Unstable identity and prefrontal injury

Abstract

Introduction. In neuropsychological research, “organic personality disorder”, lack of social insight, and executive dysfunctions have been identified in patients with prefrontal brain injury. The assessment of personality change has, in particular, been a methodological challenge in this field of research. The aim of the present pilot study was to examine personality aspects in patients with prefrontal brain injury from a neuropsychological as well as a psychodynamic point of view. Methods. A total of 13 adults with personality change as a manifest sequel after sudden onset brain injury were assessed with neuropsychological tests of executive functions, with the European Brain Injury Questionnaire (EBIQ), and with the Karolinska Psychodynamic Profile (KAPP), which to our knowledge has not previously been used as part of a neuropsychological assessment. The personality profiles of the brain‐injured patients were compared to the personality profile of a group of 65 brain‐healthy individuals. Results. The personality organisation of the prefrontally brain‐injured patients was significantly disturbed and close to a borderline personality organisation, as defined by the KAPP. Conclusions. The results of the pilot study suggest that prefrontal brain systems may support the integration of self‐functions and play a central role for inter‐personal relations. Future research regarding the relation between brain dysfunction, executive and cognitive deficit, and personality disorder needs to be carried out in larger samples to substantiate the hypothesis of a relationship between prefrontal brain systems and self‐functions.