Clinical and psychosocial predictors of post-event processing in adults who stutter

Date

2023-04-05

Authors

Croft, Robyn Lindsey

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Abstract

Despite the neurophysiological and genetic underpinnings of stuttering, there is a pervasive assumption that stuttering is the result of being nervous, anxious, or unintelligent. This misconception yields detrimental quality-of-life consequences, with many persons who stutter experiencing interactions in which they are ridiculed, discriminated against, and stigmatized. After repeated exposure to negative exchanges, individuals may develop self-deprecating behaviors, such as post-event processing. Post-event processing, defined by self-critical rumination following a stressful communication event, is significantly associated with depression, isolation, and reduced quality of life. However, despite its relevance to the stuttering experience, to date, only a few studies have investigated post-event processing among adults who stutter, and no study has identified clinical and psychosocial predictors of post-event processing. The purpose of this study was to determine the contributions of clinical markers of stuttering and psychosocial variables to post-event processing through three specific aims. Aim 1 identified the influence of clinical markers, including the experience of stuttering, self-rated stuttering severity, and observer-rated stuttering severity on post-event processing. Aim 2 determined the influence of psychosocial factors, including self-perceived performance, self-esteem, and social anxiety on post-event processing over and above clinical markers. Aim 3 evaluated the influence of trait and state self-compassion on post-event processing over and above clinical and psychosocial factors. To achieve these aims, adults who stutter (N = 96) participated in two, virtual sessions. After completing a standardized social stress task in Session 1, participants completed measures of post-event processing, clinical markers of stuttering, and psychosocial characteristics in Session 2. Hierarchical linear regression was used to identify clinical and psychosocial predictors of post-event processing. Results indicated that a more negative experience of stuttering, higher self-rated stuttering severity, and greater social anxiety predicted more post-event processing. Greater self-perceived performance and state self-compassion predicted less rumination. Observer-rated severity, self-esteem, and trait self-compassion were not significantly associated with post-event processing behavior. Taken together, findings provide a starting point for formulating a clinical and psychosocial profile that can be used to assess and mitigate post-event processing behavior in adults who stutter and bolster resiliency to social stress. Empirical, clinical, and quality-of-life implications are discussed.

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