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Panzarino R, Vanryckeghem M, Bedwell JS, Wendt O. Relationships Between Psychological Distress and Affective, Behavioral, and Cognitive Experiences of Stuttering. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:262-278. [PMID: 37956694 DOI: 10.1044/2023_ajslp-22-00347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
PURPOSE People who stutter (PWS) are vulnerable to the development of various psychopathological symptoms, although prevalence data are mixed and less clarity exists about factors that potentially influence their occurrence. The current study sought to shed light on the prevalence of self-reported psychopathology in PWS and aimed to identify relationships between affective, behavioral, and cognitive (ABC) experiences of stuttering and psychological distress (PD). METHOD Forty-four PWS were administered the Behavior Assessment Battery (BAB) for Adults who Stutter and the Brief Symptom Inventory-18. The prevalence of clinically significant PD was calculated via BSI-18 global severity index t-score cutoffs. Regression analyses examined relationships between ABC variables of stuttering and PD. RESULTS Participants' BAB scores approximated normative values, while the PD score distribution was similar to that of a nonclinical sample. Nine percent of participants met thresholds for clinically significant PD. All ABC correlates of stuttering significantly and positively correlated with PD scores, capturing considerable amounts of shared variance. CONCLUSIONS Levels of PD in PWS approximate those of the general community, highlighting the existence of psychologically distressed subgroups of PWS. Speech situation-specific anxiety had the strongest relationship to PD, followed closely by one's report of situation-specific speech disruption. To a lesser but still significant extent, PWS' frequency to which they engage in various avoidance/escape behaviors, as well as their communication attitude, predicted levels of psychopathology. These data inform diagnostic and clinical decision making, drawing attention to factors that should be attended to in treatment.
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Affiliation(s)
| | - Martine Vanryckeghem
- School of Communication Sciences and Disorders, University of Central Florida, Orlando
| | | | - Oliver Wendt
- Department of Inclusive Education, University of Potsdam, Germany
- Center for Families and Department of Educational Studies, Purdue University, West Lafayette, IN
- Centre for Augmentative and Alternative Communication, University of Pretoria, South Africa
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Mahesh S, Pushpavathi M, Seth D, Saravanan S, Yaruss JS. Adaptation and Validation of Overall Assessment of the Speaker's Experience of Stuttering for Adults in Kannada (OASES-A-K). Folia Phoniatr Logop 2023; 76:30-38. [PMID: 37231963 DOI: 10.1159/000531048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 04/28/2023] [Indexed: 05/27/2023] Open
Abstract
INTRODUCTION Psychosocial aspects of stuttering may affect the quality of life of a person who stutters (PWS). Further, the social stigma and experiences of PWS may vary globally. The WHO-ICF guidelines recommend quality of life as an essential component in the assessment of individuals who stutter. However, the availability of linguistically and culturally appropriate tools is often a challenge. Thus, the current study adapted and validated the OASES-A for Kannada-speaking adults who stutter. METHOD The original English version of OASES-A was adapted to Kannada using a standard reverse translation process. The adapted version was administered on 51 Kannada-speaking adults with very mild to very severe stuttering. The data were analyzed for item characteristics, reliability, and validity assessment. RESULTS The results revealed floor and ceiling effects for six and two items, respectively. The mean overall impact score indicated a moderate impact of stuttering. Further, the impact score for section II was relatively higher when compared to the data from other countries. The reliability and validity analyses showed good internal consistency and test-retest reliability for OASES-A-K. CONCLUSION The findings of the current research suggest that OASES-A-K is a sensitive and reliable tool to assess the impact of stuttering in Kannada-speaking PWS. The findings also highlight cross-cultural differences and the need for research in this direction.
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Affiliation(s)
- Sangeetha Mahesh
- Department of Clinical Services, All India Institute of Speech and Hearing, Mysore, India
| | - Mariswamy Pushpavathi
- Department of Speech-Language Pathology, All India Institute of Speech and Hearing, Mysore, India
| | - Divya Seth
- Department of Audiology and Speech Language Pathology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, India
| | - Sivaranjani Saravanan
- Department of Clinical Services, All India Institute of Speech and Hearing, Mysore, India
| | - J Scott Yaruss
- Department of Communicative Sciences and Disorders, College of Communication Arts and Sciences, Michigan State University, East Lansing, Michigan, USA
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O'Brian S, Jones M, Packman A, Onslow M, Menzies R, Lowe R, Cream A, Hearne A, Hewat S, Harrison E, Block S, Briem A. The Complexity of Stuttering Behavior in Adults and Adolescents: Relationship to Age, Severity, Mental Health, Impact of Stuttering, and Behavioral Treatment Outcome. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2446-2458. [PMID: 35737907 DOI: 10.1044/2022_jslhr-21-00452] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. METHOD For this study, a taxonomy was developed-LBDL-C7-which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. RESULTS The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. CONCLUSION Clinical and research applications of these findings are discussed.
