Iverach Lisa, Rapee Ronald M
Centre for Emotional Health, Department of Psychology, Macquarie University, Australia.
J Fluency Disord. 2014 Jun;40:69-82. doi: 10.1016/j.jfludis.2013.08.003. Epub 2013 Sep 2.
Anxiety is one of the most widely observed and extensively studied psychological concomitants of stuttering. Research conducted prior to the turn of the century produced evidence of heightened anxiety in people who stutter, yet findings were inconsistent and ambiguous. Failure to detect a clear and systematic relationship between anxiety and stuttering was attributed to methodological flaws, including use of small sample sizes and unidimensional measures of anxiety. More recent research, however, has generated far less equivocal findings when using social anxiety questionnaires and psychiatric diagnostic assessments in larger samples of people who stutter. In particular, a growing body of research has demonstrated an alarmingly high rate of social anxiety disorder among adults who stutter. Social anxiety disorder is a prevalent and chronic anxiety disorder characterised by significant fear of humiliation, embarrassment, and negative evaluation in social or performance-based situations. In light of the debilitating nature of social anxiety disorder, and the impact of stuttering on quality of life and personal functioning, collaboration between speech pathologists and psychologists is required to develop and implement comprehensive assessment and treatment programmes for social anxiety among people who stutter. This comprehensive approach has the potential to improve quality of life and engagement in everyday activities for people who stutter. Determining the prevalence of social anxiety disorder among children and adolescents who stutter is a critical line of future research. Further studies are also required to confirm the efficacy of Cognitive Behaviour Therapy in treating social anxiety disorder in stuttering.
The reader will be able to: (a) describe the nature and course of social anxiety disorder; (b) outline previous research regarding anxiety and stuttering, including features of social anxiety disorder; (c) summarise research findings regarding the diagnostic assessment of social anxiety disorder among people who stutter; (d) describe approaches for the assessment and treatment of social anxiety in stuttering, including the efficacy of Cognitive Behaviour Therapy; and (e) outline clinical implications and future directions associated with heightened social anxiety in stuttering.
焦虑是口吃最常被观察到且研究广泛的心理伴随症状之一。世纪之交前进行的研究发现口吃者存在焦虑加剧的证据,但结果并不一致且含混不清。未能检测到焦虑与口吃之间明确且系统的关系被归因于方法上的缺陷,包括样本量小以及焦虑的单维度测量方法。然而,最近在更大规模的口吃者样本中使用社交焦虑问卷和精神科诊断评估进行的研究,得出的结果就不那么模棱两可了。特别是,越来越多的研究表明,成年口吃者中社交焦虑障碍的发生率高得惊人。社交焦虑障碍是一种普遍且慢性的焦虑障碍,其特征是在社交或基于表现的情境中对羞辱、尴尬和负面评价存在显著恐惧。鉴于社交焦虑障碍的致残性本质,以及口吃对生活质量和个人功能的影响,言语病理学家和心理学家需要合作,为口吃者制定并实施针对社交焦虑的全面评估和治疗方案。这种综合方法有可能改善口吃者的生活质量以及他们参与日常活动的情况。确定口吃儿童和青少年中社交焦虑障碍的患病率是未来研究的一个关键方向。还需要进一步研究来证实认知行为疗法治疗口吃者社交焦虑障碍的疗效。
读者将能够:(a) 描述社交焦虑障碍的性质和病程;(b) 概述先前关于焦虑与口吃的研究,包括社交焦虑障碍的特征;(c) 总结关于口吃者社交焦虑障碍诊断评估的研究结果;(d) 描述口吃社交焦虑的评估和治疗方法,包括认知行为疗法的疗效;以及 (e) 概述与口吃者社交焦虑加剧相关的临床意义和未来方向。