Cerebral Personality Disorders and Frontal Lobe Syndromes
Emotional distress and dysjunctioning are so common after brain damage that the author considers it unlikely that TBI can occur without damage to the emotional apparatus directly, and/or some form of posttraumatic stress.
Studies after intervals of up to 15 years show that one-half to two-thirds of very severely head injured patients show personality disturbances (Grant and Alves, 1987). Relatives who live with the patient see their psychopathology as intensifying over time (Levin, 1985). It has been asserted that emotional stress is associated with litigation, and disappears afterward (Alves & Grant, 1987), but this point is doubtful.
In any event, the state of being impaired creates distress, which in turn will affect adaptive functioning. Unfortunately, emotional distress is often not documented after TBI, and this chapter is designed to help the reader understand the dimensions of this problem. To review the neurological functioning associated with cerebral emotional disorders could be like attempting to review all of neuroscience, but an overall guide will be attempted!
This chapter will emphasize disorders directly caused by trauma to the brain, including the frontal lobe syndrome(s). The vulnerability of the frontal lobes and their fiber connections has been discussed in Chapter 4 on Trauma. The next chapter (deficits of adaptability) will concern itself with sexuality (in part because it is a a social problem, contributing to deficits of self-esteem). Naturally, TBI also affects motivation and performance. Chapter 15 on Anxiety, Stress, and Psychodynamic Reactions will offer a further overview on dynamic emotional disorders frequently occurring after TBI. The difficulties found in determining accurately the emotional life of TBI victims (and other deficits) due to their inability to express their problems are discussed in Chapter 16 on Expressive Deficits.
KeywordsDepression Dopamine Dementia Cortisol Schizophrenia
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