اضطراب در سخنرانانی که لکنت زبانشان باقی بماند و کسانی از لکنت زبان بهبود می یابند
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|33504||2007||20 صفحه PDF||سفارش دهید||محاسبه نشده|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Journal of Communication Disorders, Volume 40, Issue 5, September–October 2007, Pages 398–417
Purpose The study was designed to see whether young children and adolescents who persist in their stutter (N = 18) show differences in trait and/or state anxiety compared with people who recover from their stutter (N = 17) and fluent control speakers (N = 19). Method A fluent control group, a group of speakers who have been documented as stuttering in the past but do not stutter now and a group of speakers (also with a documented history of stuttering) who persist in their stuttering participated, all aged 10–17 years. The State–Trait Anxiety Inventory for Children was administered. Results There were no differences between persistent, recovered and control groups with regard to trait anxiety. The persistent group had higher state anxiety than controls and the recovered group for three out of four speaking situations. Conclusion The findings are interpreted as showing that anxiety levels in certain affective states appear to be associated with the speaking problem.
A reader should be able to appreciate the difference between state and trait anxiety understand views about how the role anxiety has on stuttering has changed over time appreciate different views about how anxiety affects speakers who persist and recover from stuttering see why longitudinal work is needed to study these issues. Several theories maintain that anxiety precipitates stuttering (Bloodstein, 1987; Miller & Watson, 1992). There are two basic forms of anxiety that could be involved in this process, trait and state (Cattell & Scheier, 1961) which feature in a number of the studies reviewed below. Trait anxiety refers to stable individual differences in the tendency to respond in anticipation of threatening situations. State anxiety is an unpleasant emotional arousal in the face of demanding or dangerous situations (Lazarus, 1991). Endler and Parker (1990) emphasized that there is a fundamental difference between trait anxiety, which is a permanent personality characteristic and state anxiety, which is a transitory and emotional condition. Consistent with this view, reduction in state, but not trait, anxiety after treatment has been reported to occur for patients with borderline personality disorder (Bateman & Fonagy, 2001). Trait and state anxiety have been divided further using multidimensional scaling techniques (Endler, Edwards, Vitelli & Parker, 1989; Spielberger, 1980). They found that trait anxiety had four components: (a) social evaluation, (b) physical danger, (c) ambiguous situations and (d) daily routines, and state anxiety had two components: (a) worry (cognitive) and (b) emotionality (autonomic). Endler and Parker's (1990) multidimensional model suggests that state anxiety is a result of an interaction between a specific component of trait anxiety and a congruent threatening situation. For example a person who stutters may evaluate speaking on the telephone as a threatening situation (the social evaluation component of trait anxiety) leading to high levels of state anxiety (both cognitive and autonomic). While there are few who would doubt that anxiety increases when speakers who stutter are faced with demanding situations, the role that anxiety plays in the etiology of the disorder remains unclear. There are some who consider anxiety as the main cause of the disorder ( Johnson, 1942, Sheehan, 1970 and Wischner, 1952), while others see anxiety as a result of the disorder ( Perkins, 1979 and Ryan, 1974). A third view is that anxiety has a mediating role in the onset, development and severity of the problem ( Brutten & Shoemaker, 1967). Though the relationship between anxiety and stuttering has been discussed at length, there is only a small amount of evidence that it plays a role in the maintenance of the disorder into adulthood and less evidence that implicates anxiety as a factor leading to stuttering in childhood ( Andrews, Craig, Feyer, Howie, & Nielson, 1983; Bloodstein, 1987 and Ingham, 1984). Several studies using adults who stutter failed to find any relationship between anxiety and stuttering. Cox, Seider, and Kidd (1984) and Molt and Guildford (1979) found no significant differences between adults who stutter and controls in anxiety scores. Janssen and Kraaimaat (1980) also failed to find differences between adolescents who stutter and controls. Miller and Watson (1992) used the State–Trait Anxiety Inventory (STAI) (Spielberger, 1983; Spielberger, Gorsuch, & Lushene, 1970) to measure anxiety levels in adolescents and adults (aged between 16 and 42 years). They found no difference between people who stutter and a control group in either state or trait anxiety scores. Studies have failed to find different physiological reactions in anxiety-provoking situations. For instance, Blood, Blood, Bennett, Simpson, and Sussman (1994) found no difference in levels of salivary cortisol between adults who stutter and controls, although the self-reports of anxiety of adults who stutter were higher than controls. Dietrich and Roaman (2001) failed to find a relationship between speech-related anxiety and skin conduction responses in adults who stutter. Research using self-report measures of anxiety with adolescents and adults has found differences in anxiety levels between those who stutter and controls. Kraaimaat, Vanrycheghem, and van Dam-Baggen (2002) measured social anxiety using the Inventory of Interpersonal Situations (van Dam-Baggen & Kraaimaat, 1999). The results showed that the social anxiety scores of about