TY - JOUR
T1 - Analysis of Discourse Production to Assess Cognitive Communication Deficits Following Mild Traumatic Brain Injury With and Without Posttraumatic Stress
AU - Myers, Jennifer Rae
AU - Solomon, Nancy Pearl
AU - Lange, Rael T.
AU - French, Louis M.
AU - Lippa, Sara M.
AU - Brickell, Tracey A.
AU - Staines, Shelby
AU - Nelson, Jenna
AU - Brungart, Doug S.
AU - Coelho, Carl A.
N1 - Funding Information:
This project is part of the Defense and Veterans Brain Injury Center/Traumatic Brain Injury Center of Excellence (TBICoE) 15-year Longitudinal TBI Study designed to address a congressional mandate (Sec721 NDAAFY2007). The authors would like to express their sincere gratitude to the staff at the TBICoE and the National Military Au-diology and Speech Pathology Center at Walter Reed National Military Medical Center, Camp Pendleton, and the Navy Medical Center, San Diego. The identification of specific products or scientific instrumentation does not constitute endorsement or implied endorsement on the part of the author, Department of Defense, or any component agency. The views expressed in this article are those of the authors and do not necessarily represent the official policy or position of the Defense Health Agency, Department of Defense, or any other U.S. government agency. This work was prepared under Contract HT0014-19-C-0004 with DHA Contracting Office (CO-NCR) HT0014 and, there-fore, is defined as U.S. Government work under Title 17 U.S.C.?101. Per Title 17 U.S.C.?105, copyright protection is not available for any work of the U.S. Government. For more information, please contact dha.TBICoEinfo@ mail.mil. UNCLASSIFIED.
Publisher Copyright:
© 2022, American Speech-Language-Hearing Association. All rights reserved.
PY - 2022/1
Y1 - 2022/1
N2 - Purpose: Cognitive communication deficits can be difficult to assess in individuals with mild traumatic brain injury (mTBI). However, the use of discourse analysis as a direct and sensitive metric of cognitive communication skills has shown promising clinical utility for other TBI severity levels. This exploratory study investigated discourse production in service members and veterans (SMVs) with uncomplicated mTBI with and without posttraumatic stress disorder (PTSD) and SMVs with neither mTBI or PTSD. Method: Fifteen SMVs with mTBI and PTSD, 26 with mTBI, and 25 controls with no brain injury (NBI) and without PTSD were given a wordless picture story to elicit spontaneous discourse. Discourse samples were analyzed for global coherence, word count, the use of negative emotion words, cognitive process words, nonfluencies, and story completeness. Results: Results revealed a significant difference between the mTBI (Mdn = 3.33) and NBI (Mdn = 3.50) groups, χ2 (3) = 6.044, p = .017, ɛ2 = .03, for global coherence. Word count differed significantly between the mTBI + PTSD (Mdn = 135) and NBI (Mdn = 195) groups, χ2 (3) = 7.968, p = .006, ɛ2 = .06. No other group differences were observed. Discussion: Structural features of discourse production may serve as potential markers of cognitive communication deficits in mTBI. Furthermore, PTSD may contribute to verbal fluency deficits in individuals with mTBI. Additional research is needed to develop discourse-related measures that are more sensitive to the effects of mTBI and PTSD.
AB - Purpose: Cognitive communication deficits can be difficult to assess in individuals with mild traumatic brain injury (mTBI). However, the use of discourse analysis as a direct and sensitive metric of cognitive communication skills has shown promising clinical utility for other TBI severity levels. This exploratory study investigated discourse production in service members and veterans (SMVs) with uncomplicated mTBI with and without posttraumatic stress disorder (PTSD) and SMVs with neither mTBI or PTSD. Method: Fifteen SMVs with mTBI and PTSD, 26 with mTBI, and 25 controls with no brain injury (NBI) and without PTSD were given a wordless picture story to elicit spontaneous discourse. Discourse samples were analyzed for global coherence, word count, the use of negative emotion words, cognitive process words, nonfluencies, and story completeness. Results: Results revealed a significant difference between the mTBI (Mdn = 3.33) and NBI (Mdn = 3.50) groups, χ2 (3) = 6.044, p = .017, ɛ2 = .03, for global coherence. Word count differed significantly between the mTBI + PTSD (Mdn = 135) and NBI (Mdn = 195) groups, χ2 (3) = 7.968, p = .006, ɛ2 = .06. No other group differences were observed. Discussion: Structural features of discourse production may serve as potential markers of cognitive communication deficits in mTBI. Furthermore, PTSD may contribute to verbal fluency deficits in individuals with mTBI. Additional research is needed to develop discourse-related measures that are more sensitive to the effects of mTBI and PTSD.
UR - http://www.scopus.com/inward/record.url?scp=85123651548&partnerID=8YFLogxK
U2 - 10.1044/2021_AJSLP-20-00281
DO - 10.1044/2021_AJSLP-20-00281
M3 - Article
C2 - 34932411
AN - SCOPUS:85123651548
SN - 1058-0360
VL - 31
SP - 84
EP - 98
JO - American Journal of Speech-Language Pathology
JF - American Journal of Speech-Language Pathology
IS - 1
ER -