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Perseveration may be defined as repetitive and continuous behaviour, speech or thought which restricts new learning and adaptive functioning
Perseverative disorders were first identified and described in 1895. Since then, the term has been used in literature to label the inappropriate recurrence or continuation of a behaviour after a distinct change in task requirements. Over the years, perseverative behaviours have been frequently observed in a variety of patients with brain disorders. These patient populations include Alzheimer’s and Parkinson’s Disease, Aphasia, Schizophrenia and Acquired Brain Injury.
Perseveration produced by brain injury is exhibited in many different forms. Over the years, investigators have generated various classification groups and labels to categorise the wide range of perseverative behaviours. Despite some variation in classification labels and disagreement from one author to another about the underlying neuromechanisms, the Cognitive and neurobehavioural characteristics of perseveration described by each author were significantly similar for agreement on three basic categories of perseveration. These three basic types are:
- Continuous perseveration (inappropriate prolonged continuation and repetition of a current behaviour)
- Recurrent perseveration (unintentional and inappropriate repetition of a previous behaviour to a different current task demand)
- Stuck-in-set perseveration (inflexible maintenance of an inappropriate cognitive-behavioural response in the face of changing task requirements).
In continuous perseveration, the person with brain injury becomes locked into a specific activity and seems unable to voluntarily stop him/herself. An example of continuous perseveration would be someone sandpapering a table until they went through the wood.
An example of recurrent perseveration would be asking someone to draw a cat. Upon asking them to draw a car or a house they would keep drawing a cat for each request.
Stuck-in-set perseveration is often encountered in brain injury assessment and rehabilitation. It often manifests as a failure to inhibit or stop previously established maladaptive behaviours and replace them with more adaptive ones. Perseveration can be treated by behavioural and cognitive training in a structured environment, and possibly by group therapy or medication.
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