Health Care Needs of Individuals with Parkinson's Disease Living in Eastern North Carolina: Insights for Multidisciplinary Care and Telemedicine.

Parkinson's disease (PD) is a complex condition, and individuals living in rural areas often face challenges accessing the specialized care they require. To better understand the specific healthcare needs of individuals with PD in Eastern North Carolina (ENC), the present study investigated three key areas: access to a multidisciplinary care team, access to PD-specific resources, and access to resources for establishing telemedicine services. Participants were recruited through email invitations to Parkinson's Foundation members and the distribution of postcards in the region, and 106 individuals with PD in ENC completed the online survey. Only 28.3% of respondents reported access to an interdisciplinary care team, with approximately 50% stating that their healthcare provider had not informed them of the availability of such a team. Nevertheless, the quality of care received was generally perceived as high, and 41.5% of participants were part of a PD support group. Approximately half of the respondents expressed a willingness to have telemedicine appointments with a movement disorder specialist. These findings offer valuable insights for healthcare providers and policymakers in rural areas to better understand the needs of people with PD. Several strategies, including community building and increased access to telemedicine, are recommended to address these needs.

Differences in politeness perception of irony and prosocial lies: Exploring the role of age, gender, and geographic location.

In daily interactions, individuals use irony and prosocial lies for various reasons, for example, to be humorous, to criticize, or to be polite. While some studies have examined individual differences in perceiving the politeness of such language, research using naturalistic, context-rich materials is lacking. To address this gap, we utilized short videos to assess politeness perception in literal, ironic, and prosocial lie scenarios while also exploring differences based on age, gender, and geographical location. Our sample included 288 participants from the United States and the United Kingdom. We focused on five different types of language: literal positive, blunt, sarcastic, teasing, and prosocial lies. Participants rated the politeness of these statements and completed surveys on communication preferences (Self-Reported Sarcasm Questionnaire and Conversational Indirectness Scale Questionnaire). While the demographic groups showed similarities, individual factors also shaped politeness perception. Older adults perceived teasing as less polite than middle-aged and younger adults, and male participants rated blunt and sarcastic statements as more polite. Geographical variations were found for prosocial lies, with U.K. participants rating them more polite than their U.S. counterparts. These findings underscore the importance of considering context-rich materials and individual factors in understanding the social functions of irony and prosocial lies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Parkinson's Disease on Social Communication: An Exploratory Questionnaire Study.

Individuals with Parkinson's disease (PD) often show breakdown in the production and interpretation of aspects of social communication. However, there is no current method of assessment for evaluating social communication dysfunction in individuals with PD. The aim of this study was to develop a self-report questionnaire for individuals with PD to identify their social communication skills, and further recognize the impact of PD on social communication. Fifty-one individuals with Parkinson's disease answered 28 survey questions. These questions pertained to emotional expression and perception, social communication, sarcasm/humor, and pragmatic skills. Exploratory factor analysis and reliability analysis were conducted to identify items loading onto the factors and to check the internal consistency of the items. Individuals with PD reported changes in emotional expression and perception, social communication, sarcasm and humor, and pragmatic skill domains post-PD diagnosis. No correlations were found between age or time since diagnosis and emotional expression, social communication, sarcasm, and humor. This study provides self-reported evidence that individuals with PD experience social communication challenges. Future research should further quantify these challenges, study their impact on daily communicative functioning, and use the results to develop social communication interventions that improve the quality of life for persons with PD.

Reported Use of Second-Language Speech Accommodation in Everyday Interactions: The Role of Individual Differences.

