American Board of Professional Psychology (ABPP) Practice Exam

The orbitofrontal prefrontal cortex is central to integrating emotions with behavior, evaluating rewards, and exerting inhibitory control over inappropriate actions. When this region is damaged, people often show disinhibition and impulsivity, emotional lability, and distractibility. They may also confabulate or make up information as the usual reality-check processes falter, reflecting impaired monitoring of behavior. Anosmia can occur because the olfactory processing areas sit on the ventral surface of the frontal lobes near the orbitofrontal cortex, so injury there can disrupt smelling. Witzelsucht—a tendency to make excessive, inappropriate jokes—is a classic sign of orbitofrontal damage, reflecting disinhibited social behavior. By contrast, lesions in other frontal areas produce more office-standard cognitive or motivational deficits (e.g., planning and working memory problems with the dorsolateral PFC, conflict monitoring with the anterior cingulate) and do not typically present with this specific combination of symptoms.