Uncertainty and Perceived Control as Predictors of Communicative Participation and Mental Health in Adults Who Stutter

Purpose: This study examined the role of uncertainty and perceived control in predicting the communicative participation and mental health of adults who stutter. Method: Two hundred sixty-nine adults who stutter completed measures of uncertainty about stuttering, perceived control of stuttering, communicative participation, and global mental health. In addition, participants self-reported on a variety of demographic and speech-related measures. Correlational analyses and hierarchical regression were performed to determine associations between variables of interest. Results: Uncertainty accounted for significant variance in communicative participation and global mental health after statistically controlling for the effects of demographic and speech-related variables. Perceived control accounted for significant variance in communicative participation over and above what was accounted for by demographic variables, speech-related variables, and uncertainty. Conclusions: The findings suggest that uncertainty about stuttering and perceived control of stuttering should be accounted for during assessment and intervention with adults who stutter. Interventions that specifically target uncertainty and perceived control may be useful in improving therapeutic outcomes for individuals who stutter.

Paul among the Fluent in Corinth

This article foregrounds the importance of Paul’s letters for studying the experiences and perceptions of persons who stutter in antiquity. It analyzes Paul’s speech alongside the biographies of two other historical figures from antiquity who suffered from speech dysfluency: the great Athenian orator, Demosthenes, and the emperor Claudius. Accounts of Demosthenes’, Claudius’, and Paul’s speech inconsistencies, silences, incomprehensible utterances, oratory weaknesses—and their critics’ accusations that they suffered from madness—are interpreted in light of research on adults who stutter in the contemporary context, as well as studies on listener experiences and stereotypes. In introducing Paul into the study of ancient dysfluency, the article revisits Paul’s conflict with rival teachers in Corinth as it is in responding to these critics’ accusations that Paul is most revealing of his own dysfluency.

Situational factors influencing social anxiety in treatment-seeking adults who stutter: An exploratory factor analysis

Purpose: Adults who stutter (AWS) often show high levels of social anxiety. Stuttering is a speech disorder, making the latent factors influencing social anxiety potentially different from those in individuals with a social anxiety disorder (SAD) or general populations. This study aims to examine the situational factors influencing social anxiety in AWS.Methods: We analyzed data of 351 AWS using the fear/anxiety scale in the Japanese self-report version of the Liebowitz Social Anxiety Scale (LSAS). We conducted exploratory factor analysis and investigated subscale scores.Results: We extracted five factors: (i) eating, drinking, and party, (ii) telephone, (iii) observation or non-speech, (iv) interaction with strangers, and (v) public speaking. The factor for telephone was newly extracted, and anxiety in telephone situations was poorly explained by the total score of fear/anxiety of the LSAS. On the other hand, the other four factors are similar to those previously extracted in individuals with SAD and general populations, and more than 60% of the variance of the subscale constructs was explained by the total score. Preliminary comparisons revealed that AWS had saliently higher anxiety in telephone situations and lower anxiety in observation or non-speech situations than individuals with anxiety disorders and Japanese university students.Conclusions: The factor for telephone was uniquely extracted in AWS, and the severity of anxiety in telephone situations was not explained well by the overall severity of social anxiety as a whole. Telephone situations have specific impacts on social anxiety in AWS.

Heterogeneity of social anxiety in treatment-seeking adults who stutter: A latent profile analysis

Purpose: Adults who stutter (AWS) often experience social anxiety. Social anxiety is explained by several situational factors, one of which is a factor for telephone, which is unique to AWS. This unique social anxiety, which has not been observed in individuals with social anxiety disorder (SAD), may lead to heterogeneity or distinct subtypes of AWS. The present study aimed to investigate the heterogeneity of social anxiety in AWS in terms of feared social situations.Methods: Social anxiety was measured using the fear/anxiety scale of the Liebowitz Social Anxiety Scale (LSAS). The scores of the five subscales in the LSAS in 562 AWS were analyzed using latent profile analysis. First, the number of latent classes (subtypes) was determined through statistical criteria and interpretability. Next, the profiles of social anxiety, demographic data, communication attitudes, and the overall severity of social anxiety of the subtypes were investigated.Results: Five latent class solutions led to good classifications. About one-quarter of AWS (156) were included in a subtype with sub-clinical levels of overall severity of social anxiety but severe social anxiety in telephone situations. Among them, 100 AWS showed severe social anxiety only in telephone situations. Psychosocial factors, including employment status and communication attitude, were related to extracted subtypes.Conclusions: Some AWS have severe social anxiety specific to telephone situations, which is not proportional to the overall severity of social anxiety. The telephone-specific subtype of social anxiety has not been empirically extracted in principal diagnosis of SAD and can be unique in AWS.

Factors predicting satisfaction with communication in daily lives of adults who stutter: An experience sampling study

Purpose: Improving satisfaction with communication (SC) is one of the issues in treatments of adults who stutter (AWS). SC can be influenced by self-rated stuttering severity (SS), negative/positive emotions, and emotion regulations and they are variable in daily communications. The present study aimed to explore factors predicting SC in daily communications of AWS, considering their variabilities and speaking contexts.Method: Twenty-seven AWS were surveyed by trait questionnaires and then by experience sampling method (ESM) seven times per day for 2 weeks, reporting speaking contexts and subjective experiences, including SC, SS, negative/positive emotions, and emotion regulations. Intra- and inter- individual variabilities and relationships of the variables were investigated.Results: Speaking contexts were summarized by unofficial/official communications. SC, SS, and emotion regulations in unofficial communications were less variable and SC was more strongly related to trait questionnaires. Items of the ESM loaded on three latent factors in each communication type, including (1) negative emotion, (2) stuttering and associated reactions (including SS and stuttering-and anxiety-related behaviors and cognitions), and (3) positive emotion and attending to communication. SC was more strongly associated with (3) than (2) in unofficial communications while the opposite trend was found in official communications.Conclusions: SC, SS, and stuttering-and anxiety-related emotion regulations in unofficial communications are more trait-like. Not only negative emotion regulations but also positive emotion regulations should be treated to improve SC in AWS, considering speaking contexts.

Rhythmic tapping difficulties in adults who stutter: a deficit in Central Clock and/or Motor Implementation?

The study aims to better understand the origin of increased tapping variability and inaccuracy in people who stutter during paced and un-paced tapping. The overall question is to what extent these timing difficulties are related to a central clock deficit, a deficit in motor execution, or both.Finger tapping behavior of 16 adults who stutter (PWS) with different levels of musical training was compared with performance of 16 matching controls (PNS) in three finger tapping synchronization tasks ― a simple 1:1 isochronous pattern, a complex non-isochronous pattern, and a 4 tap:1 beat isochronous pattern ―, a continuation task (without external stimulation), and a reaction task involving aperiodic and unpredictable patterns. The results show that PWS exhibited larger negative asynchrony (expressed as phase angles), and increased synchronization variability (expressed as phase locking values) in paced tapping tasks, and that these differences from the PNS group were modulated by rhythmic complexity and musical training. The tapping asynchrony with a simple isochronous pattern correlated significantly with the average inter-tap duration, and with tap reaction times during the reaction task. The synchronization variability with a simple isochronous pattern correlated significantly with both the central clock and motor implementation variances as extracted during un-paced tapping, according to the Wing and Kristofferson’s model of timing.The results support the idea that increased tapping variability of PWS is associated with both a central clock and a motor execution deficit. The greater Negative Mean Asynchrony of PWS does not appear to be attributable to a deficit in time estimation but rather to a motor deficit. Several models and theories related to deficits in sensorimotor integration were considered to explain the interactions with beat strength, pattern complexity, and musical training.