Problem-solving in real-life-type situations: the effects of anterior and posterior lesions on performance

Clinical studies have described patients who show marked impairments in everyday life, including planning, problem-solving and decision-making. Several factors potentially contribute to such impairments, including difficulties in generating possible problem solutions, and difficulties in selecting an appropriate solution. The present study describes the performance of participants with unilateral anterior or posterior lesions compared to healthy controls in ability to solve real-life-type problems. These covered a range of everyday interpersonal situations, and were presented both in video and story format. Participants also carried out a set of more abstract neuropsychological tests. Those with brain lesions showed impairment relative to controls in both everyday problem-solving and on more abstract tests involving executive function and memory. The anterior group was impaired on more aspects of everyday problem-solving than the posterior group, showing reduced fluency in generating possible solutions, and also impairment in selecting appropriate problem solutions. The implications of the findings for our understanding of impairments in everyday life problem-solving after brain injury are discussed. (C) 1999 Elsevier Science Ltd. All rights reserved.