BACKGROUND: Proficient speakers of a language often accommodate less proficient speakers during conversation to facilitate comprehension, but information about factors such as personality and language experience that may shape how speakers perceive accommodation is limited. PURPOSE: We developed an online questionnaire to clarify the use of speech accommodation in relation to individual differences in anxiety, personality, and English proficiency. METHOD: Using Qualtrics Panels for recruitment, we surveyed a representative sample of second-language (L2) English speakers (n = 201) and first-language (L1) English speakers (n = 192) across the United States. We report descriptive results in addition to correlations and a factor analysis to assess the perception of accommodation in L2 and L1 speakers. RESULTS: Only a third of L2 participants reported that L1 speakers change their speech when talking to them, and more than half are frustrated when L1 speakers do not accommodate them. Indeed, a majority of our L1 participants reported that they do not change their speech when talking to L2 speakers. For both groups, measures of anxiety, personality, and L2 proficiency modify results, providing novel evidence on factors that influence L2 accommodation. CONCLUSIONS: Results suggest that L1 speakers accommodate L2 speakers less frequently than previously reported. The data are discussed under communication accommodation theory.

Perception of speaker sincerity in complex social interactions by cochlear implant users.

Understanding insincere language (sarcasm and teasing) is a fundamental part of communication and crucial for maintaining social relationships. This can be a challenging task for cochlear implant (CIs) users who receive degraded suprasegmental information important for perceiving a speaker's attitude. We measured the perception of speaker sincerity (literal positive, literal negative, sarcasm, and teasing) in 16 adults with CIs using an established video inventory. Participants were presented with audio-only and audio-visual social interactions between two people with and without supporting verbal context. They were instructed to describe the content of the conversation and answer whether the speakers meant what they said. Results showed that subjects could not always identify speaker sincerity, even when the content of the conversation was perfectly understood. This deficit was greater for perceiving insincere relative to sincere utterances. Performance improved when additional visual cues or verbal context cues were provided. Subjects who were better at perceiving the content of the interactions in the audio-only condition benefited more from having additional visual cues for judging the speaker's sincerity, suggesting that the two modalities compete for cognitive recourses. Perception of content also did not correlate with perception of speaker sincerity, suggesting that what was said vs. how it was said were perceived using unrelated segmental versus suprasegmental cues. Our results further showed that subjects who had access to lower-order resolved harmonic information provided by hearing aids in the contralateral ear identified speaker sincerity better than those who used implants alone. These results suggest that measuring speech recognition alone in CI users does not fully describe the outcome. Our findings stress the importance of measuring social communication functions in people with CIs.

Emotional voices modulate perception and predictions about an upcoming face.

When we hear an emotional voice, does this alter how the brain perceives and evaluates a subsequent face? Here, we tested this question by comparing event-related potentials evoked by angry, sad, and happy faces following vocal expressions which varied in form (speech-embedded emotions, non-linguistic vocalizations) and emotional relationship (congruent, incongruent). Participants judged whether face targets were true exemplars of emotion (facial affect decision). Prototypicality decisions were more accurate and faster for congruent vs. incongruent faces and for targets that displayed happiness. Principal component analysis identified vocal context effects on faces in three distinct temporal factors: a posterior P200 (150-250 ms), associated with evaluating face typicality; a slow frontal negativity (200-750 ms) evoked by angry faces, reflecting enhanced attention to threatening targets; and the Late Positive Potential (LPP, 450-1000 ms), reflecting sustained contextual evaluation of intrinsic face meaning (with independent LPP responses in posterior and prefrontal cortex). Incongruent faces and faces primed by speech (compared to vocalizations) tended to increase demands on face perception at stages of structure-building (P200) and meaning integration (posterior LPP). The frontal LPP spatially overlapped with the earlier frontal negativity response; these components were functionally linked to expectancy-based processes directed towards the incoming face, governed by the form of a preceding vocal expression (especially for anger). Our results showcase differences in how vocalizations and speech-embedded emotion expressions modulate cortical operations for predicting (prefrontal) versus integrating (posterior) face meaning in light of contextual details.

Social appropriateness perception of dynamic interactions.

