An Experimental Clinical Trial of a Cognitive-Behavior Therapy Package for Chronic Stuttering

Menzies, Ross G.; O’Brian, Sue; Onslow, Mark; Packman, Ann; Clare, Tamsen St; Block, Susan

doi:10.1044/1092-4388(2008/07-0070)

Cited by 220 publications

(168 citation statements)

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“…These findings confirm that social anxiety is the primary concern for children who stutter in this sample. That is, when compared to matched controls, a significantly higher rate of social anxiety disorder was found for children who stutter (based on diagnostic assessment), and this was corroborated by significantly higher social anxiety scores (based on parent and child report symptom measures).Research with adults who stutter has also shown that social anxiety is the primary disorder reported when conducting diagnostic assessments (Blumgart et al, 2010; Iverach, Jones et al, ANXIETY DISORDERS AMONG STUTTERING CHILDREN 31 2009;Menzies et al, 2008;Stein et al, 1996). Hence, findings from the present study emphasize the potential for social anxiety to be the primary concern for children who stutter, with other forms of anxiety (e.g., separation anxiety, generalized anxiety) being of secondary concern for a smaller subset of children.…”

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confidence: 80%

Prevalence of anxiety disorders among children who stutter

Iverach

Jones

McLellan

et al. 2016

Journal of Fluency Disorders

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110

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ANXIETY DISORDERS AMONG STUTTERING CHILDREN 2 Highlights Stuttering is a speech disorder that hampers communication in social situations  Roughly 22-60% of adults who stutter meet criteria for social anxiety disorder  No studies have evaluated the rate of anxiety disorders among stuttering children  Stuttering children demonstrated a significantly higher rate of anxiety disorders  Of note, 24% of stuttering children met criteria for social anxiety disorder AbstractPurpose: Stuttering during adulthood is associated with a heightened rate of anxiety disorders, especially social anxiety disorder. Given the early onset of both anxiety and stuttering, this comorbidity could be present among stuttering children.Method: Participants were 75 stuttering children 7-12 years and 150 matched non-stuttering control children. Multinomial and binary logistic regression models were used to estimate odds ratios for anxiety disorders, and two-sample t-tests compared scores on measures of anxiety and psycho-social difficulties.Results: Compared to non-stuttering controls, the stuttering group had six-fold increased odds for social anxiety disorder, seven-fold increased odds for subclinical generalized anxiety disorder, and four-fold increased odds for any anxiety disorder. Conclusion:These results show that, as is the case during adulthood, stuttering during childhood is associated with a significantly heightened rate of anxiety disorders. Future research is needed to determine the impact of those disorders on speech treatment outcomes.Keywords: Anxiety disorders; Social anxiety disorder; Diagnosis; Stuttering.ANXIETY DISORDERS AMONG STUTTERING CHILDREN 3 Prevalence of anxiety disorders among children who stutterFor some children who stutter, the negative social consequences of stuttering can begin as early as the preschool years, and continue across the lifespan. Non-stuttering preschool children have been found to negatively evaluate stuttering (Ezrati-Vinacour, Platzky, & Yairi, 2001) and may sometimes ignore, interrupt, mock, and walk away from stuttering children (Langevin, Packman, & Onslow, 2009). The communication difficulties and negative consequences of stuttering experienced by some children who stutter typically intensify during the school years, due to the increased importance of communication in social and classroom settings. Stuttering children have been rated as less popular, less likely to be considered leaders, and more likely to be considered bully victims, than their non-stuttering peers (Davis, Howell, & Cooke, 2002).Several studies have also confirmed that stuttering adolescents report a significantly higher rate of bullying than non-stuttering controls (Blood & Blood, 2004, 2007 Blood et al., 2011).Although negative consequences to stuttering may not occur for all children who stutter, these experiences have the capacity to adversely impact communication competence, selfesteem, social development, and even romantic attractiveness (Blood et al., 2011; Erickson & Block, 2013;Van Borsel, Brepoels, & De C...

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mentioning

confidence: 80%

Prevalence of anxiety disorders among children who stutter

Iverach

Jones

McLellan

et al. 2016

Journal of Fluency Disorders

Self Cite

110

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“…20,22 Speech-focused cognitive behavioral therapy has been shown to decrease social anxiety and psychological distress in adults who stutter. 23 Our finding that patients may be hesitant to discuss or even disclose their stuttering to physicians raises concerns about missed opportunities to diagnose and treat mental health problems associated with stuttering. Fortunately, we found that a trusting relationship between patient and physician can allow patients the latitude to discuss their stuttering and how it might affect their lives.…”

Section: Discussionmentioning

confidence: 98%

“…We grouped participants into three focus groups based on age category (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41)(42)(43)(44)(45)(46)(47)(48)(49), 50+ years) with the goal of enhancing participants' comfort discussing health-related information. All focus groups were conducted by H.R.P., a physician who stutters, during the NSA conference, and lasted 45-60 min.…”

