Being Uptight Could Be a Bad Stroke of Luck
Feb. 14, 2001 -- Impatient? Self-conscious? Deep thinker? Then chances are that if you have a stroke, your symptoms will be worse and your recovery more complicated than if you were a bit more relaxed and outgoing, according to research presented here at the American Stroke Association meeting in Fort Lauderdale, Fla.
Investigators from the University of Maryland School of Medicine in Baltimore asked close family members to describe the personalities of 35 stroke survivors -- both before the stroke and a year afterward. When looking at these 20 women and 15 men -- who averaged 57 years old -- the researchers observed that those described as "deep thinkers" had some of the biggest problems after their stroke.
In general, these patients were much more likely to become depressed -- and depression, doctors say, seriously impairs a patient's willingness and ability to take part in rehabilitation and lifestyle changes necessary to avoid another stroke.
"We had three main conclusions," says Lynn M. Grattan, PhD, a neuropsychologist and associate professor of neurology at the university: "that some personality traits are more vulnerable to strokes, that personality changes are exaggerations of [prestroke] features, and that prestroke personality influences poststroke adjustment."
Those having the most difficulty adjusting after a stroke tended to be the ones who avoided confronting life's problems head-on, Grattan says. Flexible people -- adapters with good problem-solving skills -- seemed to have less problems in rehabilitation and recovery. In fact, Grattan says, although half the stroke patients studied returned to work, only a small portion of those were the introverted "deep thinkers" most prone to depression and withdrawal.
To do the best job in planning rehabilitation, Grattan says, healthcare providers should try to figure out stroke patients' dominant personality traits before they send them home from the hospital. For example, she says, it would be particularly counterproductive to send an impatient person home without letting him know how long it might take to fully recover and without providing him frequent opportunities to meet rehabilitative goals.
"I would not recommend sending an impatient person home with the instructions, 'Let's see what happens in a month,'" she says. "Impatient people just want to get better."
There's no doubt personality plays a part in how well a stroke patient does in rehabilitation, says Lynne Brady Wagner, MA, director of the stroke and neurology program at Spaulding Rehabilitation Hospital in Boston.
"We know people with the ability to participate, and who are motivated, will likely have more interaction with the therapist," she says. "We also know from other research that patients with good support systems often do better than those with limited support systems."
And yet, she says, it's sometimes surprising to see which patients adjust.
"It's definitely a case-by-case basis," Wagner says. "Some patients have severe disabilities and may be able to cope with it very well. Some have minor impairment but it causes great disability for them. It's very personal."
"Personality is a very integral part of the person," Grattan agrees. "It is stable and enduring." But some traits can be modified, she points out, such as problem-solving skills. Her suggestion is that everyone -- not just stroke patients -- work on those.