Brain Injury & Chang
- sillysap
- sillysap
- graci200
- sillysap
- sillysap
- sillysap
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» sillysap - Frontal Lobe Damage & Behavior Changes
`The frontal (and temporal lobes and certain other brain structures) monitor and direct an individual's emotional/cognitive and physical behaviors.
If the frontal (or temporal) lobes are damaged, results may include difficultis in controlling their temper, actions and feelings.
The most common changes in behaviors after brain injuries include restlessness, hitting, swearing, impulsiveness and difficulty following directions.
The personality may also change with a diminishment or loss of empathy and insight when there is severe damage to the Prefrontal Lobes specifically. Damage HAS to be to this area in order to induce narcissistic shifts in behavior.
If the brain-injured person remembers how they were before their brain injury, they will typically have strong emotional reactions to the changes that have resulted and will become distressed. In turn, the distress itself can manifest in behavioral changes as the patient struggles to regain a "sense of self."
Common brain-injury behavioral changes include differences in the ability to learn, communicate, plan, organizes and interpersonal relationships.
With normal people, behaviors can be modified when negative consequences occur, but when it is brain damage that causes the behavior change, "being punished" (by legal or social group censure) will often make no difference if insight and awareness have been damaged, causing difficulties in recognizing what, exactly, is "wrong."
So how can someone know if a head injury is responsible for behavioral changes?
A neurologist (or psychoneurologist) can order an MRI to visualize any damage. Once it can be determined there is a possibility of frontal lobe damage, a neuropsychologist can determine if any observed behavior changes can possibly be directly related.
For instance, the Wisconsin Card Sorting test (administered by a psychologist) determines if a brain injury has caused any changes to response inhibition - which is manifested by a lack of control over impulse control.
PARTIAL EXCERPTS from Linked Page (see below)
Another area often associated with frontal damage is that of "behavioral sponteneity." Kolb & Milner (1981) found that individual with frontal damage displayed fewer spontaneous facial movements, spoke fewer words (left frontal lesions) or excessively (right frontal lesions).
One of the most common effects of Frontal Damage can be a dramatic change in social behavior. (emphases mine)
A person's personality can undergo significant changes after an injury to the frontal lobes, especially when both lobes are involved.
There are some differences in the left versus right frontal lobes in this area. Left frontal damage usually manifests as pseudodepression and right frontal damage as pseudopsychopathic.
- Blumer, D., & Benson, D. "Personality changes with frontal and temporal lobe lesions." In D. Benson and D. Blumer, eds. Psychiatric Aspects of Neurologic Disease. New York: Grune & Stratton, 1975.
Sexual behavior can also be effected by frontal lesions. Orbital frontal damage can introduce abnormal sexual behavior, while dorolateral lesions may reduce sexual interest. (emphasis mine)
- Walker, E., & Blumer, D. "The localization of sex in the brain." In K.J. Zulch, O. Creutzfeldt, and G. Galbraith, eds. Cerebral Localization, Berlin and New York: Springer-Verlag, 1975.
A good discussion of the many results of damage to the frontal lobes - useful links, too
http://www.neuroskills.com/tbi/bfrontal....
`
-- posted by sillysap
» sillysap - Erratum
`I wrote,
"The personality may also change with a diminishment or loss of empathy and insight when there is severe damage to the Prefrontal Lobes specifically."
But it should have read,
"The personality may also change with a diminishment or loss of empathy and insight when there is severe damage to the Prefrontal Lobes specifically."
I personally have no specific knowledge of how much damage is needed before behavior changes occur. All the cases I have read about involved severe damage, but what I read does not necessarily reflect the entire population of those with injurites resulting in prefrontal lobe damage.
And, as an addendum -- Even tho I talk about all kinds of behavioral changes secondary to brain injury, only prefrontal portion of the frontal lobes are known to be affiliated to diminished empathy and diminished impulse control. This is extensively well documented in the medical and scientific literature.
Theresa
`
-- posted by sillysap
» graci200 - Frontal Lobe Damage & Behavior Changes
In response to Frontal Lobe Damage & Behavior Changes posted by sillysap:Sillysap: "Frontal Lobe Damage & Behavior Changes"
This is great information Sillysap, thanks for locating it. I've been interested in this topic [not necessarily just damage to the frontal lobe] but the significant differences in the frontal lobe of those with AsPd [without obvious injury to the brain] that has been documented. I wonder if someone with NPD shows any difference in that area of the brain? Those with AsPD seem to have "no conscience" "no empathy" that this part of the brain plays a role in. Again thanks for this thread.
-- posted by graci200
» sillysap - Frontal Lobe Damage & Behavior Changes
In response to Frontal Lobe Damage & Behavior Changes posted by ShaeDreams:`
Hi, Shae ...
All the portions I labeled as excerpts came from the link I provided. The other came from a variety of scholarly studies and sites, many of which ones I read from recently to years ago. But one can find similar material lots of places.
Since he had brain surgery to his frontal lobes, it is important for the two of you to find out if his pre-frontal lobes were damaged and if portions were removed (which happens to macerated and nonp-viable areas). Then, a psychologist should test and assess him and counsel him for possible difficulties the brain damage caused.
If there was, then there will need to be a lot of soul-searching regarding if you can live with whatever personality and characterological changes he has incurred. In a live-together relationship where children are involved, you must focus on the most important person in that household - your child who has no options. It is only the parent who can exercise options on behalf of the child.