Section: Data Collectionmentioning

confidence: 99%

“Not Unless It’s a Life or Death Thing”: A Qualitative Study of the Health Care Experiences of Adults Who Stutter

2015

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BACKGROUND:For adults who stutter, communication difficulties can impact many spheres of life. Previous studies have not examined how stuttering might impact patient's experiences with the medical system. OBJECTIVE: Our objective was to understand the range and depth of experiences with the medical system among adults who stutter. DESIGN: This was a qualitative study using age-stratified focus groups. PARTICIPANTS: Sixteen adults who stutter were recruited at a national conference about stuttering. APPROACH: We conducted three focus groups. Participants also completed a written questionnaire about sociodemographic characteristics, health status, and the impact of stuttering on their life [using the St. Louis Inventory of Life Perspectives Scale (SL-ILP-S) Total Effect Score]. We analyzed data using an iterative, thematic analysis, with an inductive approach, at a semantic level. KEY RESULTS: Participants were mostly (75 %) male and resided throughout the United States. The mean SL-ILP-S Total Effect Score was 27.3, indicating that stuttering caused minimal concern in participants' lives. Despite this, we identified five themes that characterize ways in which stuttering affects interactions with the medical system. Participants described (1) discomfort speaking with office staff and physicians, which resulted in (2) avoiding health care interactions because of stuttering, and (3) relying on a third party to navigate the medical system. During visits with physicians, participants felt that (4) discussing stuttering with physicians required trust and rapport, and (5) speaking assertively with physicians required selfacceptance of their stuttering. CONCLUSIONS: We identified ways in which stuttering affects medical interactions. These results highlight the need for increased awareness and training for medical staff and physicians when caring for persons who stutter. Future studies among diverse samples of stutterers can determine the effects of stuttering on medical interactions, and inform the development of interventions to provide high quality health care for adults who stutter.

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“…The association between developmental stuttering and diminished psychological wellbeing has been extensively documented (Craig, Blumgart and Tran, 2009;Craig and Hancock, 1995;Craig and Tran, 2014;Iverach, O'Brian, Jones, Block, Lincoln, Harrison, Hewat, Menzies, Packman and Onslow, 2009;Iverach and Rapee, 2014;McAllister, Collier and Shepstone, 2013;McAllister, Kelman and Millard, 2015;Menzies, O'Brian, Onslow, Packman, St Clare, and Block, 2008). In particular, social anxiety disorder, an excessive and persistent fear or expectancy of negative evaluation in situations involving social interaction (American Psychiatric Association, 1994;Beck, Emery, & Greenberg, 1985) has been shown in several studies to be much more prevalent in adults who stutter than in the general population (Blumgart, Tran and Craig, 2010;Iverach and Rapee, 2014;Iverach et al, 2009;Menzies et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

“…In particular, social anxiety disorder, an excessive and persistent fear or expectancy of negative evaluation in situations involving social interaction (American Psychiatric Association, 1994;Beck, Emery, & Greenberg, 1985) has been shown in several studies to be much more prevalent in adults who stutter than in the general population (Blumgart, Tran and Craig, 2010;Iverach and Rapee, 2014;Iverach et al, 2009;Menzies et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Stuttering, alcohol consumption and smoking

Heelan

McAllister

Skinner

2016

Journal of Fluency Disorders

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Purpose Limited research has been published regarding the association between stuttering and substance use. An earlier study provided no evidence for such an association, but the authors called for further research to be conducted using a community sample. The present study used data from a community sample to investigate whether an association between stuttering and alcohol consumption or regular smoking exists in late adolescence and adulthood.Methods Regression analyses were carried out on data from a birth cohort study, the National Child Development Study (NCDS), whose initial cohort included 18,558 participants who have since been followed up until age 55. In the analyses, the main predictor variable was parent-reported stuttering at age 16. Parental socio-economic group, cohort member's sex and childhood behavioural problems were also included.The outcome variables related to alcohol consumption and smoking habits at ages 16, 23, 33, 41, 46, 50 and 55. Results No significant association was found between stuttering and alcohol consumption or stuttering and smoking at any of the ages. It was speculated that the absence of significant associations might be due to avoidance of social situations on the part of many of the participants who stutter, or adoption of alternative coping strategies. ConclusionBecause of the association between anxiety and substance use, individuals who stutter and are anxious might be found to drink or smoke excessively, but as a group, people who stutter are not more likely than those who do not to have high levels of consumption of alcohol or nicotine.

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An Experimental Clinical Trial of a Cognitive-Behavior Therapy Package for Chronic Stuttering

Abstract: The CBT treatment was associated with significant and sustained improvements in psychological functioning but did not improve fluency.

Cited by 220 publications

References 43 publications

Prevalence of anxiety disorders among children who stutter

Prevalence of anxiety disorders among children who stutter

“Not Unless It’s a Life or Death Thing”: A Qualitative Study of the Health Care Experiences of Adults Who Stutter

Stuttering, alcohol consumption and smoking

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