Investigating personality in stuttering: results of a case control study using the NEO-FFI

The perceived impact of fluency on personalities of adults who stutter: implicit evidence of self-stigma

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.

Temperament in Adults Who Stutter and Its Association With Stuttering Frequency and Quality-of-Life Impacts

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.

Altered Modulation of Silent Period in Tongue Motor Cortex of Persistent Developmental Stuttering in Relation to Stuttering Severity

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 d_unbiased = 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).

Personality attributes of Iranian people who stutter

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.

Behavioral and social competency profiles of stutterers

PURPOSE: To investigate the behavioral and social competency profiles of individuals who stutter and to compare them with persons who do not stutter, according to their parents; to correlate the behavioral and the social competence performances with the severity of stuttering. METHODS: Sixty-four participants, aged 6 to 18 years, of both genders, were divided into two groups: the study group (SG), composed of 32 individuals with persistent developmental stuttering, and the control group (CG), composed of 32 fluent individuals. The procedures used were fluency assessment, stuttering severity instrument, and the Child Behavior Checklist inventory. RESULTS: In the behavioral profile of the SG, the mean of the total score and that of the internalizing problems were classified as clinical. The comparison between the groups showed differences in the behavioral profile concerning the total score, and in the internalizing and externalizing problems; and in the social profile, concerning the total score and activity scale. There were no statistically significant differences in the scales among the mild, moderate, and severe stuttering. CONCLUSION: According to the information provided by parents, children who stutter showed peculiar behavior and social competence, with a higher tendency to manifest alterations in this area, in comparison to those who do not stutter. Fear, nervousness/tension, guilt, anxiety, perfectionism, and worry were the most frequent alterations in relation to the behavior, whereas damages in the social field and in the habitual communication situations characterized the social competence of persons who stutter.

Extraversion and communication attitude in people who stutter: A preliminary study

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.

Prevalence of risk factors for stuttering among boys: analytical cross-sectional study

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.

Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life

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).