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How to construct a case of Alzheimer's disease in three languages: case-based reasoning in narrative gerontology

Published online by Cambridge University Press:  17 October 2012

ROBERT W. SCHRAUF*
Affiliation:
Department of Applied Linguistics, Pennsylvania State University, University Park, USA.
MADELYN IRIS
Affiliation:
Leonard Schanfield Research Institute, Council for Jewish Elderly (CJE) Senior Life, Chicago, USA.
ELLEN NAVARRO
Affiliation:
George Warren Brown School of Social Work, Washington University, St. Louis, Missouri, USA.
TETYANA SMOTROVA
Affiliation:
Department of Applied Linguistics, Pennsylvania State University, University Park, USA.
*
Address for correspondence: Robert W. Schrauf, Department of Applied Linguistics, Pennsylvania State University, 234 Sparks Building, University Park, PA 16802, USA. E-mail: rws23@psu.edu

Abstract

This paper explores how people reason about Alzheimer's disease by telling stories about others who have the disease. More specifically, the paper is a cross-linguistic investigation of the narrative and linguistic devices used by African Americans in English, Mexican Americans in Spanish, and refugees/immigrants from the former Soviet Union (to the United States of America) in Russian in their oral productions of such stories. We examine the narratives as instances of case-based reasoning in which lay people (non-medical professionals) distinguish, represent and ‘perform’ symptomatic behaviours and construct a ‘case’ of the disease as a way of probing the difference between the normal and the pathological in conversational contexts. In particular, we examine situations in which stories are accepted and confirmed and situations in which stories are contested and negotiated. Common narrative and discursive devices across the three languages include concatenation, intertextuality, conjunction and conjunctive adverbs, lexical opposition, past progressive tenses, temporal adverbials, reported speech and prosodic cues. The fine-grained analysis of these narrative and discursive devices lays bare the inner-workings of case-based reasoning as a conversational task and suggests specific linguistic tools for intervening in lay narrative reasoning in clinical settings and in public health messaging about Alzheimer's disease.

