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Brain Injury & Behavioral Dyscontrol: Impact of Emotional Issues

presented by Robert Karol, Ph.D., LP, ABPP-RP, CBIST

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Disclosure Statement:

Robert Karol receives compensation from MedBridge for this course. Robert Karol receives royalties for his books from the following organizations: Oxford University Press, CRC Press and Lash and Associates Publishing.

Non-Financial: Robert Karol is on the Board of Directors – United States Brain Injury Alliance.

Satisfactory completion requirements: All disciplines must complete learning assessments to be awarded credit, no minimum score required unless otherwise specified within the course.

MedBridge is committed to accessibility for all of our subscribers. If you are in need of a disability-related accommodation, please contact [email protected]. We will process requests for reasonable accommodation and will provide reasonable accommodations where appropriate, in a prompt and efficient manner.

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Behavioral dyscontrol refers to manifestations of inappropriate conduct. It includes noncompliance/nonadherence, physical aggression, verbal aggression/threats, sexual inappropriateness, poor safety/judgment, elopement, wandering, making demands/being manipulative, hoarding, social withdrawal, self-injurious behavior, suicidal ideation/behavior, somatic complaints, unawareness of deficits, hallucinations/delusions, etc.

The emotional fallout of brain injury can trigger behavioral dyscontrol. Brain injury can generate particularly difficult coping challenges. Common challenges include grief, depression, catastrophic reaction, denial, nonadherence, paranoia, and PTSD. These emotional responses to brain injury can overwhelm coping resources and cause behavioral dyscontrol. The goal of this course is to explain the behavioral implications of these emotional variables after brain injury. This course is Part 2 of a four-part series of courses on behavioral dyscontrol following brain injury.

Meet Your Instructor

Robert Karol, Ph.D., LP, ABPP-RP, CBIST

Dr. Karol is President of a group private practice, Karol Neuropsychological Services & Consulting, in Minneapolis, that specializes in counseling for persons with brain injury and other disabilities, neuropsychological and rehabilitation evaluations, program development consultation for organizations, workshops & staff training, and case consultation for providers, insurers, and attorneys. Dr. Karol has also recently served…

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Chapters & Learning Objectives

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1. Grief, Depression, and Catastrophic Reaction

Many people undergo feelings related to loss of identity after brain injury. People may grieve their losses, and depression is common. Some may even experience a loss of self-actualization, called catastrophic reaction. Behavioral issues can stem from emotional ones. The goal of this chapter is to explain grief, depression, and catastrophic reaction and their relationship to undesirable behaviors.

2. Denial and Non-Adherence

Facing brain injury is difficult. Denial of deficits is common. People may exhibit both psychological and organic denial. In addition, some people become resistant to care or help and are labeled as non-compliant. The goal of this chapter is to explain denial and to examine non-compliance, offering non-adherence as an alternative conceptualization. Reconceptualizing non-compliance as non-adherence provides a pathway to treatment.

3. Paranoia and PTSD

Brain injury can lead to significant adjustment issues. Two different issues that can cause notable difficulty are paranoia (when caused by cognitive deficits) and PTSD. Either can lead to crucial dysfunction in relationships and impair successful return to life after brain injury. The goal of this chapter is to explain both PTSD and paranoia (when driven by cognitive deficits) to provide a basis for intervention.

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