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Affiliation(s)
- Sue O'Brian
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Jones
- Faculty of Health Sciences & Medicine, Bond University, Robina, Queensland, Australia
| | - Ann Packman
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Mark Onslow
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Ross Menzies
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Robyn Lowe
- Australian Stuttering Research Centre, University of Technology Sydney, Ultimo, New South Wales, Australia
| | - Angela Cream
- Sir Charles Gairdner Osborne Park Health Care Group, Osborne Park Hospital, Stirling, Western Australia, Australia
| | | | - Sally Hewat
- School of Humanities and Social Science, The University of Newcastle, Callaghan, New South Wales, Australia
| | - Elisabeth Harrison
- Department of Linguistics, Macquarie University, Macquarie Park, New South Wales, Australia
| | - Susan Block
- School of Allied Health, Human Services and Sport, La Trobe University, Bundoora, Victoria, Australia
| | - Anne Briem
- LMU Klinikum, Ludwig Maximilian University of Munich, Germany
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Hedinger T, Eskridge K, Porter E, Hudock D, Saltuklaroglu T. The perceived impact of fluency on personalities of adults who stutter: implicit evidence of self-stigma. LOGOP PHONIATR VOCO 2020; 46:180-185. [PMID: 33106060 DOI: 10.1080/14015439.2020.1833982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE The NEO-FFI is an extensively used instrument that has been used to identify personality differences between those who stutter and matched controls or group norms. The goal of this study was to use the NEO-FFI to implicitly capture and quantify self-stigma related to personality in persons who stutter (PWS). METHODS Thirty PWS completed the NEO-FFI twice; once as themselves and once while mentalizing (using theory of mind) to respond as though they did not stutter and had never stuttered, thus comparing their true personality to their perceived personality if they were fluent speakers. Compared to their true personalities, PWS perceived their fluent counterparts to be significantly less neurotic and more extroverted. RESULTS The differences observed are somewhat analogous, though considerably larger in magnitude than personality differences that have previously been reported when comparing PWS to fluent controls or norms. Differences were interpreted to be due to "contrast effects" influencing the comparison. That is, PWS cognitively separated themselves from their fluent counterparts, seeing their true selves in a negative light compared to their fluent counterparts. This "us" vs. "them" separation is considered evidence of self-stigma related to personality in PWS. CONCLUSIONS The finding that the perceived differences were in the domains of Neuroticism and Extraversion is consistent with prevailing stereotypes about PWS and exemplifies how public stigma can become internalized. Clinical implications are discussed with respect to how similar theory of mind/social comparison exercises can be used in cognitive behavioral therapy to help identify and restructure negative thoughts and beliefs about stuttering.
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Affiliation(s)
- Tricia Hedinger
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Kristen Eskridge
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Ellie Porter
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
| | - Daniel Hudock
- Department of Communication Sciences and Disorders, Idaho State University, Pocatello, ID, USA
| | - Tim Saltuklaroglu
- Department of Audiology and Speech-Language Pathology, University of Tennessee Health Sciences Center, Knoxville, TN, USA
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Walden TA, Lesner TA, Jones RM. Is what I think I think really what I think? Implicit and explicit attitudes toward stuttering among practicing speech-language pathologists. JOURNAL OF COMMUNICATION DISORDERS 2020; 83:105965. [PMID: 31759231 DOI: 10.1016/j.jcomdis.2019.105965] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 11/01/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE Two studies assessed implicit (Study 1) and explicit (Study 2) attitudes toward stuttering and those who stutter among speech-language pathologists (SLPs). METHOD In Study 1, 15 SLPs completed the Stuttering Implicit Association Test, a measure of implicit attitudes toward stuttered speech. In Study 2, 40 SLPs provided explicit attitudes about individuals who stutter, assessed via self-report ratings of an adult who stutters and one who does not. Participants also completed measures of experience with stuttering. RESULTS As a group, clinicians displayed negative implicit attitudes toward stuttering. Explicit attitudes toward a person who stutters were positive, albeit less positive than attitudes toward a person who does not stutter. Amount of prior exposure to stuttering among these experienced SLPs was not significantly associated with either implicit or explicit attitudes. CONCLUSIONS These findings highlight the importance of evaluating both implicit and explicit attitudes toward stuttering. The finding of positive explicit attitudes but negative implicit attitudes among similar samples of SLPs underscores the need to study implicit attitudes toward stuttering. Considering only explicit attitudes could lead to incomplete conclusions about the complex nature of attitudes toward stuttering.
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Affiliation(s)
- Tedra A Walden
- Vanderbilt University, 37203, Nashville, GPC Box 512, United States.
