A translational cross-modal control-cost framework for executive breakdown

Across neurological and neuropsychiatric conditions, patients often know what they should do yet cannot bring themselves to do it. This dissociation between intact knowledge and failed implementation, which we call the knowing-doing gap, is clinically important but lacks a unified, measurable account. We propose that converting knowledge into action carries a cost, termed executive friction (Ψ _f ), and that behavior breaks down when this cost exceeds the control resources available to pay it. The proposal is specified at two levels: a measurable factor estimated from observable indicators, and a family of candidate mechanisms in which friction is read either as accumulated control effort or as departure from a habitual default. We model distress as a function of how rapidly friction is rising, how the person appraises the situation, and of executive collapse, which we treat as the point at which control demands outstrip available capacity. The central contribution is practical: a low-cost testing chain that combines behavioral control tasks, shifts in the language of ability (e.g., "can" vs. "cannot"), and autonomic physiology (heart-rate variability and skin conductance), with neural and biochemical measures kept as optional add-ons. Depression, obsessive-compulsive disorder, and Parkinson's disease serve as contrasting test cases with distinct predicted signatures rather than as replacements for existing diagnostic categories. We present five preregistration-ready hypotheses with explicit rejection criteria. No new data are reported.