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A new approach to diagnose psychological trauma starting from a pilot study: Description of the post-traumatic psycholinguistic syndrome - 08/06/20

Doi : 10.1016/j.ejtd.2020.100167 
Yann Auxéméry a, b,
a Université de Lorraine, EA 4360 APEMAC « Adaptation, mesure et évaluation en santé. Approches interdisciplinaires » - Equipe EPSAM, 57000 Metz, France 
b Service d’urgence psychiatrique et de liaison, Hôpital Mercy, CHR Metz-Thionville, 1, allée du Château, 57085 Metz cedex 3, France 

Corresponding author.
Sous presse. Épreuves corrigées par l'auteur. Disponible en ligne depuis le Monday 08 June 2020

Abstract

Background

Due to societal evolution, the consideration of post-traumatic psychic disorders is developing with psychopathological, neurobiological and even sociological conceptions. But because of the clinical presentation of the psychic trauma and its clinical consequences, underdiagnosis and late diagnosis remain numerous. This suffering, intense and rich on the symptomatic level, appears most often mute concerning their psychotraumatic origins and therefore, without adapted therapeutic answer. However, alongside, many psychotherapeutic protocols have been developped lately from many theoretical backgrounds (behavioral and cognitive protocols, treatments by hypnosis, eye movement therapies, psychodynamic therapies, narrative therapies, etc.). It should be noted too that while the number of psychotraumatology research has exploded, the concrete evolutions useful for daily practice seem to be more tenuous. It now seems necessary to build a new phase of analysis.

Objectives

As it appears to constitute clinically what we call a “language injury”, psycholinguistics appears as a space of heuristic research in order to explain the etiopathogenesis, the clinical presentations, and especially the offer of proposed care to patients suffering from post-traumatic stress disorder. Our objectives are to better identify such disorders, develop markers that can monitor the effectiveness of recommended treatments, and develop future studies.

Methods

Based on quantitative and qualitative analyses of the discourse of patients suffering from post traumatic stress disorder, we describe the psycholinguistic disturbances they present, illustrating them with examples from clinical practice. We first conducted a quantitative exploratory study based on fifteen semi-structured interviews of war-PTSD patients in order to perform a lexical analysis of their speech thanks to a lexicometric software. Then, we defined a lexical class named “clinical psychotraumatic syndrome” in order to achieve an interpretative phenomenological analysis. We finally synthetize the data in qualitative and clinical form.

Results

We define post-traumatic psycholinguistic syndrome as a function of three symptoms: traumatic anomia, linguistic repetition and disorganised discourse. Traumatic anomia manifests in a quantitative reduction in discourse characterised by a lack of production, impaired verbal flow and lexical poverty. Linguistic repetition takes the form of phonological and syntactic repetition (verbal stereotypes, predilections, intrusions, perseverations and echophrasia). Phrasal and discursive disorganisation is characterised by tense discordance, de-subjectivation (via indefinite and impersonal pronominal markers), and disfluency that can extend to agrammatism due to a lack of logical and chronological connectors.

Conclusions

At a time when a variety of competing psychotherapeutic protocols are vying for attention, the analysis of the restoration of normal language could offer a way to create a clearer understanding of psychological trauma and its clinical consequences, federating past existing theories. In this context, psycholinguistic studies that combine quantitative and qualitative analyses of the discourse of people suffering from post-traumatic stress disorders could help to define some markers of the effectiveness of psychotherapies.

Le texte complet de cet article est disponible en PDF.

Keywords : Psychological trauma, Post-traumatic stress disorder, Psycholinguistic analysis, Post-traumatic psycholinguistic disorder, Psycholinguistic markers, Psychotherapy assessment


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