| | - Taylor A Lesner
- Vanderbilt University, 37203, Nashville, GPC Box 512, United States
| | - Robin M Jones
- Vanderbilt University, 37203, Nashville, GPC Box 512, United States
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Lucey J, Evans D, Maxfield ND. Temperament in Adults Who Stutter and Its Association With Stuttering Frequency and Quality-of-Life Impacts. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:2691-2702. [PMID: 31318628 PMCID: PMC6802908 DOI: 10.1044/2019_jslhr-s-18-0225] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 10/14/2018] [Accepted: 05/02/2019] [Indexed: 06/10/2023]
Abstract
Purpose The study aim was to determine whether self-reported temperament traits differentiate adults who stutter (AWS) from adults who do not stutter (AWNS). Additionally, associations between temperament and stuttering frequency, and between temperament and quality of life impacts of stuttering, were investigated in AWS. Method Self-reported temperament traits were documented for 33 AWS and 43 AWNS using the Adult Temperament Questionnaire (ATQ; Evans & Rothbart, 2007). Quality-of-life impacts of stuttering were assessed using the Overall Assessment of the Speaker's Experience with Stuttering (Yaruss & Quesal, 2010). Stuttering frequency was calculated from 100-word monologue and reading samples. Results A between-groups difference in scores on the ATQ Positive Affect subscale was nominally significant (i.e., before correcting for multiple tests) and also approached statistical significance after Bonferroni correction. Positive Affect scores were lower for AWS, and the size of this trending effect was moderate. Within AWS, a statistically significant positive correlation was found between impact scores on the General Information section of the Overall Assessment of the Speaker's Experience with Stuttering and ATQ Frustration subscale scores after Bonferroni correction. No associations were detected between temperament traits and stuttering frequency. Conclusions Results reveal a nontrivial tendency for AWS to experience decreased positive affect compared to AWNS. In addition, increased frustration was found to be associated with reduced general knowledge about stuttering in AWS. Neither effect has been previously reported for adults or children who stutter. Finally, self-reported temperament traits were not found to vary with stuttering frequency in adults, consistent with previous results for AWS.
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Affiliation(s)
- Jaclyn Lucey
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
| | - David Evans
- Departments of Oncologic Sciences and Psychology, University of South Florida, Tampa
- Moffitt Cancer Center, Tobacco Research & Intervention Program, Tampa, FL
| | - Nathan D. Maxfield
- Department of Communication Sciences & Disorders, University of South Florida, Tampa
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Boyle MP. Enacted stigma and felt stigma experienced by adults who stutter. JOURNAL OF COMMUNICATION DISORDERS 2018; 73:50-61. [PMID: 29574262 DOI: 10.1016/j.jcomdis.2018.03.004] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 03/05/2018] [Accepted: 03/12/2018] [Indexed: 05/14/2023]
Abstract
PURPOSE The aim of this study was to (1) document the experiences of enacted stigma (external stigma, experienced discrimination) and felt stigma (anticipation and expectation of discrimination or negative treatment by others) in adults who stutter, (2) investigate their relationships to each other, and (3) investigate their relationships to global mental health. METHOD Participants were 324 adults who stutter recruited from clinicians and self-help group leaders in the United States. Participants completed an anonymous web survey consisting of measures of enacted stigma, felt stigma, and global mental health. Data analysis focused on obtaining descriptive statistics for enacted stigma and felt stigma, and performing correlational analysis between these variables, and also between these variables and global mental health. RESULTS Most participants reported experiencing several different forms of social devaluation and negative treatment from other people at some point in their lives (i.e., enacted stigma), although they rarely experienced these events during the past year. Most participants agreed that they anticipate future stigmatizing experiences (i.e., felt stigma). Enacted stigma in the past year demonstrated a significant positive relationship to felt stigma. Both enacted stigma in the past year and felt stigma demonstrated significant negative relationships with global mental health. Enacted stigma in the past year and felt stigma were unique predictors of participants' global mental health. CONCLUSIONS People who stutter experience discrimination and social devaluation, and they anticipate future stigmatizing experiences. Both of these types of stigma, enacted and felt, are associated with reduced mental health in adults who stutter. Assessment and therapy with adults who stutter should address these aspects of stuttering.
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Affiliation(s)
- Michael P Boyle
- Department of Communication Sciences and Disorders, Montclair State University, 1515 Broad St. Building B - 2nd Floor, Bloomfield, NJ, 07003, United States.
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Busan P, Del Ben G, Bernardini S, Natarelli G, Bencich M, Monti F, Manganotti P, Battaglini PP. Altered Modulation of Silent Period in Tongue Motor Cortex of Persistent Developmental Stuttering in Relation to Stuttering Severity. PLoS One 2016; 11:e0163959. [PMID: 27711148 PMCID: PMC5053488 DOI: 10.1371/journal.pone.0163959] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/16/2016] [Indexed: 12/20/2022] Open
Abstract
Motor balance in developmental stuttering (DS) was investigated with Transcranial Magnetic Stimulation (TMS), with the aim to define novel neural markers of persistent DS in adulthood. Eleven DS adult males were evaluated with TMS on tongue primary motor cortex, compared to 15 matched fluent speakers, in a “state” condition (i.e. stutterers vs. fluent speakers, no overt stuttering). Motor and silent period thresholds (SPT), recruitment curves, and silent period durations were acquired by recording tongue motor evoked potentials. Tongue silent period duration was increased in DS, especially in the left hemisphere (P<0.05; Hedge’s g or Cohen’s dunbiased = 1.054, i.e. large effect size), suggesting a “state” condition of higher intracortical inhibition in left motor cortex networks. Differences in motor thresholds (different excitatory/inhibitory ratios in DS) were evident, as well as significant differences in SPT. In fluent speakers, the left hemisphere may be marginally more excitable than the right one in motor thresholds at lower muscular activation, while active motor thresholds and SPT were higher in the left hemisphere of DS with respect to the right one, resulting also in a positive correlation with stuttering severity. Pre-TMS electromyography data gave overlapping evidence. Findings suggest the existence of a complex intracortical balance in DS tongue primary motor cortex, with a particular interplay between excitatory and inhibitory mechanisms, also in neural substrates related to silent periods. Findings are discussed with respect to functional and structural impairments in stuttering, and are also proposed as novel neural markers of a stuttering “state” in persistent DS, helping to define more focused treatments (e.g. neuro-modulation).
