Maladaptive behavior in survivors: dysexecutive survivor syndrome

John Leach

Research output: Contribution to journalArticlepeer-review


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.
Original languageEnglish
Pages (from-to)1152-1161
JournalAviation Space and Environmental Medicine
Issue number12
Publication statusPublished - 1 Dec 2012


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