Situational speaking anxiety in adults who stutter

Psychometric properties of the Persian version of the stuttering generalization self-measure tool in adults who stutter

PURPOSE

Our study aimed to translate the Stuttering Generalization Self-Measure (SGSM) into Persian and investigate its validity, reliability, and internal responsiveness in the Iranian population.

METHOD

This study was conducted on 30 adults who stutter (AWS) and 30 adults who do not stutter (AWNS). The International Quality of Life Assessment protocol (IQOLA) was applied to translate SGSM into Persian. The face and content validity were determined. Also, the discriminant validity was evaluated by comparing the scores of two groups. In addition, the internal consistency test-retest, and inter-judge reliability were assessed with Cronbach's alpha and intra-class correlation coefficients (ICC). Moreover, the mean standardized response (MSR) and the standardized effect size were measured to determine the internal responsiveness using pre- and post-treatment data.

RESULTS

All the items were comprehensible and clear. The content validity ratio (CVR) and content validity index (CVI) for all nine questions were obtained higher than.62 and.9, respectively. The internal consistency value was high (Cronbach's alpha =.98). For the test-retest reliability, ICC values were excellent, ranging from.93 to.99. The discriminant validity results revealed a significant difference between AWS and AWNS (p < .001). Pre- and post-treatment results indicated high internal responsiveness to changes for percentage of syllable stuttered (SS%) (MSR = 1.09).

CONCLUSION

The Persian version of SGSM (P-SGSM) benefits from the high values for validity and reliability. Furthermore, it distinguishes the AWS and AWNS and reflects the treatment changes significantly.

A novel non-word speech preparation task to increase stuttering frequency in experimental settings for longitudinal research

PURPOSE

The variable and intermittent nature of stuttering makes it difficult to consistently elicit a sufficient number of stuttered trials for longitudinal experimental research. This study tests the efficacy of using non-word pairs that phonetically mimic English words with no associated meaning, to reliably elicit balanced numbers of stuttering and fluent trials over multiple sessions. The study also evaluated the effect of non-word length on stuttering frequency, the consistency of stuttering frequency across sessions, and potential carry-over effects of increased stuttering frequency in the experimental task to conversational and reading speech after the task.

METHODS

Twelve adults who stutter completed multiple sessions (mean of 4.8 sessions) where they were video-recorded during pre-task reading and conversation, followed by an experimental task where they read 400 non-word pairs randomized for each session, and then a post-task reading and conversation sample.

RESULTS

On average, across sessions and participants, non-word pairs consistently yielded a balanced distribution of fluent (60.7%) and stuttered (39.3%) trials over five sessions. Non-word length had a positive effect on stuttering frequency. No carryover effects from experimental to post-task conversation and reading were found.

CONCLUSIONS

Non-word pairs effectively and consistently elicited balanced proportions of stuttered and fluent trials. This approach can be used to gather longitudinal data to better understand the neurophysiological and behavioral correlates of stuttering.

Speech Related Anxiety in Adults Who Stutter

Abstract. The relationship between anxiety and stuttering has always been a topic of debate with a great emphasis on research focused on examining whether speech-related anxiety can exacerbate stuttering. This investigation compares some speech-related anticipatory anxiety indices in fluent and dysfluent utterances in adults who stutter (AWS). We scored the level of cognitive speech-related anxiety (anticipatory anxiety) using a self-reporting method and also evaluated the autonomic aspects of anxiety (state anxiety) through recording changes in Galvanic Skin Response (GSR) signals. Explaining the link between stuttering and anxiety is expected to assist practitioners in stuttering assessment and subsequent treatment strategies. Phasic GSR values of six events related to answering the verbal stimuli through fluent and dysfluent responses were registered to measure sympathetic arousal as an index of state anxiety in 20 AWS ( Mage = 35 ± 4 years, range: 21–42). To quantitatively examine the cognitive aspects of speech-related anticipatory anxiety, two questionnaires were rated by participants addressing the stuttering anticipation and semantic difficulty of verbal stimuli. GSR measures of fluent events were significantly higher than dysfluent counterparts within time windows before and during answering aloud the verbal stimuli ( p < .001). Later in the experiment, GSR values of dysfluent events were found to be higher than their fluent counterparts ( p < .001). Stuttering anticipation yielded a weak negative meaningful correlation with the scores of fluency ( r = −0.283, p = .046) and a positive yet nonsignificant correlation with the stuttering scores. The semantic difficulty had a moderately significant correlation with stuttering anticipation ( r = 0.354, p = .012) but not a meaningful correlation with fluency state. Autonomic and cognitive indices of speech-related anticipatory anxiety are not robust predictors of fluency. Anxiety seems to be more of a consequence of stuttering than a cause.

Anxiety and Depression Symptoms in Children and Adolescents Who Stutter: A Systematic Review and Meta-Analysis

PURPOSE

The purpose of this study was to investigate whether there are elevated symptoms of anxiety or depression in children and adolescents (aged 2-18 years) who stutter, and to identify potential moderators of increased symptom severity.