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Affiliation(s)
- Pierpaolo Busan
- IRCCS Fondazione Ospedale San Camillo, Venice, Italy
- * E-mail:
| | - Giovanni Del Ben
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
| | | | - Giulia Natarelli
- Department of Developmental and Social Psychology, University of Padua, Padua, Italy
| | - Marco Bencich
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Fabrizio Monti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Paolo Manganotti
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Piero Paolo Battaglini
- B.R.A.I.N. Center for Neuroscience, Department of Life Sciences, University of Trieste, Trieste, Italy
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Banerjee S, Casenhiser D, Hedinger T, Kittilstved T, Saltuklaroglu T. The perceived impact of stuttering on personality as measured by the NEO-FFI-3. LOGOP PHONIATR VOCO 2016; 42:22-28. [DOI: 10.3109/14015439.2016.1152504] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Shivangi Banerjee
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Devin Casenhiser
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Tricia Hedinger
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Tiffani Kittilstved
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
| | - Tim Saltuklaroglu
- Department of Audiology and Speech Pathology, University of Tennessee Health Science Center, Knoxville, Tennessee, USA
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Jafari R, Baziar M, Bleek B, Reuter M, Montag C. Personality attributes of Iranian people who stutter. JOURNAL OF COMMUNICATION DISORDERS 2015; 58:119-125. [PMID: 26547120 DOI: 10.1016/j.jcomdis.2015.10.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Revised: 09/04/2015] [Accepted: 10/07/2015] [Indexed: 06/05/2023]
Abstract
Two recent studies from Australia and Germany have both shown that people who stutter (PWS) have elevated Neuroticism scores on the widely used NEO Five Factor Inventory (NEO-FFI) compared to individuals in a control sample. The two studies showed opposite results, however, for the personality traits Agreeableness and Conscientiousness. One reason for these opposing findings could be that the two studies were conducted in different cultural settings. Given that the effect of different cultural background on the relationship between the NEO-FFI and stuttering remains an open question, we investigated the NEO-FFI scores from 98 PWS and an age- and sex-matched control-group from a less widely studied cultural background (Iran). Overall, the present study showed, in line with a study from Germany, higher Agreeableness, but not Neuroticism, in PWS compared to normally fluent controls. To get further insights into these findings, we also contrasted both samples from Iran with a healthy matched sample from Germany. The resulting cross-cultural differences from these analyses are also discussed in the present paper. Although the present study is limited by a cross-sectional design, and so no causal conclusions can be drawn, the authors discuss whether the replicated elevated Agreeableness scores in PWS might represent a self-defense mechanism to cope with one's own speech handicap.
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Affiliation(s)
- R Jafari
- Department of Speech and Language Pathology, Tehran University of Medical Sciences, Tehran, Iran
| | - M Baziar
- Department of Speech and Language Pathology, Iran University of Medical Sciences, Tehran, Iran
| | - B Bleek
- Department of Psychology, University of Bonn, Bonn, Germany
| | - M Reuter
- Department of Psychology, University of Bonn, Bonn, Germany; Center for Economics and Neuroscience, University of Bonn, Bonn, Germany
| | - C Montag
- Institute of Psychology and Education, Ulm University, Ulm, Germany.
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Stipdonk L, Lieftink A, Bouwen J, Wijnen F. Extraversion and communication attitude in people who stutter: A preliminary study. JOURNAL OF FLUENCY DISORDERS 2014; 42:13-20. [PMID: 25239798 DOI: 10.1016/j.jfludis.2014.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 08/19/2014] [Accepted: 08/25/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE The aim of the study was to determine the correlation between the personality trait extraversion and the communication attitude in people who stutter (PWS). METHOD Thirty PWS completed Erickson's Communication Attitude Scale (S-24) (Andrews & Cutler, 1974) as well as a Dutch adaptation of the extraversion scale of the NEO Five-Factor Inventory (Hoekstra, Ormel, & Fruyt, 1996). RESULTS The communication attitude scores correlated significantly with the extraversion scores: PWS with a more negative communication attitude were more introvert and PWS with a more positive attitude were more extravert. CONCLUSION This result suggests that the S-24 is not only sensitive to communication attitude in relation to speech impairment, but also to the respondent's degree of extraversion. Consequently, assessment of communication attitude needs to be re-thought so as to take personality factors into account. EDUCATIONAL OBJECTIVES Readers should be able to: (a) describe the difference between temperament and personality; (b) describe what the S-24 Communication Attitude Scale measures in PWS; (c) describe how the personality trait extraversion may influence the communication attitude in PWS; (d) describe how the extraversion scale is correlated to the communication attitude scale according to the authors of this article.
