Laures-Gore Jacqueline, Heim Christine M, Hsu Yu-Sheng
Department of Educational Psychology and Special Education, Communication Disorders Program,Georgia State University, P.O.Box 3979, Atlanta, Georgia 30302-3979, USA.
J Speech Lang Hear Res. 2007 Apr;50(2):493-507. doi: 10.1044/1092-4388(2007/034).
In this study, the authors explore a method of measuring physiologic and perceived stress in individuals with aphasia by investigating salivary cortisol reactivity and subjectively perceived stress in response to a standardized linguistic task.
Fifteen individuals with aphasia and 15 age-matched healthy controls participated in a linguistic task involving speaking to an unfamiliar listener and a nonlinguistic task consisting of the Mirror Drawing Test (Starch, 1910). Salivary cortisol samples were taken following a 30-min baseline period, at the beginning and end of each task, and at 10-min intervals throughout the posttask period. Perceptions of stress also were assessed.
No significant difference was found in cortisol levels over time within the group with aphasia between the linguistic and nonlinguistic task; however, the control group demonstrated greater cortisol reactivity during the linguistic task than during the nonlinguistic task. For the linguistic task only, the control group demonstrated greater cortisol reactivity than did the group with aphasia. Both groups perceived greater stress posttask than pretask, although the aphasia group perceived greater stress than did the control group.
Adults with aphasia perceived greater stress than did healthy controls; however, this paradigm did not stimulate salivary cortisol reactivity in the aphasia group. A potential reason for this may be differences in the type or degree of psychosocial variables that are important in modulating stress in this population. Other considerations when developing methods for assessing physiologic stress include habituation and hypothalamic-pituitary-adrenal (HPA) axis dysregulation related to the neurological changes poststroke.
在本研究中，作者通过研究唾液皮质醇反应性以及对标准化语言任务的主观感知压力，探索一种测量失语症患者生理和感知压力的方法。
15名失语症患者和15名年龄匹配的健康对照者参与了一项语言任务，即与不熟悉的听众交谈，以及一项由镜像绘图测试（施塔赫，1910年）组成的非语言任务。在30分钟的基线期后、每项任务开始和结束时以及任务后期间每隔10分钟采集唾液皮质醇样本。还评估了压力感知情况。
失语症组在语言任务和非语言任务期间，随时间推移皮质醇水平无显著差异；然而，对照组在语言任务期间的皮质醇反应性高于非语言任务期间。仅就语言任务而言，对照组的皮质醇反应性高于失语症组。两组在任务后均比任务前感知到更大的压力，尽管失语症组比对照组感知到更大的压力。
失语症成人比健康对照者感知到更大的压力；然而，该范式并未刺激失语症组的唾液皮质醇反应性。其潜在原因可能是在调节该人群压力方面重要的心理社会变量的类型或程度存在差异。在开发评估生理压力的方法时的其他考虑因素包括习惯化以及与中风后神经学变化相关的下丘脑 - 垂体 - 肾上腺（HPA）轴失调。
