Personality changes in accident victims
...y to it. The disinhibition leads to marked abnormalities of behavior, sometimes associated with outbursts of irritability and aggression. (8. Psychopathology of frontal lobe syndromes Michael H. Trimble, F.R.C.P, F.R.C. Psych 1990) Due to the destabilization to the nervous system auto accidents cause people to stay stuck in survival mode. Survival mode causes emotional and physical symptoms which may seem unrelated to the accident, making patients feel that whatever emotional pain or physical pain they are feeling it is just in their head. (5.Crash Course, Diane Poole Heller PhD 2001) The three principal frontal lobe syndromes are; orbitofrontal syndrome (disinhibited) frontal convexity syndrome (apathetic) medial frontal lobe syndrome (akinetic). All of which have various symptoms from poor judgment and insight, loss of self, indifference, sparse verbal output, and incontinence. These can lead to epilepsy, schizophrenia, and dementia. (8.Michael Thimble, F.R.C.P, F.R.C. Psych 1990) At the University of Texas medical center, (4.) Christina Meyers (1992) described a case of a 33 year old man who had a tumor removed from his left frontal lobe. Prior to having the tumor removed, he was an honest likeable, hard working man who suffered a dramatic personality disorder after surgery; he became irresponsible, irritable and grandiose. These changes tell us that the frontal lobe plays an important part in controlling our complex behaviors. So now we know that the frontal lobe is fragile and that auto accidents aren’t the only cause of them, just one of the leading causes. Common reactions after auto accidents are flooding, (anxiety attacks, out bursts of anger, and flashbacks), and freezing, (constriction, numbness, disassociation, and immobility). These are caused by trauma to the frontal lobe. (5.Crash Course, Diane Poole Heller 2001). In order to detect frontal lobe syndrome it requires testing that even (7.) Stuss and Benson (Brain Injury Association of Washington 1987) state that commonly used neuropsychological test batteries are useful as screening tests, but are not yet competent tools for detecting independent frontal lobe function. Other means of diagnosing frontal lobe syndrome is the obvious personality changes, such as becoming sloppy and messy, at times silly and prone to making juvenile jokes, tendency to lose temper and fly into fits of rage, social inappropriateness and difficulties concentrating. People with pure frontal lobe injuries don’t seem to have much wrong with them. We now understand you do not need to be knocked unconscious to suffer a possible severe head injury such as an auto accident or assault. (2.Sally Davies, Psychologist health.iafrica.com 2001). Understandably, detection as stated with the traditional neurological testing isn’t an exact science. Complications arise as the abnormal behaviors of a patient with frontal lobe damage fluctuate from one testing occasion to another. Therefore the standard neurological examination will be normal, as will the results of other psychological tests such as the Wechsler Adult Intelligence Scale, even though there is an underlying problem to the frontal lobe area. Some useful tests for frontal lobe function require: word fluency, abstract thinking( for example I have 18 books, 2 book shelves, I want twice as many books on one shelf than the other, how many books on each self?) Wisconsin Card Sorting Test, rhythm tapping, maze test as well as having patient recite as many words as possible in one minute beginning with any given letter (the normal is 15). Patients with frontal lobe abnormalities or disorders often find difficulty in performing with serial sevens. When testing for frontal lobe injury it is good for the patient’s family to give the doctor an idea of their behavior before the accident occurred and how it has changed since. Several authors have put forward exp...