Barkley Deficits In Executive Functioning Scale Research Articles

From ‘mental fog’ to post-acute COVID-19 syndrome's executive function alteration: Implications for clinical approach

A common symptom of the neuropsychiatric Post-Acute COVID-19 syndrome (neuro-PACS) is the so called ‘brain fog’. Patients describe the brain fog as problems with attention, memory and mental fatigue. Brain fog is experienced by 9–55% of people for months after having contracted SARS-CoV-2 virus. Several theories have been proposed to explain PACS's brain fog, including a neuroinflammatory hypothesis, but the hypothesis remains to be proven. Here, we examined inflammatory and immunological blood profile in a cohort of patients with PACS to investigate the association between executive functions and blood inflammatory markers. Executive function was assessed by the Trail Making Test (TMT) Part A and Part B, as well as the Barkley Deficits in Executive Functioning Scale (BDEFS), in 71 patients (36 men), average age of 40 years (range: 15–82, SD: 15.7). Impairment in executive functioning (BDEFS scores and TMT B scores) correlated with increased levels of Interleukin-6 (IL-6), fibrinogen and ferritin. Moreover, elevated levels of Il-6, fibrinogen, ferritin, tumor necrosis factor-alpha and C-reactive protein have been observed in PACS. These findings demonstrate that PACS is characterized by the presence of an immuno-inflammatory process, which is associated with diminished executive functioning. Here, we argue in favour of a shift from the non-descriptive definition of ‘mental fog’ to a characterization of a subtype of PACS, associated with alteration in executive functioning. Implication for clinical settings and prevention are discussed.

COVID-19 Anxiety in Children and Its Relationship with Self-Related Skills of Executive Functions.

Objective: Some children experience a significant deal of anxiety during the outbreak of COVID-19. Behavioral dimensions of the executive function appear to link to situational anxiety experience. Therefore, the primary aim of the present study is to investigate the relationship between self-related skills of executive functions and the level of anxiety in children (8-12-years-old) during the outbreak of COVID-19. Also, the secondary goal of this study is to predict the level of anxiety based on self-related skills of executive functions. Method : Parents of 300 children filled out the Barkley Deficits in Executive Functioning Scale (BDEFS) and the COVID-19 anxiety scale. Data were analyzed using correlation and path analysis. A significance level of less than 0.05 was set for all tests. Data were analyzed using SPSS 22 software. Results: Results demonstrated that self-related skills of executive functions can predict 28% of COVID-19 anxiety. The subscales of self-management (P < 0.015, t = 5.56), self-regulation (P < 0.011, t = 6.37), self-restraint (P < 0.035, t = 4.29) and emotional self-organization (P < 0.042, P = 0.222) predicted coronavirus anxiety, but self-motivation (P < 0.05, P = 0.894) did not. Conclusion: Given that most subscales of executive function predict anxiety tied to critical situations such as the prevalence of the corona virus, it seems that greater attention should be allocated to the fostering and development of children's executive functions by teaching such skills at home by families.

Executive function deficits associated with anxiety and depression and their impact on medical students’ academic performance in Saudi Arabia

Objectives: This study aimed to determine the relationship between EF deficits associated with anxiety and depression and their impact on medical students’ academic achievement in Saudi universities.&#x0D; Methods: A cross-sectional online survey was conducted on 242 medical students. Anxiety and depression were assessed using the Barkley Deficits in Executive Functioning Scale (BDEFS), General Anxiety Disorder-7 scale (GAD-7), and the Patient Health Questionnaire (PHQ-9).&#x0D; Results: Participants’ mean age was 22.57 (2.26) years and the mean GAD-7, PHQ-9, and BDEFS scores were 10.54 (5.83), 12.29 (6.86), and 196.78 (47.78), respectively. Males, Saudi students, those in their fourth academic year, and those who were not satisfied with their academic performance had significantly higher mean GAD-7, PHQ-9, and BDEFS scores. A significant negative association was found between students’ grade point average (GPA) and BDEFS scores, and a significant positive association was found between GPA and GAD-7 scale scores, PHQ-9 scores, and BDEFS scores. Additionally, there was a positive association between the PHQ-9 and BDEFS scores.&#x0D; Conclusion: A real-world application of EF scales to address EF deficits for all university students should be considered.

A-199 The Barkley Deficits in Executive Functioning Scale (BDEFS): Personality index or a measure of executive functioning?

