Brain, Vol 120, Issue 10 1805-1822, Copyright © 1997 by Oxford University Press
V Goel, J Grafman, J Tajik, S Gana and D Danto
It has long been argued that patients with lesions in the prefrontal cortex
have difficulties in decision making and problem solving in real- world,
ill-structured situations, particularly problem types involving planning
and look-ahead components. Recently, several researchers have questioned
our ability to capture and characterize these deficits adequately using
just the standard neuropsychological test batteries, and have called for
tests that reflect real-world task requirements more accurately. We present
data from 10 patients with focal lesions to the prefrontal cortex and 10
normal control subjects engaged in a real- world financial planning task.
We also introduce a theoretical framework and methodology developed in the
cognitive science literature for quantifying and analysing the complex data
generated by problem- solving tasks. Our findings indicate that patient
performance is impoverished at a global level but not at the local level.
Patients have difficulty in organizing and structuring their problem space.
Once they begin problem solving, they have difficulty in allocating
adequate effort to each problem-solving phase. Patients also have
difficulty dealing with the fact that there are no right or wrong answers
nor official termination points in real-world planning problems. They also
find it problematic to generate their own feedback. They invariably
terminate the session before the details are fleshed out and all the goals
satisfied. Finally, patients do not take full advantage of the fact that
constraints on real-world problems are negotiable. However, it is not
necessary to postulate a 'planning' deficit. It is possible to understand
the patients' difficulties in real world planning tasks in terms of the
following four accepted deficits: inadequate access to 'structured event
complexes', difficulty in generalizing from particulars, failure to shift
between 'mental sets', and poor judgment regarding adequacy and
completeness of a plan.
ARTICLES
A study of the performance of patients with frontal lobe lesions in a financial planning task
Department of Psychology, York University, North York, Ontario, Canada.
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