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Affiliation(s)
- L Stipdonk
- Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - A Lieftink
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - J Bouwen
- Erasmus University Medical Center, Rotterdam, The Netherlands
| | - F Wijnen
- Utrecht University, Utrecht, The Netherlands
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Alm PA. Stuttering in relation to anxiety, temperament, and personality: review and analysis with focus on causality. JOURNAL OF FLUENCY DISORDERS 2014; 40:5-21. [PMID: 24929463 DOI: 10.1016/j.jfludis.2014.01.004] [Citation(s) in RCA: 94] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 01/27/2014] [Accepted: 01/31/2014] [Indexed: 05/14/2023]
Abstract
UNLABELLED Anxiety and emotional reactions have a central role in many theories of stuttering, for example that persons who stutter would tend to have an emotionally sensitive temperament. The possible relation between stuttering and certain traits of temperament or personality were reviewed and analyzed, with focus on temporal relations (i.e., what comes first). It was consistently found that preschool children who stutter (as a group) do not show any tendencies toward elevated temperamental traits of shyness or social anxiety compared with children who do not stutter. Significant group differences were, however, repeatedly reported for traits associated with inattention and hyperactivity/impulsivity, which is likely to reflect a subgroup of children who stutter. Available data is not consistent with the proposal that the risk for persistent stuttering is increased by an emotionally reactive temperament in children who stutter. Speech-related social anxiety develops in many cases of stuttering, before adulthood. Reduction of social anxiety in adults who stutter does not in itself appear to result in significant improvement of speech fluency. Studies have not revealed any relation between the severity of the motor symptoms of stuttering and temperamental traits. It is proposed that situational variability of stuttering, related to social complexity, is an effect of interference from social cognition and not directly from the emotions of social anxiety. In summary, the studies in this review provide strong evidence that persons who stutter are not characterized by constitutional traits of anxiety or similar constructs. EDUCATIONAL OBJECTIVES This paper provides a review and analysis of studies of anxiety, temperament, and personality, organized with the objective to clarify cause and effect relations. Readers will be able to (a) understand the importance of effect size and distribution of data for interpretation of group differences; (b) understand the role of temporal relations for interpretation of cause and effect; (c) discuss the results of studies of anxiety, temperament and personality in relation to stuttering; and (d) discuss situational variations of stuttering and the possible role of social cognition.
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Affiliation(s)
- Per A Alm
- Department of Neuroscience, Speech and Language Pathology, Uppsala University, Sweden.
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Oliveira CMC, Nogueira PR. Prevalence of risk factors for stuttering among boys: analytical cross-sectional study. SAO PAULO MED J 2014; 132:152-7. [PMID: 24760215 PMCID: PMC10852094 DOI: 10.1590/1516-3180.2014.1323617] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Revised: 07/03/2013] [Accepted: 07/16/2013] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE There have been few studies on the risk factors for subgroups of stuttering. The aim of this study was to characterize the risk factors for developmental familial stuttering among boys who stutter and who do not stutter, such as disfluency types, associated quality and communication factors, emotional and physical stress, familial attitudes and personal reactions. DESIGN AND SETTING Analytical cross-sectional study with a control group, performed at the Fluency Studies Laboratory of the Department of Speech and Hearing Disorders of a public university. METHODS The parents of 40 age-matched stuttering and non-stuttering boys took part in this study. The participants were divided into two groups: stuttering children (SC) and non-stuttering children (NSC), with ages between 6 years 0 months and 11 years 11 months. Initially, all of the participants underwent a fluency assessment and then data were gathered using the Protocol for the Risk of Developmental Stuttering. RESULTS There were no differences in the physical stress distribution factors and personal reactions between the groups. Inappropriate familial attitudes were presented by 95% of the SC and 30% of the NSC. Four risk factors analyzed were not shown by the NSC, namely stuttering-like disfluency, quality factors, physical stress and emotional stresses. CONCLUSIONS The findings suggest that the presence of stuttering-like disfluency, associated quality and communication factors, emotional stress and inappropriate family attitudes are important risk factors for familial developmental stuttering among boys.
