Comparison of social anxiety between Japanese adults who stutter and non-stuttering controls

Validity and utility of the Japanese version of the brief unhelpful thoughts and beliefs about stuttering scale: UTBAS-6-J

Do adults who stutter have abnormally high social anxiety? Is it related to maladaptive cognition? As these are persistent, unresolved questions in stuttering research, it behooves clinicians to at least assess and attempt to identify social anxiety in patients who stutter and its basis before decisions are made about stuttering treatment. The Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scale is a self-administered questionnaire that measures the degree of non-adaptive cognition in people who stutter (PWS) due to social anxiety. The 66-item UTBAS is time-consuming to complete, prompting the development of a shorter 6-item version, the UTBAS-6, which is in English. Here, we aimed to assess some psychometric properties of the Japanese version of the UTBAS-6, the UTBAS-6-J, which has not been done to date. In 56 adult patients (mean 32.6 ± 11.1 years) who stutter, we quantified the reliability, the internal consistency, and the concurrent validity of the UTBAS-6-J. Along with the UTBAS-6-J, patients also were administered the Overall Assessment of the Speaker's Experience of Stuttering - Japanese version (OASES-A-J), the Modified Erickson Communication Attitude Scale - Japanese version (S-24-J), and the Liebowitz Social Anxiety Scale - Japanese version (LSAS-J). Cronbach's alpha for UTBAS-6-J total scores was 0.974, indicating excellent internal consistency. UTBAS-6-J scores were significantly correlated with scores on the OASES-A-J, the S-24-J, and the LSAS-J (all p < 0.005). Concurrent validity of the UTBAS-6-J with these three questionnaires was confirmed. The UTBAS-6-J has good internal consistency and concurrent validity, which will aid clinical decision-making about stuttering treatments.

Clinical and Psychosocial Predictors of Post-Event Processing in Adults Who Stutter

PURPOSE

Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing.

METHOD

Adults who stutter (N = 96) participated in two virtual sessions. After completing the Trier Social Stress Test, a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering (i.e., the experience of stuttering, self- and observer-rated stuttering severity), and psychosocial characteristics (i.e., self-perceived performance, self-esteem, social anxiety, trait, and state self-compassion) in Session 2.

RESULTS

Hierarchical linear regression models indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior.

CONCLUSION

Findings reveal clinical and psychosocial variables to consider in the assessment and mitigation of post-event processing behavior in adults who stutter, and to bolster resiliency to social stress.

SUPPLEMENTAL MATERIAL

https://doi.org/10.23641/asha.24223213.

Speech-language therapists' approach towards adults who stutter in Turkey: which components are important for therapeutic alliance and comprehensive assessment?

Speech-Language Therapists (SLT) may have negative approaches toward Adults Who Stutter (AWS). There is no consensus about the SLT perspectives on AWS. This study aimed to investigate the SLT approach to AWS and assessment-therapy components in their practices. SLT (N=209) were included in the study. The survey consisted of four sections: demographic information, assessment-therapy components, and attitudes. The results are reported through boxplot graphics. The majority of the SLT were female (86.6%) and aged in the young group (20-29 years) (81.2%). SLT noted that they frequently used non-standard tools in the assessments and traditional or contemporary methods are preferred in the therapy components.  The participants mentioned that important to AWS's quality of life, resilience, and psychosocial characteristics. SLT are more likely to utilize non-standard approaches while evaluating AWS. Traditional methods, as well as current approaches, are preferred by the SLT. SLT cares about AWS's resilience and temperament differences.

Sleep Problems, Social Anxiety and Stuttering Severity in Adults Who Do and Adults Who Do Not Stutter