Abstract Objective: The BDEFS was compared to objective executive functioning (EF) measures as well as five-factor model (FFM) personality traits. Methods: One hundred sixty-five participants (M=19 years old, SD=1.3; 72.7% female, 55.2% White, 35.2% African American, 4.8% Asian) completed IPIP-NEO Personality Inventory, BDEFS-Long Form, Neuropsychological Assessment Battery (NAB) EF module, and Trail-Making Test (TMT) Parts A and B. Results: EF measures were reduced to a single-factor score using EFA (TMT A and B; NAB Mazes, Categories, and Word Generation subtests) accounting for 34% of the variance. Regression predicting BDEFS total score from the EF factor score was not significant [F(1,163)=.182; p =.67, r2=.001]. Stepwise multiple regression predicting BDEFS total score from FFM traits identified three significant predictors (neuroticism: β=.390, extraversion: β=.239, and conscientiousness: β=-.572) that accounted for 54% of the variance [F(5,159)=36.78; p&amp;lt;.001, r2=.54]. Stepwise regression predicting the EF factor score from FFM traits was not significant [F(5,159)=.57; p=.721, r2=.018]. Conclusions: Performance-based EF measures were not related to BDEFS total score supporting that different constructs are being measured. Personality traits accounted for a majority of variance in BDEFS performance but minimal variance for performance-based EF performance. These results suggest that personality traits are strongly related to an individual’s appraisal of executive dysfunction.

Capturing daily-life executive impairments in adults: Does the choice of neuropsychological tests matter?

Objective Standardized executive functioning (EF) measures do not reliably capture EF-related difficulties reported in daily life. We aim to determine if an ecologically relevant neuropsychological battery is more strongly associated with self-reported everyday EF impairments than classically used tests. Method Fifty-nine adults aged 18–49 self-rated their EF abilities using the Barkley Deficits in EF Scale (BDEFS) and were randomly assigned to complete either a test battery composed of EF measures with hypothesized ecological relevance (Six Elements, Zoo Map, Hayling Sentence Completion, Iowa Gambling, and Auditory Startle Tasks) or one composed of traditional EF tasks (Card Sorting, Trail Making, Color-Word Interference, and Verbal Fluency). Associations were examined using linear regression. Results There were no strong associations between BDEFS subscales and performance on either test battery. Only the regression model predicting Emotional Regulation from ecological tasks was significant. Iowa Gambling Task performance and corrugator muscle contraction in the Auditory Startle Task individually contributed significantly to the model, with small and moderate effect sizes respectively. Conclusion Results align with evidence that self-reported EF difficulties are not adequately captured by formal neuropsychological measures, even for performance-based measures which directly tap everyday constructs. Findings are interpreted cautiously in the context of a small, high-functioning sample.

Relationship of psychological/mild traumatic brain injury (mTBI) history and invalid reporting to self-reported executive function

Individuals with mild traumatic brain injury (mTBI) often complain of executive functioning (EF) difficulties. There is a discrepancy between self-reported EF impairment and EF deficits on neuropsychological tests, with some arguing that self-report EF is more related to real-world functioning than EF tests. However, research suggests that self-reported EF may be related more to emotional distress and is vulnerable to invalid reporting. We examined the vulnerability of the short form Barkley Deficits in Executive Functioning Scale (BDEFS) to invalid reporting, using a simulated mTBI paradigm. We included four groups: individuals simulating mTBI with (N = 24) and without (N = 21) histories of mTBI/other psychological conditions and controls with (N = 21) and without (N = 25) histories of mTBI/other psychological conditions. As hypothesized, simulators performed worse on the BDEFS Total Score and EF Symptom Count relative to controls; however, this effect was larger within those who had no self-reported history of mTBI/other psychological conditions. We identified a preliminary cutoff on the EF Symptom Count that detected 42.8% of simulators, with 95% specificity relative to the controls with histories of mTBI/other psychological conditions. The present study emphasizes the need for validity scales on self-report EF measures such as the BDEFS.