half of the adults who stutter in their study fell within the same range as a group of highly socially-anxious psychiatric patients. Craig (1990) compared adults who stutter with matched controls. He found that state anxiety levels of people who stutter were significantly higher than those of controls when in a demanding speech situation. People who stutter were also reported to have higher levels of trait anxiety than the control group. The trait anxiety scores of the stuttering group became within normal limits following an intensive behavior therapy program. State anxiety was not measured post-therapy. Anxiety also seems to depend on stuttering severity. Fitzgerald, Djurdjic, and Maguin (1992) administered the Willoughby Personality Scale-R, WPS-R (Wolpe, 1982) to measure trait anxiety in adults who stutter and controls. Mean scores on the WPS-R for people who stutter were found to be similar to those reported for psychoneurotic adults. The authors did a median split using stuttering severity instrument (SSI) scores (Riley, 1972) to separate people who stutter into more and less severe groups. They reported that WPS-R scores were higher for those with a more severe stutter than for those with a less severe stutter, although the difference was not statistically significant. Ezrati-Vinacour and Levin (2004) used the STAI (Spielberger, 1983; Spielberger et al., 1970) for the speech situations Brutten (1973) employed, both for a group of people who stutter and controls. The people who stutter were divided into severe and mild sub-groups based on a median split using SSI scores. A Task-Related Anxiety scale (TRA) was also applied, which participants used to evaluate their anxiety level after performing two speech and two non-speech tasks. The three groups (severe, mild and controls) were compared on trait, state and TRA separately for performance following speech or non-speech tasks. Trait anxiety was higher for severe and mild people who stutter compared to fluent controls. State scores on the speech situation checklist were higher for those with a severe stutter than for those with a mild stutter or who were fluent. TRA scores were also higher among those with a severe stutter than both those with a mild stutter and fluent speakers for the speech, but not the non-speech task. Ezrati-Vinacour and Levin (2004) interpreted these results as showing that people who stutter have higher trait anxiety than fluent speakers and that state anxiety in social communication was higher among those with a severe stutter as compared to those with a mild stutter or who were fluent. Thus anxiety is a personality trait of people who stutter and state anxiety is related to stuttering severity. A few studies have investigated anxiety in children who stutter but they have failed to find differences in anxiety levels when compared to controls. Andrews and Harris (1964) found that scores on Sarason's General Anxiety Scale for Children (Sarason, Davidson, Lighthall, Waite, & Ruebush, 1960) did not differ between children who stutter and controls. Craig and Hancock (1996) used the State–Trait Anxiety Inventory for Children (STAIC) (Spielberger, 1973) to measure self-reported anxiety levels in children aged 9–14 years. Children who stutter had trait and state anxiety scores within norms established for the STAIC scale. The work on children who stutter is of great potential importance as it may provide an indication about the role of anxiety in the development of stuttering. If children are tested at one age to confirm they are stuttering and then retested at a later age, they can be divided into those who persist and those who recover. The following study examined a group of children who stutter who were confirmed as stuttering at age 10 and above and retested about 2 years later to determine whether or not their stuttering persisted. An age-matched group of control children was also tested. State and trait anxiety were measured. This article examined the role that trait and state anxiety plays in stuttering. One position that has been argued is that people who stutter do so because they have high trait anxiety (Craig, 1990; Craig, Hancock, Tran, & Craig, 2003; Sheehan, 1970 and Wischner, 1952). A second view is that high state anxiety leads speakers to stutter (Kraaimaat et al., 2002). As shown above, trait anxiety is a permanent personality characteristic, so people who stutter should have high levels relative to controls whether or not they continue to stutter. The experiment tests whether or not speakers who were known to stutter (persistent and recovered) have high rates of trait anxiety at a time when they were known to have recovered or persisted. Of course, it is possible that anxiety is associated with state, rather than trait, measures and in that case no difference would be expected in trait scores between persistent, recovered and control speakers. Unlike trait scores, state scores may depend on whether the speaker is still stuttering at the time of test. If state anxiety has a role in etiology of the disorder, speakers who recover and speakers who persist may show high state scores relative to controls at the time when persistence and recovery were determined. If state anxiety is associated with stuttering behavior per se, only speakers who persist in their stuttering would show high scores relative to controls after a period of time has elapsed to allow recovery. In summary, trait and state anxiety are measured in persistent, recovered and control speakers. The questions are (a) whether persistent and recovered speakers have high trait scores relative to controls, (b) whether persistent and recovered speakers have high state scores relative to controls, or (c) whether only persistent speakers have high state scores relative to controls.