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{{ClinPsy}}
 
{{ClinPsy}}
'''Perseveration''' is a [[thought disorder]]
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'''Perseveration''' is a [[thought disorder]]. It is the repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder.<ref name="Helm-Estabrooks">{{vcite journal |author=Helm-Estabrooks N |title=The problem of perseveration |journal=Semin Speech Lang |volume=25 |issue=4 |pages=289–90 |year=2004 |pmid=15599818 |doi=10.1055/s-2004-837241 |url=http://www.thieme-connect.com/ejournals/html/ssl/doi/10.1055/s-2004-837241 }}</ref> Symptoms include "the inability to switch ideas along with the social context, as evidenced by the repetition of words or gestures after they have ceased to be socially relevant or appropriate," <ref name="PC def">[http://psychcentral.com/encyclopedia/2008/perseveration/ Psych Central definition]</ref> or the "act or task of doing so," <ref name="Di def">[http://dictionary.reference.com/browse/perseveration Dictionary.com definition]</ref> and are not better described as [[stereotypy]] (a highly repetitive [[idiosyncrasy|idiosyncratic]] behaviour).
   
There are a number of relevent meanings related to the tendency for thoughts, feelings or behavior to persist in a way which is unhelpful:
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In a broader sense it is used for a wide range of functionless behaviours that arise from a failure of the brain to either [[inhibitory|inhibit]] [[Executive_functions#Hypothesized_role|prepotent responses]] or to allow its usual progress to a different behavior, and includes impairment in [[set shifting]] and [[task switching (psychology)|task switching]] in social and other contexts.<ref name="Dict Bio Psych">[http://books.google.co.uk/books?id=UbL2MZ9xI7oC&pg=PA595&lpg=PA595&source=bl&ots=b09V9gEKCM&sig=86fdTY5t_S077K7l3gtYZJxP2yo&hl=en#v=onepage&f=false Dictionary of Biological Psychology] - p.595</ref>
   
*The tendency to continue to a particular behaviour beyond the point where it is useful. See [[Punding]],[[Stimming]], [[Stereotypy]]
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== Definition ==
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The primary definition of perseveration in [[biology]] and [[clinical psychiatry]] involves some form of response repetition or the inability to undertake [[set shifting]] (changing of goals, tasks or activities) as required, and is usually evidenced by behaviours such as words and gestures continuing to be repeated despite absence or cessation of a [[Stimulus (psychology)|stimulus]].<ref name="Dict Bio Psych" /><ref name="Helm-Estabrooks" /><ref name="PC def" /><ref name="Di def" />
   
*Uncontrollable repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by [[brain injury]] or other [[neurological disorder]].
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More broadly in clinical psychology, it describes mental or physical behaviours which are not excessive in terms of quantity but are apparently both functionless and involve a narrow range of behaviours, and are not better described as [[stereotypy]] (a highly repetitive [[idiosyncrasy|idiosyncratic]] behaviour).<br />
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In general English, perseveration (vb: "to perseverate") refers to insistent or redundant repetition, not necessarily in a clinical context.<ref>http://dictionary.reference.com/browse/perseverate</ref>
   
