An Empirical Study of Personality Change After Stroke
Personality changes after stroke are not well understood. There are three specific areas that need to be examined: 1) the dimensions of personality vulnerable to change post-stroke, 2) the extent to which personality patterns converge to a unitary “Organic Personality Disorder” or reflect exaggerations of premorbid personality features; and, 3) the contribution of pre-morbid personality characteristics to post-stroke depression. Toward this end, close relatives of ischemic stroke patients rated pre- and post-stroke personality patterns with the NEO Personality Inventory-Revised (NEO-PI-R; Costa & McCrae, 1985), a standard personality measure. Non-parametric comparison tests (Bonferroni corrections were used to adjust the alpha level for each set of multiple comparisons) showed significant changes in 3 of 5 personality domains assessed by the NEO. These included higher neuroticism (p<.005) (anxiety, p<.01; depression, p<.001; vulnerability, p<.005), lower extraversion (p<.001) (reduced activities, p<.001; positive emotions, p<.005) and less conscientiousness (p<.01) (self-discipline, p<.05). Findings were maintained regardless of stroke laterality or frontal vs. non-frontal lesion location. Correlational analyses of pre- and post-stroke scores on the NEO’s personality scales suggested that an exaggeration of premorbid personality features exists among this sample (i.e., 35 of the 36 scales had significant positive correlations). Regression analyses indicated that pre-stroke scores on self-consciousness (R2=.26, p<.005), gregariousness (R2=.19, p<.01), straightforwardness (R2=.15, p<.05), and deliberation in thinking (R2=.25, p<.005) were predictive of post-stroke depression as measured by the NEO depression facet. Findings suggest that specific personality changes post-stroke are identifiable, strongly related to premorbid personality and may be predictive of post-stroke depression. This research was funded by NIH/NINDS, grant 1R29NS33608, Favorable Outcome in Stroke Survivors awarded to Lynn M. Grattan, Ph.D.