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The Cognitive, Emotional, and Social Sequelae of Stroke: Psychological and Ethical Concerns in Post-Stroke Adaptation
Abstract
In the clinical domain, ethical analyses involve examination of complex individual responses, psychological processes, and social context. Psychological aspects of stroke adaptation include the risk for depression and anxiety, changes in identity and personality processes, and potential for social isolation. Depression and anxiety are heterogeneous constructs and can affect individuals' emotional functioning and cognitive abilities. Executive function, self-agency, and volition may be affected. Alterations in identity and personality may also result from the interaction of fluctuating emotional, cognitive, and physical abilities as well as from changes in social context and family dynamics. Social isolation, or lack of access to social contact or resources, can be a consequence of difficulties in cognitive and emotional function that influence interpersonal relationships, changes in social roles, communication difficulties, and challenges in transportation and employment. Social stigma and marginalization also contribute to isolation. The authors describe these psychological phenomena in the context of brain damage and recovery and raise ethical concerns including impact on decision-making capacity, pre- and postinjury selves and interests, and the social milieu in which strokes are experienced.
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“The cognitive, physical, social and emotional consequences of stroke can have widespread implications for a person's functioning (Littooji, Dekker, Vloothuis, Legt, & Widdershoven, 2016;Mukherjee, Levin, & Heller, 2006).”
From “Giving yourself some breathing room…”: an exploration of group meditation for people with aphasia (2021) · cites this paper as Mukherjee, Levin, & Heller, 2006
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Curatoli, C., Marcassoli, A., Guastafierro, E., Leonardi, M., Bersano, A., Boncoraglio, G. B., Canavero, I., & Raggi, A. (2023) · International Journal of Rehabilitation Research · doi:10.1097/mrr.0000000000000605 · Cited by 1
Comparing Speech Movements in Different Types of Noise
Scott, S. J. (2014) · ScholarsArchive (Brigham Young University) · Cited by 1
The Effect of Psychological Factors on Cognitive Functions in Stroke Patients With Chronic Fatigue
Lajevardi, L., Taghizade, G., & Parnain, Z. (2021) · Function and Disability Journal · doi:10.32598/fdj.3.24 · Cited by 1
Jefferson, L. J., & Dunne, S. (2024) · Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine · doi:10.1177/13634593241279207 · Cited by 1
Hedlund, M. (2012) · DiVA at Umeå University (Umeå University) · Cited by 1
Metadata
- Authors
- Mukherjee, D., Levin, R. L., & Heller, W.
- Affiliations
- Northwestern University (US)
- University of Illinois Urbana-Champaign (US)
- Venue
- Topics in Stroke Rehabilitation
- Publisher
- Informa UK Limited
- Published
- 2006-10
- Volume
- 13
- Issue
- 4
- Pages
- 26-35
- ISSN
- 1074-9357 (ISSN-L)
- 1945-5119
- OpenAlex
- W2060791700
- Cited by
- 126
- References
- 54
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 10 · 2023: 13 · 2022: 8 · 2021: 4 · 2020: 11 · 2019: 7 · 2018: 4 · 2017: 7 · 2016: 6 · 2015: 4 · 2014: 6 · 2013: 5 · 2012: 7
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Topics in Stroke Rehabilitation (publishedVersion)
- PubMed (publishedVersion)
- DigitalGeorgetown (Georgetown University Library) (submittedVersion)
- Topics
- Health Sciences › Medicine › Rehabilitation › Stroke Rehabilitation and Recovery
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Health Professions › Physical Therapy, Sports Therapy and Rehabilitation › Medical Practices and Rehabilitation
- Keywords
- stroke, depression, anxiety, executive function, self-agency, volition, personal transformation, personality change, social isolation, social stigma, marginalization, decision-making capacity, family dynamics, ethical considerations, psychological sequelae
- MeSH terms
- Mental Disorders, Humans, Personality, Social Isolation, Mental Competency, Stroke, Ethics, Clinical
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