Validity and reliability of safety behaviors questionnaire for Persian adults who stutter: A cultural perspective

INTRODUCTION

Adults who stutter (AWS) are reported to have higher social anxiety compared to those who do not stutter. Previous studies have suggested that safety behaviors, which are cognitive or behavioral strategies used by people with anxiety to prevent negative consequences, are important factors in maintaining anxiety. However, the frequency and types of such behaviors might vary in different cultures. Therefore, the aim of the present study was to develop a transcultural adaptation of Safety Behaviors Questionnaire (Helgadottir et al., 2014) for Persian-speaking AWS and assess its validity and reliability.

METHODS

In the first step, the original English questionnaire was translated into Persian using the International Quality of Life Assessment (IQOLA) method. Then, 17 speech and language pathologists (SLPs) and 5 AWS evaluated all questionnaire items using Likert scales to determine face validity. Finally, 167 Persian-speaking AWS completed the questionnaire to assess its construct validity and reliability. Their responses were analyzed using factor analysis and Cronbach's Alpha.

RESULTS

Some items of the original questionnaire were modified or combined with other similar items after assessing the face validity of the Persian-translated questionnaire. Construct validity analysis categorized the remaining 29 questionnaire items into four factors: general avoidance, practice and control, rehearsal, and choosing safe and easy people. The high Cronbach's Alpha of 0.89 for all items confirmed the internal reliability of the Persian-translated questionnaire.

DISCUSSION/CONCLUSIONS

The results confirmed the psychometric characteristics of the Persian- translated version of the Safety Behaviors Questionnaire (Helgadottir et al., 2014); therefore, speech pathologists can apply it in future clinical and research settings. Similar to Australian AWS, Persian participants of this study self-reported use of various types of safety behaviors frequently.

Examining implicit and explicit attitudes toward stuttering

PURPOSE

This study assessed implicit and explicit attitudes toward people who stutter among typically-fluent young adults.

METHOD

Participants completed an Implicit Association Test, a measure of implicit attitudes, to assess the strength of association between stuttered vs. fluent speech and positive vs. negative evaluative words. Participants also completed self-report ratings of their attitudes toward people who do and do not stutter (explicit attitude scales). In addition, participants completed measures of social desirability and a survey that assessed lifetime experience with people who stutter.

RESULTS

Results supported the existence of a negative stuttering stereotype. Participants demonstrated negative implicit and explicit attitudes toward people who stutter. Explicit attitudes toward those who stutter, but not implicit attitudes, were significantly predicted by social desirability scores. Familiarity with stuttering was significantly associated with implicit but not explicit attitudes toward stuttering.

CONCLUSIONS

These findings indicate the importance of examining both implicit and explicit attitudes toward stuttering to fully understand the challenges faced by those who stutter.

Long-term Consequences of Childhood Bullying in Adults who Stutter: Social Anxiety, Fear of Negative Evaluation, Self-esteem, and Satisfaction with Life

PURPOSE

Psychosocial disorders have been reported in adults who stutter, especially social anxiety disorder. Social anxiety has been linked to childhood victimization. It is possible that recalled childhood victimization could be linked to psychosocial problems reported in some adults who stutter.

METHOD

Participants were 36 adults who stutter and 36 adults who do not stutter (mean age=21.9 years). The Retrospective Bullying Questionnaire was completed for primary school, secondary school and university environments for physical, verbal, relational and cyber bullying. Participants were categorized into one of five groups (bully, victim, bully-victim, bystander and uninvolved) based ontheir responses. Participants completed four psychosocial scales: social interaction anxiety, fear of negative evaluation, self-esteem and satisfaction with life scales.

RESULTS

The two groups differed with adults who stutter having higher social interaction anxiety, fear of negative evaluation and satisfaction with life. Analyses of variance revealed that victims had the highest scores among both groups on all four scales.

CONCLUSION

Adults who recalled being victimized during childhood were more likely, regardless of whether they stutter or did not stutter, to have poorer psychosocial scale scores. These results show the lingering effects of childhood victimization, common in some children who stutter, may contribute to the reported psychosocial problems in adulthood. The need for early intervention for children who are bullied and future research with larger samples is warranted.

The social and communication impact of stuttering on adolescents and their families

PURPOSE

Stuttering can cause wide ranging psychosocial impact. This is particularly the case for adolescents who may face additional physical, emotional and personality changes as they become adults. This study reports the findings of an investigation into the social and communication impacts of stuttering on Australian adolescents seeking treatment for stuttering and their families.

METHOD

A cross-sectional design utilising questionnaires assessed the self-perceived communication competence and apprehension, stigma and disclosure, and experiences of teasing and bullying of 36 adolescents who stutter. Additionally, the impact of stuttering on the families of these adolescents was investigated.

RESULTS

Adolescents who stutter have below average self-perceived communication competence, heightened communication apprehension, are teased and bullied more often than fluent peers, and they try to keep their stuttering secret. The families of the adolescents in the study reported high levels of emotional strain, family conflict and difficulty managing their child's frustrations.

CONCLUSION

The findings from this study emphasise the wide-ranging impact of stuttering beyond the surface level behaviours. Clinicians working with adolescents who stutter should take note of both the outcomes of this study and the suggestions for more effectively coping with the condition in this population.

EDUCATIONAL OBJECTIVES

The reader will be able to: (a) summarise findings with regards to the impact of stuttering on an adolescent's social and communication skills; (b) summarise areas of impact on the families of adolescents who stutter; (c) compare these findings with previous reported data for this population; (d) discuss the clinical implications of the results for working with adolescents who stutter and their families.