Brain-Behavior Relationships

Goal Achievement

Adaptive Reactions

Organization

Anterior Cerebral Lesions

Impairment of Expression of Needs, Purposes, and Goal-Directed Activity

1. Diminished expressions of feelings of satisfaction, joy, sparkle and , love, support, friendship, and sympathetic understanding
2. Behavior determined to a less extent by feelings of love, respect, and concern.
3. Report and description of less intense "feelings"; apathy
4. Less show of warmth, with conspicuous but short lived abreactions, as seen in patterns of anger, hostility, resentment, and despair
5. Reduced expressiveness, fluidity of communication, and response to humor and illusion

1. Reduced seeking of challenge, adventure, stimulation, and novelty.
2. Reduced curiosity, inquiry, and pursuit of knowledge
3. Establishment of rigid routines insuring ready success.
4. Reduced participation in diversions, entertainment, and in taking in news
5. Reduced reaction to esthetic objects and activities
6. Reduced participation and assumption of familial, vocational, interpersonal, and community responsibility
7. Avoidance of excitement, the unfamiliar situations involving unexpected demands, poorly defined or unstructured situations, new situations, or situations involving the risk of failure, conflict, and fatigue

C. Impaired Pursuit of Values

1. Diminished seeking of communication and reaction with others
2. Reduction or abandonment of occupational and social goals - fall-off in "ambition"
3. Lessened significance of abstract, impersonal, and altruistic goals
4. Reduction of concern in the approval of others
5. Reduction of disinterest and selfless, detached attitudes and behavior

D. Reduced Purposive Activity or Restless, Ineffective Overactivity

1. Reduced intensity of activity - occupational, domestic, recreational
2. Shortened periods of activity
3. Less vigor, enthusiasm, and initiative
4. Ready fatigability, with necessity for frequent rest periods

E. Reduced Expression of Simple Biological Needs

1. Diminished eating of food, with inadequate diet
2. Diminished pursuit of proper temperature, ventilation shelter, and clothing
3. Diminished pursuit of health, survival, and well-being of family and self
4. Reduction in quantity and alteration in significance of sexual activity

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Impairment of Mechanisms for Goal Achievement

1. Reduced fantasy, creativity, imagination
2. Poverty of alternate solutions after failure or frustration
3. Reduced revery, and night dreaming, reduced imagery

B. Impairment of Alertness and Vigilance

1. Difficulties in concentration and contemplation, focusing and sustaining attention, distractibility, difficulty, in perception with simultaneous irrelevant stimulation
2. Diminished responsiveness, alertness, "consciousness" and awareness

C. Impaired Ability for Appropriate Inhibition

1. Impulsive, unrestrained, unsuitable behavior
2. Impatience
3. Inability to brook postponement, frustration, and delay
4. Impaired modulation of the expression of feelings, with:
   1. irritability
   2. temper outbursts
   3. ready weeping
   4. assaultive, brash, and aggressive behavior
   5. excessive talk, laughter, etc.
   6. poorly maintained and rapidly dwindling attitudes, expressions, and behavior
   7. altered response to noxious stimulation

D. Impaired Initiation

1. Slow to get started, procrastination

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E. Impaired Abstraction Capacity

1. Defects in analysis and synthesis, poor comprehension of aphorism and metaphor,
   1. defective recognition of incongruity and non sequitur, defects in inductive and
   2. deductive logic
2. Defects in planning, prediction, extrapolation, categorization
3. Defects in ability to form concepts and see relationship; over literal interpretations and impaired abstract thinking
4. Defects in judgment
5. Reduction in ability to extract recurrent and significant elements in changing situations

F. Impairment of Orientation

1. Reduced exploratory and other orienting activity, reduced "incidental" perception
2. Impaired orientation for time, place, person, and situation

G. Memory Defects

1. Impaired recall of names and symbols promptly on demand, poor recording of current experience
2. Defects in recent, intermediate, and remote memory and recall
3. Difficulty in following conversations, or maintaining continuity in reading books, newspapers, etc.

H. Reduced Learning Ability

1. Slower rate of learning
2. Reduction in complexity of learning achieved
3. Lack of stability of learned responses
4. Diminished ability to discriminate

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I. Impaired Ability to Extinguish Responses

1. Slower rate of extinction of responses when no longer appropriate
2. Preservation of responses

J. Impairment of Skilled Actions and Sensory-Motor Efficiency

1. Slowing of action patterns
2. Need for "conscious" control of action patterns that had previously been "automatic"
3. Clumsiness, loss of skill, loss of "technical know how"

K. Impaired Ability to Fulfill Social, Vocational, Interpersonal, and Community Responsibilities

1. Impaired management of finances, allocation of responsibility, decision making
2. Inability to take incisive action, or assign an order of importance to a series of acts
3. Reduced ability for appropriate personal appearance, grooming, and social conventions

L. Impaired Perception of Self and the Self-Environment Relationship

1. Impaired perception of social structure and interpersonal relationship
2. Failure to perceive the import of actions and difficulties in their early stages
3. Impaired awareness of success and failure
4. Impairment of perception of the import of actions to others and the possible consequences and ramifications of one's actions

M. Impaired Perception of the Environment

1. Vague, slow, and distorted perceptions
2. Difficulties in discrimination between the effects of sensory stimulation and of sensory "fantasy"
3. Need for greater stimulus intensity for perception
4. Increased suggestibility
5. Ready "confabulation"
6. Need for strong contrasts between stimuli for differences to be perceived

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Impairment of the Capacity to Initiate, Organize, and Maintain Appropriate and Effective Adaptive Reactions

A. Evidence of failure or inadequacy of defenses:

1. anxiety, depression
2. bizarre, illogical, and highly personalized perceptions
3. conspicuous, transparent, splintered, and socially unacceptable defensive reactions
4. poorly elaborated and inappropriate compensatory reactions

B. Evidence of excessive display of defenses (excessive blaming, projection, suspiciousness, social withdrawal, and constriction of activities and interests, compulsive activity, perfectionistic striving; denial; depersonalization; reaction formation, etc.

The Capacity to Maintain Organization During Stress and to Recover Promptly from Its Effects

A. More ready disorganization during periods perceived as threatening, as in situations of fatigue, postponement, assault or betrayal, changes in intimate interpersonal relationships, conflict, fatigue, isolation, etc. with evidence of "blocking," "catastrophic" reactions and feelings of anxiety; severer disorganization following deprivation of food, sleep, warmth, sexual satisfaction, human companionship, support, and approval

B. Longer-lasting and severer disorganization following the above, with necessity for longer periods of recovery

C. Reduced tolerance for alcohol, oxygen lack,and noxious chemical agents

D. Enhanced susceptibility to perceptual distortions, hallucinations, illusions, delusions, and delirium; increased seeking of support, encouragement, praise, and approval