Initiation refers to an individual’s intrinsic ability to begin a series of goal-directed behaviors. Impaired initiation is a diminished ability to take the first steps toward beginning an action, despite an often intact ability to describe a comprehensive plan.
Initiation exists within the larger context of general executive functioning, which refers to the ability to plan, initiate, direct, and monitor one’s activities. Deficits in initiation may result in a person having difficulty starting and completing tasks without repeatedly being prompted. In mild forms, an individual may be able to engage in normal activities, particularly if these activities are structured or familiar to the person, yet may fail to start complicated or unfamiliar activities. In more severely affected individuals, self-care and productivity can become impaired, and patients may appear lazy, apathetic, or unmotivated. Initiation is often worse when individuals experience stress,...