Article

Disclosure of stuttering and quality of life in people who stutter

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Abstract

Purpose: This study investigated the disclosure practices of people who stutter, and the relationship between disclosure of stuttering and quality of life. Method: Participants were 322 adults who stutter recruited from speech-language pathologists and support group leaders. Participants completed a survey that contained items measuring level of disclosure of stuttering, as well as a global measure of self-rated quality of life. Participants were grouped into low, average, and high quality of life subgroups. Analysis of variance tests compared disclosure levels among these subgroups. Results: The low quality of life subgroup reported significantly lower levels of disclosure compared to both the average and high quality of life subgroups. Participants with self-help/support group experience for stuttering demonstrated significantly higher levels of disclosure of stuttering compared to individuals without such experience. In addition, a substantial number of participants in the overall sample reported that they more than rarely feel the need to conceal stuttering from others (40%), and that no one knows that they stutter in many areas of life (37%). Conclusions: Attempts to conceal stuttering in at least some life situations are not uncommon among adults who stutter. However, being involved in self-help support groups may be a helpful way of increasing disclosure of stuttering. Speech-language pathologists should become aware of the positive relationship between disclosure of stuttering and quality of life and its relevance in assessment and treatment when working with people who stutter.

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... The literature suggests that negative perceptions of stuttering transcend ethnic, cultural, and linguistic differences (Daly & Leahy, 2014;St. Louis & Roberts, 2010); however, these perceptions manifest differently across populations, cannot be assumed, and must be considered prior to implementing specific treatments or techniques. While previous studies support the use of self-disclosure as a tool to mitigate stereotype threat for PWS (Byrd, Croft, Gkalitsiou, & Hampton, 2017;Byrd, McGill, Gkalitsiou, & Cappellini, 2017;Boyle, Milewski, & Beita-Ell, 2018;Mancinelli, 2019), more research regarding the cultural and linguistic sensitivity of this tool is needed. perceived as negative (St. Louis & Roberts, 2010), and the nature of listeners' responses to stuttering (Zhang & Kalinowski, 2012). ...
... The use of self-disclosure to reduce the impact of stuttering Self-disclosure, the act of revealing information about one's self to a listener, has been used as a tool to combat negative stereotypes and increase positive listener perceptions across a variety of stigmatised conditions, such as HIV (Poindexter & Shippy, 2010), mental health disorders (Corrigan, Kosyluk, & Rusch, 2013), and stuttering (Byrd, Croft, et al., 2017;Byrd, McGill, et al., 2017;Boyle et al., 2018;Mancinelli, 2019). As indicated by previous research, potential benefits of self-disclosure include increased selfesteem, decreased worry and concern over the stigmatised condition, and increased resiliency, psychosocial support, and quality of life (e.g. ...
... As indicated by previous research, potential benefits of self-disclosure include increased selfesteem, decreased worry and concern over the stigmatised condition, and increased resiliency, psychosocial support, and quality of life (e.g. Boyle et al., 2018;Corrigan et al., 2013). ...
... The literature suggests that negative perceptions of stuttering transcend ethnic, cultural, and linguistic differences (Daly & Leahy, 2014;St. Louis & Roberts, 2010); however, these perceptions manifest differently across populations, cannot be assumed, and must be considered prior to implementing specific treatments or techniques. While previous studies support the use of self-disclosure as a tool to mitigate stereotype threat for PWS (Byrd, Croft, Gkalitsiou, & Hampton, 2017;Byrd, McGill, Gkalitsiou, & Cappellini, 2017;Boyle, Milewski, & Beita-Ell, 2018;Mancinelli, 2019), more research regarding the cultural and linguistic sensitivity of this tool is needed. perceived as negative (St. Louis & Roberts, 2010), and the nature of listeners' responses to stuttering (Zhang & Kalinowski, 2012). ...
... The use of self-disclosure to reduce the impact of stuttering Self-disclosure, the act of revealing information about one's self to a listener, has been used as a tool to combat negative stereotypes and increase positive listener perceptions across a variety of stigmatised conditions, such as HIV (Poindexter & Shippy, 2010), mental health disorders (Corrigan, Kosyluk, & Rusch, 2013), and stuttering (Byrd, Croft, et al., 2017;Byrd, McGill, et al., 2017;Boyle et al., 2018;Mancinelli, 2019). As indicated by previous research, potential benefits of self-disclosure include increased selfesteem, decreased worry and concern over the stigmatised condition, and increased resiliency, psychosocial support, and quality of life (e.g. ...
... As indicated by previous research, potential benefits of self-disclosure include increased selfesteem, decreased worry and concern over the stigmatised condition, and increased resiliency, psychosocial support, and quality of life (e.g. Boyle et al., 2018;Corrigan et al., 2013). ...
Article
Purpose: Research suggests that self-disclosure can improve listeners' perceptions of stuttering; however, it is unknown whether the effectiveness of self-disclosure transcends culture and language. This study examined the clinical utility of self-disclosure in a culturally and linguistically diverse population: Hebrew-speaking people who stutter in Israel. Method: The experimental protocol replicated Byrd, Croft et al. Participants (N ¼ 92 adults in Israel) viewed a video of either a male or female Hebrew-speaking person who simulated stuttering and self-disclosed informatively, apologetically, or not at all. Participants then rated the speaker on ten traits (i.e. friendly, outgoing, intelligent, confident, engaging, distracting , unfriendly, shy, unintelligent, insecure) using a bipolar likert scale. Result: Results indicated that participants rated the speaker who self-disclosed in a neutral and informative manner as significantly more outgoing compared to the speaker who did not self-disclose at all, supporting the results from Byrd, Croft et al. Additionally, the male speaker was rated as significantly more friendly and outgoing than the female speaker. Conclusion: This study suggests that self-disclosing in a neutral and informative manner can improve listeners' perceptions of people who stutter similarly across culture and language.
... Self-efficacy is also associated with psychological resilience, a protective mechanism against negative effects of stuttering on quality of life (Craig et al., 2011). In addition, a history of SHSG participation was found to be related to disclosure of stuttering and increased social support, which were, in turn, associated with higher selfreported quality of life (Boyle, 2015;Boyle et al., 2018). AWS who made causal attributions for stuttering externally reported greater levels of anxiety and depression and lower levels of self-esteem/self-efficacy and hope while internal causal attributions (sense of power, it can be managed) were more likely to result in greater levels of selfesteem/self-efficacy and hope and lower levels of self-stigma (Boyle, 2015). ...
... We believe that this causal attribution and negative evaluation of stuttering may lead AWS to have a more external LOC view. In addition, based on the previous literature on SHSG participation and stuttering (Boyle, 2013(Boyle, , 2015Boyle et al., 2018;Carter et al., 2017), we hypothesize that AWS with SHSG participation experience will show significantly lower scores on I-E LOC than AWS without such experience. ...
Article
Full-text available
Locus of control (LOC) orientation is one of the personality traits that have been found to be important for adults who stutter (AWS) in terms of treatment outcome and its predictive value on maintenance of treatment gains. Due to its culturally sensitive nature, we aimed to compare AWS with adults who do not stutter (AWNS) in Turkey. We also examined LOC score differences in terms of treatment-related conditions and self-help support group (SHSG) participation among AWS. The participants completed Rotter’s Internal–External LOC (I-E LOC) Scale and a participant information form. These forms were combined into a single electronic format and sent to the participants. SHSG participants were reached via their official social media account. Group differences were examined using descriptive and inferential statistics. No statistically significant difference was observed between AWS and AWNS. SHSG participation, treatment involvement and other treatment-related conditions did not yield statistically significant I-E LOC score differences among AWS subgroups, either. General LOC measurement might not be suitable for examining treatment-related group differences in AWS as none of our observations produced statistically significant results. Affective temperament, self-efficacy, self-stigma, hopelessness and depression measurements could be implemented with more specific LOC measurements such as LCB scale to better understand life views of AWS as well as to observe immediate and long-term effects of stuttering interventions. This study has potential clinical implications while working with AWS.
... 'um', 'like'), changing the feared word with its synonym (substitution), talk around the feared word (circumlocution), etc. Research has shown that avoidance behaviours are common among PWS [42] and all people who stutter use such strategies to some degree [56]. It should be noted that avoidance behaviours such as word substitution doesn't improve the underlying condition and can even have some negative effects [5,8]. However, such tactics can help conceal stuttering with little or no observable disfluency. ...
... Avoiding behaviors can be empowering [12] but they can also have some negative effects. For example, research has shown that people who try to conceal stuttering report lower levels of self-esteem and quality of life [5,8]. Users are advised to visit a speech language pathologist for proper personalized treatment. ...
Preprint
Full-text available
Stuttering is a speech disorder which impacts the personal and professional lives of millions of people worldwide. To save themselves from stigma and discrimination, people who stutter (PWS) may adopt different strategies to conceal their stuttering. One of the common strategies is word substitution where an individual avoids saying a word they might stutter on and use an alternative instead. This process itself can cause stress and add more burden. In this work, we present Fluent, an AI augmented writing tool which assists PWS in writing scripts which they can speak more fluently. Fluent embodies a novel active learning based method of identifying words an individual might struggle pronouncing. Such words are highlighted in the interface. On hovering over any such word, Fluent presents a set of alternative words which have similar meaning but are easier to speak. The user is free to accept or ignore these suggestions. Based on such user interaction (feedback), Fluent continuously evolves its classifier to better suit the personalized needs of each user. We evaluated our tool by measuring its ability to identify difficult words for 10 simulated users. We found that our tool can identify difficult words with a mean accuracy of over 80% in under 20 interactions and it keeps improving with more feedback. Our tool can be beneficial for certain important life situations like giving a talk, presentation, etc. The source code for this tool has been made publicly accessible at github.com/bhavyaghai/Fluent.
... Self-disclosure has been argued to be an external social cue that may help minimize the strength of these explicit negative social attributes made about PWS Lee & Manning, 2010;. PWS and Self-Disclosure PWS are sometimes encouraged to self-disclose their stutter when engaging with a new communication partner (Collins & Blood, 1990) but may be more likely to engage in avoidant behaviors such as using text-based rather than spoken communication to conceal stuttering (for a review, see Boyle et al., 2018). Self-disclosure has been argued to be a tool of empowerment (Corrigan & Rao, 2012) to reduce self-stigmatization (for a review, see McGill et al., 2018). ...