METHOD

We conducted a preregistered systematic review of databases and gray literature; 13 articles met criteria for inclusion. A meta-analysis using robust variance estimation was conducted with 11 cohort studies comparing symptoms of anxiety in children and adolescents who do and do not stutter. Twenty-six effect sizes from 11 studies contributed to the summary effect size for anxiety symptoms (851 participants). Meta-analysis of depression outcomes was not possible due to the small number of studies.

RESULTS

The summary effect size indicates that children and adolescents who stutter present with increased anxiety symptoms (g = 0.42) compared with nonstuttering peers. There were insufficient studies to robustly analyze depression symptoms, and qualitative review is provided. No significant between-groups differences were reported in any of the depression studies.

CONCLUSIONS

Preliminary evidence indicates elevated symptoms of anxiety in some children and adolescents who stutter relative to peers. There was a tendency toward higher depression scores in this population, although reported between-groups differences did not reach statistical significance. These findings require replication in larger, preferably longitudinal studies that consider factors that may moderate risk. Nevertheless, our findings highlight a need for careful monitoring of mental health and well-being in young people who stutter. Supplemental Materials: http://osf.io/5m6zv.

Comparing evaluations of social situations for adults who do and do not stutter

PURPOSE

Numerous research studies indicate that stuttering is associated with increased risk for social anxiety disorder (SAD). Interpretation bias is one of four cognitive biases thought to maintain symptoms associated with SAD. Interpretation bias occurs when one evaluates social situations as more negative than they actually are. The purpose of this study was to investigate if adults who do and do not stutter interpret positive, ambiguous, mildly negative, and profoundly negative social situations similarly, or-if like individuals with SAD-adults who stutter exhibit negative interpretation biases.

METHOD

Forty-eight adults who stutter and 42 age-and gender-matched adults who do not stutter participated. Participants completed the Fear of Negative Evaluation (FNE) and were assigned to one of four groups: adults who stutter with high FNE (AWS-High), adults who stutter with low FNE (AWS-Low), adults who do not stutter with high FNE (AWNS-High), and adults who do not stutter with low FNE (AWNS-Low). All participants completed the trait scale of the State Trait Anxiety Inventory (STAI) and the Interpretation and Judgmental Questionnaire (IJQ). The IJQ contains descriptions of four types of social situations: positive, mildly negative, profoundly negative, and ambiguous. Within each situation type there are five different scenarios, for a total of 20 scenarios across the four situation types. Participants provided written responses to these 20 social scenarios. Qualitative analyses were used to understand how members of each group interpreted the different social scenarios.

RESULTS

Thematic analysis revealed that each group responded in similar ways to each of the social scenarios, regardless of the type of situation. Adults who do and do not stutter with low and high FNE agreed on many themes related to the 20 social scenarios, and they agreed across all four types of social situations. Somewhat surprisingly, the theme "stuttering" was mentioned infrequently by the adults who stutter.

CONCLUSIONS

Results suggested that adults who do and do not stutter with low and high FNE interpret social situations similarly, and that no group demonstrated a negative interpretation bias consistent with what is observed in adults with SAD. The interpretations provided by each group were appropriate to the specific scenarios being evaluated.

Preliminary study of self-perceived communication competence amongst adults who do and do not stutter

PURPOSE

Adults who stutter report a significant impact of stuttering on their quality of life, including negative thoughts and attitudes toward communication. In addition to this impact, adolescents who stutter also report lower levels of self-perceived communication competence (SPCC) compared to fluent peers. The purpose of this study was to extend the investigation of SPCC to adults who do and do not stutter. Additional aims investigated included if 1) SPCC predicted overall impact of stuttering, and, 2) stuttering frequency predicted SPCC among adults who stutter.

METHODS

Twenty-four adults who stutter and twenty-seven adults who do not stutter matched for age, gender, and education completed the Self-Perceived Communication Competence Scale (Richmond & McCroskey, 1997). All participants who stutter completed the Overall Assessment of the Speaker's Experience of Stuttering (OASES [ages 18+]; Yaruss & Quesal, 2006) and speaking samples to measure stuttering frequency.

RESULTS

Adults who stutter reported significantly lower SPCC scale total scores than adults who do not stutter. For adults who stutter, lower SPCC scale scores significantly predicted more severe overall impact of stuttering as measured by the OASES. Stuttering frequency did not predict SPCC scale scores.

DISCUSSION

This is the first study to report differences in self-perceived communication competence between adults who do and do not stutter. Results suggest adults who stutter report lower self-perceived communication competence compared to adults who do not stutter. Adults who perceive themselves to have greater communication competence reported less severe overall impact of stuttering, and stuttering frequency did not influence SPCC. Clinical implications for intervention are discussed.