Developing a daily life measure of depression for persons with aphasia and examining its relation with communicative confidence

制定失语症患者抑郁症的日常生活测量方法并检查其与交际信心的关系

• 批准号: 10571547
• 负责人: Sameer Afzal Ashaie
• 金额: $ 16.35万
• 依托单位: REHABILITATION INSTITUTE OF CHICAGO D/B/A SHIRLEY RYAN ABILITYLAB
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-01 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10571547
• 关键词: Adopted; Affect; Alzheimer' s Disease; American; Aphasia; Assessment tool; Behavior; Caregivers; Cellular Phone; Clinical assessments; Communication; Community Participation; Comprehension; Data; Diagnostics Research; Ecological momentary assessment; Educational workshop; Ensure; Environment; Exclusion; Focus Groups; Foundations; Friends; Funding; Goals; Individual; Intervention; K-Series Research Career Programs; Knowledge; Language; Lead; Left; Life; Major Depressive Disorder; Malignant Neoplasms; Measures; Mental Depression; Mentors; Mentorship; Methods; Moods; Nature; Neurologic; Pathologist; Patients; Persons; Physical activity; Population; Psychopathology; Quality of life; Questionnaires; Reading; Sampling; Scientist; Social Well-Being; Speech; Stroke; Surveys; Symptoms; Testing; Time; Training; Training Activity; United States National Institutes of Health; Work; Writing; career; cognitive interview; cognitive performance; demographics; depressive symptoms; design; design and construction; diagnostic criteria; expectation; experience; improved; innovation; mood symptom; mortality; multimodality; novel; post stroke depression; response; sensor; statistics; usability; user centered design

Aphasia is a multi-modality disturbance of language that is often acquired after a left hemisphere stroke. Post-stroke depression is two times higher in persons with aphasia (PWAs) than in the general stroke population. Post-stroke depression is associated with worse language and cognitive performance and overall decreased quality of life. However, PWAs are typically excluded from studies of post-stroke depression due to a lack of valid assessment tools. More importantly, studies of depression in PWAs only assess depression using weekly retrospective measures thus ignoring the day-to-day variability in mood. An innovative approach to assessing the dynamic nature of depression is ecological momentary assessment (EMA). EMAs involve repeated sampling of data over time in the real-time in real-world environments. EMAs are brief thus minimizing response burden and are typically collected using mobile phones which are owned by more than 85% of Americans. EMAs are ecologically valid but have not been used in PWAs due to their language disturbances. A goal of this study is to use user-centered design to create and validate an aphasia-friendly EMA of depression and investigate its association with communicative confidence (N = 95). Having the confidence to communicate despite aphasia is a robust predictor of overall quality of life. Aim 1 of the study will adapt a user-centered design by involving PWAs, their caregivers, and speech-language pathologists to design and construct brief (~less than 60s) EMA measure of depression. Validity of the EMA measure will be established using a convergent validity approach and use as its validator an established depression scale for PWAs. Aim 2 will establish the validity of the EMA assessment of depression using a smartphone-based measure of physical activity (i.e., step count). Reduced physical activity is a robust correlate of depression in both neurologically healthy individuals and those with stroke. Aim 3 will investigate the relationship between depression and communicative confidence and test the incremental validity of the EMA measure over the retrospective weekly measure of depression. Usability and feasibility of the EMA will also be established. Lastly, an exploratory aim will determine the association between smartphone-based physical activity and communicative confidence. The proposed career development award aims to provide Dr. Ashaie with training activities that will increase his knowledge of (1) psychopathology especially depression, (2) user-centered design, (3) EMA methods, and (4) analyzing smartphone-based sensor data. The training goals will be accomplished through mentored training, formal coursework, and seminars and workshops. His interdisciplinary mentorship team consists of leading experts in depression and transdiagnostic research (Dr. Shankman), user-centered design (Dr. Reddy), designing depression assessments (Dr. Griffith), statistics (Dr. Siddique), and analyzing passive smartphone-based sensor data (Dr. Jayaraman). The K23 will enable Dr. Ashaie to submit an R01 and become an NIH-funded independent scientist whose work in depression assessment can lead to better depression management and ultimately improve PWA’s quality of life.

失语症是一种多模态的语言障碍，往往是收购后，左半球中风。失语症患者中风后抑郁的发生率是普通中风患者的两倍。中风后抑郁症与语言和认知能力下降以及整体生活质量下降有关。然而，由于缺乏有效的评估工具，PWA通常被排除在卒中后抑郁的研究之外。更重要的是，PWA中的抑郁症研究仅使用每周回顾性测量来评估抑郁症，从而忽略了情绪的日常变化。一个创新的方法来评估抑郁症的动态性质是生态瞬时评估（EMA）。EMA涉及在真实世界环境中实时地随时间对数据进行重复采样。EMA是简短的，因此最大限度地减少了响应负担，通常使用超过85%的美国人拥有的移动的手机收集。EMA在生态学上是有效的，但由于其语言障碍，尚未在PWA中使用。本研究的目的是使用以用户为中心的设计，以创建和验证失语友好的抑郁症EMA，并探讨其与沟通信心（N = 95）的关联。尽管有失语症，但有信心进行沟通是整体生活质量的一个强有力的预测因素。本研究的目的1将采用以用户为中心的设计，包括PWA、其护理人员和语言病理学家，以设计和构建抑郁症的简要（约小于60秒）EMA测量。EMA测量的有效性将使用收敛有效性方法确定，并使用PWA的既定抑郁量表作为其验证者。目标2将使用基于智能手机的身体活动测量（即，步数）。减少体力活动是神经系统健康个体和中风患者抑郁症的一个强相关因素。目的3将探讨抑郁症和沟通信心之间的关系，并测试EMA测量的增量效度超过抑郁症的回顾性每周测量。还将确定EMA的可用性和可行性。最后，一个探索性的目标将确定基于智能手机的身体活动和沟通信心之间的关联。拟议的职业发展奖旨在为Ashaie博士提供培训活动，以增加他在以下方面的知识：（1）精神病理学，特别是抑郁症，（2）以用户为中心的设计，（3）EMA方法，以及（4）分析基于智能手机的传感器数据。培训目标将通过辅导培训、正式课程以及研讨会和讲习班来实现。他的跨学科导师团队由抑郁症和跨诊断研究（Shankman博士）、以用户为中心的设计（Reddy博士）、设计抑郁症评估（Griffith博士）、统计学（Siddique博士）和分析被动智能手机领域的领先专家组成。基于传感器数据（Jayaraman博士）。K23将使Ashaie博士能够提交R01并成为NIH资助的独立科学家，其抑郁症评估工作可以导致更好的抑郁症管理，并最终提高PWA的生活质量。