... McGill et al. (2018) found that the most common form of stuttering disclosure is informational in nature, whereas other studies have indicated that nonapologetic disclosures did not promote positive change (Byrd, McGill, et al., 2017). Boyle et al. (2018) indicates that disclosure may not involve an overt statement that one stutters. Rather, it could simply consist of the person stuttering openly, either by not attempting to conceal it or by stuttering voluntarily early on in a communication interaction. ...
Article
Full-text available
Purpose People who stutter are susceptible to discrimination, stemming from negative stereotypes and social misattributions. There has been a recent push to evaluate the underlying explicit and implicit cognitive mechanisms associated with social judgments, moving away from only evaluating explicit social bias about people who stutter. The purpose of the current study was to evaluate how listeners change their implicit and explicit social (mis)attributions after hearing a people who stutter produce disfluent speech. Method The current project was an adaptation of the Byrd et al. (2017) study to evaluate listener implicit/explicit social judgments of stuttered speech across five categories (i.e., confidence, friendliness, intelligence, distractibility, and extroversion) before and after a stuttering self-disclosure. This was done by implementing a modified version of the Ferguson et al. (2019) computer mouse-tracking paradigm. Results Consistent with previous findings, participants made more explicit positive social judgments of confidence, friendliness, extroversion, and intelligence after a stuttering self-disclosure, but the distractedness category was resistant to change. Also consistent with previous findings, participants experienced a higher degree of cognitive competition (i.e., higher area under the curve) shortly after self-disclosure, which lessened over time. Conclusions Explicit and implicit biases exist, but self-disclosure significantly impacts the cognitive system of listeners. Specifically, self-disclosure may reduce explicit bias through experience and explicit belief updating, but when cognitive heuristics are strong, implicit bias may be slower to change.
... These data are consistent with past findings correlating stuttering disclosure and the perceptions of people who stutter (Bajaj et al., 2017;Boyle et al., 2018;Byrd, Croft, et al., 2017;Byrd & Gkalitsiou, 2016;Byrd, McGill, et al., 2017;McGill et al., 2018). However, the present data add to the body of literature by demonstrating the differential effects of the person verbally providing the stuttering disclosures. ...
Conference Paper
While research reveals benefits of stuttering disclosure in adults, there is far less data documenting the effects of pediatric stuttering self-disclosure, or the effects of stuttering disclosure by third-party advocates. The purpose of this study is to explore the effects of stuttering disclosure relative to the perceptions of a child who stutters, particularly when the source of stuttering disclosure is from the child who stutters or adults serving as child advocates. This study measures the perception of speech skills and personality characteristics of a 12-year-old boy who stutters as a function of the source of stuttering disclosure. Sources of stuttering disclosure conditions included a: non-disclosure control condition, child self-disclosure, “parent” disclosure, and “teacher” disclosure experimental conditions. Initial results support the documented benefits of stuttering disclosure when provided by the child who stutters, and also his “teacher”. Stuttering disclosure from the “mother” generally provided no substantial benefit relative to the perceived speech skills or personality characteristics of the 12-year-old boy who stutters.
... Despite evidence that disclosure may ameliorate stigma and promote mental health among people with developmental disabilities, autistic people (and stutterers) often choose not to disclose their diagnostic status and may even hide or camouflage characteristics associated with their conditions (Blood, Blood, Tellis, & Gabel, 2003;Boyle, Milewski, & Beita-Ell, 2018;Cage & Troxell-Whitman, 2019;Hull et al., 2017). Although costs and benefits of disclosure are highly context dependent and the decision to share or withhold diagnostic information should be left to the discretion of affected individuals, the decision not to disclose seems potentially counterproductive when considered in light of recent autism research. ...
Preprint
Full-text available
Revising this paper about stigma towards college students with different diagnoses in response to reviewer feedback. This is the version submitted prior to upcoming revisions. The version accepted to JADD is now available above.
... Disclosure has been shown to have significant positive associations with psychological outcomes among people with CSIs (e.g., Sheridan, 2017) and is advantageous to health in that it can increase social support and promote feelings of emotional wellbeing (Beals et al., 2009;Derlega et al., 1993). Although there have been numerous studies investigating the effects of verbal self-disclosure on listener perceptions of AWS (e.g., Byrd, McGill et al., 2017;Collins & Blood, 1990;Healey et al., 2007), research investigating the effects of disclosure on speakers who stutter is in its infancy (Boyle & Gabel, 2020c;Boyle et al., 2018). ...
Article
Purpose In the current study, stuttering was conceptualized as a concealable stigmatized identity (CSI). The purpose of this investigation was to determine if four specific stigma-identity constructs that contribute to variability in psychological distress among people in other CSI groups also contribute among adult who stutter (AWS). Method 505 AWS completed an online survey that included measures of four stigma-identity constructs in addition to general demographics and measures of self-rated stuttering severity, distress, and adverse impact of stuttering on quality of life. Hierarchical regression was performed to determine the extent that stigma-identity constructs explained variability in psychological health outcomes among AWS. Self-rated stuttering severity was investigated as a moderator in these relationships. Results The stigma-identity constructs accounted for a significant proportion of the variability in distress (∼25%) and adverse impact of stuttering on quality of life (∼30%) among AWS. Further, the constructs of salience, centrality, and concealment were positively predictive of distress and adverse impact of stuttering after controlling for demographics and neuroticism. Compared to the other predictor variables (self-rated stuttering severity, demographic characteristics, neuroticism, and the three other stigma-identity constructs), concealment was the strongest predictor of adverse impact of stuttering on quality of life. Finally, self-rated stuttering severity was a moderating variable. Conclusions The results from this study suggest that there are useful applications in conceptualizing stuttering as a type of CSI. Speech-language pathologists should be aware of the relationships that stigma has with psychological health outcomes among AWS and should consider the implications for intervention.
... These three intentions are all valid, and reflect the different reasons that people make want to change how they talk or stutter. Another common therapy activity that can be informed by various intentions is selfdisclosing stuttering (Boyle et al., 2018;Boyle & Gabel, 2020;Byrd, Croft, et al., 2017;Byrd, McGill, et al., 2017;Croft & Byrd, 2021;McGill et al., 2018). Some people who stutter self-disclose with the intent of freeing themselves from the pressure of trying to hide their stuttering during an interaction. ...
Article
Purpose The aim of this study was to document the behaviors that adults who stutter (AWS) may engage in to make positive changes to living with stuttering. Method We interviewed 23 key stakeholders, including 11 AWS and 12 speech-language pathologists who specialize in stuttering therapy. The semi-structured interviews began with the primary question, “If an adult who stutters was making positive changes to living with stuttering, what would they be doing?” Follow-up probing questions focused the interviews on identifying actionable behaviors that would suggest positive changes. The interviews were transcribed and qualitatively analyzed using applied and reflexive thematic analyses to develop multilevel themes. Results Meaningful units extracted from the interviews contributed to three high-order global themes: (a) noticing and adjusting physical behaviors involved in speaking, to the extent that it is personally important to do so; (b) developing neutral or positive thoughts and feelings about stuttering; and (c) participating more fully in social and professional activities, even if the person stutters or thinks they might stutter. We developed 35 low-order basic themes, which we grouped into 11 mid-order organizing themes, to richly illustrate the three global themes. Conclusions These findings extend the ongoing discussion regarding best practices for therapy targets in stuttering intervention. We identified measurable, multidimensional actions that clinicians can integrate in their therapy plans with AWS. While these actions represent a holistic approach to making positive changes, it grants clients and clinicians space to develop individualized intentions and outcomes.
... These data are consistent with past findings correlating stuttering disclosure and the perceptions of people who stutter (Bajaj et al., 2017;Boyle et al., 2018;Byrd, Croft, et al., 2017;Byrd & Gkalitsiou, 2016;Byrd, McGill, et al., 2017;McGill et al., 2018). However, the present data add to the body of literature by demonstrating the differential effects of the person verbally providing the stuttering disclosures. ...
Article
Purpose This study measured between-group differences in perceived speech skills and personality characteristics of a 12-year-old boy who stutters as a function of a factual stuttering disclosure statement, delivered by the boy who stutters, his “mother,” or his “teacher.” Method Two hundred seventeen college-aged adults were randomly assigned to one of four groups, including a control group (no stuttering disclosure) and three experimental groups (child disclosure, mother disclosure, and teacher disclosure). Participants in the control condition viewed a brief video of a 12-year-old boy who stutters. For the experimental conditions, participants viewed a brief factual stuttering disclosure video (delivered by the child, mother, or teacher), followed by the same minute-long video of a boy who stutters used in the control condition. Following the videos, participants completed surveys relative to their perception of the boy's speech skills and personality characteristics. Results Results support previous research citing benefits of stuttering disclosure. Significant between-group differences in both perceived speech skills and personality characteristics were observed when stuttering was disclosed by not only the child who stutters but also his teacher. When stuttering was disclosed by the mother, limited positive attitudinal differences were observed in speech skills; as a matter of fact, a number of personality characteristics were perceived more negatively as a function of stuttering disclosure by the mother. Conclusions While results were generally most positive when the boy disclosed his own stuttering, data from this study support the efficacy of verbal stuttering disclosure provided by a teacher as a means of improving perceptions associated with stuttering. Accordingly, data support the notion that children who stutter will experience an improved quality of life when taught effective self-disclosure strategies by both parents and professionals, and that professionals (but not necessarily parents) can effectively disclose their clients' stuttering during this mentorship and self-advocacy process.
Article
Purpose There are many therapy approaches for stuttering, but speech-language pathologists (SLPs) often report that they are uncomfortable treating stuttering. The 3Es model for stuttering therapy (education, ease, and empowerment) is proposed to help SLPs understand stuttering treatment options efficiently and effectively. This model is based on emerging stuttering research trends such as redefining stuttering, anticipation of stuttering, and stigma of stuttering. A primary function of the 3Es model is to serve as a translational research-to-practice funnel for practicing SLPs. Conclusions This tool is conceptualized by identifying three key thematic components of stuttering therapy: education, ease, and empowerment. The Es are the values-based themes of stuttering therapy, and a successful application of the model will create an accessible, robust, and structured “menu” of activities for clinicians to use in treatment planning. These therapy activities can be flexibly combined to provide holistic stuttering therapy and communication outcomes, which include competence, confidence, and change.