Background: While there is sufficient evidence that children and adolescents who stutter reported more impaired sleep compared to children and adolescents who did not stutter, findings among adults who stutter (AWS) were scarce. Furthermore, stuttering is associated with issues related to verbal communication in a social context. As such, it was conceivable that AWS reported higher scores for social anxiety, compared to adults who do not stutter (AWNS). In the present study, we tested whether AWS reported higher sleep complaints compared to AWNS. We further tested whether scores for social anxiety and stuttering independently predicted sleep disturbances. Methods: A total of 110 AWS (mean age; 28.25 years, 27.30% females) and 162 AWNS (mean age; 29.40 years, 51.20% females) completed a series of self-rating questionnaires covering sociodemographic information, sleep disturbances and social anxiety. Adults with stuttering further completed a questionnaire on stuttering. Results: Compared to AWNS, AWS reported a shorter sleep duration, a lower sleep efficiency, higher scores for drug use in terms of sleep-promoting medications (significant p-values and medium effect sizes), and an overall higher PSQI score (significant p-values and large effect size), when controlling for age and social anxiety. Next, while p-values were always significant for subjective sleep quality, sleep disturbances, and daytime functioning, when controlling for age and social anxiety, their effect sizes were trivial or small. For sleep latency, the p-value was not significant and the effect size was trivial. Among AWS, higher scores for stuttering and older age, but not social anxiety, predicted higher sleep disturbances. The association between higher sleep disturbances and higher stuttering severity was greatest among those AWS with highest scores for social anxiety. Conclusions: When compared to AWNS, AWS self-reported higher sleep disturbances, which were associated with older age, and higher scores for stuttering severity, but not with social anxiety. Adults who stutter might be routinely asked for their sleep quality.

Relationship between social anxiety and coping profile in adults who stutter

INTRODUCTION

Stuttering is a condition that can be severely disabling in the workplace and socially. Although many stuttering cases resolve, some adults who stutter (AWS) continue to be affected not only by dysfluent speech, but also by other social and psychological conditions that may develop as a result of stuttering. The aim of the present study was to determine the relationship between severity of stuttering, severity of social anxiety, and coping profile.

METHODS

We objectively assessed adults who stutter (n = 44; mean age = 27.5 years) and age-matched non-stuttering control subjects on four variables: stuttering frequency, communication attitude, social anxiety, and coping profile. Stuttering frequency was calculated as the percentage stuttered morae in the Kitsuon-kensa-ho test. All subjects were assessed on the Japanese versions of the Modified Erickson's Communication Attitude Scale (S-24-J), Liebowitz Social Anxiety Scale (LSAS-J), and the Brief Scale for Coping Profile (BSCP).

RESULTS

Compared to the non-stuttering group, the stuttering group had a higher average score on the S-24-J and LSAS-J, and tended to "avoid and suppress" instead of "seek help for resolution" on the BSCP. Comparison of individual stutterers' S-24-J scores whose LSAS-J scores were above or below the LSAS-J cutoff score revealed that their the S-24-J scores tended to be higher. Also, BSCP participants tended to engage in "proactive resolution" and "emotional venting involving others," not "seeking help for resolution." The stuttering group (vs. the non-stuttering group) and the high social-anxiety group (vs. the low social-anxiety group) adopted non-adaptive coping strategies.

CONCLUSIONS

This suggests that the coping profile of AWS may contribute to the cycle of social anxiety and stuttering to a greater or lesser extent. Thus, therapy that reduces anxiety and helps AWS to adopt more adaptive coping strategies may improve stuttering.

Situational Embarrassment and Its Relationship to Social Anxiety in Adults Who Stutter

Purpose Adults who stutter (AWS) have increased risk of comorbid social anxiety about speaking in social contexts. AWS also report experiencing embarrassment in different social situations; however, research has rarely been conducted on embarrassment and its relationship to social anxiety in AWS. Method AWS (N = 200) reported their level of embarrassment on four 10-point Likert items when speaking in four situational contexts: at home, to an individual important to them, in social groups, and at work. Participants were also assessed for sociodemographic, stuttering, and anxiety variables. Construct validity for the four embarrassment items was examined, the extent of embarrassment established in the four contexts as a function of age and sex, and the relationship of embarrassment to social anxiety evaluated. Results Evidence of acceptable construct validity and reliability is presented for the four embarrassment Likert items. Sixty-five percent of the sample experienced high levels of embarrassment when speaking in groups or at work, while 35.5% experienced high levels when speaking at home or to an individual important to them. Participants were significantly more embarrassed (p < .01) when speaking at work or when socializing in groups. Embarrassment was lowest when speaking in the home. Younger females were significantly more embarrassed when speaking at work or when socializing in groups. Those with high embarrassment scores on all four items were more likely to have elevated social anxiety scores (p < .001). Conclusion These preliminary results suggest that the assessment of situational embarrassment could be an important clinical measure that may help improve stuttering treatment outcomes that also target social anxiety.