Persönlichkeitsstörungen und Hirnschädigung: Theoretische Grundlagen

  • George P. Prigatano


Dieses und das vorangegangene Kapitel fassen das für das 4. und 5. Prinzip relevante Datenmaterial zusammen. Beide Prinzipen beziehen sich darauf, dass neuropsychologische Rehabilitation Patienten und Angehörige unterstützen muss, die Verhaltensveränderungen nach einer Hirnschädigung zu verstehen und ihre Verwirrung und Frustration zu reduzieren. Kognition und Emotion/ Motivation (im Sinne der Persönlichkelt) stehen dabei in einem engen Zusammenhang.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th edn). American Psychiatric Association, Washington, D.C.Google Scholar
  2. Baerends, E.P. (1988). Ethology. In R.C. Atkinson, R. J. Herrnstein, G. Lardyey, und R. D. Luce (eds), Stevens’ Handbook of Experimental Psychology (2nd edn,Vol. 1).Perceptions and Mot ivation (pp.765-830). John Wiley & Sons, New York.Google Scholar
  3. Bakchine, S., Lacomblez, L., Benoit, N., Parisot, D., Chain, F., und Lehermitte, F. (1989). Manic-like state after bilateral orbitofrontal and right temporoparietal injury: efficacy of clonidine. Neurology 39: 777–781.PubMedCrossRefGoogle Scholar
  4. Beck, A.T., Rush, J.A., Shaw, B. F., und Emery, G. (1979). Cognitive Therapy of Depression. Guilford, New York.Google Scholar
  5. Bigler, E.D. (1989). Behavioural and cognitive changes in traumatic brain injury: a spouse’s perspective. Brain Inj. 3:73–78.PubMedCrossRefGoogle Scholar
  6. Brarnanti, P., Sessa, E., und Saltuari, L. (1994). Post-traumatic mutism. J. Neurosurg. Sci. 38: 117–122.Google Scholar
  7. Brooks, N., McKinlay, W., Symington, C, Beattie, A., und Campsie, L. (1987). Return to work within the first seven years of severe head injury. Brain Inj. 1(1):5–19.PubMedCrossRefGoogle Scholar
  8. Brown, J.W. (1984). Hallucinations imagery and the microstructure of perception. In J. A. M. Frederiks (ed), Handbook of Clinical Neurology, Vol. 1 (45) (pp. 351–372). Clinical Neuropsychology. Elsevier Science, Amsterdam.Google Scholar
  9. Bruner, J. (1986). Actual Minds, Possible Words. Harvard University Press, Cambridge, MA.Google Scholar
  10. Cantor, N. und Fleeson, W. (1994). Social intelligence and intelligent goal pursuit: a cognitive slice of motivation. In W. D. Spaulding (ed), Integrative Views of Motivation, Cognition, and Emotion (pp. 125-179). University of Nebraska, Lincoln.Google Scholar
  11. Chandler, M.C, Barnhill, J. L., und Gualtieri, C.T. (1988). Amantadine for the agitated head-injury patient. Brain Inj. 2:309–311.PubMedCrossRefGoogle Scholar
  12. Corrigan, J. D. (1989). Development of a scale for assessment of agitation following traumatic bra in injury. J. Clin. Exp. Neuropsychol. 11:261–277.PubMedCrossRefGoogle Scholar
  13. Damasio, A.R. und Anderson, S.W. (1993). The frontal lobes. In K. M. Heilman und E. Valenstein (eds), Clinical Neuropsychology (3rd ed) (pp. 409-460). Oxford University Press, New York.Google Scholar
  14. Darwin, C (1872/1965). The Expression of the Emotions in Man and Animals. University of Chicago, Chicago.CrossRefGoogle Scholar
  15. Davidson, R. J. (1992). Anterior cerebral asymmetry and the nature of emotion. Brain Cogn. 20:125–151.PubMedCrossRefGoogle Scholar
  16. Derryberry, D., und Tucker, D.M. (1992). Neural mechanisms of emotion. J. Consult. Clin. Psychol. 60(3):329–338.PubMedCrossRefGoogle Scholar
  17. Dollard, J., und Miller, N.E. (1950). Personality and Psychotherapy: An Analysis in Terms of learning, Thinking and Culture. McGraw-Hill, New York.Google Scholar
  18. Ekman, P., und Friesen, W.V. (1975). Unmasking the Face. Prentice-Hall, Englewood Cliffs, NJ.Google Scholar