The current study explored the judgment of communicative appropriateness while processing a dialogue between two individuals. All stimuli were presented as audio-visual as well as audio-only vignettes and 24 young adults reported their social impression (appropriateness) of literal, blunt, sarcastic, and teasing statements. On average, teasing statements were rated as more appropriate when processing audio-visual statements compared to the audio-only version of a stimuli, while sarcastic statements were judged as less appropriate with additional visual information. These results indicate a rejection of the Tinge Hypothesis for audio-visual vignettes while confirming it for the reduced, audio-only counterparts. We also analyzed time-frequency EEG data of four frequency bands that have been related to language processing: alpha, beta, theta and low gamma. We found desynchronization in the alpha band literal versus nonliteral items, confirming the assumption that the alpha band reflects stimulus complexity. The analysis also revealed a power increase in the theta, beta and low gamma band, especially when comparing blunt and nonliteral statements in the audio-only condition. The time-frequency results corroborate the prominent role of the alpha and theta bands in language processing and offer new insights into the neural correlates of communicative appropriateness and social aspects of speech perception.

No, No One Had Fun. Individual Differences in Nonliteral Language Perception.

Nonliteral language represents a complex form of communication that can be interpreted in numerous different ways. Our study explored how individual differences in personality and communication styles affect the evaluation of literal and nonliteral language in the context of assumptions made by the Tinge Hypothesis (Dews & Winner, 1995). Participants watched videos of social interactions focusing on positive, negative, sarcastic, and jocular statements. They evaluated speaker intentions and social impressions and completed several personality and communication style questionnaires. Individual differences in empathy, defense style, and sarcasm use correlated with the accuracy of identifying speaker intent. Additionally, positive statements were rated as friendlier when compared to jocular statements, thereby supporting the Tinge Hypothesis. However, literal negative statements were rated as more friendly than sarcastic statements, which is inconsistent with the Tinge Hypothesis. The current results provide novel evidence for the Tinge Hypothesis using multimodal, dynamic stimuli and highlight the role of the individual personality of the recipient in evaluating sarcasm and jocularity.

Change in humor and sarcasm use based on anxiety and depression symptom severity during the COVID-19 pandemic.

BACKGROUND: Humor and sarcasm may be used as potential coping strategies during challenging times, and to improve wellbeing. We investigated changes in humor and sarcasm use during the COVID-19 pandemic in participants with varying anxiety and depression symptom severity, and in those with versus without psychiatric disorders. METHODS: Online data was collected from N = 661 Canadian adults during the height of COVID-19-related restrictions. Depression and anxiety symptom severity were assessed using the Patient Health Questionnaire (PHQ-9) and General Anxiety Disorder (GAD-7) scale. Participants were queried on current presence/absence of a psychiatric disorder, and on changes in humor and sarcasm use during compared to before the pandemic. RESULTS: Participants with any vs. no depression symptoms reported more sarcasm and humor use during the pandemic. Respondents with mild and severe vs. no anxiety symptoms reported using more sarcasm. However, those with any vs. no anxiety symptoms used less humor during the pandemic. Finally, less humor use was noted in those without vs. with a psychiatric disorder. LIMITATIONS: The use of self-report measures and a sample that may limit generalizability. CONCLUSIONS: Adults with depression symptoms used more humor and sarcasm as a potential coping strategy during COVID-19. While individuals with anxiety symptoms used more sarcasm, this was not true of humor, suggesting their decreased reliance on levity during a crisis. Humor use was greater in those with psychiatric disorders, perhaps due to self-preservation mechanisms during times of distress. Our findings have implications for using humor in therapy in individuals with mental health struggles and mood disorders.

Tracking nonliteral language processing using audiovisual scenarios.

Recognizing sarcasm and jocularity during face-to-face communication requires the integration of verbal, paralinguistic, and nonverbal cues, yet most previous research on nonliteral language processing has been carried out using written or static stimuli. In the current study, we examined the processing of dynamic literal and nonliteral intentions using eye tracking. Participants (N = 37) viewed short, ecologically valid video vignettes and were asked to identify the speakers' intention. Participants had greater difficulty identifying jocular statements as insincere in comparison to sarcastic statements and spent significantly more time looking at faces during nonliteral versus literal social interactions. Finally, participants took longer to shift their attention from one talker to the other talker during interactions that conveyed literal positive intentions compared with jocular and literal negative intentions. These findings currently support the Standard Pragmatic Model and the Parallel-Constraint-Satisfaction Model of nonliteral language processing. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Eye Tracking Measures for Studying Language Comprehension Deficits in Aphasia: A Systematic Search and Scoping Review.