Chapter
The purpose of this study is to analyze the effect of Islamic Leadership on Teacher Performance through Competency based on Information Technology (IT) Intervention and Quality of Work Life. This study used 100 teachers as a sample with Purposive Random Sampling. The result of this research showed that Islamic Leadership, Competency based on IT Intervention, and Quality of Work Life positively affect Teacher Performance. Based on data analysis, only Quality of Work Life on Teacher Performance which has no significant effect. However, Competency based on IT Intervention and Quality of Work Life cannot be considered as intervening variable in this research.
Article
Purpose: This study examined whether people who stutter would associate biological and non-biological explanations of stuttering with the endorsement of stereotypes about people who stutter, prognostic expectations for the reduction of stuttering, feelings of guilt, self-blame, and shame about stuttering, and agency for speech modification. Method: This was a cross-sectional study including 372 adults who stutter. Participants completed a web survey with scales that measured their agreement with biological and non-biological models of stuttering; their endorsement of common stereotypes for people who stutter; prognostic expectations for reduced stuttering; feelings of guilt, self-blame, and shame about stuttering; and feelings of agency in their ability to modify their speech. Result: Biological explanations for stuttering were significantly correlated with reduced stereotype endorsement about people who stutter, lower prognostic expectations for reducing stuttering, and reduced feelings of guilt and self-blame regarding stuttering. Non-biological explanations for stuttering were significantly correlated with increased endorsement of negative stereotypes about people who stutter, increased prognostic expectations for reducing stuttering, and increased feelings of guilt, self-blame, and shame about stuttering. Conclusion: It is concluded that the implications of biological framing of stuttering among people who stutter are complex and should be well thought out by professionals. Explaining stuttering as biological, but responsive to personal and environmental influences, may lead to reduced guilt and self-blame, while at the same time fostering feelings of agency for speech modification.
Article
Purpose The purpose of this study was to evaluate whether persons who stutter (PWS) reported benefits related to their stuttering and to describe the nature of those benefits. Method A mixed-methods approach was utilized. Qualitative content analysis was conducted with 5 different books, which included chapters written by PWS that focused on the experiences of stuttering and psychosocial aspects of the condition. In addition, 4 survey items measuring perceived benefits from stuttering were administered to 322 adults who stutter. Results Three major themes with 11 subthemes were identified in the qualitative analysis. PWS reported personal benefits from stuttering, including positive behavioral outcomes, cultivation of determination, feeling stronger, and emotional growth. Relationship benefits included social support access, deepening of relationships, and increased sensitivity to others. Changes in perspective included gained perspective about stuttering, gained perspective on life, a sense of appreciation, and finding positive meaning in challenges. Quantitative analysis revealed that over 90% of PWS agreed that stuttering has made them more understanding of other people, and over 80% agreed that it has made them stronger. Conclusion It is concluded that benefit finding among PWS should continue to be investigated in order to obtain a more complete understanding of the psychosocial aspects of stuttering and potentially to enhance therapeutic and support services for PWS.
Article
Purpose: The purpose of this study was to identify components of disclosure events among people who stutter, and identify possible relations between these components in order to understand how disclosure events unfold. Method: Twelve adults who stutter participated in semi-structured interviews focused on disclosure of stuttering. Participants were purposefully selected due to their self-reported history of disclosing stuttering. Qualitative content analysis using a grounded theory approach helped to identify relevant themes and subthemes related to the process of disclosure of stuttering. Results: The findings describe the complex process of disclosure as being comprised of antecedents (including considerations about when and why to disclose), the disclosure event itself (including the content and form of the disclosure, most and least helpful methods of disclosure, as well as immediate listener reactions), and the perceived outcomes of the disclosure at individual, dyadic, and societal/contextual levels. These components of the process are linked and affect one another, resulting in a feedback loop. Disclosure methods are context-dependent and not mutually exclusive within individuals who stutter. Conclusion: Professionals and advocates gaining a more nuanced understanding of the process of disclosure events can increase their ability to help people who stutter make optimal decisions about disclosure. Making good disclosure decisions can help PWS improve their quality of life and reduce a variety of environmental communicative barriers.
Article
Purpose The purpose of this study was to gain a deeper understanding of the experience of people who stutter as they navigate through the growth process from concealment to openness. Method Twelve adults who stutter who are active in self-help/support groups for stuttering described their experiences of concealment and openness in a semi-structured interview. Purposeful selection was utilized in order to recruit participants who could comment thoughtfully on previous concealing, but are now more open about their stuttering. A phenomenological approach was utilized to gain a deeper understanding of how people who stutter experience the transition from concealment to openness regarding their stuttering and identity. Thematic analysis contributed to identification of themes and subthemes describing participants’ experiences. Results Participants described precursors to concealment that led to hiding and avoidance, which grew in strength until they reached a turning point. They then changed how they related to their stuttering by changing their behaviors and perceptions of stuttering, which led to increased openness about their identity. This process of continued adaptation to stuttering was ongoing and non-linear, but suggested general trends from concealment to more openness over time. Level of openness was impacted by situational context and individual differences. Conclusions The findings extend our understanding of how people who stutter navigate transitions from concealment to openness. This deeper understanding could be helpful in explaining the complexities involved in managing the identity of a person who stutters, and the process of adapting to living with stuttering over time.
Article
Purpose: The purpose of this study was to investigate the relationship between depressive symptoms and suicidal ideation and living with stuttering while accounting for time, sex, and health-related confounders. Method: The data for this study come from the National Longitudinal Study of Adolescent to Adult Health, a nationally representative survey study that has followed 13,564 respondents over the course of 14 years. Responses to the question "Do you have a problem with stuttering or stam-mering?" at two time points were used to establish stuttering and non-stuttering groups. Regression analysis, propensity score matching, and structural equation modeling were used. Results: Compared to their fluent counterparts, males and females reported significantly elevated symptoms of depression. Although symptoms of depression among males who stutter were stable over time, depressive symptoms among females who stutter increased with age. Compared to males who do not stutter, males who stutter were significantly more likely to report feelings of suicidal ideation. There were no differences in suicidal ideation between females who do and do not stutter. Conclusions: Speech-language pathologists should be aware of the associations between stuttering and depressive symptoms, as well as the increased risk for suicidal ideation among males who stutter. Clinicians should be knowledgeable about symptoms of depression and suicidal ideation and be familiar with processes to refer as needed.
Article
Purpose The purpose of this study was to identify levels of self-compassion in adults who do and do not stutter and to determine whether self-compassion predicts the impact of stuttering on quality of life in adults who stutter. Method Participants included 140 adults who do and do not stutter matched for age and gender. All participants completed the Self-Compassion Scale. Adults who stutter also completed the Overall Assessment of the Speaker's Experience of Stuttering. Data were analyzed for self-compassion differences between and within adults who do and do not stutter and to predict self-compassion on quality of life in adults who stutter. Results Adults who do and do not stutter exhibited no significant differences in total self-compassion, regardless of participant gender. A simple linear regression of the total self-compassion score and total Overall Assessment of the Speaker's Experience of Stuttering score showed a significant, negative linear relationship of self-compassion predicting the impact of stuttering on quality of life. Conclusions Data suggest that higher levels of self-kindness, mindfulness, and social connectedness (i.e., self-compassion) are related to reduced negative reactions to stuttering, an increased participation in daily communication situations, and an improved overall quality of life. Future research should replicate current findings and identify moderators of the self-compassion–quality of life relationship.
Article
Purpose The current research study investigates the speech therapy experiences of an individual who covertly stuttered for approximately 40 years; at the time of the interview, she was in her mid-40s. Method The single-case study is a qualitative thematic analysis of the speech therapy experiences of one individual across her life span. In addition to her stuttering, the participant lives with a significant primary diagnosis that she has had since birth, which impacts her activities in daily living. Interview questions were open-ended and conducted via Skype. The interview was transcribed, and a thematic analysis of the recorded transcripts was conducted to investigate her experiences in speech therapy as an individual who covertly stutters. Findings The current findings reveal five major themes regarding the speech therapy experiences of an individual who covertly stutters: (a) nonindividualized treatment and goals, (b) blaming and shaming associated with speech therapy and stuttering, (c) positive self-regard during speech therapy attendance, (d) the use of avoidance strategies and relation to speech therapy, and (e) the evolution of therapy goals. Direct quotations from the participant are used to support these themes. Discussion The significant impact of covert stuttering on an individual is discussed. Results from the participant's experiences indicate an essential need to conduct individualized speech therapy for people who stutter. Speech-language pathologists and others working with persons who stutter maintain a responsibility to recognize the role that case history and counseling play in order to appropriately serve people who covertly stutter.
Article
Purpose Stuttering can have a significant detrimental effect on the overall well-being of children, including anxiety, stigma, and adverse impact on the development of healthy social relationships. This clinical focus article proposes a collaborative, ecological model of stuttering intervention consistent with interprofessional practice that combines the expertise of the speech-language pathologist and school-based mental health provider to support fluency and social–emotional health for school-age children who stutter. The literature in the fields of speech pathology and mental health interventions was summarized to provide the underlying evidence base for such a collaborative approach. Conclusions While collaborative approaches are recommended as best practice for stuttering, there is scant evidence in the literature of such approaches being used. An ecological, collaborative framework will enable practitioners to help teachers, parents, and others address speech disfluency as well as the accompanying anxiety and avoidance that are pervasive in the lives of many children who stutter. Such an approach will help ensure that gains in the treatment room are carried across settings (i.e., transfer/generalization of skills) and will help children be better able to manage the challenges associated with stuttering to find success in the real world.