Type
Articles
Copyright
Copyright © Cambridge University Press 2012 

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References

Arrendondo, G. F. and Vaillant, D. 2004. Mexicans. In Grossman, J. R., Keating, A. D. and Reiff, J. L. (eds), Encyclopedia of Chicago. University of Chicago Press, Chicago, 532–4.Google Scholar
Austin, J. L. 1962. How to Do Things with Words. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Ballenger, J. F. 2006. Self, Senility, and Alzheimer's Disease in Modern America. Johns Hopkins University Press, Baltimore, Maryland.CrossRefGoogle Scholar
Bauman, R. 1986. Story, Performance, and Event: Contextual Studies of Oral Narratives. Cambridge University Press, Cambridge.Google Scholar
Birren, J. F., Kenyon, G. M., Ruth, J. E., Schroots, J. and Svensson, T. (eds) 1996. Aging and Biography: Explorations in Adult Development. Springer, New York.Google Scholar
Canguilhelm, G. 1989 [1978]. The Normal and the Pathological. Translators Carolyn R. Fawcett and Robert S. Cohen, Zone Books, New York.Google Scholar
Capps, L. and Ochs, E. 1995 a. Constructing Panic: The Discourse of Agoraphobia. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Capps, L. and Ochs, E. 1995 b. Out of place: narrative insights into agoraphobia. Discourse Processes, 19, 407–39.Google Scholar
Carrillo, M. C., Blackwell, A., Hampel, H., Lindborg, J., Sperling, R., Schenk, D., Sevigny, J. J., Ferris, S., Bennet, D. A., Craft, S., Hsu, T., Klunk, W. and Klunk, W. 2009. Early risk assessment for Alzheimer's disease. Alzheimer's and Dementia, 5, 182–96.Google Scholar
Charon, R. 2008. Narrative Medicine: Honoring the Stories of Illness. Oxford University Press, New York.Google Scholar
Clark, H. H. and Gerrig, R. T. 1990. Quotations as demonstrations. Language, 66, 4, 764805.Google Scholar
Dilworth-Anderson, P. and Gibson, B. E. 2002. The cultural influence of values, norms, meanings, and perceptions in understanding dementia in ethnic minorities. Alzheimer Disease and Associated Disorders, 16, 2, S5663.Google Scholar
Edwards, D. 1997. Discourse and Cognition. Sage, Thousand Oaks, California.CrossRefGoogle Scholar
Galvin, J. E. and Sadowsky, C. H. 2012. Practical guidelines for the recognition and diagnosis of dementia. Journal of the American Board of Family Medicine, 25, 3, 367–82.Google Scholar
Graham, A. 2003. Intertextuality (The New Critical Idiom). Routledge, New York.Google Scholar
Grossman, J. R., Keating, A. D. and Reiff, J. L. 2004. Encyclopedia of Chicago. University of Chicago Press, Chicago.Google Scholar
Guba, E. and Lincoln, Y. 1989. Fourth Generation Evaluation. Sage, Newbury Park, California.Google Scholar
Gubrium, J. F. 2011. Narrative events and biographical construction in old age. In Kenyon, G. M., Bohlmeijer, E. and Randall, W. (eds), Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology. Oxford University Press, New York, 3950.Google Scholar
Gubrium, J. F. and Holstein, J. A. 1998. Narrative practice and the coherence of personal stories. The Sociological Quarterly, 39, 1, 163–87.Google Scholar
Hinton, L., Franz, C. E., Yeo, G. and Levkoff, S. 2005. Conceptions of dementia in a multiethnic sample of family caregivers. Journal of the American Geriatrics Society, 53, 1405–10.Google Scholar
Hochschild, A. 1973. The Unexpected Community. Prentice-Hall, Englewood Cliffs, New Jersey.Google Scholar
Holt, E. 1996. Reporting on talk: the use of direct reported speech in conversation. Research on Language and Social Interaction, 29, 219–45.Google Scholar
Holt, G. R. 2011. Timely diagnosis and disclosure of Alzheimer's disease gives patients opportunities to make choices. Southern Medical Journal, 104, 12, 779–80.CrossRefGoogle ScholarPubMed
Hunter, K. M. 1993. Doctors' Stories: The Narrative Structure of Medical Knowledge. Princeton University Press, Princeton, New Jersey.Google Scholar
Hutchby, I. and Wooffitt, R. 1998. Conversation Analysis: Principles, Practices, and Applications. Blackwell, Malden, Massachusetts.Google Scholar
Kenyon, G., Birren, J. and Schroots, J. (eds) 1991. Metaphors of Aging in Science and the Humanities. Springer, New York.Google Scholar
Kenyon, G. M., Bohlmeijer, E. and Randall, W. (eds) 2011. Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology. Oxford University Press, New York.Google Scholar
Kenyon, G. M., Clark, P. and de Vries, B. (eds) 2001. Narrative Gerontology: Theory, Research, and Practice. Springer, New York.Google Scholar
Kenyon, G. M. and Randall, W. 2001. Narrative gerontology: an overview. In Kenyon, G. M., Clark, P. and de Vries, B. (eds), Narrative Gerontology: Theory, Research, and Practice. Springer, New York, 318.Google Scholar
Kleinman, A. 1988. The Illness Narratives: Suffering, Healing, and the Human Condition. Basic Books, New York.Google Scholar