  19. Elliott, F.A. (1982). Neurological findings in adult minimal brain dysfunction and the dyscontrol syndrome. J. Nerv. Ment. Dis. 170:680–687.PubMedCrossRefGoogle Scholar
  20. Fedoroff, J.P., Starkstein, S.E., Forrester, A.W. et al. (1992). Depression in patients with acute traumatic brain injury. Am. J. Psychiatry 149:918–923.PubMedGoogle Scholar
  21. Feighner, J.P., und Boyer, W.M. (1991). Perspectivesin Psychiatry, Vol. 2. Diagnos is of Depression. Wiley, Chichester, England.Google Scholar
  22. Fordyce, D.J., Roueche, J.R., und Prigatano, G.P. (1983). Enhanced emotional reactions in chronic head trauma patients. J. Neurol. Neurosurg. Psychiatry 46:620–624.PubMedCrossRefGoogle Scholar
  23. Freud, S. (1895/1966). Project for a Scientific Psychology. Standard Edition, Vol. 1 (pp.281–237).Google Scholar
  24. Freud, S. (1900/1953). The Interpretation of Dreams. Standard Edition, Vols. 45.Google Scholar
  25. Gainotti, G.(1972). Emotional behavior and hemispheric side of lesion. Cortex 8:41–55.PubMedGoogle Scholar
  26. Gainotti, G. (1993). Emotional and psychosocial problems after brain injury. Neuropsychological Rehabilitation 3(3): 259–277.CrossRefGoogle Scholar
  27. Godfrey, H.P.D., Partridge, E.M., und Knight, R.G. (1993). Course of insight disorder and emotional dysfunction following closed head injury: a controlled cross-sectional follow-up study. J. Clin. Exp. Neuropsychol. 15(4):503–515.PubMedCrossRefGoogle Scholar
  28. Goldstein, K. (1942). After effects of Brain Injuries in War. Grune and Stratton, New York.Google Scholar
  29. Goldstein, K. (1951/1971). On emotions: Considerations from the organismic point of view. J. Psychology 31, 37–49.CrossRefGoogle Scholar
  30. Reprinted in A. Gurwitsch, E. M. Goldstein Haudek, und W.E. Haudek (eds), Kurt Goldstein. Selected Papers. Martinus Nijhoff, The Hague.Google Scholar
  31. Goldstein, K. (1952). Effect of brain damage on the personality. Psychiatry 15:245–260.PubMedGoogle Scholar
  32. Heilman, K. M., Bowers, D., und Valenstein, E. (1993). Emotional disorders associated with neurological disease. In K. M. Heilman und E. Valenstein (eds), Clinical Neuropsychology (3rd edn). Oxford University Press, New York.Google Scholar
  33. Hinkeldey, N.S., and Corrigan, J.D. (1990). The structure of head injured patients’ neurobehavioural complaints: a preliminary study. Brain. Inj. 4:115–133.PubMedCrossRefGoogle Scholar
  34. Izard, C.E., und Saxton, P.M. (1988). Emotions. In R. C. Atkinson, R. J. Herrnstein, G. Lindzey, und R. D. Luce (eds), Stevens’ Handbook of Experimental Psychology (2nd edn) (pp. 627-676). John Wiley & Sons, New York.Google Scholar
  35. Jennett, B., und Teasdale G. (1981). Management of Head Injuries. E. A. Davis, Philadelphia.Google Scholar
  36. Jorge, R. E., Robinson, R. G., und Arndt, S. (1993a). Are there symptoms that are specific for depressed mood in patients with traumatic brain injury? J. Nerv. Ment. Dis. 181(2): 91–99.PubMedCrossRefGoogle Scholar
  37. Jorge, R.E, Robinson, R.G., Arndt, S., Forrester, A.W., Geisler, E. und Starkstein, S. E. (1993b). Comparison between acute-and delayed-onset depression following traumatic brain injury. Journal of Neuropsychiatry 5:43–49.Google Scholar
  38. Jorge, R.E, Robinson, R.G., Arndt, S.V., Starkstein, S.E., Forrester, A.W., und Geisler, E (1993c). Depression following traumatic brain injury:A 1 year longitudinal study. J. Affect. Disord. 27:233–243.PubMedCrossRefGoogle Scholar
  39. Jung, C.G. (1912/1956). Symbols ofTransformation, Collected Works, Vol. 5. Bollingen Series XX, Princeton University, NJ.Google Scholar
  40. Jung, C.G. (1927171). Psychological Types, Collected Works, Vol. 6. Bollingen Series, Princeton University, NJ.Google Scholar
