Psychogenic Foreign Accent Syndrome: A New Case

Abstract

This paper presents the case of a 33-year-old, right-handed, French-speaking Belgian lady who was involved in a car accident as a pedestrian. Six months after the incident she developed a German/Flemish-like accent. The patient's medical history, the onset of the FAS and the possible psychological causes of the accent change are analyzed. Relevant neuropsychological, neurolinguistic, and psychodiagnostic test results are presented and discussed. The psychodiagnostic interview and testing will receive special attention, because these have been underreported in previous FAS case reports. Furthermore, an accent rating experiment was carried out in order to assess the foreign quality of the patient's speech. Pre- and post-morbid spontaneous speech samples were analyzed phonetically to identify the pronunciation characteristics associated with this type of FAS. Several findings were considered essential in the diagnosis of psychogenic FAS: the psychological assessments as well as the clinical interview confirmed the presence of psychological problems, while neurological damage was excluded by means of repeated neuroimaging and neurological examinations. The type and nature of the speech symptoms and the accent fluctuations associated with the patient's psychological state cannot be explained by a neurological disorder. Moreover, the indifference of the patient toward her condition may also suggest a psychogenic etiology, as the opposite is usually observed in neurogenic FAS patients.

Non-Neurogenic Language Disorders: A Preliminary Classification

“…Although some patients with neurogenic FAS haveagrammatism and some patients with psychogenic FAS have general dysfluency (3, 27), the presence of substantial or preponderant grammatical deficits in otherwise fluent conversation and normal language comprehension suggests a psychogenic cause (26, 47, 49). Third, psychogenic FAS may have variable and inconsistent dysgrammatisms with irregularly affected articles, word order, misused grammatical words, plural-singular verb correspondence, erroneous verb tenses, and drop-out of articles (26). Their dysgrammatisms suggest paragrammatism with mistakes in grammatical use and occasional child-like constructions rather than the agrammatic omissions or telegraphic speech of Broca’s aphasia (50).…”

Functional Foreign Accent Syndrome in suspected Conversion Disorder: A case study

“…The onset of FAS after a traumatic experience has been previously reported in Verhoeven et al, 13 where the patient was nearly involved in a car accident as a cyclist and developed FAS after this experience. In Keulen et al, 45 the patient was hit by a car as a pedestrian, but did not suffer any structural CNS damage. A few months later, an abrupt change of personality is described.…”

Cognitive Behavioral Therapy for Foreign Accent Syndrome: A Single-Case Experimental Design

“…Neurogenic FAS involves an accent change caused by damage to the central nervous system (CNS), which affects the language dominant areas of the brain (Verhoeven et al, 2013). Neurogenic FAS is associated with etiologies including brain trauma, stroke, multiple sclerosis (MS), and vascular dementia (Keulen et al, 2016), with possible comorbid speech and language impairments such as dysarthria, apraxia, and aphasia that might accompany FAS. Psychogenic FAS has no known organic cause but may be preceded by mutism (Jones et al, 2011) and may be characterized by difficulties including, for example, dysphonia (impaired or disordered voice) or aphonia (absent voice), which is believed to be perpetuated by psychological or emotional factors (Butcher et al, 2007).…”

“…For example, abnormal emotional regulation has been identified among those with FAS (Berthier et al, 2016). In addition, links have been established between FAS and the withdrawal of medication, specifically high-dose dopamine or anticholinergic agents (Schuh, 2017) and antipsychotic drugs (Keulen et al, 2016). The term psychogenic FAS is considered by some to be problematic, particularly in instances where there is neither a neurogenic cause nor a presence of any psychiatric conditions (Mariën et al, 2019).…”