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Affiliation(s)
- Cristiane Moço Canhetti Oliveira
- PhD. Professor, Postgraduate Program on Speech and Hearing Disorders, Department of Speech and Hearing Disorders, Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil
| | - Paula Roberta Nogueira
- Speech Therapy Student, Department of Speech and Hearing Disorders, Universidade Estadual Paulista (Unesp), Marília, São Paulo, Brazil
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Manning W, Gayle Beck J. The role of psychological processes in estimates of stuttering severity. JOURNAL OF FLUENCY DISORDERS 2013; 38:356-367. [PMID: 24331243 DOI: 10.1016/j.jfludis.2013.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2013] [Revised: 07/23/2013] [Accepted: 08/08/2013] [Indexed: 06/03/2023]
Abstract
PURPOSE To examine the associations of trait anxiety (STAI), social anxiety (SIAS), depression (BDI-II), and personality features (ADP-IV) with three measures of stuttering severity: %SS, Stuttering Severity, Instrument, and the Overall Assessment of the Speaker's Experience of Stuttering. METHOD Fifty adults with a history of stuttering served as participants. Participant scores on trait, anxiety, social anxiety, depression, and personality features were entered into a regression analysis, with the criterion variables (DVs) being: %SS, SSI-3, OASES total score. In order to explore the OASES, further, each of the four OASES subscales were also examined. A separate regression was conducted for, each dependent variable. RESULTS The OASES total score model was significant (p<.0001) and revealed that social anxiety and, trait anxiety were the only significant predictors, with medium effect sizes noted for both variables. In contrast, percent syllables stuttered and the SSI were not significantly associated with psychological, variables, suggesting that anxiety may not always be related to overt indicators of stuttering. Depression and personality dysfunction were not significantly associated with any measure of, stuttering severity. CONCLUSION Anxiety in the form of social and trait anxiety are significantly associated with stuttering, severity as indicated by the OASES. Traditional procedures for assigning severity ratings to individuals, who stutter based on percent syllables stuttered and the Stuttering Severity Instrument are not, significantly related to psychological processes central to the stuttering experience. Depression and, personality characteristics do not meaningfully account for stuttering. EDUCATIONAL OBJECTIVES The reader will be able to: (a) differentiate forms of anxiety that are likely to be associated with stuttering (b) understand the importance of determining features of stuttering that go beyond the obvious, surface characteristics of stuttering frequency, and (c) discuss the important clinical and theoretical implications for understanding the degree of psychological dysfunction that is likely to be characteristic of those who stutter.
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Affiliation(s)
- Walter Manning
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, TN, United States.
| | - J Gayle Beck
- Department of Psychology, The University of Memphis, Memphis, TN, United States
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Boyle MP. Assessment of stigma associated with stuttering: development and evaluation of the self-stigma of stuttering scale (4S). JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2013; 56:1517-29. [PMID: 23838992 DOI: 10.1044/1092-4388(2013/12-0280)] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
PURPOSE To create a psychometrically sound scale that measures different levels of internalized stigma (i.e., self-stigma) among adults who stutter and to analyze factor structure, reliability, and initial construct validity of the scale. METHOD Two-hundred ninety-one adults who stutter were recruited from Board Recognized Specialists in Fluency Disorders and the National Stuttering Association. Participants completed a web-based survey including an experimental scale called the Self-Stigma of Stuttering Scale (4S), designed to measure different levels of self-stigma in people who stutter, along with a series of established measures of self-esteem, self-efficacy, and life satisfaction. RESULTS The experimental scale demonstrated adequate reliability in internal consistency and temporal stability. Factor analysis revealed underlying components supportive of a multidimensional model of stigma. Stigma self-concurrence and, to a lesser extent, stereotype agreement and stigma awareness were negatively correlated with self-esteem, self-efficacy, and life satisfaction, supporting initial construct validity of the scale. CONCLUSION Speech-language pathologists can identify the presence of self-stigma in their adult clients who stutter and help them to alter these beliefs. The 4S can be a means for researchers and clinicians to achieve these goals.
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Affiliation(s)
- Michael P Boyle
- Correspondence to Michael P. Boyle, who is now at Oklahoma State University, Stillwater:
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Manning W, Beck JG. Personality dysfunction in adults who stutter: another look. JOURNAL OF FLUENCY DISORDERS 2013; 38:184-92. [PMID: 23773670 DOI: 10.1016/j.jfludis.2013.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2012] [Revised: 02/11/2013] [Accepted: 02/13/2013] [Indexed: 05/13/2023]
Abstract
PURPOSE Given reports of the frequent occurrence of personality disorders (PD) among individuals who stutter, this investigation was designed to determine the presence of personality disorders (PD) for individuals seeking treatment for stuttering, using a different self-report measure. METHOD The sample included 50 adults who were undergoing treatment for stuttering. The participants also completed a self-report measure (Assessment of the DSM-IV Personality Disorders, ADP-IV) that is known to have good differential validity in the assessment of personality disorders as well as good convergent validity with a structured interview administered by a skilled mental health professional. RESULTS Four participants met threshold values for one personality disorder (PD) and one participant met criteria for two personality disorders. The remaining 45 participants (90%) did not meet criteria for a PD. CONCLUSION Rates of observed PDs in this sample approximated rates that have been observed in general community samples using structured clinical interviews and trained interviewers. Related reports which have claimed high levels of personality disorders among adults who stutter appear to be inflated by the use of self-report devices that overestimate the occurrence and co-morbidity of these conditions. Implications for the treatment of adults who stutter are discussed. EDUCATIONAL OBJECTIVES The reader will be able to (a) summarize two basic perspectives of how individuals who stutter are influenced by the possibility of personality dysfunction (b) describe the factors that influence the detection of personality dysfunction using self-report procedures, discuss the important (c) theoretical and (d) clinical implications of accurately identifying personality dysfunction for adults who stutter.
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Affiliation(s)
- Walter Manning
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, TN 38105, USA.
