Editorial Type:
Article Category: Review Article
 | 
Online Publication Date: 01 Dec 2012

Maladaptive Behavior in Survivors: Dysexecutive Survivor Syndrome

Page Range: 1152 – 1161
DOI: 10.3357/ASEM.3199.2012
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Leach J. Maladaptive behavior in survivors: dysexecutive survivor syndrome. Aviat Space Environ Med 2012; 83:1152–61.This paper attempts to answer the question: why does normal, goal-directed, purposeful, and coordinated behavior fragment in a survival situation? Events accompanying the initial impact phase of a survival incident are characterized by speed, danger, violence, and uncontrollability. The following recoil phase is known to produce behavioral and cognitive impairment that leads to a reduced ability to produce a response that is meaningful and may result in tonic immobility. The author argues that the commonly witnessed responses among survivors comprise a subset of known behaviors, including loss of initiative, stereotypy, perseveration of thought and action, hyperkinesia, hypokinesia, and, in extreme cases, akinesia or cognitive paralysis. These behaviors are characteristic of executive dysfunction and a model is given suggesting how this condition may arise under survival conditions. The case is presented that during the initial phase of a survival incident, victims show a transient, nonclinical dysexecutive syndrome. This model should aid survival training and provide a context for conducting behavioral autopsies by accident investigators.

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