  41. Jung, C.G. (1964). Man and His Symbols. Doubleday Windfall, Garden City, New York.Google Scholar
  42. Kozloff, R. (1987). Network of social support and the outcome from severe head injury. Journal of Head Trauma Rehabilitation 2:14–23.CrossRefGoogle Scholar
  43. Kupfer, D. J. (1991). Biological markers of depression. In J. P. Feighner und W.E. Boyer (eds), The Diagnosis of Depression (pp. 79-98). Wiley, Chichester, England.Google Scholar
  44. Levin, H. S., und Grossman, R.G. (1978). Behavioral sequelae of closed head injury: a quantitative study. Arch. Neurol. 35:720–727.PubMedCrossRefGoogle Scholar
  45. Lezak, M. D. (1987). Relationships between personality disorders, social disturbances, and physical disability following traumatic brain injury. Journal of Head Trauma Rehabilitation 2(1):57–69.CrossRefGoogle Scholar
  46. Lishman, W.A. (1968). Brain damage in relation to psychiatric disability after head injury. Br.J. Psychiatry 114:373–410.PubMedCrossRefGoogle Scholar
  47. Maclean, P. D. (1954). The limbic system and its hippocampal formation.Studies in animals and their possible application to man. J. Neurosurg. 11:29–44.PubMedCrossRefGoogle Scholar
  48. Maclean, P. D. (1957a). Chemical and electrical stimulation of hippocampus in unrestrained animals. I. Methods and electroencephalographic findings. AMA Archives of Neurology and Psychiatry 78: 113–127.PubMedCrossRefGoogle Scholar
  49. Maclean, P. D. (1957b). Chemical and electrical stimulation of hippocampus in unrestrained animals. II. Behavioral findings. AMA Archives Neurology and Psychiatry 78: 128–142.CrossRefGoogle Scholar
  50. Maclean, P. D. (1958a). Contrasting functions of limbic and neocort ical systems of the brain and their relevance to psychophysiological aspects of medicine. Am. J. Med. 25:611–626.PubMedCrossRefGoogle Scholar
  51. Maclean, P. D. (1958b). The limbic system with respect to self preservation and the preservation of the species. J. Nerv. Ment. Dis. 127: 1–11.PubMedCrossRefGoogle Scholar
  52. Maclean, P. D. (1959). The limbic system with respect to two basic life principles. In Transactions of Second Conference on the Central Nervous System and Behavior. Josiah Macy, Jr. Foundation, New York (pp. 31–118).Google Scholar
  53. Maclean, P. D. (1962). New findings relevant to the evolution of psychosexual functions of the brain. J. Nerv. Ment. Dis. 135:289–301.CrossRefGoogle Scholar
  54. Maclean, P. D. (1970). The triune brain, emotion, and scientific bias. In E. O. Schmitt (ed). The Neurosciences. Second Study Program (pp.336-349). Rockefeller University, New York.Google Scholar
  55. Maclean, P. D. (1973). A triune concept of the brain and behavior. Lecture I. Man’s reptilian and limbic inheritance; Lecture II. Man’s limbic brain and the psychoses; Lecture III. New trends in man’s evolution. In T. Boag und D. Campbell (eds), The Hincks Memorial Lectures (pp. 6-66). University of Toronto, Toronto.Google Scholar
  56. Maclean, P. D. (1985). Brain evolution relating to family, play, and the separation call. Arch. Gen. Psychiatry 42:405–417.PubMedCrossRefGoogle Scholar
  57. Maclean, P. D. (1987). The midline frontolimbic cortex and the evolution of crying and laughter. In E. Perecman (ed), The Frontal lobes Revisited (pp. 121-140). IRBN, New York.Google Scholar
  58. Maclean, P. D. (1990). The Triune Brain in Evolution. Plenum, New York.Google Scholar
  59. Markus, H., und Nurius, P. (1986). Possible selves. Am. Psychol. 41:954–969.CrossRefGoogle Scholar
  60. Marlowe, W.B. (1992). The impact of a right prefrontal lesion on the developing brain. Brain Cogn. 20:205–213.PubMedCrossRefGoogle Scholar
  61. Meyer, A. (1904). The anatomical facts and clinical varieties of traumatic insanity. American Journal of Insanity LX(3):25–141.Google Scholar
