PROJECT SUMMARY/ABSTRACT Aphasia is commonly operationalized as a linguistic impairment affecting expressive or receptive language. People with aphasia (PWA) often experience profound emotional disturbances to a greater extent than post-stroke adults without aphasia given the direct relationship between emotional well-being and the capacity to engage in human interaction. PWA have been reported to develop ‘linguistic anxiety’, or stress when using language, due to the preoccupation with communication breakdown opportunities. Acute stress can be adaptive and inform our bodies of when to avoid or escape danger. However, persistent episodes of stress (i.e., chronic stress) can have adverse effects on physical and mental health. Chronic stress may also lead to harmful changes in the body’s neurological function, which may, in turn, interfere with language rehabilitative outcomes. Given the direct relationship between chronic stress, well-being, and rehabilitation, there is a critical need to better understand sources of stress related to communication in PWA to inform clinical practice and interventions. In line with NIDCD’s mission, the study plans to explore perceptions of stress concerning communication in PWA to enhance long-term outcomes and promote communicative participation. This will be achieved by conducting a mixed methods research paradigm to explore sources and self-management strategies of chronic stress in PWA. PWA will complete patient-reported outcome measures (PROMs) and semi-structured interview prompts related to sources of stress that may impact communication participation. To our knowledge, this project will be the first to directly examine the lived experiences of PWA through a mixed methods research paradigm to identify candidate sources of chronic stress in relation to communication (Aim 1a). Next, we will collect PROMs and interview prompts to elucidate the self-management strategies used to reduce perceptions of stress during communication attempts. While self-management strategies can be adaptive, we suspect PWA will endorse recruiting maladaptive strategies, such as avoidance or excessive rehearsal, that may suppress acute stress but facilitate long-term stress toward the feared situation (Aim 2a). Finally, we will collect longitudinal stress and coping data via ecological momentary assessments (EMAs), or repeated real-time data sampling, for the first time in PWA. Data collected via EMAs are suspected to provide a better insight into the variation of stress and coping perceptions from day to day. (Aim 1b and 2b). Potential moderating variables (i.e., socioeconomic status, physical immobility) will be accounted for in the proposed project. The findings of this study will provide critical information to inform future interventions that address chronic stress as it impedes communicative participation. The fellowship training plan will take place at a large, research-intensive university under the direction of a strong, s...