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Profiles of pragmatic impairment in neurological diseases

Giorgio Arcara1*, Elisabetta Tonini2 and Valentina Bambini2
  • 1 San Camillo Hospital IRCCS, Italy
  • 2 Institute for Advanced Study (IUSS), Center for Neurocognition, Epistemology and theoretical Syntax (NEtS), Italy

Many neurological conditions are associated with cognitive deficits in different domains. Among the possible deficits, pragmatic and communicative impairments seem to be widespread across pathologies and seem to be more common than previously thought. In a recent book edited by Cummings (2017), several clinical conditions are examined with respect to pragmatic breakdowns and, in summary, almost all of them show an impairment in discourse and in the use of non-literal language. However, despite the growing interest in pragmatic impairment, there is scarce evidence on the specific differences across pathologies. This is, at least in part, due to the different batteries or tests that are used for the assessment of pragmatic abilities. The discrepancies in the tools do not allow for a direct comparison of the results. In the present study we analyze similarities and differences across several groups of individuals with several neurological and psychiatric conditions using the same test, namely the Assessment of Pragmatic Abilities and Cognitive Substrates (APACS, Arcara & Bambini, 2016). APACS is a freely available test composed by six tasks (Interview, Description, Narratives, Figurative Language 1, Humor, and Figurative Language 2), covering both production and comprehension abilities, with a focus on discourse and non-literal aspects of language. APACS, so far, has been used to assess the pragmatic impairment in people with Amyotrophic Lateral Sclerosis (Bambini, Arcara, Martinelli, et al., 2016), Schizophrenia (Bambini, Arcara, Bechi, et al., 2016), Traumatic Brain Injury (Arcara, Bambini, Mondin, et al., 2016), Multiple Sclerosis (Carotenuto et al., under review), and Developmental Dyslexia (Cappelli et al., in preparation). To investigate if different pathologies may show different pattern of pragmatic impairment, we analyzed data from a pool of patients (Amyotrophic Lateral Sclerosis, n = 33; Schizophrenia, n = 47; Traumatic Brain Injury, n = 41; Multiple Sclerosis, n = 42, Adults with Dyslexia, n = 19). We compared the results from previous studies and performed additional statistical analyses on the joint data using several strategies, based on raw data and on results below/above clinical cut-offs. Results showed that pragmatic impairment might show specific patterns across different pathologies, and also some similarities. We argue that the differences can be traced back to different underlying cognitive correlates, and to different developmental trajectories. These findings can contribute to shed light on the mechanisms underlying pragmatic and communicative behavior and can help clinicians in directing intervention programs targeting the ability to use language in communication.

References

Arcara, G., & Bambini, V. (2016). A test for the assessment of Pragmatic Abilities and Cognitive Substrates (APACS): Normative data and psychometric properties. Frontiers in Psychology, 7(FEB), 1–13. http://doi.org/10.3389/fpsyg.2016.00070

Arcara, G., Bambini, V., Mondin, E., Muriago, G., Sgarabottolo, E., Bertagnoni, G., & Semenza, C. (2016). Pragmatic Abilities in Patients with Traumatic Brain Injury. Frontiers in Psychology, 7. http://doi.org/10.3389/conf.fpsyg.2016.68.00092

Bambini, V., Arcara, G., Bechi, M., Buonocore, M., Cavallaro, R., & Bosia, M. (2016). The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Comprehensive Psychiatry, 71, 106–120. http://doi.org/10.1016/j.comppsych.2016.08.012

Bambini, V., Arcara, G., Martinelli, I., Bernini, S., Alvisi, E., Moro, A., Cappa, S., & Ceroni, M. (2016). Communication and pragmatic breakdowns in amyotrophic lateral sclerosis patients. Brain and Language, 153, 1–12. http://doi.org/10.1016/j.bandl.2015.12.002

Cappelli, G., Noccetti, S., Arcara, G., Bambini, V. (in preparation). Pragmatic Abilities in Developmental Dyslexia.
Carotenuto, A., Arcara, G., Orefice, G., Cerillo, I., Giannino, V., Rasulo, M., Iodice, R., & Bambini, V. (under review)

Cummings, L. (2017). Research in Clinical Pragmatics. Springer Verlag.

Keywords: pragmatics, Communication, neurological disorders, Pragmatic disorder, Pragmatic impairment, Schizophrenia, developmental dyslexia, Traumatic Brain Injury, Amyotrophic Lateral Sclerosis, Multiple Sclerosis

Conference: XPRAG.it Behavioral and Neural Evidence on Pragmatic Processing , Genoa, Italy, 10 Jun - 11 Jun, 2017.

Presentation Type: Oral Presentation

Topic: Patients studies on pragmatic abilities

Citation: Arcara G, Tonini E and Bambini V (2019). Profiles of pragmatic impairment in neurological diseases. Front. Psychol. Conference Abstract: XPRAG.it Behavioral and Neural Evidence on Pragmatic Processing . doi: 10.3389/conf.fpsyg.2017.71.00009

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Received: 10 May 2017; Published Online: 25 Jan 2019.

* Correspondence: PhD. Giorgio Arcara, San Camillo Hospital IRCCS, Venice, Italy, giorgio.arcara@gmail.com