Department of Communication Sciences and Disorders, University of New Hampshire, Durham, New Hampshire, USA.
Department of Life Sciences, Carroll University, Waukesha, Wisconsin, USA.
Int J Lang Commun Disord. 2025 Jan-Feb;60(1):e13130. doi: 10.1111/1460-6984.13130. Epub 2024 Nov 6.
Pragmatic communication difficulties encompass many distinct behaviours, including the use of vague and/or insufficient language, a common characteristic following traumatic brain injury (TBI) that negatively impacts psychosocial outcomes. Existing assessments evaluate pragmatic communication broadly, often with only one or two items capturing each behaviour, thus limiting sensitivity and precision to variations within each behaviour. Given that greater nuance is needed to detect subtle pragmatic communication differences and investigate underlying cognitive mechanisms, a more refined measure is critical to improve psychosocial outcomes. The Vague scale was developed to address those needs.
To provide preliminary evidence supporting the novel Vague language use (Vague) scale's reliability, validity and clinical utility.
The Vague scale rates each discourse sample utterance for vague language use on a 3-point scale; the measure's Vague score represents the mean of utterance-level ratings. Using the Vague scale, two raters naïve to diagnosis evaluated Cinderella narratives of 46 adults with severe TBI and 46 controls with no brain injury, providing reliability, construct validity and classification accuracy evidence. Vague scores were also compared to other clinical measures to gather criterion-related validity evidence.
Interrater agreement across all transcripts was moderate. Construct validity was supported by expected group differences and criterion validation, including significant relationships with increased violations of Grice's maxim of quantity and measures of lexical variation; significant relationships with psychosocial outcomes, supporting clinical utility; and nonsignificant relationships with measures of syntax and overall pragmatic communication. Classification accuracy expectedly did not support using Vague scores in isolation for diagnosis, due to unacceptable sensitivity (0.696).
Evidence supported the Vague scores' psychometric properties. Thus, the Vague scale shows promise as a measure of one distinct pragmatic communication behaviour: vague language use. Future research should apply the Vague scale to determine its sensitivity in individuals with subtle social communication challenges (e.g., mild TBI), explore its utility with more naturalistic discourse samples as part of a pragmatic communication battery, longitudinally examine changes in Vague scores, and investigate cognitive mechanisms underlying this specific pragmatic communication behaviour.
What is already known on this subject Use of vague language is common following traumatic brain injury (TBI) and may contribute to negative psychosocial outcomes related to employment and relationships. However, existing measures of vague language lack sensitivity and precision, limiting their utility for identifying subtle performance variations or determining the cognitive mechanisms underlying this specific pragmatic communication behaviour. What this study adds to existing knowledge The current study gathered promising reliability, validity and clinical utility evidence to support using the novel Vague language use (Vague) scale, which was developed to address these limitations. Based on complex (Cinderella) stories of adults with and without TBI, Vague scores demonstrated moderate interrater agreement and promising construct validity based on expected group differences and criterion validation, including moderate associations with related constructs and weak associations with unrelated constructs. Because pragmatic communication profiles post-TBI can vary, classification accuracy expectedly indicated that Vague scores should not be used alone to identify communication differences post-TBI. What are the clinical implications of this work? Vague scores show promise for documenting clients' use of vague language and planning intervention to address associated discourse-level challenges. Future research should investigate applying the Vague scale to naturalistic discourse samples (1) as part of a battery that sensitively and precisely identifies pragmatic communication differences and (2) as a tool for investigating cognitive mechanisms underlying vague language use, with the goal of improving interventions that support pragmatic communication and enhance psychosocial outcomes.
实用沟通困难包括许多不同的行为，包括使用模糊和/或不充分的语言，这是创伤性脑损伤（TBI）后的一个常见特征，会对心理社会结果产生负面影响。现有的评估方法广泛评估实用沟通，通常只有一到两个项目来捕捉每种行为，因此限制了对每种行为内变化的敏感性和精度。鉴于需要更细微的洞察力来检测微妙的实用沟通差异并研究潜在的认知机制，因此更精细的衡量标准对于改善心理社会结果至关重要。模糊量表就是为了满足这些需求而开发的。
提供初步证据支持新开发的模糊语言使用（Vague）量表的可靠性、有效性和临床实用性。
模糊量表对每个话语样本的模糊语言使用情况进行 3 分制评分；该量表的模糊评分代表话语水平评分的平均值。使用模糊量表，两位对诊断一无所知的评分者对 46 名严重 TBI 患者和 46 名无脑损伤的对照组的灰姑娘故事进行评估，提供了可靠性、构念效度和分类准确性的证据。模糊评分还与其他临床测量指标进行了比较，以收集效标关联效度的证据。
所有转录本的评分者间一致性为中等。预期的组间差异和标准验证支持了构念效度，包括与违反格里夫斯数量准则的增加以及词汇变化的测量指标的显著关系；与心理社会结果的显著关系，支持了临床实用性；与语法和整体实用沟通的测量指标无显著关系。由于敏感性不可接受（0.696），分类准确性预计不能单独使用模糊评分进行诊断。
证据支持模糊评分的心理测量特性。因此，模糊量表作为一种衡量特定实用沟通行为的方法（即模糊语言使用）具有很大的潜力。未来的研究应该应用模糊量表来确定其在具有细微社交沟通挑战的个体（例如轻度 TBI）中的敏感性，探索其在实用沟通电池中使用更自然的话语样本的效用，纵向检查模糊评分的变化，并研究这种特定实用沟通行为背后的认知机制。
