Efficiency and Control

Abstract

Mental efficiency includes functions such as problem-solving style, concentration, planning, and behavioral monitoring. This chapter will illustrate component functions, and how their disorders contribute to impairment. Sometimes referred to as the “executive function” (Lezak, 1983; Stuss & Benson, 1986), the mental efficiency system involves many relatively narrow temperamental and cognitive functions, which are very vulnerable to damage to widely scattered areas of the brain. Deficits range from subtle, though impairing, to obviously disabling. Deficits of mental efficiency are related to problems of cerebral emotional disorder, including the frontal lobe syndrome. Patterns of emotional, motivational, and cognitive dysfunctioning are given in Chapter 13 on the Frontal Lobe Syndromes.

The role of the mental efficiency system in adaptation may be illustrated by the complaint of a patient: “I’m confused. I don’t know if its all in my head or if it really happened. I can’t understand why I can’t dust myself off and start over again.”

Cognitive control is relatively independent of level of intellectual ability, although it supports it. We have all met individuals, without outstanding education or high intelligence, who were admirable in the effectiveness with which they coped with personal or job problems. Similarly, memory is dependent on the integrity of other functions, e.g., attention, motivation, and programming (Bowen, 1989).