Understanding the nature and course of personality alterations following traumatic brain injury (TBI) is needed for rational planning and effective management of TBI patients' many behavioral and social problems. Therefore, levels of emotional and social adjustment and socially relevant aspects of physical status during the first 5 years posttrauma were documented for 39 male TBI patients at six time intervals using the Portland Adaptability Inventory (PAI), an instrument developed for this study. Responses to 21 items (seven dealing with Temperament and personality, eight with Activities of Social Behavior, and six with Physical Competence) were analyzed for evidence of moderate to severe impairment. Three types of problem areas were identified: (a) those which represented persistent difficulty for many patients throughout the 5-year follow-up period; (b) those in which there was significant improvement that was sustained over time; and (c) those in which there was slight or variable improvement. At 5 years posttrauma, most patients were still socially dysfunctional in one or more ways.
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References
1.
Alexander, M.P. (1982). Traumatic brain injury. In D.F. Benson & D. Blumer (Eds.), Psychiatric aspects of neurologic disease: Volume II (pp. 239–341). New York: Grune & Stratton.
2.
Bond, M.R. (1975). Assessment of psychosocial outcome after severe head injury.Ciba Foundation Symposium, 34, 141–157.
3.
Brooks, D.N. (1984). Head injury and the family. In D.N. Brooks (Ed.), Closed head injury (pp. 123–147). Oxford, England: Oxford University Press.
4.
Brooks, D.N., & McKinlay, W. (1983). Personality and behavioral change after severe blunt head injury–A relative's view.Journal of Neurology, Neurosurgery, and Psychiatry, 46, 336–344.
5.
Crawford, C. (1983). Social problems after severe head injury.New Zealand Medical Journal, 96, 972–974.
6.
Crosson, B. (1987). Treatment of interpersonal deficits for head-trauma patients in inpatient rehabilitation settings.The Clinical Neuropsychologist, 1, 335–352.
7.
Dikman, S., McLean, A., & Temkin, N. (1986). Neuropsychological and psychosocial consequences of minor head injury.Journal of Neurology, Neurosurgery, and Psychiatry, 49, 1227–1232.
8.
Elsass, L., & Kinsella, G. (1987). Social interaction following severe closed head injury.Psychological Medicine, 17, 67–78.
9.
Goldstein, K. (1942). Aftereffects of brain injuries in war. New York: Grune & Stratton.
10.
Harlow, J.M. (1868). Recovery after severe injury to the head. Publication of the Massachusetts Medical Society (Boston), 2, 327–346.
11.
Heilman, K.M., & Satz, P. (1983). Neuropsychology of human emotion. New York: Guilford Press.
12.
Leigh, D. (1979). Psychiatric aspects of head injury.Psychiatry Digest, 40, 21–33.
13.
Levin, H.S., Benton, A.L., & Grossman, R.G. (1982). Neurobehavioral consequences of closed head injury (pp. 172–188). New York: Oxford University Press.
14.
Levin, H.S., & Grossman, R.G. (1978). Behavioral sequelae of closed head injury.Archives of Neurology, 35, 720–727.
15.
Lezak, M.D. (1978). Living with the characterologically altered brain injured patient.Journal of Clinical Psychiatry, 39, 592–598.
16.
Lezak, M.D. (1979). Recovery of memory and learning functions following traumatic brain injury.Cortex, 15, 63–70.
17.
Lezak, M.D. (1987). Relationships between personality disorders, social disturbances, and physical disability following traumatic brain injury.Journal of Head Trauma and Rehabilitation, 2, 57–69.
Luria, A.R. (1966). Higher cortical functions in man (2nd ed.). New York: Basic Books.
20.
Merskey, H., & Woodforde, J.M. (1972). Psychiatric sequelae of minor head injury.Brain, 95, 521–528.
21.
O'Brien, K.P. (1986). Parental mood, emotional distress, and coping in families with a head-injured offspring. Unpublished doctoral dissertation. University of Victoria, Victoria, BC.
22.
O'Brien, K.P., & Lezak, M.D. (1982, June). Long-term improvements in intellectual function following brain damage. Paper presented at the Fourth European Meeting of the International Neuropsychological Society, Bergen, Norway.
23.
Oddy, M. (1984). Head injury and social adjustment. In N. Brooks (Ed.), Closed head injury (pp. 108–121). Oxford: Oxford University Press.
24.
Oddy, M., Coughlan, T., Tyerman, A., & Jenkins, D. (1985). Social adjustment after closed head injury: A further follow-up seven years after injury.Journal of Neurology, Neurosurgery, and Psychiatry, 48, 564–568.
25.
Oddy, M., Humphrey, M., & Uttley, D. (1978). Subjective impairment and social recovery after closed head injury.Journal of Neurology, Neurosurgery, and Psychiatry, 41, 611–616.
26.
Prigatano, G.P., and Others (1986). Neuropsychological rehabilitation after brain injury. Baltimore: Johns Hopkins University Press.
27.
Prigatano, G.P., O'Brien, K.P., & Klonoff, P.S. (accepted for publication). The clinical management of delusions in patients with traumatic brain injuries.
28.
Rosenbaum, M., & Najenson, T. (1976). Changes in life patterns and symptoms of low mood as reported by wives of severely brain-injured soldiers.Journal of Consulting and Clinical Psychology, 44, 881–888.
29.
Van Zomeren, A.H., & Van den Burg, W. (1985). Residual complaints of patients two years after severe head injury.Journal of Neurology, Neurosurgery, and Psychiatry, 48, 21–28.
30.
Vigouroux, R.P., Baurand, D., Naquet, R., Chament, J.H., Choux, M., Benayoun, R., Bureau, M., Charpy, J.P., Clamens-Guey, M.J., & Guey, J. (1971). A series of patients with cranio-cerebral injuries studied neurologically, psychometrically, electroencephalographically, and socially. Proceedings of the International Symposium on Head Injuries (pp. 335-341). Edinburgh: Churchill Livingstone.
