Frontal stroke: Problem solving, decision making, impulsiveness, and depressive symptoms in men and women.

Morgana Scheffer,Janine Kieling Monteiro,Rosa Maria Martins De Almeida

doi:10.3922/j.psns.2011.2.012

Abstract

The present study compared men and women who suffered a frontal lobe stroke with regard to problem solving, decision making, impulsive behavior and depressive symptoms and also correlated these variables between groups. The sample was composed of 10 males and nine females. The study period was 6 months after the stroke. The following instruments were used: Wisconsin Card Sort Test (WCST), Iowa Gambling Task (IGT), Barrat Impulsiveness Scale (BIS11), and Beck Depression Inventory (BDI). For the exclusion criteria of the sample, the Mini International Psychiatric Interview (M.I.N.I Plus) and Mini Mental Stage Examination (MMSE) were used. To measure functional severity post-stroke, the Rankin Scale was used. The average age was 60.90 ± 8.93 years for males and 60.44 ± 11.57 years for females. In females, total impulsiveness (p = .013) and lack of planning caused by impulsiveness (p = .028) were significantly higher compared with males, assessed by the BIS11. These data indicate that females in the present sample who suffered a chronic frontal lesion were more impulsive and presented more planning difficulties in situations without demanding cognitive processing. These results that show gender differences should be considered when planning psychotherapy and cognitive rehabilitation for patients who present these characteristics.

Highlights

Stroke is characterized by an acute onset of neurological impairment with a minimum duration of 24 h
Among the damage caused by a stroke are emotional disorders and executive dysfunction (Zinn, Bosworth, Hoenig, & Swartzwelder, 2007) that correspond to the lesion area
No significant differences were found in age, education, and time of injury between men and women

Summary

Introduction

Stroke is characterized by an acute onset of neurological impairment with a minimum duration of 24 h. Executive function in the brain includes the processes and functions related to appropriate planning and strategies (Lezak, 2004) and serves to adapt individuals to new situations (van der Linden, Ceschi, Zermatten, Dunker, & Perroud, 2005). It requires flexibility, control, and the regulation of information processing in the brain (Gazzanigra, Ivry, & Mangum, 2002; Was, 2007). Epidemiological data show that women present more internalization, such as depression, and are affected twice as much by this disorder in their lifetime compared with men (Angst et al, 2000; Appelros, Stegmayr, & Terént, 2010) This disorder, in most cases, is misdiagnosed or untreated (Poynter et al, 2009). According to Ramasubbu (2000), post-stroke depression is directly related to etiology, not including psychosocial factors, and may manifest as affective, cognitive, behavioral, motivational, and physiological symptoms (American Psychiatric Association [DSMIV-TR], 2002)

Results

Discussion

Conclusion