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Agitation is an excess of one or more behaviors that occur during the course of delirium when cognition is impaired. The behaviors most often in excess during agitation include aggression, akathisia, disinhibition, and/or emotional lability. Specific examples of agitated behavior may include pacing, hand wringing, pulling at tubes or restraints, inappropriate verbalizations, excessive crying or laughter, etc.
Agitation is often conceptualized to result from an inability to cope with overstimulation. Stimulation may be internal (e.g., pain or hallucinations) or external (e.g., noise, light, or conversation). One’s ability to cope with stimulation may be viewed as a threshold. Adverse changes to the brain’s typical functioning have the potential to lower this threshold. Thus, individuals with traumatic brain injury or dementia may become agitated at lower levels of stimulation than noninjured individuals.
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References and Readings
Corrigan, J. D. (1989). Development of a scale for assessment of agitation following traumatic brain injury. Journal of Clinical and Experimental Neuropsychology, 69, 261–277.
Sandel, M. E., & Bysiw, W. J. (1996). The agitated brain injured patient. Part 1: Definitions, differential diagnosis, and assessment. Archives of Physical Medicine and Rehabilitation, 77, 617–623.
Smith, M., Gardner, L. A., Hall, G. R., & Buckwalter, K. C. (2004). History, development, and future of the progressively lowered stress threshold: A conceptual model for dementia care. Journal of the American Geriatric Society, 52, 1755–1760.
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Newman, P. (2017). Agitation. In: Kreutzer, J., DeLuca, J., Caplan, B. (eds) Encyclopedia of Clinical Neuropsychology. Springer, Cham. https://doi.org/10.1007/978-3-319-56782-2_2113-2
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DOI: https://doi.org/10.1007/978-3-319-56782-2_2113-2
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