Aim The aim of this scoping review is to identify the eye tracking paradigms and eye movement measures used to investigate auditory and reading comprehension deficits in persons with aphasia (PWA). Method MEDLINE via PubMed, Cochrane, CINAHL, Embase, PsycINFO, OTseeker, Scopus, Google Scholar, Grey Literature Database, and ProQuest Search (Dissertations & Theses) were searched for relevant studies. The Covidence software was used to manage the initial and full-text screening process for the search. Results and Discussion From a total of 1,803 studies, 68 studies were included for full-text screening. In addition, 418 records from gray literature were also screened. After full-text screening, 16 studies were included for this review-12 studies for auditory comprehension in PWA and four studies for reading comprehension in PWA. The review highlights the use of common eye tracking paradigms used to study language comprehension in PWA. We also discusse eye movement measures and how they help in assessing auditory and reading comprehension. Methodological challenges of using eye tracking are discussed. Conclusion The studies summarized in this scoping review provide evidence that the eye tracking methods are beneficial for studying auditory and reading comprehension in PWA.

Nonliteral language processing across the lifespan.

Studies investigating the effects of aging on nonliteral language processing have mainly focused on one sensory modality, for example written vignettes. In the current study, we used a video-based task to examine the effect of healthy aging on social communication perception using a novel database called RISC (Relation Inference in Social Communication). By means of an online recruitment platform, we asked young, middle-aged, and older adults between the ages of 18 and 76 (N = 100) to evaluate videos of actors using different forms of literal and nonliteral language, such as sarcasm or teasing. The participants' task was to infer the speakers' belief and the speakers' intention. Older participants demonstrated lower accuracy in discriminating nonliteral from literal interactions compared to younger and middle-aged groups. When evaluating speaker intentions, older adults judged sarcasm as friendlier compared to literal negative utterances. We also found that the older the participant, the more difficulty they have identifying teasing as insincere. Our results expand on age-related similarities and differences in evaluating speaker intentions and demonstrate the practicality of the RISC database for studying nonliteral language across the lifespan.

Evaluation of the Symmetry of the Levator Veli Palatini Muscle and Velopharyngeal Closure Among a Noncleft Adult Population.

PURPOSE: The goal of this study is to determine the typical range of asymmetry between the length and thickness of the levator veli palatini muscle and to explore the impact of the observed asymmetry on velopharyngeal closure. A second objective is to report normative length and thickness of the levator veli palatini muscle among adults with typical velopharyngeal anatomy. METHOD: Magnetic resonance imaging (MRI) data and Amira 5.5 Visualization software were used to evaluate the levator veli palatini muscle among 89 participants with typical velopharyngeal anatomy. Flexible nasopharyngoscopy was used to determine the function of velopharyngeal closure among 39 of the 89 participants with typical velopharyngeal anatomy to examine the functional impact of observed asymmetry. RESULTS: Matched paired t tests demonstrated a nonsignificant difference between the length and thickness of the right and left levator muscle. The mean difference between the right and left length of the levator muscle was 2.28 mm but ranged from 0.09 mm to 10.37 mm. In all cases where individuals displayed asymmetry in the levator muscle through MRI, there was no observed impact on the symmetry of velopharyngeal closure. DISCUSSION: This study suggest that differences in the right and left levator veli palatini muscle are not significant among individuals without cleft palate. However, among individual cases where asymmetry was sizeable, there was no direct impact on the closure pattern. This may suggest there are multiple factors that contribute to asymmetrical velopharyngeal closure that are beyond the level of the levator veli palatini muscle.

Second Language Learners' Listener Impressions of Foreigner-Directed Speech.

