Origin and Pawn scaling for adults who do and do not stutter: A preliminary comparison

PurposeIn order to determine whether adults who stutter (AWS) would show changes in locus of causality during stuttering treatment and approximate those of adults who do not stutter (AWNS) this preliminary study compared the locus of causality as indicated by Origin and Pawn scaling procedures from two groups of young adults who do and do not stutter.MethodA total of 20 age- and gender-matched undergraduate and graduate students who did (n = 10) and did not (n = 10) stutter participated. The AWS took part in a three week intensive stuttering treatment provided by the American Institute for Stuttering (AIS). Along with measures of treatment outcome, writing samples were analyzed for Origin and Pawn statements that indicated the participant's locus of causality.ResultsAt the outset of treatment the AWS showed significantly greater Pawn scores than the control group of AWNS and similar occurrences of Origin statements. The AWS showed a statistically significant increase in pre- to post-treatment Origin scores and a statistically significant decrease in Pawn scores. Following treatment the AWS showed the Origin and Pawn score ratios similar to those of AWNS.ConclusionA pattern of increasing Origin and decreasing Pawn scores may indicate a pattern of increasing agency during successful stuttering treatment. Moreover the post-treatment Origin and Pawn score ratios of AWS, which were not significantly different from those of AWNS, may indicate a change trend toward normalization. Further research will determine whether such change patterns are predictive of long-term maintenance.Educational Objectives: By reading this article the reader will be able to: (a) describe advantages of content analysis measure such as the Origin and Pawn Scales; (b) discuss the purposes and procedures of the Origin and Pawn Scales; (c) describe typical change pattern of Origin and Pawn scores of adults who stutter while receiving treatment; (d) discuss how successful treatment for stuttering can result in the normalization of one's locus of causality.     

Frequency of stuttering during challenging and supportive virtual reality job interviews

This paper seeks to demonstrate the possibility of manipulating the frequency of stuttering using virtual reality environments (VREs). If stuttering manifests itself in VREs similarly to the way it manifests itself in real world interactions, then VREs can provide a controlled, safe, and confidential method for treatment practice and generalization. Though many researchers and clinicians recognize the need for generalization activities in the treatment of stuttering, achieving generalization in a clinical setting poses challenges to client confidentiality, safety, and the efficient use of a professionals’ time. Virtual reality (VR) technology may allow professionals the opportunity to enhance and assess treatment generalization while protecting the safety and confidentiality of their clients. In this study, we developed a VR job interview environment which allowed experimental control over communication style and gender of interviewers. In this first trial, persons who stutter (PWS) experienced both challenging and supportive VR job interview conditions. The percentage of stuttered syllables was calculated for both interviews for each participant. Self-reported ratings of communication apprehension and confidence were also obtained, and were not significantly correlated with stuttering severity. Results indicated that interviewer communication style affected the amount of stuttering produced by participants, with more stuttering observed during challenging virtual interviews. Additionally, the amount of stuttering observed during the VR job interviews was significantly, positively correlated with the amount of stuttering observed during an interview with the investigator prior to VR exposure. Participants’ subjective reports of the VR experience indicate reactions similar to those they report experiencing in the real world. Possible implications for the use of VR in the assessment and treatment of stuttering are discussed.

Educational objectives: After reading this article, the reader will be able to—(1) list some of the challenges to treatment generalization; (2) describe how virtual reality technology can assist in alleviating some of these challenges; (3) describe how the frequency of stuttering varies across two different virtual environments.     

Resilience in people who stutter: Association with covert and overt characteristics of stuttering

PurposeRecent literature stresses the importance of resilience, as a trait, for successful coping with life’s difficulties or stressors. However, only a limited number of studies were conducted on resilience among people-who-stutter (PWS). These studies did not examine the association between resilience and the specific characteristics of stuttering. This study was, therefore, aimed to directly examine the association between resilience and measures of both the covert and overt characteristics of stuttering.MethodThirty adults who stutter completed the Connor-Davidson Resilience Scale (CD-RISC) and the Overall Assessment of Speaker’s Experience of Stuttering - Adults (OASES-A). In addition, stuttering severity of all participants was quantified using the Stuttering Severity Instrument-4 (SSI-4). The associations between all measures were examined statistically.ResultsA strong and significant association was found between the participants' scores on the CD-RISC and the OASES-A (r= -.79, p < .001). In contrast, no significant correlation was found between the participants' scores in the CD-RISC and the SSI-4 (r = .02, p > .05). Within our cohort, no significant association was observed between the participants’ gender and age and their resilience levels (p > 0.05).ConclusionThis study demonstrates the role of resilience in shaping the individual's experience with stuttering. Results also show that the individuals' resilience levels do not necessarily predict stuttering severity per se, or its overt manifestations but can predict the individuals' subjective perception of his/her stuttering. This highlights the importance of addressing and promoting resilience among PWS in stuttering therapy.     

Public awareness and knowledge of stuttering in Rio de Janeiro

This study reports the results of an investigation of public awareness and knowledge of stuttering in Rio de Janeiro, Brazil. A total number of 606 street recruited respondents answered questions on various aspects of stuttering, including prevalence, onset, gender distribution, occurrence in different cultures, cause, treatment, intelligence, and hereditariness. The questionnaire used was a Portuguese version of the one by [Van Borsel, J., Verniers, I. & Bouvry, S. (1999). Public awareness of stuttering. Folia Phoniatrica et Logopaedica, 51, 124–132]. Although, stuttering is a disorder which is known to a majority of the participants, knowledge appears to be limited for certain aspects. Knowledge also differs among subgroups of participants according to gender, age and educational level. Comparison of the results of the current study with similar studies conducted in Belgium and in Shanghai, China shows several similarities but also some differences.