Article
Purpose This study measured between-groups differences in perceived speech skills and personality characteristics of a 12-year-old male child who stutters (CWS) as a function of a written factual stuttering disclosure statement, delivered by the CWS, his “mother,” or his “teacher.” Method Four hundred twenty-four college-age adults were assigned to one of four groups, including three experimental groups (i.e., written self-disclosure, mother-written disclosure, and teacher-written disclosure) and a control group (no written disclosure). Participants in the control conditions viewed a brief video of the CWS. In the experimental conditions, participants read a brief written disclosure statement for 30 s, followed by the same video used in the control condition. After viewing the video, all participants completed surveys relative to their perceptions of the CWS speech skills and personality characteristics. Results Results reveal that a written stuttering disclosure statement provided by the mother correlated with select significant desirable perceptual differences of the CWS, while a written disclosure statement provided by the CWS yielded insignificant or even undesirable perceptual differences of the CWS. Written stuttering disclosures provided by a “teacher” did not yield any significant between-groups differences in the perception of a CWS. Gender affiliation was found to be a source of covariance in a number of perceived speech skills and personality characteristics. Conclusions Written stuttering disclosure statements provided by the “mother” correlated with select favorable perceptual differences of speech skills and personal characteristics of a CWS. Clinically, the application of novel methods (written and oral disclosure statements) and sources (i.e., CWS advocates such as “mother” and “teacher”) of stuttering disclosure statement can be integrated into a systematic therapeutic program, creating an innovative approach of scaffolding self-advocacy via stuttering disclosure in CWS. Supplemental Material https://doi.org/10.23641/asha.15505857
Article
Purpose Adults who stutter (AWS) have increased risk of comorbid social anxiety about speaking in social contexts. AWS also report experiencing embarrassment in different social situations; however, research has rarely been conducted on embarrassment and its relationship to social anxiety in AWS. Method AWS ( N = 200) reported their level of embarrassment on four 10-point Likert items when speaking in four situational contexts: at home, to an individual important to them, in social groups, and at work. Participants were also assessed for sociodemographic, stuttering, and anxiety variables. Construct validity for the four embarrassment items was examined, the extent of embarrassment established in the four contexts as a function of age and sex, and the relationship of embarrassment to social anxiety evaluated. Results Evidence of acceptable construct validity and reliability is presented for the four embarrassment Likert items. Sixty-five percent of the sample experienced high levels of embarrassment when speaking in groups or at work, while 35.5% experienced high levels when speaking at home or to an individual important to them. Participants were significantly more embarrassed ( p < .01) when speaking at work or when socializing in groups. Embarrassment was lowest when speaking in the home. Younger females were significantly more embarrassed when speaking at work or when socializing in groups. Those with high embarrassment scores on all four items were more likely to have elevated social anxiety scores ( p < .001). Conclusion These preliminary results suggest that the assessment of situational embarrassment could be an important clinical measure that may help improve stuttering treatment outcomes that also target social anxiety.
Article
This article highlights the value for speech–language pathologists of considering the overall stuttering condition—including speakers' experiences during and around moments of stuttering—in treatment with individuals who stutter. We first highlight a framework for conceptualizing the entirety of the stuttering condition. We then present recent research and clinical perspectives about stuttering to support the claim that speech–language pathologists who account for individual differences in how their clients experience stuttering are better positioned to treat stuttering more effectively. Ultimately, this will yield better treatment outcomes and help clinicians achieve greater gains in quality of life for their clients who stutter.
Article
Personalized URL with free access until end of May 2019: https://authors.elsevier.com/c/1YqWy,29sRyqa9 Childhood-onset stuttering is a complex and multifaceted disorder. Intervention for adults who stutter has historically addressed speech fluency more so than psychosocial aspects of the disorder, including the nature of the individual’s self-efficacy beliefs concerning their confidence in their capacity to enact change. Self-efficacy is an important construct related to quality of life, resilience, and maintenance of treatment gains for adults who stutter. The purpose of this qualitative study is to explore the nature of the self-efficacy beliefs expressed by adults who stutter in order to inform efficacious and holistic intervention for these individuals. Semi-structured interviews were conducted with 29 adults who stutter to describe their experiences as a person who stutters and elucidate the nature of their self-efficacy beliefs. Thematic analysis identified several major themes that provided novel insight into the complex nature of the self-efficacy beliefs experienced by adults who stutter: speaker experiences shaped communicative confidence, there was a conflict between communication and fluency, stuttering was viewed as more than fluency, and individual perspectives shaped communicative confidence, as did the pervading influence of self. The notion that fluency and confidence are inextricably linked was evident within and across each major theme. These preliminary findings provide further support for a multidimensional approach to the treatment of adults who stutter. Findings will be used to inform a novel integrated fluency and psychosocial intervention for adults who stutter that addresses fluency and self-efficacy concurrently, with a view of engendering durable improvements in speech fluency and communicative confidence.
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Social relationships often decline after brain injury. Although much of this is due to psychosocial impairments caused by the injury, the reactions to the injury of others in the person’s wider social network, along with the response of the person with the injury to those reactions, also need to be considered. Anxiety about stigmatising reactions from others may lead some to conceal information about their brain injury. This study investigated some of the social consequences of such concealment. Sixty-five participants with acquired brain injury completed the Anticipated Stigma and Concealment Questionnaire, the Social Avoidance and Distress Scale, the UCLA Loneliness Scale, the Rosenberg Self-Esteem Scale, the Social Integration subscale of the Community Integration Questionnaire, and the Enacted Social Support Questionnaire. As hypothesised, concealment was associated with social anxiety, social avoidance, loneliness and lower self-esteem; and anxiety mediated the impact that concealment had on avoidance, loneliness and reduced community activity. However, contrary to expectation, concealment was not associated with reduced use of social support. Concealment may have negative consequences, but inappropriate disclosure can also be harmful. Services should support individuals to make optimal decisions about disclosing information about the brain injury and also help them address psychological barriers to disclosure.
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Purpose: The purpose of this study was to examine the influence of self-disclosure on observers' perceptions of persons who stutter. Method: Participants (N = 173) were randomly assigned to view 2 of 4 possible videos (i.e., male self-disclosure, male no self-disclosure, female self-disclosure, and female no self-disclosure). After viewing both videos, participants completed a survey assessing their perceptions of the speakers. Results: Controlling for observer and speaker gender, listeners were more likely to select speakers who self-disclosed their stuttering as more friendly, outgoing, and confident compared with speakers who did not self-disclose. Observers were more likely to select speakers who did not self-disclose as unfriendly and shy compared with speakers who used a self-disclosure statement. Controlling for self-disclosure and observer gender, observers were less likely to choose the female speaker as friendlier, outgoing, and confident compared with the male speaker. Observers also were more likely to select the female speaker as unfriendly, shy, unintelligent, and insecure compared with the male speaker and were more likely to report that they were more distracted when viewing the videos. Conclusion: Results lend support to the effectiveness of self-disclosure as a technique that persons who stutter can use to positively influence the perceptions of listeners.
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Support for lesbians’, gay men’s, bisexuals’, and transgender people’s (LGBT) rights has increased over the last two decades. However, these recent trends hide existing disparities between and within countries. In particular, workplace discrimination is still a relatively widespread phenomenon. Although many countries lack legal provision protecting LGBT employees, numerous organizations have adopted LGBT-supportive policies over the last two decades. Many studies have investigated the business case for diversity arguments and tested whether diversity brings about positive business outcomes. However, few studies have studied their effect on outcomes that do not directly affect employees’ productivity. This article aims at filling this gap and examines whether LGBT-supportive policies help (1) to reduce discrimination based on sexual discrimination and (2) to increase LGB employees’ well-being and psychological health at work. Results show that diversity management contributes to shaping the experience of LGB employees by reducing discrimination and increasing overall well-being at work. However, LGBT-supportive policies do not influence employees’ psychological health outcomes.
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To investigate what goals influence the decisions of people with a traumatic brain injury to disclose (or not to disclose) information about their brain injury. Ten people with a traumatic brain injury were interviewed about disclosing information about their injury to others. Thematic analysis was used to analyse the data. The report focuses on disclosure to people other than immediate family and close friends. Reasons for not disclosing included concern about negative reactions from others, feelings of shame about the injury, wanting to avoid getting distressed, wanting to fit in, lack of interest from others and the perception that the stress associated with the act of disclosing outweighed the benefits. Reasons for disclosing included obtaining emotional and practical support from others, the emotional release obtained from disclosure, the need to explain their behaviour to others and giving others the benefit of their experience. Experience of negative and stigmatizing reactions from others was common. Participants varied in their willingness to disclose. Disclosure can have important advantages and disadvantages. Some people with a TBI may need support in making optimal decisions about disclosure.
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This research examined whether the relationship between perceived social support and health would be moderated by level of outness for people living with different concealable stigmatized identities (mental illness, substance abuse, domestic violence, rape, or childhood abuse). A total of 394 people living with a concealable stigmatized identity completed a survey. Consistent with hypotheses, at high levels of outness, social support predicted better health; at low levels of outness, social support was less predictive of health. People concealing a stigmatized identity may only be able to reap the health benefits of social support if they are "out" about the stigmatized identity. © The Author(s) 2015.
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Facing frequent stigma and discrimination, many people with mental illness have to choose between secrecy and disclosure in different settings. Coming Out Proud (COP), a 3-week peer-led group intervention, offers support in this domain in order to reduce stigma's negative impact. To examine COP's efficacy to reduce negative stigma-related outcomes and to promote adaptive coping styles (Current Controlled Trials number: ISRCTN43516734). In a pilot randomised controlled trial, 100 participants with mental illness were assigned to COP or a treatment-as-usual control condition. Outcomes included self-stigma, empowerment, stigma stress, secrecy and perceived benefits of disclosure. Intention-to-treat analyses found no effect of COP on self-stigma or empowerment, but positive effects on stigma stress, disclosure-related distress, secrecy and perceived benefits of disclosure. Some effects diminished during the 3-week follow-up period. Coming Out Proud has immediate positive effects on disclosure- and stigma stress-related variables and may thus alleviate stigma's negative impact.
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This study examined if disclosure to their spouses by married women living with HIV/AIDS resulted in conflicts. Fifty-seven women completed a questionnaire on conflict indicators. While 93% disclosed their status within 6 months of diagnosis, 12.3% did so through a third party. More than thirty-six percent (36.8%) confirmed that disclosure led to conflict. Although 19.3% had their conflicts resolved through a third party, 10% suffered separation. Marital status and fear of stigma significantly influence time to disclose (p < .01 and p < .05), while type of marriage strongly influences whether status will be disclosed (p < .01). Programs for women with HIV should consider conflicts that may arise from disclosure.
