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Perseveration & brain injury

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Brain injury effects

Perseveration & brain injury

Perseveration is repetitive and continuous behaviour, speech or thought which is often due to frontal lobe injury to the brain.

Perseverative disorders can occur with various conditions including Alzheimer's disease, aphasia, schizophrenia, Parkinson's disease, and brain injury.


An example of perseveration is someone sandpapering a table until they go through the wood, or will continue talking about a given topic even when the conversation has moved on to other things. 


Another person might be asked to draw a cat, but if you then ask them to draw a car or a house they would keep drawing a cat each time. 


Perseveration occurs due to changes in various cognitive skills such as memory, attention, and mental flexibility. Stress and anxiety can trigger perseveration, or at the very least make it worse. 


What you can do to help

It is important to understand that when a person is perseverating they feel unable to stop and will be made worse by anxiety, so getting frustrated will only make it worse. It is important to respond in a calm supportive way.


Try using redirection, such as changing the topic of conversation or asking the person to do another activity. This will often help them to move on from the behaviour, speech or thoughts they are stuck on. 


For example, if the person is stuck on an activity, engage them on a topic of conversation not associated with the activity.


Conversely, if the person is stuck on a repetitive phrase, ask them to help with an activity. This will hopefully let them move on. 


As with most aspects of a brain injury, there are some key fundamentals that will make life, and therefore perseveration, much easier to manage:

  • Sleep well
  • Get regular exercise
  • Avoid alcohol or limit your intake
  • Eat a healthy diet and watch your weight
  • Learn stress management techniques
  • Maintain contact with friends and family. 


Perseveration can be treated by behavioural and cognitive training in a structured environment, and possibly by group therapy or medication.


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