Cognitive function following SARS-CoV-2 infection in a population-representative Canadian sample

BackgroundSARS-CoV-2 infection is believed to adversely affect the brain, but the degree of impact on socially relevant cognitive functioning and decision-making is not well-studied, particularly among those less vulnerable to age-related mortality. The current study sought to determine whether infection status and COVID-19 symptom severity are associated with cognitive dysfunction among young and middled-aged adults in the general population, using self-reported lapses in executive control and a standardized decision-making task. MethodThe survey sample comprised 1958 adults with a mean age of 37 years (SD ​= ​10.4); 60.8% were female. Participants reported SARS-CoV-2 infection history and, among those reporting a prior infection, COVID-19 symptom severity. Primary outcomes were self-reported symptoms of cognitive dysfunction assessed via an abbreviated form of the Barkley Deficits in Executive Functioning Scale (BDEFS) and performance on a validated delay-discounting task. ResultsYoung and middle-aged adults with a positive SARS-CoV-2 infection history reported a significantly higher number of cognitive dysfunction symptoms (Madj ​= ​1.89, SE ​= ​0.08, CI: 1.74, 2.04; n ​= ​175) than their non-infected counterparts (Madj ​= ​1.63, SE ​= ​0.08, CI: 1.47,1.80; n ​= ​1599; β ​= ​0.26, p ​= ​.001). Among those infected, there was a dose-response relationship between COVID-19 symptom severity and level of cognitive dysfunction reported, with moderate (β ​= ​0.23, CI: 0.003–0.46) and very/extremely severe (β ​= ​0.69, CI: 0.22–1.16) COVID-19 symptoms being associated with significantly greater cognitive dysfunction. These effects remained reliable and of similar magnitude after controlling for demographics, vaccination status, mitigation behavior frequency, and geographic region, and after removal of those who had been intubated during hospitalization. Very similar—and comparatively larger—effects were found for the delay-discounting task, and when using only PCR confirmed SARS-CoV-2 cases. ConclusionsPositive SARS-CoV-2 infection history and moderate or higher COVID-19 symptom severity are associated with significant symptoms of cognitive dysfunction and amplified delay discounting among young and middle-aged adults with no history of medically induced coma.

Self-Directedness Positively Contributes to Resilience and Quality of Life: Findings From a Mixed Psychiatric Sample

Introduction: This study zoomed into the relation between self-regulation, resilience and quality of life (QOL) within a mixed psychiatric sample of patients with Dual-Diagnosis (DD) or an Autism spectrum disorder (ASD).Method: Patients with DD or ASD participated and healthy control (HC) data were present. The Barkley Deficits in Executive Functioning Scale (BDEFS), Shortened Temperament and Character Inventory and Manchester Short Assessment of Quality of Life were administered.Results: The BDEFS revealed more executive problem reporting by DD or ASD patients than by HC. Both patient groups revealed that, the more problems were reported in executive self-regulation (like self-motivation, problem-solving), the lower QOL was experienced. The resilience aspect of self-directedness (goal-directed, responsible attitude) was positively related to higher QOL and to lesser experience of self-motivational and problem-solving problems. But, the more harm-avoidant, the lesser one was self-directed and the more self-motivational and problem-solving problems were reported.Discussion: Self-regulation and harm-avoidance problems were related to lower QOL in DD and ASD. Self-directedness, executive self-motivation and problem-solving predicted higher QOL. Treatment focus on self-directedness, executive self-regulation and resilience is recommended.

Barkley Deficits in Executive Functioning Scale (BDEFS): Validation in a Large Multisite College Sample.

Despite the importance of daily life executive functioning (EF) for college students' success, few measures exist that have been validated in college students specifically. This study examined the factor structure of the Barkley Deficits in Executive Functioning Scale (BDEFS) in college students. Participants were 1,311 students (ages 18-28 years, 65% female) from five universities in the United States. Additionally, the study examined invariance across sex, age, and attention-deficit/hyperactivity disorder symptoms. Exploratory structural equation modeling provided strong support for the BDEFS five-factor structure though some items had high cross-loadings on multiple factors. Findings generally supported invariance across sex and age; however, loadings, thresholds, and factor means differed based on attention-deficit/hyperactivity disorder symptoms. Stronger support for invariance across sex emerged for a reduced item version that eliminated cross-loading items. Overall, findings provide support for the validity and utility of the BDEFS in college students.