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Analysis of data collected from 124 lesbians (aged 20–66 yrs) currently involved in a couple relationship indicated that closeting was related to the couple's relationship quality. Openness vs secrecy with family and friends was most highly associated with the quality of their relationship. Further analyses suggest that particular family behaviors (e.g., inviting a member's lesbian partner to family events, accepting demonstrations of affection between the couple) can influence their relationship. Findings underscore the importance of support from family members. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Serious mental illness is a two-edged sword: It challenges those affected not only with disability but also with unjust social stigma, which denies them opportunities to work, live independently, and pursue other goals. Written by participants and first-rate social scientists in the Chicago Consortium for Stigma Research, On the Stigma of Mental Illness: Practical Strategies for Research and Social Change explores the causes and ramifications of mental illness stigma and possible means to eliminate it. The book translates basic behavioral research, especially from social psychology, to an issue of prime importance to clinical psychology. At the core of many problems facing people with mental illness is public reaction to their disabilities (e.g. landlords may not rent to and employers may not hire someone with a serious mental illness). The authors explore the causes of such stigmatizing attitudes, including media images and a culture that does not respect people with mental illness. Living within such a culture often leads to self-stigmatization as well. Although laws such as the Americans With Disabilities Act have decreased the impact of discrimination, contact between those with mental illness and those without may be one of the most effective ways to diminish stigma. This book includes practical strategies for dealing with public stigma and self-stigma, including deciding when and how to disclose one's psychiatric history to others. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Background: There are costs and benefits for people with psychiatric disorders to decide to disclose publicly these disorders. Aims: The gay and lesbian community has struggled with the same tension and their discoveries about coming out may prove useful for the disclosure concerns of persons with mental illness. Methods: Lessons learned about coming out by the gay and lesbian community include a variety of models that map the stages for successfully coming out; e.g., identity confusion, comparison, identify acceptance, immersion, and identity synthesis. Navigating these stages requires consideration of the costs and benefits of disclosure; we review some of these including social avoidance and disapproval as key costs and improved psychological well-being and interpersonal relations as benefits. Conclusions: The paper ends with a review of levels of disclosure for people who opt to come out. Declaration of interest: This paper was made possible in part by MH62198-01 from the National Institute of Mental Health.
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This cross-sectional study examined the relationships between social support, HIV disclosure, and depression among 340 rural African American women with HIV disease living in the southeastern United States. Three aspects of social support (perceived availability of support, sources of available support, and satisfaction with available support) were measured along with HIV disclosure and depression. Perceived availability of support (p < .0001), sources of support (p = .03), satisfaction with support (p = .003), and HIV disclosure (total and to children; p = .05 and .04, respectively) were significantly and inversely correlated with depression. Perceived availability of support and satisfaction with support mediated the relationship between HIV disclosure and depression. If confirmed in longitudinal studies, these findings have implications for designing and implementing interventions supporting African American women with HIV disease in disclosing their HIV status appropriately, particularly to their children. In long run, appropriate self-disclosure may help decrease depression and improve quality of life among HIV infected African American women living in limited resource settings.
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To describe and analyse how two adults with traumatic brain injury (TBI) construct meaning about their communication and its impact upon friendships. This information was sought with a view to understanding whether these adults perceived a link between their post-TBI communication and their experience of friendship; and, in addition, which aspects of their communication, if any, emerged as being important in this scenario. A qualitative approach based on Grounded Theory. Purposive sampling of two participants living in the community at a minimum of 2 years post-severe TBI was utilized. Data was collected via in-depth semi-structured interviews. Transcripts were analysed for categories and themes. Three major themes were evident: (1) The experience of friendship following TBI, (2) Changes to conversational skill and (3) Opening up to others. Communication change was important in the experience of friendships in so much as difficulties with conversational skill impacted on participation levels and self-disclosure. Participants identified aspects of communication associated with difficulties when interacting with friends and peers. Participants' stories illustrate the need to address post-TBI communication difficulties within social contexts. Further research addressing communication difficulties that impact on friendships specific to gender, age and time post-injury is warranted.
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Goffman (Stigma: Notes on the management of spoiled identity, Prentice-Hall Inc., Englewood Cliffs, NH, 1963) distinguished stigmatized groups as discredited (with relatively obvious marks such as people of color or gender) or discreditable (without obvious marks, causing stigma to be largely hidden). Like gay men and lesbians, people with various mental illnesses can opt to stay in the closet about these conditions in order to avoid corresponding prejudice and discrimination. In this study, we completed semi-structured interviews with 13 gay men and lesbians in order to better understand the personally perceived consequences that guide the coming out process. This information would, in turn, help us to better comprehend the process of coming out for people with mental illnesses. Interview participants identified specific benefits and costs. Benefits that promote disclosure include acceptance, community, and comfort and happiness. Costs that diminish coming out decisions include shame and conformity as well as harm and discrimination. We then postulated how these consequences might manifest themselves in the disclosure process of people with serious mental illnesses. Finally, implications for stigma management and change were considered.
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The authors' goal was to examine the extent to which perceived stigma affected treatment discontinuation in young and older adults with major depression. A two-stage sampling design identified 92 new admissions of outpatients with major depression. Perceived stigma was assessed at admission. Discontinuation of treatment was recorded at 3-month follow-up. Although younger patients reported perceiving more stigma than older patients, stigma predicted treatment discontinuation only among the older patients. Patients' perceptions of stigma at the start of treatment influence their subsequent treatment behavior. Stigma is an appropriate target for intervention aimed at improving treatment adherence and outcomes.
Article
Purpose: To (1) analyze verbatim wording used by adults who stutter (AWS) to self-disclose stuttering, (2) determine contexts in which AWS may self-disclose, (3) examine the use of self-disclosure by AWS about other aspects of their identity, and (4) investigate the ways in which speech-language pathologists (SLPs) develop self-disclosure statements with AWS. Method: Web-based questionnaires were administered to AWS (N = 42) and SLPs (N = 33) who work with AWS. The AWS questionnaire asked about the verbatim wording of self-disclosure statements used by AWS and the contexts in which they utilize them. For SLPs, the questionnaire probed how and why they work with AWS to formulate self-disclosure statements. Responses were openly coded and then funneled into concepts for analysis. Results: The majority of AWS provided verbatim self-disclosure statements which were educational in nature. However, when responding to fixed choices and when reporting on self-disclosing other aspects of their lives, the majority of participants selected a direct statement. The majority of AWS reported that they self-disclose when interviewing for a job. SLPs reportedly instruct their clients to use educational self-disclosure statements. SLPs also reported that they use an individualized approach to brainstorming self-disclosure statements. Finally, SLPs reported that they find self-disclosure beneficial because it facilitates self-empowerment for AWS. Conclusion: AWS may benefit from learning about the type of self-disclosure statements and the contexts in which other AWS chose to disclose. Additionally, SLPs who work with AWS may benefit from the reported procedures for and types of self-disclosure statements formulated by AWS.
Article
Purpose: This study aimed to identify contributors to communicative participation in adults who stutter. Specifically, it was of interest to determine whether psychosocial variables of self-esteem, self-efficacy, and social support were predictive of communicative participation beyond contributions of demographic and speech-related variables. Method: Adults who stutter (N = 339) completed an online survey that included measures of communicative participation, self-esteem, self-efficacy, social support, self-reported speech-related variables (speech usage, number of years stuttering, history of treatment and self-help support group participation for stuttering, and physical speech disruption severity), and demographics (age, sex, living situation, education, and employment status). Hierarchical regression was performed for prediction of communicative participation, in addition to calculating Spearman correlations between social roles variables, communicative participation, and physical speech disruption severity. Results: After controlling for demographic and speech-related variables, self-esteem, self-efficacy, and social support each significantly predicted communicative participation in adults who stutter. Large correlations were observed between communicative participation and measures of social roles, whereas medium correlations were observed between physical speech disruption severity and measures of social roles. Conclusions: Communicative participation in adults who stutter is associated with a variety of demographic, speech-related, and psychosocial variables. Speech-language pathologists should be aware of predictors of communicative participation such as self-esteem, self-efficacy, and social support, in addition to severity of physical speech disruptions. They should consider and evaluate these factors in clients who stutter and target them in treatment if necessary.
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Purpose: The aim of this study was to (1) document the experiences of enacted stigma (external stigma, experienced discrimination) and felt stigma (anticipation and expectation of discrimination or negative treatment by others) in adults who stutter, (2) investigate their relationships to each other, and (3) investigate their relationships to global mental health. Method: Participants were 324 adults who stutter recruited from clinicians and self-help group leaders in the United States. Participants completed an anonymous web survey consisting of measures of enacted stigma, felt stigma, and global mental health. Data analysis focused on obtaining descriptive statistics for enacted stigma and felt stigma, and performing correlational analysis between these variables, and also between these variables and global mental health. Results: Most participants reported experiencing several different forms of social devaluation and negative treatment from other people at some point in their lives (i.e., enacted stigma), although they rarely experienced these events during the past year. Most participants agreed that they anticipate future stigmatizing experiences (i.e., felt stigma). Enacted stigma in the past year demonstrated a significant positive relationship to felt stigma. Both enacted stigma in the past year and felt stigma demonstrated significant negative relationships with global mental health. Enacted stigma in the past year and felt stigma were unique predictors of participants' global mental health. Conclusions: People who stutter experience discrimination and social devaluation, and they anticipate future stigmatizing experiences. Both of these types of stigma, enacted and felt, are associated with reduced mental health in adults who stutter. Assessment and therapy with adults who stutter should address these aspects of stuttering.
Article
Background: Due to public stigma or self-stigma and shame, many adolescents with mental illness (MI) struggle with the decision whether to disclose their MI to others. Both disclosure and nondisclosure are associated with risks and benefits. Honest, Open, Proud (HOP) is a peer-led group program that supports participants with disclosure decisions in order to reduce stigma's impact. Previously, HOP had only been evaluated among adults with MI. Methods: This two-arm pilot randomized controlled trial included 98 adolescents with MI. Participants were randomly assigned to HOP and treatment as usual (TAU) or to TAU alone. Outcomes were assessed pre (T0/baseline), post (T1/after the HOP program), and at 3-week follow-up (T2/6 weeks after T0). Primary endpoints were stigma stress at T1 and quality of life at T2. Secondary outcomes included self-stigma, disclosure-related distress, empowerment, help-seeking intentions, recovery, and depressive symptoms. The trial is registered on ClinicalTrials (NCT02751229; http://www.clinicaltrials.gov). Results: Compared to TAU, adolescents in the HOP program showed significantly reduced stigma stress at T1 (d = .92, p < .001) and increased quality of life at T2 (d = .60, p = .004). In a longitudinal mediation model, the latter effect was fully mediated by stigma stress reduction at T1. HOP further showed significant positive effects on self-stigma, disclosure-related distress, secrecy, help-seeking intentions, attitudes to disclosure, recovery, and depressive symptoms. Effects at T1 remained stable or improved further at follow-up. In a limited economic evaluation HOP was cost-efficient in relation to gains in quality of life. Conclusions: As HOP is a compact three-session program and showed positive effects on stigma and disclosure variables as well as on symptoms and quality of life, it could help to reduce stigma's negative impact among adolescents with MI.
