Biomarkers of “Linguistic Anxiety” in aphasia: A proof-of-concept case study

Abstract

This is a proof-of-concept case study designed to evaluate the presence of "Linguistic Anxiety" in a person with mild aphasia. The participant (aged 68) was tested on linguistic and non-linguistic cognitive tasks administered under conditions that differed in levels of anxiety. A validated anxiety-induction technique rarely used in previous aphasia studies was employed: the participant was instructed to prepare for a public speaking presentation. Measures of linguistic and non-linguistic cognitive performance, and anxiety (self-report and psychophysiologic) were obtained. The participant exhibited increased psychophysiologic stress reactivity (heart rate, skin conductance and self-report ratings) in the high-anxiety condition. In the state of increased anxiety, performance on language tasks, in particular discourse production, declined relative to performance in low-anxiety settings. Even in mild aphasia, language-based anxiety can interfere with language performance. This finding provides a basis for carrying out a study with a larger sample that can open a new path to assessment and treatment of persons with aphasia.

Dual-Task Effects on Story Retell for Participants With Moderate, Mild, or No Aphasia: Quantitative and Qualitative Findings

“…Cahana-Amitay et al, 2011); however, empirical support is lacking for general anxiety associated with language use (see Laures-Gore & Buchanan, 2015). Alternatively, the heightened anxiety may be more context-specific: An everyday communication situation that is perceived as challenging by neurotypical adults, for example secondary to attentional demands, may be perceived as threatening by PWA, leading to a heightened neurovisceral response (Laures-Gore & Buchanan, 2015) and potentially affecting spoken language (see e.g., Cahana-Amitay et al, 2015) and life participation. Individual differences related to overall health, energy, and coping resources are likely to mediate the indvididual response (see framework presented in Laures-Gore & Buchanan, 2015).…”

How Responsiveness From a Communication Partner Affects Story Retell in Aphasia: Quantitative and Qualitative Findings

“…The primary aim of Study 1 was to determine how communication partner responsiveness affects ratings of psychological stress and measures of spoken language accuracy and speed for people with aphasia. Based on previous findings, we hypothesized that participants would report greater psychological stress and decreased fluency when retelling a story to an unresponsive communication partner (Buchanan, Laures-Gore, & Duff, 2014;Cahana-Amitay et al, 2015;Lepore et al, 1993). Based on qualitative findings suggesting that people with aphasia react negatively to unresponsive partners (Le Dorze et al, 2014;Parr, 2001;Skelly, 1975), we suspected they would experience greater psychological stress than control participants.…”

“…Based on qualitative findings suggesting that people with aphasia react negatively to unresponsive partners (Le Dorze et al, 2014;Parr, 2001;Skelly, 1975), we suspected they would experience greater psychological stress than control participants. We thought that this might lead to even greater spoken language interference for people with aphasia than controls (Cahana-Amitay et al, 2015).…”

“…Stress response has been investigated using both physiological (i.e., salivary cortisol, heart rate, and skin conductance) and psychological (i.e., self-rated stress or anxiety) measures. Although findings regarding physiological stress response have been equivocal, people with aphasia have consistently reported greater psychological stress when participating in a socially demanding interpersonal communication task (e.g., telling an unfamiliar communication partner about their occupation prior to their stroke; Cahana-Amitay et al, 2015;Laures-Gore, Heim, & Hsu, 2007). In one case study, a participant with mild aphasia performed a free discourse task under typical assessment conditions and when anticipating having to give a speech to a group of experts following the session (i.e., high stress; Cahana-Amitay et al, 2015).…”

Language as a Threat: Multimodal Evaluation and Interventions for Overwhelming Linguistic Anxiety in Severe Aphasia

“…This means that in clinical settings, the existing language deficits might be reinforced by the anxiety reaction which may lead to inaccurate conclusions about the clinical profile and severity of aphasia and the effectiveness of therapeutic interventions. Intriguingly, despite the relevance and potential clinical implications of LA, very few studies have addressed its impact on language performance in the aphasic population (Laures-Gore et al, 2007; Cahana-Amitay et al, 2015; Laures-Gore and Buchanan, 2015). In addition, there is limited evidence on the contributing factors (e.g., premorbid personality traits, lesion location) and the behavioral, psychological and physiological characteristics of anxiety response in PWA.…”