Background According to sociolinguistic frameworks such as Communication Accommodation Theory, English native speakers modify their speech to meet the communicative needs of non-native speakers (Beebe & Giles, 1984). However, when foreigner-directed speech is used inappropriately, it may lead to overaccommodation, which in turn can act counterproductively toward communicative goals. Purpose To date, much of the research on foreigner-directed speech toward non-native speakers has focused on its acoustic parameters, but few studies have examined how second language learners interpret it emotionally and pragmatically. Method This study asked 36 English second language learners to listen to four types of speech accommodation styles (casual, clear, infant-directed, and foreigner-directed) spoken by four different speakers. Their task was to evaluate the extent to which the speaker was easy to understand, competent, condescending, friendly, and respectful. Results Acoustic analyses of the speech stimuli showed that speakers used distinct acoustic cues for each speech accommodation style, for example, slower speech rate for foreigner-directed speech. The rating results show that second language learners of English judged casual speech as least intelligible, least competent, and least friendly compared to all other speech types. Respectfulness ratings show that participants perceived casual speech as less respectful compared to clear speech and infant-directed speech, but not foreigner-directed speech. However, no effects were found for condescension. Conclusion The results suggest second language learners in the current experiment generally perceived speech accommodation positively.

Unaltered emotional experience in Parkinson's disease: Pupillometry and behavioral evidence.

INTRODUCTION: Recognizing emotions in others is a pivotal part of socioemotional functioning and plays a central role in social interactions. It has been shown that individuals suffering from Parkinson's disease (PD) are less accurate at identifying basic emotions such as fear, sadness, and happiness; however, previous studies have predominantly assessed emotion processing using unimodal stimuli (e.g., pictures) that do not reflect the complexity of real-world processing demands. Dynamic, naturalistic stimuli (e.g., movies) have been shown to elicit stronger subjective emotional experiences than unimodal stimuli and can facilitate emotion recognition. METHOD: In this experiment, pupil measurements of PD patients and matched healthy controls (HC) were recorded while they watched short film clips. Participants' task was to identify the emotion elicited by each clip and rate the intensity of their emotional response. We explored (a) how PD affects subjective emotional experience in response to dynamic, ecologically valid film stimuli, and (b) whether there are PD-related changes in pupillary response, which may contribute to the differences in emotion processing reported in the literature. RESULTS: Behavioral results showed that identification of the felt emotion as well as perceived intensity varies by emotion, but no significant group effect was found. Pupil measurements revealed differences in dilation depending on the emotion evoked by the film clips (happy, tender, sadness, fear, and neutral) for both groups. CONCLUSIONS: Our results suggest that differences in emotional response may be negligible when PD patients and healthy controls are presented with dynamic, ecologically valid emotional stimuli. Given the limited data available on pupil response in PD, this study provides new evidence to suggest that the PD-related deficits in emotion processing reported in the literature may not translate to real-world differences in physiological or subjective emotion processing in early-stage PD patients.

Introducing RISC: A New Video Inventory for Testing Social Perception.

Indirect forms of speech, such as sarcasm, jocularity (joking), and 'white lies' told to spare another's feelings, occur frequently in daily life and are a problem for many clinical populations. During social interactions, information about the literal or nonliteral meaning of a speaker unfolds simultaneously in several communication channels (e.g., linguistic, facial, vocal, and body cues); however, to date many studies have employed uni-modal stimuli, for example focusing only on the visual modality, limiting the generalizability of these results to everyday communication. Much of this research also neglects key factors for interpreting speaker intentions, such as verbal context and the relationship of social partners. Relational Inference in Social Communication (RISC) is a newly developed (English-language) database composed of short video vignettes depicting sincere, jocular, sarcastic, and white lie social exchanges between two people. Stimuli carefully manipulated the social relationship between communication partners (e.g., boss/employee, couple) and the availability of contextual cues (e.g. preceding conversations, physical objects) while controlling for major differences in the linguistic content of matched items. Here, we present initial perceptual validation data (N = 31) on a corpus of 920 items. Overall accuracy for identifying speaker intentions was above 80% correct and our results show that both relationship type and verbal context influence the categorization of literal and nonliteral interactions, underscoring the importance of these factors in research on speaker intentions. We believe that RISC will prove highly constructive as a tool in future research on social cognition, inter-personal communication, and the interpretation of speaker intentions in both healthy adults and clinical populations.