Malinowski, B. 1923. The problem of meaning in primitive languages. In Ogden, C. K. and Richards, I. A. (eds), The Meaning of Meaning. Supplement I, Kegan Paul, London, 296336.Google Scholar
Manning, C. 2004. African Americans. In Grossman, J. R., Keating, A. D. and Reiff, J. L. (eds), Encyclopedia of Chicago. Chicago University Press, Chicago, 57.Google Scholar
Mattingly, C. 1998. Healing Dramas and Clinical Plots: The Structure of Narrative Experience. Cambridge University Press, Cambridge.CrossRefGoogle Scholar
Mattingly, C. and Garro, L. C. (eds) 2000. Narrative and the Cultural Construction of Illness and Healing. University of California Press, Berkeley, California.Google Scholar
McKhann, G. M., Knopman, D. S., Chertkow, H., Hyman, B. T., Jack, C. R. Jr., Kawas, C. H., Klunk, W. E., Koroshetz, W. J., Manly, J. J., Mayeux, R., Mohs, R. C., Morris, J. C., Rossor, M. N., Scheltens, P., Carrillo, M. C., Thies, B., Weintraub, S. and Phelps, C. H. 2011. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's disease workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's and Dementia, 7, 3, 263–9.Google Scholar
Miles, M. and Huberman, A. 1994. Qualitative Data Analysis: An Expanded Sourcebook. Second edition, Sage, Thousand Oaks\, California.Google Scholar
Muhr, T. 2004. Atlas.ti: The Knowledge Workbench (Version 5.0). Scientific Software Development, Berlin.Google Scholar
Nikander, P. 2008. Working with transcriptions and translated data. Qualitative Research in Psychology, 5, 3, 225231.CrossRefGoogle Scholar
Ochs, E. 2004. Narrative lessons. In Duranti, A. (ed.), A Companion to Linguistic Anthropology. Blackwell, Malden, Massachusetts, 269–89.Google Scholar
Ochs, E. and Capps, L. 2001. Living Narrative: Creating Lives in Storytelling. Harvard University Press, Cambridge, Massachusetts.Google Scholar
Phoenix, C. 2011. Young bodies, old bodies, and stories of the athletic self. In Kenyon, G. M., Bohlmeijer, E. and Randall, W. (eds), Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology. Oxford University Press, New York, 111–25.Google Scholar
Phoenix, C., Smith, B. and Sparkes, A. C. 2010. Narrative analysis in aging studies: a typology for consideration. Journal of Aging Studies, 24, 1, 111.Google Scholar
Phoenix, C. and Sparkes, A. C. 2006 a. Keeping it in the family: narrative maps of ageing and young athletes' perceptions of their futures. Ageing & Society, 26, 4, 631–48.Google Scholar
Phoenix, C. and Sparkes, A. C. 2006 b. Young athletic bodies and narrative maps of aging. Journal of Aging Studies, 20, 2, 107–21.Google Scholar
Powers, W. R. 2005. Transcription Techniques for the Spoken Word. Altamira Press, Lanham, Maryland.Google Scholar
Randall, W. 2011. Memory, metaphor, and meaning: reading for wisdom in the stories of our lives. In Kenyon, G. M., Bohlmeijer, E. and Randall, W. (eds), Storying Later Life: Issues, Investigations, and Interventions in Narrative Gerontology. Oxford University Press, New York, 2038.Google Scholar
Riessman, C. K. 2008. Narrative Methods for the Human Sciences. Sage, Thousand Oaks, California.Google Scholar
Ryan, G. W. and Bernard, H. R. 2003. Techniques to identify themes. Field Methods, 15, 1, 85109.Google Scholar
Schrauf, R. W. and Iris, M. 2011 a. A direct comparison of popular models of normal memory loss and Alzheimer's disease in samples of African Americans, Mexican Americans, and refugees and immigrants from the Former Soviet Union. Journal of the American Geriatrics Society, 59, 4, 628–36.Google Scholar
Schrauf, R. W. and Iris, M. 2011 b. Using consensus analysis to investigate cultural models of Alzheimer's disease. In Kronenfeld, D., Bennardo, G., de Munck, V. and Fischer, M. D. (eds), A Companion to Cognitive Anthropology. Wiley-Blackwell, Malden, Massachusetts, 548–68.Google Scholar
Schrauf, R. W. and Iris, M. 2011 c. Very long pathways to diagnosis among African Americans and Hispanics with memory and behavioural problems associated with dementia. Dementia, doi: 10.1177/1471301211416615.Google Scholar
Spradley, J. P. 1979. The Ethnographic Interview. Holt, Rinehart, and Winston, New York.Google Scholar
Waugh, L. 1995. Reported speech in journalistic discourse. Text, 15, 129–73.Google Scholar
Whitehouse, P. J. and George, D. 2008. The Myth of Alzheimer's Disease: What You Aren't Being Told About Today's Most Dreaded Diagnosis. St Martin's Press, New York.Google Scholar
Whitehouse, P. J., Maurer, K. and Ballenger, J. F. (eds) 2000. Concepts of Alzheimer's Disease: Biological, Clinical, and Cultural Perspectives. Johns Hopkins University Press, Baltimore, Maryland.Google Scholar
Zechenter, K. 2004. Russians. In Grossman, J. R., Keating, A. D. and Reiff, J. L. (eds), Encyclopedia of Chicago. University of Chicago Press, Chicago, 725.Google Scholar