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Bleek B, Reuter M, Yaruss JS, Cook S, Faber J, Montag C. Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life. JOURNAL OF FLUENCY DISORDERS 2012; 37:325-333. [PMID: 23218215 DOI: 10.1016/j.jfludis.2012.07.003] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2012] [Revised: 07/17/2012] [Accepted: 07/31/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVE This study investigates the association between the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI) and the Overall Assessment of the Speaker's Experience of Stuttering (OASES). The OASES measures the adverse impact of stuttering on a person's life. DESIGN Participants in the present study were 112 persons who stutter from Germany. METHODS All participants filled in both the NEO-FFI and the OASES questionnaires. RESULTS Results revealed a strong positive correlation between the personality trait Neuroticism and scores on the OASES. Moreover, Extraversion was negatively correlated with the OASES scores. CONCLUSIONS The findings suggest that people with higher Neuroticism and lower Extraversion scores experience a greater impact of stuttering on their daily life. The results underscore the importance of considering personality as a potential moderator or mediator factor in future stuttering research and, potentially, also in treatment. EDUCATIONAL OBJECTIVES The reader will learn (a) about the different personality dimensions reflected by the NEO-FFI, (b) why it is important to consider the impact of stuttering on everyday life from the perspective of the people who stutter and (c) how personality is linked to the Overall Assessment of the Speaker's Experience of Stuttering (OASES).
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Affiliation(s)
- Benjamin Bleek
- Department of Psychology, University of Bonn, Bonn, Germany
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Ingham RJ, Ingham JC, Bothe AK. Integrating functional measures with treatment: a tactic for enhancing personally significant change in the treatment of adults and adolescents who stutter. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2012; 21:264-277. [PMID: 22493023 DOI: 10.1044/1058-0360(2012/11-0068)] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
PURPOSE It is proposed that stuttering treatment, particularly for adults and adolescents who stutter, may benefit from more inventive and extensive use of functional measurement-measures that are also treatment agents. Such measures can be tailored to produce more personally significant and evidence-based treatment benefits. They may be especially useful when employed in conjunction with partial self-management and performance-contingent procedures. METHOD Previous approaches to the definition of stuttering treatment goals and the measurement of stuttering treatment outcomes are critically reviewed. Suggestions for improvements are presented within the framework of an evidence-based and relatively standardized stuttering treatment. RESULTS AND CONCLUSION Results from a review of existing literature and from 2 case studies show that 2 specific personally significant problems, saying one's name and addressing large audiences, were improved by implementing these strategies in treatment. Functional measures directly connected to treatment, and partially self-managed performance-contingent schedules, merit further research as methodologies that are suitable for conducting personally significant and evidence-based treatments with adults and adolescents who stutter.
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The role of the DRD2 C957T polymorphism in neuroticism in persons who stutter and healthy controls. Neuroreport 2012; 23:246-50. [DOI: 10.1097/wnr.0b013e3283505b8a] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Bragatto EL, Osborn E, Yaruss JS, Quesal R, Schiefer AM, Chiari BM. Brazilian version of the Overall Assessment of the Speaker's Experience of Stuttering - Adults protocol (OASES-A). ACTA ACUST UNITED AC 2012; 24:145-51. [DOI: 10.1590/s2179-64912012000200010] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Accepted: 02/13/2012] [Indexed: 11/22/2022]
Abstract
PURPOSE: To verify the applicability of the protocol Overall Assessment of the Speaker's Experience of Stuttering - Adults (OASES-A), translated into Brazilian Portuguese, in a sample of adults who stutter. METHODS: The Brazilian Portuguese version of the OASES-A protocol was individually applied to 18 people who stutter. The classification of stuttering severity was based on the Stuttering Severity Instrument for Children and Adults (SSI-3) protocol. Translation and back-translation processes were carried out by specialists, considering semantic, conceptual, cultural, and idiomatic equivalences. RESULTS: There was no correlation between the severity degrees of stuttering assessed by the SSI-3 protocol and the self-assessment performed using the OASES-A. Subjects reported impairments in perceived fluency; speech ability; level of knowledge about stuttering and treatment options; use of confrontational techniques; quality of life. They also mentioned having difficulty coping with emotional states such as anxiety and embarrassment, and with communication in daily situations. CONCLUSION: The OASES-A protocol is useful in the assessment and treatment of stutterers, as it provides specialized speech-language pathologists with sutterers' self-perception regarding their communication difficulties and the impact of stuttering on their quality of life.
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Blood GW, Blood IM, Dorward S, Boyle MP, Tramontana GM. Coping Strategies and Adolescents: Learning to Take Care of Self and Stuttering during Treatment. ACTA ACUST UNITED AC 2011. [DOI: 10.1044/ffd21.3.68] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The purpose of this paper is to describe coping in the context of adolescence and stuttering. Adolescents who stutter are a unique group of individuals dealing with an episodic, variable, and chronic disorder during a critical developmental stage in their lives. We provide a brief review of adolescence, coping constructs, coping during adolescence, and coping programs. We highlight the role of the speech-language pathologist is as an advocate/guide assisting adolescents who stutter develop appropriate, adaptive strategies for dealing with everyday stressors and the added potential stress associated with stuttering.