Article
Purpose: The aim of this study was to identify potential relationships between self-stigma (stigma awareness and stigma application) and stress, physical health, and health care satisfaction among a large sample of adults who stutter. It was hypothesized that both stigma awareness and stigma application would be inversely related to measures of physical health and health care satisfaction, and positively related to stress. Furthermore, it was anticipated that stress mediated the relationship between self-stigma and physical health. Method: A sample of adults who stutter in the United States (n=397) completed a web survey that assessed levels of stigma awareness and stigma application, stress, physical health, and health care satisfaction. Correlational analyses were conducted to determine the relationships between these variables. Results: Higher levels of stigma awareness and stigma application were associated with increased stress, decreased overall physical health, and decreased health care satisfaction (i.e., discomfort obtaining health care due to stuttering, and adverse health care outcomes due to stuttering), and these relationships were statistically significant. Stress was identified as a mediator between stigma application and physical health. Conclusion: Because adults who stutter with higher levels of self-stigma are at risk for decreased physical health through increased stress, and lower satisfaction with their health care experiences as a result of stuttering, it is important for professionals to assess and manage self-stigma in clients who stutter. Self-stigma has implications for not only psychological well-being, but stress, physical health, and health care satisfaction as well.
Article
BACKGROUND: Individuals must disclose their disability to their employer to benefit from work accommodations. Since individuals with multiple sclerosis often have "invisible" symptoms, they must decide whether or not to disclose their diagnosis to employers and whether the perceived benefits are worth the perceived risks. OBJECTIVE: The purpose of this study was to identify factors that may influence the decision to disclose disability to an employer and the consequences of disclosure for participants with multiple sclerosis (MS). METHODS: Qualitative analysis was conducted using narratives from 8 focus groups held in three US states (South Carolina, Georgia and Ohio). All participants (N=74) were 18 years of age or older, spoke English, and had worked after MS diagnosis, although not all were employed at the time of the study. In focus groups sessions, participants were asked "Did you decide to tell your employer about your MS? If so, how did it impact either finding or maintaining employment?" RESULTS: Narrative responses indicated eight themes that fell into two categories: decision to disclose and consequences of disclosure. In the category of Decision to Disclose, themes included (1) disclosing to explain, prepare, or educate, (2) general disclosure, no concerns, (3) limiting, delaying, or deciding not to disclose, and (4) unsure about future disclosure. Within Consequences of Disclosure, themes included (5) positive and supportive reactions, (6) mixed or variable reaction in the same work environment, (7) no real reaction, positive or negative, and (8) leading to termination of employment. CONCLUSION: Our findings shed important light on the diversity of considerations and impact on employment of disclosing disability in the workplace for those with MS and highlight the importance of individuals' feeling that they have control over the process.
Article
Purpose The purpose of the present study was to explore the clinical utility of self-disclosure, particularly, whether disclosing in an informative manner would result in more positive observer ratings of the speaker who stutters than either disclosing in an apologetic manner or choosing not to self-disclose at all. Method Observers (N = 338) were randomly assigned to view one of six possible videos (i.e., adult male informative self-disclosure, adult male apologetic self-disclosure, adult male no self-disclosure, adult female informative self-disclosure, adult female apologetic self-disclosure, adult female no self-disclosure). Observers completed a survey assessing their perceptions of the speaker they viewed immediately after watching the video. Results Results suggest that self-disclosing in an informative manner leads to significantly more positive observer ratings than choosing not to self-disclose. In contrast, use of an apologetic statement, for the most part, does not yield significantly more positive ratings than choosing not to self-disclose. Conclusion Clinicians should recommend their clients self-disclose in an informative manner to facilitate more positive observer perceptions.
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The impact of mental illness stigma on societyWhat is the reader's role in changing society?Definitions relevant to public service announcements and social marketingStrategy I. Provide contact with persons with mental illnessMoshe Levi's storyRobert Lundin's storyThe story of Liu Ying and ChowStrategy II. Changing stigma through educationStrategy III. Protest discriminatory practices
Article
Purpose: The experience of passing as fluent, also called covert stuttering, has been uncritically framed as an inherently negative pursuit. Historically passing has been understood as a repression of one's true, authentic self in response to either psychological distress or social discrimination. The authors of this paper seek a more nuanced understanding of passing. We ask, how must a person relate to herself in order to pass as fluent? Methodology: This is a qualitative research study in which the authors utilized the ethical theories of philosopher Michel Foucault to contextualize data obtained from semi-structured interviews with nine participants who pass as fluent. Results: Rather than a repression of an authentic self our data suggests passing is more usefully understood as a form of resistance by people who stutter to a hostile society. Participants learned from experiences of delegitimization that their stuttering had ethical ramifications. Consequently, they used a variety of self-forming practices to pass and thereby achieve the privileges that come with perceived able-bodiedness. Conclusion: Passing as fluent is not an inauthentic form of stuttering but a form of stuttering that is produced through the use of specific technologies of communication. These technologies of communication are constituted by the unique ethical relationship of the person who stutters with herself. Passing can be understood as an active form of resistance rather than a passive form of repression. By theorizing passing as fluent as an ethical relationship, we open up the possibility of changing the relationship and performing it differently.
Article
An important priority for advocates in the area of stuttering has been to reduce the public stigma related to stuttering. Previous research has demonstrated that the anti-stigma approaches of interpersonal contact with individuals with lived experience with stuttering, education on myths and facts about stuttering, and protest of negative attitudes and behaviors toward stuttering can be effective for improving public attitudes. However, it is important to clarify key components of these different anti-stigma approaches. This research study used qualitative content analysis to describe important elements in these programs. Participants were 135 adults who were randomly assigned to watch one of three anti-stigma videos related to contact, education, and protest, and reported more positive attitudes about people who stutter after watching the video. Using a grounded theory approach for qualitative analysis of participant responses to an open ended question asking about what specific aspects of the videos led to their improved attitude, several themes and sub-themes were identified. Elements of a successful interpersonal contact approach included the presenter being a person who stutters (PWS), the presenter’s message describing struggles with stuttering and also the recovery process, in addition to a clear request for affirming attitudes and behaviors toward PWS. Components of successful education and protest approaches included providing a more accurate understanding of stuttering by giving facts and dispelling myths about stuttering, emphasizing that there are successful people who stutter who also have jobs that require speaking, and stating clearly PWS are fundamentally no different from other people despite their disfluent speech. The results of this study can help advocates in creating anti-stigma programs that contain empirically validated key elements, as well as generating fidelity measures for these programs.
Article
Purpose: The effects of three anti-stigma strategies for stuttering-contact (hearing personal stories from an individual who stutters), education (replacing myths about stuttering with facts), and protest (condemning negative attitudes toward people who stutter)-were examined on attitudes, emotions, and behavioral intentions toward people who stutter. Method: Two hundred and twelve adults recruited from a nationwide survey in the United States were randomly assigned to one of the three anti-stigma conditions or a control condition. Participants completed questionnaires about stereotypes, negative emotional reactions, social distance, discriminatory intentions, and empowerment regarding people who stutter prior to and after watching a video for the assigned condition, and reported their attitude changes about people who stutter. Some participants completed follow-up questionnaires on the same measures one week later. Results: All three anti-stigma strategies were more effective than the control condition for reducing stereotypes, negative emotions, and discriminatory intentions from pretest to posttest. Education and protest effects for reducing negative stereotypes were maintained at one-week follow-up. Contact had the most positive effect for increasing affirming attitudes about people who stutter from pretest to posttest and pretest to follow-up. Participants in the contact and education groups, but not protest, self-reported significantly more positive attitude change about people who stutter as a result of watching the video compared to the control group. Conclusion: Advocates in the field of stuttering can use education and protest strategies to reduce negative attitudes about people who stutter, and people who stutter can increase affirming attitudes through interpersonal contact with others.
Article
Purpose: This study explored the relationship between self-acceptance of stuttering and (1) psychosocial factors (self-esteem, hostility towards others, emotional support, and perceived discrimination); (2) treatment history (support group participation, therapy duration, and perceived therapy success); and (3) previously reported variables in self-acceptance of stuttering, which include age and stuttering severity. Method: Participants were 80 adults who stutter who were recruited with assistance from the National Stuttering Association and Board Certified Specialists in Fluency Disorders. Participants completed an electronic survey composed of an acceptance of stuttering scale, psychosocial scales, and a participant information questionnaire. Results: Statistical analysis identified significant correlations between participants' reports of self-acceptance of stuttering and self-esteem, perceived discrimination, hostility towards others, and perceived therapy outcome. Self-esteem was positively correlated with self-acceptance, while hostility towards others and perceived discrimination was negatively correlated with self-acceptance. Participants who perceived their therapy outcome to be successful were significantly more likely to report higher levels of self-acceptance. No significant relationships were found between self-acceptance of stuttering and support group participation, emotional support, stuttering severity, and participant age. Conclusion: This exploratory investigation has provided a foundation for future studies on the self-acceptance of stuttering. The findings indicate common psychosocial variables in self-acceptance of stuttering and of other disabilities. The significant relationships between self-acceptance of stuttering and psychosocial and therapeutic variables found need to be further explored to identify its causalities and clinical implications. Learning outcomes: The reader will be able to (1) discuss the importance of assessing self-acceptance of stuttering, (2) summarize the literature on self-acceptance of disability, and (3) describe the significant findings related to self-acceptance of stuttering and psychosocial, therapeutic variables.
