A thesis submitted in partial fulfilment of - Queen Margaret University

neuronal connections, but once learned was not a significant factor in the
retrieval of these newly acquired words. These findings are consistent with
evidence from the literature that reports that emotional status impacts negatively
upon the linguistic performance of people with aphasia. While the biological
nature of depression is acknowledged, the daily social factors that affect
participants cannot be ignored. This aspect of social emotional influences were
observed with a number of main investigation participants and was reflected in
their HADs scores. During the training sessions C3 (abnormal anxiety levels)
discussed her fears at being at risk of future strokes. C6 (abnormal anxiety and
depression levels) revealed his frustration and disappointment at remaining in a
difficult situation and C10 (abnormal anxiety and depression levels) discussed
her bereavement and fears for the future. The self-rating HADs scores reflected
the impact of the social factors relating to C3, C6 and C10 and also likely
impacted upon their ability to learn new vocabulary.
These findings suggest explicit implications for the rehabilitation of language,
particularly in the timing of therapy and the type of speech and language therapy
provided. As the literature indicates, depression can occur in both the acute and
chronic stages of recovery from stroke (see section 2.6.3.2). This influences a
person’s motivation, language and cognitive processes, in particular attention
and memory (see section 2.6.3.3). Therefore it may be more appropriate not to
offer direct therapy until such time as a person’s emotional status recovers but
instead provide indirect therapy, for example working with family and carers in
terms of support and education of compensatory techniques to help facilitate
communication. Direct therapy could begin when emotional stability returned to
within normal limits and the person with aphasia was better able to actively
participate in the therapeutic process. As depression can occur at any stage of
recovery from stroke it would be important to note any deterioration in mood with
individuals and postponing direct therapy input until an appropriate time.
Additionally, liasing with the multidisciplinary team could accelerate the
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