He’s no longer the same person: how families adjust to personality change after head injury

Abstract

It is not only the families of head-injured people who have to adapt to sudden, long-term disability in one of their number. Spinal injuries, amputations and burns all occur suddenly in previously healthy individuals. Indeed many disabling illnesses may have a relatively sudden onset. However after head injury, although any or all functions may be affected, the most common and fundamental effects of head injury are to the higher functions. Changes in cognition and emotional responsiveness may alter the core characteristics of the person. Many studies have suggested that it is these changes in personality that cause relatives most distress. Rosenbaum and Najenson [1] compared the lives of wives of Israeli soldiers who had suffered a severe head injury with those of wives of soldiers who had suffered a spinal injury resulting in paraplegia. They found that the wives of head-injured soldiers were more disturbed by the changes than the wives of paraplegics. They disliked physical contact with their husband more than the wives of paraplegics and found their husband’s disability more of a social handicap leading to a greater loss of contact with friends. Wives of the head-injured had significantly more symptoms of low mood. These findings have since been echoed by a number of studies [2–4].