Article
This paper hypothesizes that official labeling gives personal relevance to an individual's beliefs about how others respond to mental patients. According to this view, people develop conceptions of what others think of mental patients long before they become patients. These conceptions include the belief that others devalue and discriminate against mental patients. When people enter psychiatric treatment and are labeled, these beliefs become personally applicable and lead to self-devaluation and/or the fear of rejection by others. Such reactions may have negative effects on both psychological and social functioning. This hypothesis was tested by comparing samples of community residents and psychiatric patients from the Washington Heights section of New York city. Five groups were formed (1) first-treatment contact patients, (2) repeat-treatment contact patients, (3) formerly treated community residents, (4) untreated community cases, and (5) community residents with no evidence of severe psychopathology. These groups were administered a scale that measured beliefs that mental patients would be devalued and discriminated against by most people. Scores on this scale were associated with demoralization, income loss, and unemployment in labeled groups but not in unlabeled groups. The results suggest that labeling may produce negative outcomes like those specified by the classic concept of secondary deviance.
Article
This study was set up to further establish the construct validity of the Self-Stigma of Stuttering Scale (4S) by demonstrating its associations with other established scales and replicating its original factor structure and reliability estimates. Web surveys were completed by 354 adults who stutter recruited from Board Certified Specialists in Fluency Disorders, and adult chapters of the National Stuttering Association. Participants completed a series of psychometrically validated scales measuring self-stigma, hope, empowerment, quality of life, social support, anxiety, depression, and self-rated speech disruption. Higher subscale and total stigma scores on the 4S were associated with significantly lower levels of hope, empowerment, quality of life, and social support, and significantly higher levels of anxiety, depression, and self-rated speech disruption. The original factor structure of the 4S was replicated, and reliability estimates of the subscales ranged from adequate to excellent. The findings of this study support the construct validity of the 4S and its use by clinicians and researchers intending to measure the construct of self-stigma in adults who stutter. Educational objectives: Readers should be able to: (a) distinguish between the various components of self-stigma; (b) describe how the various components of the self-stigma model relate to hope, empowerment, quality of life, and social support, self-rated speech disruption, anxiety, and depression; (c) summarize the psychometric properties of the Self-Stigma of Stuttering Scale (4S) in terms of reliability, factor structure, and construct validity; (d) discuss how the 4S could be used in research and clinical practice. Copyright © 2015 Elsevier Inc. All rights reserved.
Article
To examine the relationship of social support, empowerment, self-help support group participation, and group identification to quality of life in adults who stutter. Two-hundred and forty-nine adults who stutter completed a Web based survey including measures of social support, empowerment, self-help support group participation, group identification, and quality of life. After controlling for demographic and stuttering parameters, both empowerment in the self-esteem/self-efficacy domain and social support from family significantly predicted quality of life in adults in the sample. Increased self-esteem/self-efficacy and social support from family relates to improved quality of life in adults who stutter, independent of stuttering severity. Treatments that increase feelings of self-esteem/self-efficacy and strengthen social support from the family should be considered for individuals who struggle to cope with stuttering in order to enhance their quality of life.
Article
For lesbian, gay, bisexual, and transgender (LGBT) youth, coming out (i.e., disclosure of LGBT identity to others) can be a key developmental milestone, one that is associated with better psychological well-being. However, this greater visibility may come with increased risk of peer victimization. Being out, therefore, may reflect resilience and may unfold differently depending on ecological context as some spaces may be more or less supportive of LGBT youth than others. This article explores a model of risk and resilience for outness among LGBT youth, including whether it varies by community context. We tested our hypothesized model with a national dataset of 7,816 LGBT secondary school students using multi-group structural equation modeling. Consistent with our hypotheses, outness was related to higher victimization but also to higher self-esteem and lower depression. Greater victimization was related to negative academic outcomes directly and indirectly via diminished well-being. The increases in victimization associated with outness were larger for rural youth, and benefits to well-being partly compensated for their lower well-being overall. This article suggests that being out reflects resilience in the face of higher risk of victimization, in addition to promoting well-being in other ways. Nonetheless, contextual factors influence how this model operates among LGBT youth.
Article
To compare adults who stutter with and without support group experience on measures of self-esteem, self-efficacy, life satisfaction, self-stigma, perceived stuttering severity, perceived origin and future course of stuttering, and importance of fluency. Participants were 279 adults who stutter recruited from the National Stuttering Association and Board Recognized Specialists in Fluency Disorders. Participants completed a Web-based survey comprised of various measures of well-being including the Rosenberg Self-Esteem Scale, Generalized Self-Efficacy Scale, Satisfaction with Life Scale, a measure of perceived stuttering severity, the Self-Stigma of Stuttering Scale, and other stuttering-related questions. Participants with support group experience as a whole demonstrated lower internalized stigma, were more likely to believe that they would stutter for the rest of their lives, and less likely to perceive production of fluent speech as being highly or moderately important when talking to other people, compared to participants with no support group experience. Individuals who joined support groups to help others feel better about themselves reported higher self-esteem, self-efficacy, and life satisfaction, and lower internalized stigma and perceived stuttering severity, compared to participants with no support group experience. Participants who stutter as an overall group demonstrated similar levels of self-esteem, higher self-efficacy, and lower life satisfaction compared to averages from normative data for adults who do not stutter. Findings support the notion that self-help support groups limit internalization of negative attitudes about the self, and that focusing on helping others feel better in a support group context is linked to higher levels of psychological well-being. Educational objectives: At the end of this activity the reader will be able to: (a) describe the potential psychological benefits of stuttering self-help support groups for people who stutter, (b) contrast between important aspects of well-being including self-esteem self-efficacy, and life satisfaction, (c) summarize differences in self-esteem, self-efficacy, life satisfaction, self-stigma, perceived stuttering severity, and perceptions of stuttering between adults who stutter with and without support group experience, (d) summarize differences in self-esteem, self-efficacy, and life satisfaction between adults who stutter and normative data for adults who do not stutter.
Article
Stuttering can cause wide ranging psychosocial impact. This is particularly the case for adolescents who may face additional physical, emotional and personality changes as they become adults. This study reports the findings of an investigation into the social and communication impacts of stuttering on Australian adolescents seeking treatment for stuttering and their families. A cross-sectional design utilising questionnaires assessed the self-perceived communication competence and apprehension, stigma and disclosure, and experiences of teasing and bullying of 36 adolescents who stutter. Additionally, the impact of stuttering on the families of these adolescents was investigated. Adolescents who stutter have below average self-perceived communication competence, heightened communication apprehension, are teased and bullied more often than fluent peers, and they try to keep their stuttering secret. The families of the adolescents in the study reported high levels of emotional strain, family conflict and difficulty managing their child's frustrations. The findings from this study emphasise the wide-ranging impact of stuttering beyond the surface level behaviours. Clinicians working with adolescents who stutter should take note of both the outcomes of this study and the suggestions for more effectively coping with the condition in this population. Educational objectives: The reader will be able to: (a) summarise findings with regards to the impact of stuttering on an adolescent's social and communication skills; (b) summarise areas of impact on the families of adolescents who stutter; (c) compare these findings with previous reported data for this population; (d) discuss the clinical implications of the results for working with adolescents who stutter and their families.
Article
For many employees with multiple sclerosis (MS), disclosure of their diagnosis at work is seen as a high-risk strategy that might lead to diminished perceptions of their capabilities by supervisors and colleagues, if not outright discrimination. The consequence of this mistrust surrounding the disclosure process is that employees with MS may leave it until too late to effectively manage symptoms at work. The objective of this paper is to statistically evaluate the relationship between disclosure of diagnosis at work and maintenance of employment. Three annual, large-sample self-report surveys of MS patients prospectively examined the relationship between disclosure of diagnosis at work and employment status. A total of 1438 people responded to all three surveys. Of employed persons in 2010 (n = 946), 673 also responded to the 2012 survey. Of these 673 respondents 564 were still employed. People who had disclosed their MS status to an employer were more likely to remain in employment in Year 3. The effect of disclosure in predicting employment status remained after controlling for age, gender, hours worked and level of disability. This study provides the first empirical support for the positive role of disclosure in maintaining employment status, measured both as job retention and tenure in current employment.
Article
Self-stigma can undermine self-esteem and self-efficacy of people with serious mental illness. Coming out may be one way of handling self-stigma and it was expected that coming out would mediate the effects of self-stigma on quality of life. This study compares coming out to other approaches of controlling self-stigma. Eighty-five people with serious mental illness completed measures of coming out (called the Coming Out with Mental Illness Scale, COMIS), self-stigma, quality of life, and strategies for managing self-stigma. An exploratory factor analysis of the COMIS uncovered two constructs: benefits of being out (BBO) and reasons for staying in. A mediational analysis showed BBO diminished self-stigma effects on quality of life. A factor analysis of measures of managing self-stigma yielded three factors. Benefits of being out was associated with two of these: affirming strategies and becoming aloof, not with strategies of shame. Implications for how coming out enhances the person's quality of life are discussed.
Article
To create a psychometrically sound scale that measures different levels of internalized stigma (i.e., self-stigma) among adults who stutter and analyze factor structure, reliability, and initial construct validity of the scale. Two-hundred and ninety one adults who stutter were recruited from Board Recognized Specialists in Fluency Disorders and the National Stuttering Association. Participants completed a Web-based survey including an experimental scale called the Self-Stigma of Stuttering Scale (4S), designed to measure different levels of self-stigma in people who stutter, along with a series of established measures of self-esteem, self-efficacy, and life satisfaction. The experimental scale demonstrated adequate reliability in internal consistency and temporal stability. Factor analysis revealed underlying components supportive of a multidimensional model of stigma. Stigma self-concurrence, and to a lesser extent stereotype agreement and stigma awareness, were negatively correlated with self-esteem, self-efficacy, and life satisfaction, supporting initial construct validity of the scale. Speech-language pathologists can identify the presence of self-stigma in their adult clients who stutter and help them to alter these beliefs. The 4S can be a means for researchers and clinicians to achieve these goals.
Article
Individuals who experience speech dysfluency are often stigmatised because their speech acts differ from the communicative norm. This article is located in and seeks to further the identity debates in exploring how individuals who are subject to the intermittent emergence of a stigmatised characteristic manage this randomised personal discrediting in their identity work. Through a series of focus groups and semi-structured interviews participants grudgingly report their management approaches which include concealing, drafting in unwitting others, role-playing and segregating self from their stammer. In describing how they manage their stammer they detail their use of the social space in a number of ways, including as a hiding place; a site for 'it' (the stammer); a gap in which to switch words; and a different area in which to perform. This study offers important insights, increasing our understanding of the often hidden negotiations of identity work and the sometime ingenious use of space in the management of a social stigma.