Dutch translation and adaptation of the Barkley Deficits in Executive Functioning Scale (BDEFS)

Abstract Background Based on his model of self-regulation and executive functions, Barkley developed a self- and other-report questionnaire (the Barkley Deficits in Executive Functioning Scale – BDEFS). The BDEFS measures deficits in executive functions as expressed in daily life activities like self-management of time, self-organization, self-restraint, self-motivation, and self-regulation of emotion. Objectives This study created and analyzed a Dutch translation and adaptation in conformance with official guidelines. Methods The Dutch and English BDEFS were completed by 25 bilingual Dutch adults to evaluate semantic correspondence. Consequently, 60 Dutch participants completed the Dutch BDEFS, Barratt Impulsiveness Scale-Eleventh edition (BIS-11) and the Dysexecutive Questionnaire (DEX) to evaluate concurrent validity and internal consistency. Results The versions demonstrated sufficient semantic equivalence and Spearman’s rho of total scores was high; items mostly showed moderate-to-high correlations. Regression analysis showed no proportional bias. Internal consistency was also high. Correlations between BDEFS, BIS-11 and DEX supported concurrent validity. Discussion We conclude that a successful BDEFS translation and adaptation was created with satisfactory reliability and validity. Further research should assess the utility of the BDEFS in Dutch clinical practice.

INTERNET ADDICTION OR PSYCHOPATHOLOGY IN DISGUISE? RESULTS FROM A SURVEY OF COLLEGE-AGED INTERNET USERS

Internet addiction, is a term describing pathological, compulsive internet use and has an estimated prevalence of 6% among the general population and higher in students[1]. Extreme internet use may have significant public health importance as it has been attributed to several cardio-pulmonary deaths and at least one murder. While the pathological use of alcohol or drugs has been historically accepted as an addiction, questions remain concerning whether extreme internet use should be conceptualized as an addiction. The Internet Addiction Test (IAT) was developed in 1998, prior to the wide-spread use of Smartphone and other mobile devices, to detect internet addiction [2]. It is unclear whether this instrument is capable of capturing problematic modern internet use. The purpose of this study was to examine the construct of “internet addiction” in a sample of college aged internet users. A survey was administered to first year undergraduate students at McMaster University and posted to our centre website www.macanxiety.com. Following acknowledgment of a disclosure statement, participants completed several self-report scales detailing internet usage, symptoms of depression and anxiety, impulsiveness and executive functioning. Measures included: a short demographics questionnaire as well as a survey containing the IAT, sections from the Mini International Neuropsychiatric Interview for OCD, GAD, SAD, the Barkley Adult ADHD Rating Scale, the Barratt Impulsiveness Scale, the Depression, Anxiety and Stress Scale (DASS-21), the Barkley Deficits in Executive Functioning Scale (BDEFS) and the Sheehan Disability Scale (SDS). Individuals were also asked to complete the Dimensions of Problematic Internet Use (DPIU); a scale based on DSM-5 addiction criteria. Once the survey was complete, respondents were informed of their score and interpretation on the IAT. Two hundred and fifty-four participants completed all assessments. They had a mean age of 18.5±1.6 years and 74.5% were female. In total 12.5% (n = 33) met screening criteria for internet addition according to the IAT, while 107 (42%) met addiction criteria according to the DPIU. The most frequently reported dimensions of internet use where respondents had difficulty controlling their use were: video streaming services (55.8%), social networking (47.9%) and instant messaging tools (28.5%). Those screening positive on the IAT and on the DPIU had significantly higher levels of functional impairment (p < 0.001), depression and anxiety symptoms (p < 0.001), greater executive functioning impairments (p < 0.001) and greater levels of attentional problems (p < 0.001) as well as ADHD symptoms (p < 0.001). Those with IAT and DPIU internet addiction spent more of their non-essential (leisure) time online compared to those who did not meet internet addiction criteria. When examining the different dimensions of internet use, positive screeners were more likely to have difficulty controlling their use of instant messaging tools compared to negative screeners (p = 0.01). No other differences in use were observed. A high proportion of the sample met criteria for internet addiction. Participants meeting criteria for internet addiction had greater levels of psychopathology and functional impairment. With the exception of instant messaging tools, none of the dimensions of internet use differed between individuals who did and did not meet internet addiction criteria on the IAT. This study highlights that problematic internet use may be more widespread than once thought. Further studies are needed to understand the relationship between problematic internet use and psychopathology.

Psychometric properties of the Barkley Deficits in Executive Functioning Scale: A Spanish-Language Version in a community sample of puerto rican adults.