*The tendency for a [[memory]] or [[idea]] to be maintained without any obvious stimulus for it. This implies internal mechanisms for the [[persistence]] of the phenomena (eg [[defence mechanism]]) and usually carries a negative connotation.
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== Conditions and manifestations associated with perseveration ==
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Perseveration of thought indicates an inability to switch ideas or responses.<ref name="priory">[http://priory.com/gloss.htm#perseveration Priory psychiatric glossary]</ref> An example of perseveration is, during a conversation, if an issue has been fully explored and discussed to a point of resolution, it is not uncommon for something to trigger the reinvestigation of the matter. This can happen at any time during a conversation.{{cn|date=September 2012}}
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'''Physical brain injury, trauma or damage'''
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* Perseveration is particularly common with those who have had [[traumatic brain injuries|traumatic brain injury]].
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* Perseveration is sometimes a feature of frontal lobe lesions;<ref name="priory" /> and other conditions involving dysfunction or disregulation within the frontal lobe ([[ADHD]] is one such example).
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'''Other neurological conditions'''
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* Perseveration may also refer to the obsessive and highly selective interests of individuals on the [[autism spectrum]]. This term is most connected to [[Asperger syndrome]].
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* In [[attention deficit hyperactivity disorder]] (ADHD) perseverance may occur as a well documented feature<ref name="webb">[http://books.google.co.uk/books?id=NQrtt-peg5AC&pg=PA50&lpg=PA50&source=bl&ots=SgPrxTreVn&sig=sgz-SD-J9BGaK6NFyq4ZTkmMNUw&hl=en&sa=X&ei=J-xRUIOtDrLI0AXIpYHQCA&ved=0CDAQ6AEwAA#v=onepage&f=false Misdiagnosis And Dual Diagnoses Of Gifted Children And Adults: Adhd, Bipolar...] - Webb, p.50-51]: Notes prior research into "hyperfocus" in ADHD, identifies it with "flow" in gifted children, observes that what is called hyperfocus in such cases "seems to be a less medical-sounding description of perseveration. Thus the apparent ability to concentrate in certain limited situations does not exclude the diagnosis of ADD/ADHD."</ref> (often informally and probably inaccurately<ref name="webb" /> described as "[[hyperfocus]]") as an impairment of [[set shifting]] and task switching,<ref>[http://books.google.co.uk/books?id=WUV93J5BSbAC&pg=PA62&lpg=PA62&source=bl&ots=J1QyBMWZLp&sig=T4VYkNmv28R2xPa4KLs29tCz0_Q&hl=en&sa=X&ei=Se5RUP2eEIuQ0QXavoGwDQ&ved=0CEMQ6AEwAw#v=onepage&f=false Taking Charge of Adult ADHD, Barkley R.] - p.61-62 "One track Mind"</ref><ref>[http://informahealthcare.com/doi/abs/10.1080/01460860050121394 STOP, LOOK, AND LISTEN: The Challenge for Children with ADHD] - Meaux, Issues in comprehensive paediatric nursing, 2000, Vol. 23, No. 1 , Pages 1-13: ''Perseveration of ongoing responses means that the child with ADHD is less able to interrupt
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an ongoing response or response pattern to “stop and think,” resulting in behavior that is less
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flexible and less likely to change as the context of the situation changes''</ref><ref>[http://xa.yimg.com/kq/groups/17265367/1232720356/name/ADHD+and+LD+-+CPT.pdf PATTERNS OF PERFORMANCE ON THE CONNERS'CPT IN CHILDREN WITH ADHD AND LEARNING DISABILITIES] - Miranda et al: ''We found that children with ADHD made more omission and commission errors, more variable RTs, and more perseveration responses, and were less able to discriminate target from non-target stimuli''</ref> and may act as a brain coping mechanism or be a symptom of impaired ability to consciously regulate attention.
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* In [[twice exceptional|people who are both intellectually gifted and suffer a learning disability]], the state of [[hyperfocus]] and [[flow (psychology)|flow]] can be confounded with perseverance.<ref name="webb" />
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* Apart from their direct symptoms, people with [[obsessive–compulsive disorder]], can have specific problems with [[set shifting]] and inhibition of prepotent responses.<ref>{{cite journal|last=Demeter|first=G|coauthors=Racsmány, M; Csigó, K; Harsányi, A; Németh, A; Döme, L|title=Intact short-term memory and impaired executive functions in obsessive compulsive disorder.|journal=Ideggyogyaszati szemle|date=2013 Jan 30|volume=66|issue=1-2|pages=35-41|pmid=23607228|accessdate=26 April 2013}}</ref>
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'''Confounds (conditions with similar appearing symptoms)'''
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* Perseveration may be confused with habitual behaviours in a number of other conditions and disorders, such as obsessive–compulsive disorder, including [[post-traumatic stress disorder]] (PTSD), [[body dysmorphic disorder]], [[trichotillomania]], and habit problems.<ref name="differential">[http://emedicine.medscape.com/article/1826591-differential Pediatric Obsessive-Compulsive Disorder Differential Diagnoses] - 2012</ref>
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'''Unproven:'''
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* Several researchers have tried to connect perseveration with a lack of [[memory inhibition]] (the person repeats the answer because they have not been able to forget a past question and move on to the current subject); however, this connection could not be found, or was small.<ref>{{cite journal |author=Zelazo PD, Müller U, Frye D, ''et al.'' |title=The development of executive function in early childhood |journal=Monogr Soc Res Child Dev |volume=68 |issue=3 |pages=vii–137 |year=2003 |pmid=14723273 |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0037-976X&date=2003&volume=68&issue=3&spage=vii |doi=10.1111/j.1540-5834.2003.06803010.x}}</ref><ref>{{cite journal |author=Sharon T, DeLoache JS |title=The role of perseveration in children's symbolic understanding and skill |journal=Developmental Sci |volume=6 |issue=3 |pages=289–96 |month=May |year=2003 |doi=10.1111/1467-7687.00285 |url=http://www.blackwell-synergy.com/doi/abs/10.1111/1467-7687.00285?cookieSet=1&journalCode=desc}}</ref>
   
Several researchers have tried to connect perseveration with a lack of [[inhibition]]; however, this connection could not be found, or was small.<ref>{{cite journal |author=Zelazo PD, Müller U, Frye D, ''et al'' |title=The development of executive function in early childhood |journal=Monogr Soc Res Child Dev |volume=68 |issue=3 |pages=vii–137 |year=2003 |pmid=14723273 |url=http://www.blackwell-synergy.com/openurl?genre=article&sid=nlm:pubmed&issn=0037-976X&date=2003&volume=68&issue=3&spage=vii}}</ref><ref>{{cite journal |author=Sharon T, DeLoache JS |title=The role of perseveration in children's symbolic understanding and skill |journal=Developmental Sci |volume=6 |issue=3 |pages=289–96 |month=May |year=2003 |doi=10.1111/1467-7687.00285 |url=http://www.blackwell-synergy.com/doi/abs/10.1111/1467-7687.00285?cookieSet=1&journalCode=desc}}</ref>
 
