Brain Injury, November 2011; 25(12): 1249–1255 ORIGINAL ARTICLE Frontal acquired brain injury, substance abuse and their common psychological symptoms in the Iranian population KOUROSH BANIHASHEMIAN 1 , RAZIEH ETESAMI POUR 1 , & MANSOUR MOAZZEN 2 1 Payam-e-Nour University, Jahrom Branch, and 2 Payam-e-Nour University, Khavaran Branch, Iran (Received 5 January 2011; revised 27 June 2011; accepted 23 July 2011) Abstract Primary objective: To compare the scores from the Iranian version of the Frontal Systems Behavioral Scale (FSBS) with the norms collected for the American, English-speaking population and to examine the ability of the FSBS to discriminate between acquired brain injury and addiction. Research design: Multivariate analysis of variance (MANOVA) and post hoc Bonferroni tests. Methods and procedures: 120 subjects (41 patients with frontal acquired brain injury [FABI], 47 abstinent Substance Abusers (SA), and 32 healthy controls from the Iranian population) were selected. An Iranian version of the FSBS was administered to all participants. Main outcomes and results: Patients with FABI and SA had higher scores than the control group on the FSBS total score; patients with FABI scored significantly higher than SA, and SA significantly higher than controls. While SA had greater subscales of executive dysfunction than controls, patients with FABI had higher scores than SA and the control group in the subscales of disinhibition, apathy, and executive dysfunction. Conclusions: Two clinical samples of Iranian participants had detective behavioral problems associated with frontal systems dysfunction based on Iranian version of the FSBS, which makes this scale a useful instrument for the detection of behavioral problems. Keywords: Frontal brain injury, substance abuse, symptoms There is a wide spectrum of behavioral problems such as poor inhibition (e.g., impulsive responses, inappropriate social behaviors), apathy (e.g., loss of initiative, lack of energy and interest, reduced affective expression), and executive dysfunction (e.g., poor planning and working memory, cognitive inflexibility, and defective decision-making) in both patients with acquired frontal brain injury and individuals with substance abuse [1, 2]. These behavioral problems are associated with functional disruption of three functional and anatomical neural systems involving different sections of the frontal cortex and its projections to subcortical structures. Studies about neurological lesion have linked apathy symptoms to alterations in the anterior cingulated– thalamic system, whereas disinhibition problems have been associated with alterations in the orbito- frontal–thalamic system, and declines of executive functioning have been associated with alterations in the lateral prefrontal–thalamic system [3]. Several injury studies have indicated that there are cognitive–executive deficits after acquired brain Correspondence: Kourosh Banihashemian, Iran-Jahrom-Azadegan Blv-Payam-e-Nour University. Tel: þ989173148778. Fax: þ987912230801. E-mail: kouroshcpsp@yahoo.com ISSN 0269–9052 print/ISSN 1362–301X online ß 2011 Informa UK Ltd. DOI: 10.3109/02699052.2011.608208 Brain Inj Downloaded from informahealthcare.com by Tomkins Mccaw Library on 10/25/11 For personal use only.