  62. Oddy, M., Coughlan, T., Tyerman, A., und Jenkins, D.(1985). Social adjustment after closed head injury:a further follow-up 7 years after injury. J. Neurol. Neurosurg. Psychiatry 48:564–568.PubMedCrossRefGoogle Scholar
  63. Ota, Y. (1969). Psychiatric studies on civilian head injuries. In A.E. Walker, W. F. Caveness, und M. Critchley (eds), The Late Effects of Head Injury (pp. 110-119). Charles C Thomas, Springfield, III.Google Scholar
  64. Papero, P. H., Prigatano, G. P., Snyder, H. M., und Johnson, D. L. (1993). Children’s adaptive behavioural competence after head injury. Neuropsychological Rehabilitation 3(4):321–340.CrossRefGoogle Scholar
  65. Papez, J.W. (1937). A proposed mechanism of emotion. Archives of Neurology and Psychiatry 38:725–743.CrossRefGoogle Scholar
  66. Penfield, W., und Jasper, H. (1954). Epilepsy and the Functional Anatomy of the Human Brain. Little, Brown, Boston.Google Scholar
  67. Pribram, K.H. (1971). Languages of the Brain: Experimental Paradoxes and Principles in Neuropsychology. Prentice-Hall, Englewood Cliffs, NJ.Google Scholar
  68. Pribram, K. H., und Gill, M. M. (1976). Freud’s „Project“ Re-Assessed. Basic Books, New York.Google Scholar
  69. Price, B.H., Daffner, K.R., Stowe, R.M., und Mesulam, M.M.(1990). The comportmental learning disabilities of early frontal lobe damage. Brain 113(Pt 5): 1383–1393.PubMedCrossRefGoogle Scholar
  70. Prigatano, G. P. (1986). Personality and psychosocial consequences of brain injury. In Prigatano et al. (eds), Neuropsychological Rehabilitation After Brain Injury (pp. 29-50). Johns Hopkins University Press, Baltimore.Google Scholar
  71. Prigatano, G. P. (1988). Emotion and motivation in recovery and adaptation after brain damage. In S. Finger, T. E. LeVere, C.R. Almli, und D. G. Stein (eds), Brain Injury and Recovery: Theoretical and Controversial Issues (pp. 335-350). Plenum, New York.Google Scholar
  72. Prigatano, G. P. (1992). Personality disturbances associated with traumatic brain injury. J. Consult. Clin. Psychol. 60(3): 360–386.PubMedCrossRefGoogle Scholar
  73. Prigatano, G. P., Altman, I.M., und O’Brien, K. P. (1990). Behavioral limitations that brain injured patients tend to underestimate. Clinical Neuropsychologist 4: 163–176.CrossRefGoogle Scholar
  74. Prigatano, G. P., Fordyce, D., Zeiner, H., Roueche, J., Pepping, M., und Wood, B. (1986). Neuropsychological Rehabilitation After Brain Injury. Johns Hopkins University Press, Baltimore.Google Scholar
  75. Prigatano, G. P., O’Brien, K.P., und Klonoff, P. S.(1988). The clinical management of delusions in postacute traumatic brain injured patients. Journal of Head Trauma Rehabilitation 3(3):23–32.CrossRefGoogle Scholar
  76. Prigatano, G. P., und Schacter, D. L. (1991). Awareness of Deficit After Brain Injury: Clinical and Theoretical Issues. Oxford University Press, New York.Google Scholar
  77. Prigatano, G. P., und Summers, J. D. (1997). Depression in traumatic brain injury patients. In M.M. Robertson und C. L. E. Katona (eds), Depression and Physical Illness (pp. 341-358). John Wiley & Sons, New York.Google Scholar
  78. Rekate, H. L., Grubb, R.L., Aram, D.M., Hahn, J.F., und Ratcheson, R.A. (1985). Muteness of cerebellar origin. Arch. Neurol. 42:697–698.PubMedCrossRefGoogle Scholar
  79. Reyes, R.L., Bhattacharyya, A. K., und Heller, D. (1981). Traumatic head injury: restlessness and agitation as prognosticators of physical and psychologic improvement in patients. Arch. Phys. Med. Rehabil. 62:20–23.PubMedGoogle Scholar
  80. Roberts, A.H. (1979). Severe Accidental Head Injury: An Assessment of Long-Term Prognosis. Macmillan, New York.Google Scholar
