Patients with Left Lesions

Damage to the left hemisphere is often accompanied by anxiety, undue cautiousness, oversen-sitivity to the impairment, and depression (Buck, 1968; Galin, 1974; Jones-Gotman & Milner, 1977; Lezak, 1995). Lezak notes: "Patients with left hemispheric lesions are more likely than those with right-sided brain damage to exhibit a catastrophic reaction (extreme and disruptive transient emotional disturbance). The catastrophic reaction may appear as acute—often disorganizing—anxiety, agitation, or tearfulness, disrupting the activity that provoked it. Typically, it occurs when patients are confronted with their limitations, as when taking a test" (p. 66). Goldstein (1948) first used the term catastrophic reaction to describe the profound depression ac companying left-hemisphere lesions; subsequent empirical investigations have supported the tendency for catastrophic reactions and depression to be more associated with left- than right-hemispheric damage (e.g., Gainotti, 1972; Gasparrini, Satz, Heilman, & Coolidge, 1977).

Depression, a common side effect of left-hemisphere damage, is often accompanied by numerous clinical presenting symptoms. These include "depressed mood and agitation;...psy-chomotor retardation; impaired immediate memory and learning abilities; defective attention, concentration, and tracking; impaired orientation; an overall shoddy quality to cognitive products; and listlessness with loss of interest in one's surroundings" (Lezak, 1995, p. 327).

Caine (1986), summarizing literature on depressed patients, stressed their impairments in sustaining attention, memory, learning ability, mental control, and motor performance. Based on these presenting clinical symptoms, it is not surprising that "[d]epressed people often have distinctly higher Verbal [than Performance] IQs" (Gregory, 1987, p. 72).

Gass and Russell (1985) studied the relationship of emotional adjustment (MMPI profile) to functional loss (WAIS Verbal IQ) in a study of 31 Caucasian male patients with carefully documented left-hemisphere damage. These investigators were critical of previous investigations of the emotional behavior in patients with left-brain lesions because of failure to control for premorbid status, to exclude aphasics, to exclude patients with right-hemisphere pathology, and to screen for inconsistent MMPI profiles.

Gass and Russell (1985) used state-of-the-art neurodiagnostic techniques to ensure that the patients' lesions were confined to the left hemisphere; they also controlled for education level in their multivariate data analysis. Their results showed that, regardless of the degree of impairment in verbal intelligence, the patients with right lesions consistently had MMPI profiles suggestive of the following emotional symptoms: "mild dysphoria, worry, and concerns or preoccupations with regard to one's physical condition" (p. 669). The implications of the left-lesion patients' MMPI emotional profiles are quite consistent with the stereotypical behaviors described previously for these patients.

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Do Not Panic

Do Not Panic

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.

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