   
 
==See also==
 
==See also==
* [[Obsessive compulsive disorder]]
 
 
* [[Asperger's syndrome]]
 
* [[Asperger's syndrome]]
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* [[Obsessive compulsive disorder]]
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* [[Perseverative reaching]]
   
 
==References==
 
==References==

Latest revision as of 22:07, October 28, 2013

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Perseveration is a thought disorder. It is the repetition of a particular response, such as a word, phrase, or gesture, despite the absence or cessation of a stimulus, usually caused by brain injury or other organic disorder.[1] Symptoms include "the inability to switch ideas along with the social context, as evidenced by the repetition of words or gestures after they have ceased to be socially relevant or appropriate," [2] or the "act or task of doing so," [3] and are not better described as stereotypy (a highly repetitive idiosyncratic behaviour).

In a broader sense it is used for a wide range of functionless behaviours that arise from a failure of the brain to either inhibit prepotent responses or to allow its usual progress to a different behavior, and includes impairment in set shifting and task switching in social and other contexts.[4]

Definition Edit

The primary definition of perseveration in biology and clinical psychiatry involves some form of response repetition or the inability to undertake set shifting (changing of goals, tasks or activities) as required, and is usually evidenced by behaviours such as words and gestures continuing to be repeated despite absence or cessation of a stimulus.[4][1][2][3]

More broadly in clinical psychology, it describes mental or physical behaviours which are not excessive in terms of quantity but are apparently both functionless and involve a narrow range of behaviours, and are not better described as stereotypy (a highly repetitive idiosyncratic behaviour).
In general English, perseveration (vb: "to perseverate") refers to insistent or redundant repetition, not necessarily in a clinical context.[5]

Conditions and manifestations associated with perseveration Edit

Perseveration of thought indicates an inability to switch ideas or responses.[6] An example of perseveration is, during a conversation, if an issue has been fully explored and discussed to a point of resolution, it is not uncommon for something to trigger the reinvestigation of the matter. This can happen at any time during a conversation.[citation needed]

Physical brain injury, trauma or damage

  • Perseveration is particularly common with those who have had traumatic brain injury.
  • Perseveration is sometimes a feature of frontal lobe lesions;[6] and other conditions involving dysfunction or disregulation within the frontal lobe (ADHD is one such example).

Other neurological conditions


Confounds (conditions with similar appearing symptoms)

Unproven:

  • Several researchers have tried to connect perseveration with a lack of memory inhibition (the person repeats the answer because they have not been able to forget a past question and move on to the current subject); however, this connection could not be found, or was small.[13][14]


See alsoEdit

ReferencesEdit

  1. 1.0 1.1 Helm-Estabrooks N. The problem of perseveration. Semin Speech Lang. 2004;25(4):289–90. doi:10.1055/s-2004-837241. PMID 15599818.
  2. 2.0 2.1 Psych Central definition
  3. 3.0 3.1 Dictionary.com definition
  4. 4.0 4.1 Dictionary of Biological Psychology - p.595
  5. http://dictionary.reference.com/browse/perseverate
  6. 6.0 6.1 Priory psychiatric glossary
  7. 7.0 7.1 7.2 Misdiagnosis And Dual Diagnoses Of Gifted Children And Adults: Adhd, Bipolar... - Webb, p.50-51]: Notes prior research into "hyperfocus" in ADHD, identifies it with "flow" in gifted children, observes that what is called hyperfocus in such cases "seems to be a less medical-sounding description of perseveration. Thus the apparent ability to concentrate in certain limited situations does not exclude the diagnosis of ADD/ADHD."
  8. Taking Charge of Adult ADHD, Barkley R. - p.61-62 "One track Mind"
  9. STOP, LOOK, AND LISTEN: The Challenge for Children with ADHD - Meaux, Issues in comprehensive paediatric nursing, 2000, Vol. 23, No. 1 , Pages 1-13: Perseveration of ongoing responses means that the child with ADHD is less able to interrupt an ongoing response or response pattern to “stop and think,” resulting in behavior that is less flexible and less likely to change as the context of the situation changes
  10. PATTERNS OF PERFORMANCE ON THE CONNERS'CPT IN CHILDREN WITH ADHD AND LEARNING DISABILITIES - Miranda et al: We found that children with ADHD made more omission and commission errors, more variable RTs, and more perseveration responses, and were less able to discriminate target from non-target stimuli
  11. Demeter, G, Racsmány, M; Csigó, K; Harsányi, A; Németh, A; Döme, L (2013 Jan 30). Intact short-term memory and impaired executive functions in obsessive compulsive disorder.. Ideggyogyaszati szemle 66 (1-2): 35-41.
  12. Pediatric Obsessive-Compulsive Disorder Differential Diagnoses - 2012
  13. Zelazo PD, Müller U, Frye D, et al. (2003). The development of executive function in early childhood. Monogr Soc Res Child Dev 68 (3): vii–137.
  14. Sharon T, DeLoache JS (May 2003). The role of perseveration in children's symbolic understanding and skill. Developmental Sci 6 (3): 289–96.


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