Article
People with mental illness have long experienced prejudice and discrimination. Researchers have been able to study this phenomenon as stigma and have begun to examine ways of reducing this stigma. Public stigma is the most prominent form observed and studied, as it represents the prejudice and discrimination directed at a group by the larger population. Self-stigma occurs when people internalize these public attitudes and suffer numerous negative consequences as a result. In our article, we more fully define the concept of self-stigma and describe the negative consequences of self-stigma for people with mental illness. We also examine the advantages and disadvantages of disclosure in reducing the impact of stigma. In addition, we argue that a key to challenging self-stigma is to promote personal empowerment. Lastly, we discuss individual- and societal-level methods for reducing self-stigma, programs led by peers as well as those led by social service providers.
Article
An instrument to measure the stigma perceived by people with HIV was developed based on the literature on stigma and psychosocial aspects of having HIV. Items surviving two rounds of content review were assembled in a booklet and distributed through HIV-related organizations across the United States. Psychometric analysis was performed on 318 questionnaires returned by people with HIV (19% women, 21% African American, 8% Hispanic). Four factors emerged from exploratory factor analysis: personalized stigma, disclosure concerns, negative self-image, and concern with public attitudes toward people with HIV. Extraction of one higher-order factor provided evidence of a single overall construct. Construct validity also was supported by relationships with related constructs: self-esteem, depression, social support, and social conflict. Coefficient alphas between .90 and .93 for the subscales and .96 for the 40-item instrument provided evidence of internal consistency reliability. The HIV Stigma Scale was reliable and valid with a large, diverse sample of people with HIV. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:518–529, 2001
Article
The impact of self-help groups on the person who stutters appears to be highly positive; however, only a few studies on the topic have been conducted. Consequently, little is known regarding the components that contribute to their success. The author encourages more research on this topic and offers questions needing answers regarding the impact of self-help groups in order to learn more of the specifics as to why they work. This research needs to be more systematic and should include significantly larger sampling than previous studies. A description of the larger self-help and related groups in the United States is also given. Problems associated with local chapters are mentioned and the need for better clinician awareness of the benefits of self-help are stated.
Article
Unlabelled: Self-help activities for people who stutter (PWS) have been gaining in popularity; however, there is a scarcity of evidence to support their utility in stuttering management. The purpose of this investigation was to understand the lived experience of individuals who attended a self-help conference(s) for PWS from the perspective of a PWS to learn its potential utility in stuttering management. The investigator used Interpretive Phenomenological Analysis (IPA) to systematically collect authentic data of this social phenomenon. Twelve participants were recruited from a self-help conference and the self-help community of PWS. Semi-structured interviews were conducted 4-18 months after each participant's last conference. Interviews were transcribed and analyzed. Themes were explained in investigator narratives and illustrated through participants' quotes. Interpreted themes of the experience of having attended a self-help conference(s) for PWS included: socializing opportunities with other PWS, affiliation, redefining oneself and post-conference disclosures. A conclusion of the study was that the experience of having attended a self-help conference(s) for PWS helped to minimize negative impact that stuttering can have on daily functioning. It appears that self-help conferences were perceived as a safer or "stutter-friendly" environment and promoted social interaction, relationship building, and community building through planned and unplanned activities. Another conclusion was that the experience of having attended self-help conferences for PWS helped participants to communicate more easily. Reported increases in social activity and an "openness" about stuttering, suggest self-help conferences' utility in stuttering management. These findings are supported by other studies about successful stuttering management and self-help activities for PWS. They have helped attendees who stutter to communicate more easily and suggest a reduction in the negative impact that stuttering has on their lives. Educational objectives: The reader will be able to: (1) describe recurring themes associated with the lived experience having attended a self-help conference(s) for people who stutter (PWS) from the perspective of a group of adults who stutter, and (2) describe the potential benefits of attending self-help conferences for PWS in order to make appropriate evidence-based referrals to self-help conferences for PWS.
Article
Unlabelled: Given the well-documented understanding that stuttering behavior elicits stereotypically negative responses from listeners, two experiments explored the equivocal results of earlier investigations concerning the potential for self-acknowledgment and modification of stuttering to elicit positive responses from naïve (unfamiliar with stuttering) listeners. In the first experiment, listeners viewed one of four video conditions of an adult male speaker presenting combinations of stuttering, self-acknowledgment, and stuttering modification. Using a semantic differential scale, participants responded with non-significant (p>.05) differences across conditions. In the second experiment, participants listened to two randomly assigned conditions containing speech with stuttering and speech with stuttering and acknowledgment, providing them with the opportunity to experience both situations. In this case, statistically significant (p=.004) differences were found with moderately (Cohen's d=.59) more favorable responses by listeners when self-acknowledgment of stuttering occurred. The results of the current study help to explain the conflicting findings of previous investigations and indicate that when naïve listeners have an opportunity to contrast conditions of stuttering with and without acknowledgment, perceptions about the characteristics of the speaker are more likely to be favorable when the speaker self-acknowledges stuttering. It is suggested that the capability of a speaker to self-acknowledge his or her stuttering reflects the person's adoption of more effective coping strategies and that a positive listener response is likely to be associated with the speaker's ability to inform the listener about the nature of stuttering. Educational objectives: The reader will be able to: (1) describe the formation of negative responses toward stuttering, (2) describe how to change negative responses toward stuttering, and (3) describe benefits of stuttering acknowledgment and modification.
Article
Unlabelled: As with the first of two companion manuscripts, this investigation employed a grounded theory approach to identify patterns of coping responses by adults responding to the stress resulting from the threat of stuttering. The companion paper described emotion-based avoidant coping responses that were used to protect both the speaker and the listener from experiencing discomfort associated with stuttering. This paper describes two cognitive-based approach patterns that emphasize self-focused and problem-focused forms of coping. The first of the cognitive-based coping patterns involved speakers approaching stuttering with a broader perspective about themselves and the experience of stuttering, resulting in an improved self-concept and increased self-confidence. The second coping pattern involved speakers focusing on their own goals which results in increased agency and self-confidence. Participants described the development of more functional coping responses. They moved from emotion-based avoidant patterns of coping that focused on protecting the self and the listener from experiencing discomfort associated with stuttering to cognitive-based approach patterns that focused on the needs of the speaker. As the participants chose to approach rather than avoid or escape stuttering, they experienced many positive social, physical, cognitive, and affective results. Educational objectives: The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with the process of coping with stuttering, (2) describe the basic rationale for the procedures associated with grounded theory methods, (3) describe the factors that influence coping choices, and (4) explain the factors that contribute the use of approach-oriented and agentic coping strategies.
Article
Unlabelled: Using a grounded theory approach, four clusters were identified that represent patterns of coping by adults who stutter. In order to understand the complexities within the coping responses of speakers to the experience of stuttering, this first of two companion papers summarizes the literature on the human coping response to stress and the nature of two of the four main findings identified. These findings describe a coping process that emphasizes strategies of protecting both the speaker and the listener from experiencing discomfort associated with stuttering. The companion paper describes the remaining two main findings that emphasize the characteristics of self-focused and action oriented coping responses. Educational objectives: The reader will be able to: (1) describe, from the perspective of a select group of adults who stutter, the themes associated with the process of coping with stuttering, (2) describe the basic rationale for the procedures associated with grounded theory methods, (3) describe the factors that influence the choice to use emotion-focused and problem-focused coping strategies, and (4) explain the factors that contribute to the use of methods of escape.
Article
Theorists posit that personal decisions to disclose being HIV positive are made based on the perceived consequences of that disclosure. This study examines the perceived costs and benefits of self-disclosure among African American injection drug users (IDUs). A total of 80 African American IDUs were interviewed in-depth subsequent to testing HIV positive. Participants reported that interpersonal costs of self-disclosure included stigma, loss of sexual/romantic partners, emotional harming of family/friends, shattering of privacy, physical isolation, blame, and loss of income. The benefits of disclosure included social support, emotional catharsis, and income. Four factors that help to tip the scales in either direction were identified. Study findings have implications for the delivery of counseling, testing, and partner notification services to African American IDUs living with HIV.
Article
The purpose of this study was to determine (a) if nonstutterers prefer to interact with mild and severe stutterers who acknowledge their stuttering and (b) if nonstutterers' perceptions of mild and severe stutterers' intelligence, personality, and appearance are altered as a function of stutterers' acknowledgment of their stuttering. Acknowledgment and nonacknowledgment videotapes of two mild and two severe male stutterers were made during interview situations. Eighty-four female subjects examined the interview tapes and were then instructed to answer questions and complete adjective scales. Findings indicate that significant numbers of female nonstutterers prefer to interact with severe stutterers who acknowledged their stuttering. Mild and severe stutterers who acknowledged their stuttering receive more favorable ratings on intelligence, personality, and appearance.
Article
The Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q) is a self-report measure designed to enable investigators to easily obtain sensitive measures of the degree of enjoyment and satisfaction experienced by subjects in various areas of daily functioning. The summary scores were found to be reliable and valid measures of these dimensions in a group of depressed outpatients. The Q-LES-Q measures were related to, but not redundant with, measures of overall severity of illness or severity of depression within this sample. These findings suggest that the Q-LES-Q measures may be sensitive to important differences among depressed patients that are not detected by the measures usually employed.
Article
This study investigated the effects of a 10-week, educational-experiential group intervention--the Coming Out Issues Group--designed to address issues pertinent to adult lesbians, including lesbian identity development, homophobia and heterosexism, religious concerns, career concerns, family issues, sexism and racism, and assertiveness skills development. The impact of the intervention was assessed using various instruments in four areas: (1) ego development, (2) lesbian identity development, (3) empowerment, and (4) disclosure. The results indicated modest gains in ego development and lesbian identity development and major gains in empowerment and disclosure.
Article
A mail survey obtained a sample of 117 gay men with HIV/AIDS to examine levels of disclosure of HIV status to the family of origin and the association between disclosure and levels of support and barriers to support from the family. Among men with HIV there was a significant difference in knowledge of HIV status between family members such that mothers and siblings were more likely to be knowledgeable than fathers. For the total sample disclosure of HIV status was associated with higher levels of support from all family members and with a lower level of barrier to support from mothers and fathers. Implications for practice are discussed.