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Affiliation(s)
- Gordon W. Blood
- Department of Communication Sciences and Disorders, The Pennsylvania State University University Park, PA
| | - Ingrid M. Blood
- Department of Communication Sciences and Disorders, The Pennsylvania State University University Park, PA
| | - Sarah Dorward
- Department of Communication Sciences and Disorders, The Pennsylvania State University University Park, PA
| | - Michael P. Boyle
- Department of Communication Sciences and Disorders, The Pennsylvania State University University Park, PA
| | - G. Michael Tramontana
- Department of Communication Sciences and Disorders, The Pennsylvania State University University Park, PA
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Koushik S, Hewat S, Shenker RC, Jones M, Onslow M. North-American Lidcombe Program file audit: replication and meta-analysis. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2011; 13:301-307. [PMID: 21793775 DOI: 10.3109/17549507.2011.538434] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Thousands of North American clinicians have trained for the Lidcombe Program of Early Stuttering Intervention, yet there are no benchmark data for that continent. This retrospective file audit includes logistical regression of variables from files of 134 children younger than 6 years who completed Stage 1 of the Lidcombe Program. Benchmarking data for clinic visits to Stage 2 is available for these files. Meta-analysis supplements worldwide Lidcombe Program benchmark data. The median number of clinic visits to Stage 2 was 11. High pre-treatment stuttering severity predicted more clinic visits than low severity. A trend toward statistical significance was found for the frequency of clinic visits. Frequent attendance of mean less than 11 days was associated with longer treatment times than infrequent attendance of mean 11 days or more. Results for North America were consistent with benchmark data from the UK and Australia. The mean attendance trend is clinically important and requires further investigation because of its potential clinical significance.
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Tran Y, Blumgart E, Craig A. Subjective distress associated with chronic stuttering. JOURNAL OF FLUENCY DISORDERS 2011; 36:17-26. [PMID: 21439420 DOI: 10.1016/j.jfludis.2010.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2010] [Revised: 12/14/2010] [Accepted: 12/20/2010] [Indexed: 05/30/2023]
Abstract
UNLABELLED Stuttering is a chronic condition involving involuntary disruption to speech fluency. While elevated social anxiety has been found to be a risk factor for adults who have stuttered all their lives, it is unclear how stuttering influences other negative mood states such as interpersonal sensitivity and depressive mood. Consequently, controlled research was conducted that investigated negative affectivity across a number of domains in adults who stutter. Participants included 200 adults who have stuttered since childhood, with comparisons made to 200 non-stuttering controls of similar age and sex. The adults who stuttered were found to have significantly elevated levels of distress and negative mood states compared to the controls. As expected, significant differences were found for anxiety, however, significant and substantial differences were also found across a broad range of negative affect, including dimensions such as somatization, interpersonal sensitivity, depressive mood, hostility and paranoia. The implications of these findings for the better management of stuttering are discussed. EDUCATIONAL OBJECTIVES The reader will be able to describe: (a) the negative impact of a chronic disorder like stuttering on people who have stuttered all their life; (b) the factor structure of the SCL-90-R; (c) the negative affectivity construct, and (d) the difference between psychogenic theories of stuttering and neurological theories of stuttering.
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Affiliation(s)
- Yvonne Tran
- Rehabilitation Studies Unit, Sydney Medical School-Northern, The University of Sydney, PO Box 6, Ryde, NSW 1680, Australia.
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Bleek B, Montag C, Faber J, Reuter M. Investigating personality in stuttering: results of a case control study using the NEO-FFI. JOURNAL OF COMMUNICATION DISORDERS 2011; 44:218-222. [PMID: 21163491 DOI: 10.1016/j.jcomdis.2010.11.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2010] [Revised: 07/27/2010] [Accepted: 11/01/2010] [Indexed: 05/30/2023]
Abstract
UNLABELLED A recent study by Iverach et al. (Journal of Communication Disorders, 2010) compared persons who stutter with two normative samples in the context of the five-factor model of personality measured by the NEO Five-Factor Inventory (NEO-FFI). Persons who stutter were characterized by higher Neuroticism, lower Conscientiousness and lower Agreeableness scores in contrast to the normative data from an Australian and a United States sample. Moreover, the authors report that the scores on all five personality dimensions in the stuttering group were within those of the normative samples. A shortcoming of the Iverach et al. study is the lack of a matched control group. In the present study we compared persons who stutter with a control group matched to age and gender. Furthermore, none of the controls had a history of personal and family stuttering. The findings with respect to Neuroticism could be replicated in our sample. But in contrast to Iverach et al. we found higher Conscientiousness and Agreeableness scores in persons who stutter compared to the control group. LEARNING OUTCOMES The reader of the present study will learn that elevated Neuroticism scores can be observed in persons who stutter across cultures such as Germany or Australia. With respect to other personality dimensions such as Conscientiousness or Agreeableness the picture is much more difficult.
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Affiliation(s)
- Benjamin Bleek
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, D-53117 Bonn, Germany
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