Changes in Personality and Cognition

Question: I just reviewed your online booklet Post-Polio Health Care Considerations but didn’t see a section on personality and cognitive changes. I am a mental health therapist and friend to two women who have post-polio. I am seeing changes in both their personalities and cognition. Do you have further information on these changes?

Response from Rhoda Olkin, PhD: The very brief answer to whether there are personality and cognitive changes in post-polio is no. But you are observing both, so what might we make of this?

First, there is a tendency to see many aspects of a person in terms of his or her disability. This is what Beatrice Wright (1983) called the spread effect. It means that the disability spreads to other presumed characteristics of the person. An example might be talking loudly to a blind person, on the assumption that hearing is likewise impaired. Another type of example is assuming that Itzak Perlman (the world-renowned violinist, who had polio) excelled at violin because he couldn’t play sports. In your case it might mean attributing observed changes to the polio. However, any changes you observe may be due to aging, menopause, stress, child rearing, worry over the November election (which was not resolved at the time of this writing), low thyroid or any myriad other possible explanations.

‘Personality changes’ can co-occur with fatigue, i.e., people get grouchy or less tolerant or more self-absorbed or less flexible and accommodating when they are trying to manage symptoms. I would not describe these so much as personality changes, but mood changes, which in turn change behavior.

To an outside observer, who makes what sociologists call the fundamental attribution error, the changes are ascribed to the person rather than to the environment or circumstances or context. To support this idea that it is the fatigue per se and not an actual personality change, one study found that the fatigue associated with PPS had a negative impact on psychosocial functioning (On, Oncu, Atamaz, & Durmaz, 2006).

Regarding cognitive changes, there do not seem to be changes associated with polio or post-polio syndrome. For example, one study of people with polio with and without fatigue found no evidence that fatigue or cognitive load (doing multiple tasks in a row) affected cognitive functioning (Ostlund, Borg, & Wahlin, 2005).

Although an earlier study did find that polio fatigue is associated with attention deficits, a more recent study found “no support [for] the hypothesis of ‘brain fatigue’ in polio survivors, assessed by cognitive tests or event-related brain potentials” (Schanke, et al., 2002). So ask your friends what they think. Do they notice changes in themselves? If so, to what do they ascribe these changes? Describe what you notice, then listen to their responses.

Post-Polio Health (Vol. 32, No. 2, Spring 2016)