) disorder (OELD) and oppositional defiant disorder (ODD). Materials and methods. The study included 66 patients aged 6–8 years, 36 diagnosed with OELD and 30 with ODD. Study methods were: parental assessment of fatigue using a 10-point numerical rating scale, determination of the severity of behavioral impairments using the SNAP-IV scale, assessment of emotional impairments using the Strengths and Difficulties questionnaire, determination of the index of anxiety using the Temple, Dorkey, Amen, and Luria test, and evaluation of auditory verbal memory using the Luriya memorization method. The severity of impairments to attention was evaluated using the computerized test of continuous activity (Test of Variables of Attention, TOVA). Results and conclusions. Cognitive and emotional impairments were severe in children with OELD. It is suggested that while impairment to the functions regulating activation of behavior and impairment to the cognitive control of behavior play important roles in the pathogenesis of OELD, the leading role in children with ODD is played by impairments to behavioral self-regulation associated with emotional reinforcement. Keywords: organic emotional lability (asthenic) disorder, oppositional defiant disorder, cognitive control, executive functions.
One of the commonest causes of parents taking preschool and early school-age children to doctors is severe emotional lability. Children with this pathology are characterized by constant tearfulness, capriciousness, affective arousability, and increased fatigue. The status of these children is defined using the terms “neuropathy,” “early childhood nerves,” “neuropathic constitution,” “autonomic-visceral impairment syndrome,” “increased neuroreflex arousal,” and others. The term “neuropathy” in Russian psychoneurology refers to a syndrome of elevated arousability of the nervous system and immaturity of autonomic regulation. The occurrence of this pathology is explained by exogenous actions in the perinatal and early postnatal periods [1, 2]. The term “neuropathy” was introduced in 1915 by Kraepelin to designate nonspecific heritable disorders occurring mainly in childhood. Minukhin [1] and Sukharev [2] subsequently establi-
shed that the origin of neuropathic states lies not so much in constitutional-genetic as much as exogenous-organic factors. According to ICD-10 (F.06.6), these states can be classified as organic emotional lability (asthenic) disorders (OELD). Psychiatry outside Russia has used the term “oppositional defiant disorder” since the 1980s (ICD-10 F.91.4
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