Performance-based measures have shown some limitation in the assessment of executive functioning (EF) and rating scales have been proposed as an alternative. Our aim was to conduct a comprehensive psychometric evaluation of the Barkley Deficits in Executive Functioning Scale (BDEFS), as administered in 452 Latino community adults (65.5% female). The BDEFS was back-translated into Spanish. We performed exploratory factor analysis (EFA) to assess the structure of the translated BDEFS and to compare it with the original five-factor structure based on the English-language version. Confirmatory factor analysis (CFA) was performed to test the original language structure of the instrument, and also a modified version with items that loaded equally in both versions. The Adult Self-Report Scale was used to screen for ADHD symptoms. We assessed invariance on the latent factor's mean by age and gender, and to estimate associations with ADHD symptom dimensions. The five-factor structure of the BDEFS was partially supported by EFA/CFA, in which 78 out of 89 items loaded similar to the original English-language structure. Factor scores were significantly associated with ADHD symptom dimensions. Model-based contrasts revealed that inattention was primarily associated with disorganization, time-management and motivational aspects of EF; hyperactivity was predominantly related to self-restraint and self-regulation factors. The BDEFS seemingly assesses similar dimensions of the EF construct in English and in the present Spanish-language versions. Factor scores were differentially associated with ADHD subtypes. Replication and confirmation of the Spanish-language BDEFS in a larger sample is advised. (PsycINFO Database Record

Brazilian Portuguese transcultural adaptation of Barkley Deficits in Executive Functioning Scale (BDEFS)

Background Considering the importance of Executive Functions to clinical and nonclinical situations, Barkley proposed a new theory of executive functioning based on an evolutionary neuropsychological perspective and clinical research using large samples of clinical and community identified adults and children as well as children with ADHD followed to adulthood. Objective The present study aims to adapt the Barkley Deficits in Executive Functions Scales (BDEFS) to Brazilian Portuguese and also assess its construct validity in a sample of normal Brazilian adults. Methods The original version of scale was adapted to Brazilian Portuguese according to the guideline from the ISPOR Task Force. To assess the semantic equivalence between the original and adapted version, both of them were applied into a sample of 25 Brazilian bilingual adults. Finally, 60 Brazilian adults completed the BDEFS and the Brazilian versions of Barratt Impulsiveness Scale (BIS-11) and Adult Self-Report Scale (ASRS-18) to assess convergent validity. Results The BDEFS Brazilian Portuguese version has semantic correspondence with the original version indicating that the adaptation procedure was successful. The BDEFS correlated significantly with the impulsivity and attention scores from the BIS-11 and ASRS-18 supporting its construct validity. Cronbach’s alpha (α = 0.961) indicated that the BDEFS translated version has satisfactory internal consistency. Discussion Together, these findings indicate the successful adaptation of the BDEFS to Brazilian Portuguese and support its utility in that population.

Executive functioning difficulties as predictors of academic performance: Examining the role of grade goals

Concepts related to self-regulation have emerged repeatedly in research on college academic achievement. We hypothesized that self-reported executive functioning (EF) deficits would predict academic performance and investigated whether grade goals could account for this relationship. In Study 1 we obtained data on the Barkley Deficits in Executive Functioning Scale (BDEFS) and self-reported GPA from co-educational university students (N=250). In Study 2, we collected BDEFS and GPA goals from students at a women’s college (N=229) and obtained grades from the registrar. EF deficits predicted GPA concurrently and prospectively even when controlling for prior grades. Self-motivation problems were most consistently related to grades and mediation analysis revealed a significant indirect effect via lower grade goals. However, goals did not fully account for this relationship. While our results suggest potential value for goal-setting interventions, additional measures to improve self-regulation are likely needed to help struggling students with self-motivation problems.

An Analysis of the Barkley Deficits in Executive Functioning Scale in a College Population: Does It Predict Symptoms of ADHD Better Than a Visual-Search Task?

Objective: Executive functioning (EF) deficits have been associated with ADHD. However, disagreement exists concerning the extent to which cognitive tests of EF accurately reflect a diagnosis of ADHD. Barkley developed the Barkley Deficits in Executive Functioning Scale (BDEFS) by categorizing the meta-construct of EF into five subdomains. This study investigated the incremental validity of the BDEFS in predicting symptoms of ADHD compared with a visual-search task. We also investigated patterns among the five BDEFS domains. Method: One hundred and sixteen college students completed a visual-search task and the BDEFS and reported on their symptoms of ADHD. Results: (a) BDEFS total scores significantly predicted total ADHD symptoms, whereas the visual-search task failed to predict ADHD symptoms. (b) The BDEFS demonstrated significant correlations with symptoms of ADHD in expected patterns. Conclusion: This study provides evidence of validity for the BDEFS in a college sample.

Test Review: Barkley deficits in executive functioning scale (BDEFS)

Test Review: Barkley deficits in executive functioning scale (BDEFS)