And realize that it is not so much how he treats your daughter, but how he treats you and how you handle those changes that impacts her.
You've got a lot on your plate for the next few months. I am glad you are going to a therapist.
Theresa
`
-- posted by sillysap
» sillysap - Frontal Lobe Damage & Behavior Changes
In response to Frontal Lobe Damage & Behavior Changes posted by graci200:`
Hi, Graci ....
Now, while LOTS AND LOTS of such studies, in this country and others, such as M.Sc. Carlos Saborío Valverde, have been done on incarcerated persons who have been identified (some thru Hare's criteria) as psychopaths and AsPD..... there have been no brain imaging studies on identified NPDs of which I'm currently aware.
These sort of studies are expensive... and studies are supported by governmental and drug company grants. AsPD/Psychopaths attract a lot of government dollars because they cause an undo percentage of societal harm - in the commission of crimes and in the dollars spent to incarcerate them.
Now, with BPD (borderline), there are increasing numbers of studies, partly because borderlines are highly over-represented in prison populations - particularly women).. And they have the vast majority of suicides, inpatient days in psych hospitals, and a large economic burden. And, since various pharmaceutical treatments have proven valuable - and even therapies have been evaluated, with CBT (Cognitive Behavioral Therapy) showing the most success in preventing suicide attempts, they attract studies of this type.
Now, the problem with NPD is that, until Sam's book, and even just in 1999, it was almost impossible to even find journalists and reporters aware of this PD or even using the term narcissistic personality. While few are willing to admit to the fact where they get the concepts they toss about, the language they use to describe the PD, they undoubtedly lean heavily on Sam's writings. They learn about it from Sam, and if they want to include an authoritative reference or two, they follow the references provides.
Some things HAVE been definitively shown. One is that Grandiosity is the most likely trait to be diminished or eliminated by therapy. And that signs/symptoms of NPD CAN be diminished in patients who work diligently in therapy with a therapist working with the right paradigm -- specifically something that was once termed "Psychology of the Self."
However, the successful outcomes sometimes come about by such things as completing educational goals, like getting a college degree and their being able to see that they ARE a good and worthy person.
BUT - these therapy outcomes are not hard science - they are anecdotal reports of the people conducting the therapy. So what does this tell us? It tells us that NARCISSISTIC persons can stop being laughably and insufferably grandiose - at least in a demonstrable way. It tells us that reaching previously unreachable goals can solve a lot of the problems that brought on the condition to begin with.
But it does not prove that each of these patients had full-blown NPD as verifiable by a number of skilled diagnosticians before the therapy began...
Perhaps these types of cases are mainly late-onset, a situational or acquired NPD - we just don't know for there isn't the research to define what happens.
And it does not prove where NPD comes from -- is it nature, nuture or a mixture. According to these therapy reports, one would say that nuture looms pretty large, in that the therapist is able to assume a "good parent" role in therapy.
The truth is, as Sam says, that science still does not understand WHAT a so-called personality disorder is - never mind what causes NPD. At present, it seems most logical, given differential diagnosis and the huge overlap of PDs with a wide variety of disorders from Bipolar Disorder (manic-depressive illness) to Tourette's syndrome, nevermind childhood behavioral disorders, and PTSD (which also causes both brain structure changes in several areas of the brain), etc, etc, that it is a bit of both, with a large genetic propensity component. (Forgive the run-on sentence. 
)
According to Anthony M. Benis, MD, non-human primates show a great propensity to Narcissism (not NPD, but narcissism) which is most shown by arms held out wide and a smile that shows the gums (which you see a lot in pagaent queens )
He advocates for a Mendelian theory of human evolution into 3 over-riding behavioral inherited categories - aggression, narcissism and passivity, all of which can be studied in primate social behavioral studies and further genetic inheritance studies.
All human behaviors follow the bell-shaped curve, whether you are talking about people with highly optimistic happy congenial personalities or overly pessimistic morose curmudgeonly personalities. Most of us are generally "in the middle" --an "average"-- with lesser numbers clustered at the extremes. But will we find out that prefrontal differences are unavoidable, set in stone at birth? And what other brain differences will be found to parallel the pre-frontal differences? And why did they happen??
Will we find that abuse causes the brain to change? Or will we find that it truly differs from one person to another - with one it mainly "just personality" and the next "set in brain tissue"
And if we can now grow new inner ear structures from embryo stem cells that enable a deaf mouse to hear again ----- what can we imagine for the future? Perhaps by the end of the century, we might have a chance to find out. Wish I could be around.
Great place to begin scholarly research (see link below) on a number of PDs. If you live near a medical school with a residency program and research in NeuroPsychiatry or NeuroPsychology, you should visit - you will find a wealth of material. But you need to know more than a smattering of statistics and be fluent in research study contruction to make sense of a great deal of it, and able to tell what is sound science and what is pseudo-science.
http://www.bpdresources.com/otherdisorde...
`
Madame de Stael."
-- posted by sillysap
» sillysap - tiny editing addenda
`I meant to add that the professional resources that journalists and reporters generally follow up on are ones that Sam has so conveniently provided by virtue of his OWN research.
Also, when I mentioned a foreign criminal researcher (a real researcher, by the way), I had actually been thinking of Sabatino. Years ago, a WONDERFUL paper of his was freely available online, but it is now restricted and you have to pay for it. I have a copy of it - but it is on another harddrive. I need to buy an external USB drive.
Theresa
-- posted by sillysap
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