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Narrative discourse patterns in dementia

This study was designed with the aim of exploring from a qualitative point of view the communicative abilities of people affected by dementia. From among the different discourse genres, narratives were selected as these appear frequently in conversation and at the same time are a complex activity in which different cognitive and social skills interact. In spite of their apparent simplicity, they require an extended effort by the teller, who needs to choose an appropriate point in the conversation when the narrative can be introduced, recall all the necessary details and organize them in a comprehensible order, possibly employing a series of devices to hold the audience's attention. The focus on the investigation of communicative disorders was chosen with the aim of gaining a better understanding of what is normal or neurotypical in narrative discourse production. As a possible cause for impairment in communication I opted for dementia because it is a major health issue of which we have only a partial understanding. In particular, inconsistencies in the diagnostic practices have been pointed out, revealing an urgent need for a more accurate description of the behavioural symptoms. The data under examination have been collected in informal conversations with sixteen people affected by dementia. Further information on the communicative behaviour of the person affected by dementia was elicited from a family member by means of a semi-structured interview. The application of a simplified version of Labov and Waletzky's (1967) framework of narrative analysis, integrated with insights from Conversation Analysis, and contributions from anthropology, social sciences, narratology, as well as cognitive psychology, yield a number of results. Although a certain amount of variation was observed in the behaviour of the participants, the overall results seem to reflect findings from previous research and show how the progressive deterioration of the ability to retrieve and encode autobiographical memory is reflected in the diminishing ability to structure narrative discourse. Complex or canonical narratives seem to become frequent as dementia progresses, narratives become more fragmented, and contain more pauses and fillers, confusion in the chronological organization and confabulation, which is often fitted into previously established storylines; stories and story chunks are frequently repeated, then are reduced to brief comments that are scattered throughout discourse, so that they are no longer recognizable as narratives, but only as traces. The findings also add information on this process, such as that the ability to provide all the necessary details of orientation seems to be compromised since the early stages of the condition, as well as the ability to plan the narration, due to impairment of the executive function. Speakers in the moderate to severe stages displayed either a tendency to withdraw from the conversation or the opposite tendency to rely on a number of repetitions of small stories, story chunks and formulaic expressions, and on confabulation, in order to provide their contribution to the interaction. Some instances of potentially disordered behaviour displayed by mildly impaired participants have highlighted that both the interactional outcome and the frequency with which they appear in discourse can help make decisions on the level of acceptability of apparently deviant linguistic expressions. This may contribute to the description of the early symptoms of dementia. More research is urgently needed on the discourse abilities of neurotypical elderly speakers, as well as more collaboration between the clinical and linguistic field.

Identiferoai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:742387
Date January 2018
CreatorsMaccari, Emanuela
PublisherUniversity of Aberdeen
Source SetsEthos UK
Detected LanguageEnglish
TypeElectronic Thesis or Dissertation
Sourcehttp://digitool.abdn.ac.uk:80/webclient/DeliveryManager?pid=236553

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