While many people benefit from aphasia treatments, others do not. This unexplained variability in aphasia treatment outcomes is likely due to a number of factors. Chronic stress – reportedly experienced by many people with aphasia – is a potentially modifiable factor that may impact degree of treatment success. Recent neuropsychological research findings suggest chronic stress may be a substantial barrier to the neuroplasticity required for rehabilitation. Specifically, individuals experiencing chronic stress may have suppressed capacity for neuroplasticity, particularly in the hippocampus and the prefrontal cortex, the primary regions involved with learning. Neuroplasticity, particularly in these regions, is the key mechanism subserving change in language function following aphasia treatment. Clinicians and researchers working with people with aphasia (PWA) typically do not have the knowledge or tools to accommodate patients who are chronically stressed. To further our understanding of the impact of chronic stress in people with aphasia, we will 1) modify an existing and well-validated self-report measure of chronic stress (the Perceived Stress Scale; Cohen & Janicki-Deverts, 2012) so it may be maximally understood by PWA, 2) establish construct and convergent validity of the modified scale (mPSS) with n=75 PWA using behavioral and biomarker measurements, 3) establish test-retest reliability of the mPSS with n=25 PWA, and 4) examine associations between chronic stress and psychological factors of depression and anxiety in PWA. The long-term objectives of this line of research are to use the mPSS to a) explore the influence of chronic stress on cognitive-linguistic treatments and outcomes, and b) explore treatments that mitigate chronic stress and improve treatment outcomes for PWA and other populations with cognitive impairment.


Date Range: 
01/01/2016 to 01/01/2018
Funding Source: 
Career Development Award-1 from VA Rehabilitation Research and Development
Diane Kendall
Dagmar Amtmann
Charles Bombardier