  81. Robinson, R.G., Bolduc, P., und Price, T. R. (1987). A two-year longitudinal study of poststroke depression: diagnosis and outcome at one and two years. Stroke 18:837–843.PubMedCrossRefGoogle Scholar
  82. Robinson, R. G., Kubos, K. L., Starr, L.B., Rao, K., und Price, T. R. (1983). Mood changes in stroke patients: relationship to lesion location. Compr. Psychiatry 24:555–556.PubMedCrossRefGoogle Scholar
  83. Robinson, R. G. und Price, T. R. (1982). Post-stroke depressive disorders: a follow-up study of 103 patients. Stroke 13:635–641.PubMedCrossRefGoogle Scholar
  84. Robinson, R. G., Starr, L. B., Lipsey, J. R., Rao, K., und Price, T. R. (1984a). A two-year longitudinal study of post-stroke mood disorders: dynamic changes in associated variables over the first six months of follow-up. Stroke 15:510–517.PubMedCrossRefGoogle Scholar
  85. Robinson, R.G., Starr, L.B., Kubos, K. L., Rao, K., und Price, T. R. (1984b). Mood disorders in stroke patients: importance of location of lesion. Brain 197:91–93.Google Scholar
  86. Robinson, R.G., und Szetela, B. (1981). Mood change following left hemispheric brain injury. Ann. Neurol. 9:447–453.PubMedCrossRefGoogle Scholar
  87. Rosenbaum, A., und Hoge, S. K.(1989). Head injury and marital aggression. Am. J. Psychiatry 146:1048–1051.PubMedGoogle Scholar
  88. Ross, E.D., und Rush, J.A. (1981). Diagnosis and neuroanatomical correlates of depression in brain-damaged patients. Arch. Gen. Psychiatry 38, 1344–1354.PubMedCrossRefGoogle Scholar
  89. Schilder, P. (1934). Psychic disturbances after head injuries. Am. J. Psychiatry 91: 155–188.Google Scholar
  90. Shukla, S., Cook, B. L., Mukherjee, S., Godwin, C, und Miller, M.G. (1987). Mania following head trauma. Am. J. Psychiatry 144(1): 93–96.PubMedGoogle Scholar
  91. Simon, H. A. (1967). Motivational and emotional controls of cognition. Psychological Review 76:29–39.CrossRefGoogle Scholar
  92. Simon, H. A. (1994). The bottleneck of attention: connecting thought with motivation. In W. D. Spaulding (ed), Integrative Views of Motivation, Cognition, and Emotion (pp. 1-21). University of Nebraska, Lincoln.Google Scholar
  93. Simon, H. A. (1995). The information-processing therapy of mind. American Psychologist 50(7):507–508.PubMedCrossRefGoogle Scholar
  94. Starkstein, S.E., Robinson, R. G., und Price, T.R. (1987). Comparison of cortical and subcortical lesions in the production of poststroke mood disorders. Brain 110:1045–1059.PubMedCrossRefGoogle Scholar
  95. Starkstein, S.E., Robinson, R.G., und Price, T. R. (1988). Comparison of patients with and without poststroke major depression matched for size and location of lesion. Arch. Gen. Psychiatry 45: 247–252.PubMedCrossRefGoogle Scholar
  96. Storey, P. B. (1970). Brain damage and personality change after subarachnoid haemorrhage. Br. J. Psychiatry 117:129–142.PubMedGoogle Scholar
  97. Thomsen, I.V. (1984). Late outcome of very severe blunt head trauma: a 10-15 year second follow-up. J. Neural. Neurosurg. Psychiatry 47:260–268.CrossRefGoogle Scholar
  98. Valzelli, L. (1980). An Approach to Neuroanatomical and Neurochemical Psychophysiology. John Wright, Littleton, Mass.Google Scholar
  99. van Zomeren, A. H., und van Den Burg, W. (1985). Residual complaints of patients two years after severe head injury. J. Neurol. Neurosurg. Psychiatry 48:21–28.PubMedCrossRefGoogle Scholar
  100. Wise, S. E, und Herkenham, M. (1982). Opiate receptor distribution in the cerebral cortex of the rhesus monkey. Science 218:387–389.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2004

Authors and Affiliations

  • George P. Prigatano
    • 1
  1. 1.Barrow Neurological InstituteSt. Joseph’s Hospital and Medical CenterPhoenixUSA

Personalised recommendations