Challenging & complex behaviours: impulsive behaviour
Injury to the frontal lobes after a
traumatic brain injury can affect the area of the brain that
normally controls our impulses.
This inability to control urges can lead to impulsive and
inappropriate social behaviour. For example, a previously shy
person may become quite extroverted and talkative. In a more severe
case, a normally reserved person might make crude or sexually
inappropriate comments to strangers.
When others don't understand how brain injury can cause
impulsive behaviour, it often leads to rejection and criticism.
Social isolation often results, as existing relationships break
down and there is an inability to form new ones.
Apart from a traumatic brain injury involving the frontal lobes,
impulsivity can also result from a brain injury caused by alcohol
and other drugs, dementia, other types of brain disorder and mood
Common features of
- Acting without thinking
- Inability to save money or regulate finances
- Irritability and temper outbursts
- Too familiar with strangers and sharing very personal
- Asking personal questions that cause discomfort
- Yelling out answers before questions have been completed
- Intruding or interrupting conversations
- Unable to wait patiently for their turn
- Sexual promiscuity.
Lack of insight
Another common outcome from a traumatic brain injury (TBI) is
lack of awareness, so the person may deny their behaviour is
impulsive, fail to see the consequences of their actions, or
understand how someone else is feeling.
How is impulsivity treated?
Treatment varies depending on the underlying cause - usually
there will be several techniques used. The most common treatment is
medication, with other options including behavioural therapy,
parent training and school-based interventions for children.
Consult your rehabilitation specialist or doctor to see if
medication could be useful.
Strategies for partners & family
Research as much as possible about impulsivity and TBI - the
more you understand the more you can respond positively when
needed, instead of just reacting negatively and becoming part of
As with so many aspects of a brain injury, impulsivity often
arises when the person is confused or fearful, so predictable daily
schedules and routines will help greatly.
Encourage self-monitoring techniques such as:
- Do I really want to do this, am I ready?
- What are the pros and cons of doing or saying this?
- What will the outcome be?
Read our fact sheets about positive behaviour support. When you
look for the message behind an impulsive behaviour, you will often
see it is caused by confusion or fear.
Encourage the person to develop their listening and social
skills again (see our fact sheets). Role play how to listen,
introduce new topics, and how to politely interrupt two other
If the person engages in attention seeking behaviour such as
yelling or interrupting, tell them this is not a good way to get
your attention and advise on an alternative strategy.
Try to remember it is the impulsivity that is at fault, not your
loved one. Generally they will not be speaking or acting
intentionally to annoy you or hurt your feelings. Separating the
person from the behaviour can go a long way to coping with the
In serious cases your local Brain Injury Association who may be
able to put you into contact with specialists in your State.