Gunn Anthony, Menzies Ross G, O'Brian Sue, Onslow Mark, Packman Ann, Lowe Robyn, Iverach Lisa, Heard Robert, Block Susan
Australian Stuttering Research Centre, The University of Sydney, Australia.
Department of Psychology, Macquarie University, Australia.
J Fluency Disord. 2014 Jun;40:58-68. doi: 10.1016/j.jfludis.2013.09.002. Epub 2013 Sep 29.
The purpose of this study was to evaluate anxiety and psychological functioning among adolescents seeking speech therapy for stuttering using a structured, diagnostic interview and psychological questionnaires. This study also sought to determine whether any differences in psychological status were evident between younger and older adolescents.
Participants were 37 stuttering adolescents seeking stuttering treatment. We administered the Computerized Voice Version of the Diagnostic Interview Schedule for Children, and five psychometric tests. Participants were classified into younger (12-14 years; n=20) and older adolescents (15-17 years; n=17).
Thirty-eight percent of participants attained at least one diagnosis of a mental disorder, according to the diagnostic criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; APA, 2000), with the majority of these diagnoses involving anxiety. This figure is double current estimates for general adolescent populations, and is consistent with our finding of moderate and moderate-severe quality of life impairment. Although many of the scores on psychological measures fell within the normal range, older adolescents (15-17 years) reported significantly higher anxiety, depression, reactions to stuttering, and emotional/behavioral problems, than younger adolescents (12-14 years). There was scant evidence that self-reported stuttering severity is correlated with mental health issues. There are good reasons to believe these results are conservative because many participants gave socially desirable responses about their mental health status.
These results reveal a need for large-scale, statistically powerful assessments of anxiety and other mental disorders among stuttering adolescents with reference to control populations.
The reader will be able to: (a) explain the clinical importance of assessing for mental health with stuttering adolescents, (b) state the superior method for adolescent mental health assessment and (c) state a major issue with determining the genuineness of stuttering adolescent responses to psychological assessment.
本研究旨在通过结构化诊断访谈和心理问卷，评估寻求口吃言语治疗的青少年的焦虑及心理功能状况。本研究还试图确定青少年在心理状态上是否存在年龄差异。
37名寻求口吃治疗的青少年参与了研究。我们采用了儿童诊断访谈量表的计算机语音版以及五项心理测量测试。参与者被分为青少年组（12 - 14岁；n = 20）和年长青少年组（15 - 17岁；n = 17）。
根据《精神疾病诊断与统计手册》第四版（DSM - IV；美国心理学会，2000）的诊断标准，38%的参与者至少被诊断出一种精神障碍，其中大多数诊断涉及焦虑症。这一数字是目前普通青少年人群估计数的两倍，与我们发现的生活质量中度及中重度受损情况相符。尽管许多心理测量指标的得分落在正常范围内，但年长青少年（15 - 17岁）报告的焦虑、抑郁、对口吃的反应以及情绪/行为问题显著高于青少年组（12 - 14岁）。几乎没有证据表明自我报告的口吃严重程度与心理健康问题相关。有充分理由相信这些结果较为保守，因为许多参与者在心理健康状况方面给出了符合社会期望的回答。
这些结果表明，需要针对口吃青少年的焦虑及其他精神障碍，参照对照人群进行大规模、具有统计学效力的评估。
读者将能够：（a）解释对口吃青少年进行心理健康评估的临床重要性，（b）阐述青少年心理健康评估的最佳方法，以及（c）说明在确定口吃青少年对心理评估回答真实性方面的一个主要问题。
