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Book contents
- Frontmatter
- Contents
- Preface
- Part I Introduction
- Part II Poststroke depression
- Part III Poststroke mania
- Part IV Poststroke anxiety disorders
- Part V Other poststroke disorders
- 34 Psychosis
- 35 Anosognosia and denial of illness
- 36 Catastrophic reaction
- 37 Apathy
- 38 Disturbance of prosody
- 39 Irritability and aggression
- 40 Pathological laughing and crying
- 41 Summary and future directions
- Index
36 - Catastrophic reaction
from Part V - Other poststroke disorders
Published online by Cambridge University Press: 01 October 2009
- Frontmatter
- Contents
- Preface
- Part I Introduction
- Part II Poststroke depression
- Part III Poststroke mania
- Part IV Poststroke anxiety disorders
- Part V Other poststroke disorders
- 34 Psychosis
- 35 Anosognosia and denial of illness
- 36 Catastrophic reaction
- 37 Apathy
- 38 Disturbance of prosody
- 39 Irritability and aggression
- 40 Pathological laughing and crying
- 41 Summary and future directions
- Index
Summary
The sudden onset of anxiety, tears, aggressive behavior, swearing, displacement, refusal, denouncement, and compensatory boasting constitute a syndrome referred to by Goldstein (1948) as a catastrophic reaction (CR). Goldstein believed that this syndrome represented a response to the inability of an organism to cope when faced with a serious defect in their physical or cognitive function. These emotional outbursts would generally last only a few seconds and were usually associated with a stressor, such as a demanding, cognitive examination or a request to perform a task. Gainotti (1972) was the first investigator, to my knowledge, who systematically studied CRs in patients with stroke or other causes of brain damage. Gainotti examined 160 patients with brain injury due to stroke, traumatic brain injury or other causes. Eighty patients had left-sided lesions and 80 patients had right-sided lesions. Of those, 53 had vascular lesions of the left hemisphere and 58 vascular lesions of the right hemisphere. When the presence of CRs was compared between patients with left and right hemisphere lesions, patients with left hemisphere lesions had significantly greater frequency of anxiety reactions, tears, swearing, refusal, and renouncement. He noted that patients with Broca's aphasia were particularly prone to developing CRs with 68% of these patients showing outbursts of tears during the examination.
- Type
- Chapter
- Information
- The Clinical Neuropsychiatry of StrokeCognitive, Behavioral and Emotional Disorders following Vascular Brain Injury, pp. 383 - 391Publisher: Cambridge University PressPrint publication year: 2006
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