Modifying and Validating a Measure of Chronic Stress for People With Aphasia Purpose Chronic stress is likely a common experience among people with the language impairment of aphasia. Importantly, chronic stress reportedly alters the neural networks central to learning and memory—essential ingredients of aphasia rehabilitation. Before we can explore the influence of chronic stress on rehabilitation outcomes, we must be able to ... Research Article
Research Article  |   December 10, 2018
Modifying and Validating a Measure of Chronic Stress for People With Aphasia
 
Author Affiliations & Notes
  • Rebecca Hunting Pompon
    Department of Speech and Hearing Sciences, University of Washington, Seattle
    VA Puget Sound Health Care System, Seattle, WA
  • Dagmar Amtmann
    Department of Rehabilitation Medicine, University of Washington, Seattle
  • Charles Bombardier
    Department of Rehabilitation Medicine, University of Washington, Seattle
  • Diane Kendall
    Department of Speech and Hearing Sciences, University of Washington, Seattle
    VA Puget Sound Health Care System, Seattle, WA
    Speech-Language Pathology and Audiology, University of Pretoria, South Africa
  • Disclosure: The authors have declared that no competing interests existed at the time of publication.
    Disclosure: The authors have declared that no competing interests existed at the time of publication. ×
  • Correspondence to Rebecca Hunting Pompon: rhp@udel.edu
  • Editor-in-Chief: Sean Redmond
    Editor-in-Chief: Sean Redmond×
  • Editor: Carl Coelho
    Editor: Carl Coelho×
Article Information
Research Issues, Methods & Evidence-Based Practice / Language Disorders / Aphasia / Attention, Memory & Executive Functions / Language / Research Articles
Research Article   |   December 10, 2018
Modifying and Validating a Measure of Chronic Stress for People With Aphasia
Journal of Speech, Language, and Hearing Research, December 2018, Vol. 61, 2934-2949. doi:10.1044/2018_JSLHR-L-18-0173
History: Received May 3, 2018 , Revised June 8, 2018 , Accepted June 25, 2018
 
Journal of Speech, Language, and Hearing Research, December 2018, Vol. 61, 2934-2949. doi:10.1044/2018_JSLHR-L-18-0173
History: Received May 3, 2018; Revised June 8, 2018; Accepted June 25, 2018

Purpose Chronic stress is likely a common experience among people with the language impairment of aphasia. Importantly, chronic stress reportedly alters the neural networks central to learning and memory—essential ingredients of aphasia rehabilitation. Before we can explore the influence of chronic stress on rehabilitation outcomes, we must be able to measure chronic stress in this population. The purpose of this study was to (a) modify a widely used measure of chronic stress (Perceived Stress Scale [PSS]; Cohen & Janicki-Deverts, 2012) to fit the communication needs of people with aphasia (PWA) and (b) validate the modified PSS (mPSS) with PWA.

Method Following systematic modification of the PSS (with permission), 72 PWA completed the validation portion of the study. Each participant completed the mPSS, measures of depression, anxiety, and resilience, and provided a sample of the stress hormone cortisol extracted from the hair. Pearson's product–moment correlations were used to examine associations between mPSS scores and these measures. Approximately 30% of participants completed the mPSS 1 week later to establish test–retest reliability, analyzed using an interclass correlation coefficient.

Results Significant positive correlations were evident between the reports of chronic stress and depression and anxiety. In addition, a significant inverse correlation was found between reports of chronic stress and resilience. The mPSS also showed evidence of test–retest reliability. No association was found between mPSS score and cortisol level.

Conclusion Although questions remain about the biological correlates of chronic stress in people with poststroke aphasia, significant associations between chronic stress and several psychosocial variables provide evidence of validity of this emerging measure of chronic stress.

Acknowledgments
This research was completed with funding from VA Rehabilitation Research & Development Career Development Award (1IK1RX001934). We thank neurologists Kyra Becker and Stephen Nadeau for their thoughtful input at the inception of this project and JoAnn Silkes for her support. We also thank the clinicians, clinical researchers, family members, and especially the participants with aphasia involved with this project for their time and efforts.
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