Maintenance of Social Anxiety in Stuttering: A Cognitive-Behavioral Model.
OBJECTIVE
Stuttering is a speech disorder frequently accompanied by anxiety in social-evaluative situations. A growing body of research has confirmed a significant rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a chronic and disabling anxiety disorder associated with substantial life impairment. Several influential models have described cognitive-behavioral factors that contribute to the maintenance of social anxiety in nonstuttering populations. The purpose of the present article is to apply these leading models to the experience of social anxiety for people who stutter.


METHODS
Components from existing models were applied to stuttering in order to determine cognitive-behavioral processes that occur before, during, and after social-evaluative situations, which may increase the likelihood of stuttering-related social fears persisting.


RESULTS
Maintenance of social anxiety in stuttering may be influenced by a host of interrelated factors, including fear of negative evaluation, negative social-evaluative cognitions, attentional biases, self-focused attention, safety behaviors, and anticipatory and postevent processing.


CONCLUSIONS
Given the chronic nature of social anxiety disorder, identifying factors that contribute to the persistence of stuttering-related social fears has the potential to inform clinical practice and the development of psychological treatment programs to address the speech and psychological needs of people who stutter with social anxiety.
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, AustraliaAustralian Stuttering Research Centre, The University of Sydney.
Lisa
L
Iverach
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
Ronald M
RM
Rapee
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia.
Quincy J J
QJJ
Wong
Australian Stuttering Research Centre, The University of Sydney.
Robyn
R
Lowe
D000293:Adolescent; D000328:Adult; D059031:Anticipation, Psychological; D002648:Child; D002675:Child, Preschool; D015928:Cognitive Behavioral Therapy; D003469:Culture; D006801:Humans; D007398:Interpersonal Relations; D008960:Models, Psychological; D010379:Peer Group; D000072861:Phobia, Social / Q000523:psychology* / Q000628:therapy*; D012929:Psychological Distance; D012307:Risk Factors; D020377:Self Efficacy; D013342:Stuttering / Q000523:psychology*; D055815:Young Adult