Social perception in adults with Parkinson's disease.

OBJECTIVE: Our study assessed how nondemented patients with Parkinson's disease (PD) interpret the affective and mental states of others from spoken language (adopt a "theory of mind") in ecologically valid social contexts. A secondary goal was to examine the relationship between emotion processing, mentalizing, and executive functions in PD during interpersonal communication. METHOD: Fifteen adults with PD and 16 healthy adults completed The Awareness of Social Inference Test, a standardized tool comprised of videotaped vignettes of everyday social interactions (McDonald, Flanagan, Rollins, & Kinch, 2003). Individual subtests assessed participants' ability to recognize basic emotions and to infer speaker intentions (sincerity, lies, sarcasm) from verbal and nonverbal cues, and to judge speaker knowledge, beliefs, and feelings. A comprehensive neuropsychological evaluation was also conducted. RESULTS: Patients with mild-moderate PD were impaired in the ability to infer "enriched" social intentions, such as sarcasm or lies, from nonliteral remarks; in contrast, adults with and without PD showed a similar capacity to recognize emotions and social intentions meant to be literal. In the PD group, difficulties using theory of mind to draw complex social inferences were significantly correlated with limitations in working memory and executive functioning. CONCLUSIONS: In early PD, functional compromise of the frontal-striatal-dorsal system yields impairments in social perception and understanding nonliteral speaker intentions that draw upon cognitive theory of mind. Deficits in social perception in PD are exacerbated by a decline in executive resources, which could hamper the strategic deployment of attention to multiple information sources necessary to infer social intentions.

Predictions in speech comprehension: fMRI evidence on the meter-semantic interface.

When listening to speech we not only form predictions about what is coming next, but also when something is coming. For example, metric stress may be utilized to predict the next salient speech event (i.e. the next stressed syllable) and in turn facilitate speech comprehension. However, speech comprehension can also be facilitated by semantic context, that is, which content word is likely to appear next. In the current fMRI experiment we investigated (1) the brain networks that underlie metric and semantic predictions by means of prediction errors, (2) how semantic processing is influenced by a metrically regular or irregular sentence context, and (3) whether task demands influence both processes. The results are three-fold: First, while metrically incongruent sentences activated a bilateral fronto-striatal network, semantically incongruent trials led to activation of fronto-temporal areas. Second, metrically regular context facilitated speech comprehension in the left-fronto-temporal language network. Third, attention directed to metric or semantic aspects in speech engaged different subcomponents of the left inferior frontal gyrus (IFG). The current results suggest that speech comprehension relies on different forms of prediction, and extends known speech comprehension networks to subcortical sensorimotor areas.

Functional dissociation of pre-SMA and SMA-proper in temporal processing.

The ability to assess temporal structure is crucial in order to adapt to an ever-changing environment. Increasing evidence suggests that the supplementary motor area (SMA) is involved in both sensory and sensorimotor processing of temporal structure. However, it is not entirely clear whether the structural differentiation of the SMA translates into functional specialization, and how the SMA relates to other systems that engage in temporal processing, namely the cerebellum and cortico-striatal circuits. Anatomically, the SMA comprises at least two subareas, the rostral pre-SMA and the caudal SMA-proper. Each displays a characteristic pattern of connections to motor and non-motor structures. Crucially, these connections establish a potential hub among cerebellar and cortico-striatal systems, possibly forming a dedicated subcortico-cortical temporal processing network. To further explore the functional role of each SMA subarea, we performed a meta-analysis of functional neuroimaging studies by contrasting activations according to whether they linked with either sensory, sensorimotor, sequential, non-sequential, explicit, non-explicit, subsecond, or suprasecond temporal processing. This procedure yielded a set of functional differences, which mirror the rostro-caudal anatomical dimension. Activations associated with sensory, non-sequential, and suprasecond temporal processing tend to locate to the rostral SMA, while the opposite is true for the caudal SMA. These findings confirm a functional dissociation of pre-SMA and SMA-proper in temporal processing.