Educational objectives: The reader will be able to: (1) discuss public awareness and knowledge of stuttering in Rio de Janeiro, Brazil; (2) discuss the differences in knowledge according to gender, age and educational level and; (3) discuss similarities and differences with comparable studies run in Belgium and Shanghai, China.     

The relationship between locus of control and long-term stuttering treatment outcome in adult stutterers

The present study was designed to investigate the extent to which adult stutterers' scores on the Locus of Control of Behaviour (LCB) scale are predictive of their ability to maintain speech fluency immediately following intensive treatment and approximately 2 years later. Twenty-one subjects participated in a 3-week intensive treatment program based on the Precision Fluency Shaping Program. Thirteen subjects could be contacted again 2 years later to participate in a follow-up evaluation. While most subjects showed a significant long-term improvement in fluency, no predictive relationship was found between scores on the LCB scale and the level of fluency, measured in percentage of words stuttered, post-treatment or at follow-up. However, LCB scores were found to be predictive of the subjects' fluency self-evaluation measured post-treatment and at follow-up. Overall, the present study suggests that while the LCB scale may contribute to the prediction of long-term treatment outcome, particularly as perceived by the client, other client and process variables will need to be considered as well.     

The relationship between treatment exposure times and changes in stuttering frequency during contingent stimulation

Four adult stutterers were exposed to 60 consecutive minutes of verbal contigent stimulation. In each session subjects spoke until a stuttering frequency stability criterion was met (baserate) followed by 60 min of exposure to the word wrong presented contingently upon each instance of stuttering. The data were analyzed according to changes in stuttering which occured following 20, 40, and 60 min of treatment exposure. The results revealed that stuttering frequency was reduced for all subjects during all three 20-min segments of the treatment condition. The only significant reductions in stuttering frequency, however, occured within the first 20 min of treatment.     

Changes in colour and location as cues of generative transmission in perception of causality

Observers viewed modified launching effect displays containing a spatial gap between the final location of the launcher (a black square) and the initial location of the target (a black outline square with a white interior). In some conditions, a set of stationary objects (black outline squares with white interiors) filled the spatial gap, and these objects began changing colour upon contact from the launcher. The colour changes could involve all gap objects turning black, the first gap object turning dark grey and subsequent gap objects turning successively lighter grey, or first gap object turning light grey and subsequent gap objects turning successively darker grey. The colour changes could move from the launcher to the target or from the target to the launcher. The gap objects could also remain unchanged. Participants rated whether the launcher caused subsequent motion of the target and how much force the launcher imparted to the target. The sequence of colour changes, and the sequence of locations in which colour changes occurred, influenced ratings; sequences of colour changes consistent with the idea that influence of the launcher was transmitted across gap objects to the target resulted in higher ratings. Implications for visual perception of causality are discussed.     

Critical words and the locus of stuttering in speech

The locus of stuttering in the communicative speech of 26 stutterers was studied in situations where subjects received and conveyed specific information. It was hypothesized that a larger proportion of critical rather than noncritical words would be stuttered. Critical words were those which necessarily had to be pronounced if a listener should be able to understand and act according to the messages given. The critical words were selected by the experimenter before the experiment started. The results showed that 35.8% of the critical and 8.4% of the noncritical words were stuttered. There was also significantly more stuttering on critical words than on long noncritical words. The largest proportion of critical words appeared in the final position of sentences, which was also where most stuttering was located. Whole-word repetitions, an instance of normal nonfluency, were associated with noncritical words. No correlation between frequency of stuttering and whole-word repetitions was found.     

Associations between type of treatment and illness-specific locus of control in type 1 diabetes patients

Abstract

This study examined differences in diabetes-specific locus of control beliefs of 82 insulin-treated Type I diabetes patients undergoing either conventional therapy (CT), intensified conventional therapy (ICT) or continuous subcutaneous insulin infusion (CSII). Compared to CT with its adherence to a strict regimen, ICT and CSII allow a much greater flexibility in timing of meals and daily activities. On the other hand, such flexibility requires a much more active role of the patient. The hypotheses of higher internality and lower powerful others locus of control beliefs in ICT and CSII patients than in CT patients could be supported for powerful others locus of control only. A one-year follow-up replicated this finding. Furthermore, high powerful others locus of control was associated with low diabetes-related knowledge and poor glycaemic control. The relevance of the patients' experience with the respective treatment is examined in view of the results and implications for studies on the feasibility of diabetes regimens are discussed.     

Placing hope in self and others: Exploring the relationships among self-construals,locus of hope,and adjustment

Traditional hope theory is dominated by an individualistic assumption wherein the self is considered as the focal agent of goal attainment. However, in collectivist cultures more relational dimensions of hope also need to be considered. The locus of hope dimension (internal vs. external locus) was added to the traditional hope theory in order to capture both individualistic and collectivist types of hope. Hope could either be anchored on oneself (internal locus) or on significant others (external locus). External locus could further be divided into family, friends, and spiritual hope. There is still a dearth of research on the external locus of hope, with most of the previous studies focusing on the internal locus. Therefore, the aim of this study was to examine how internal and external loci of hope could predict various indices of psychological adjustment. We also examined how individual differences in self-construals would predict locus of hope. Results among the Chinese university students indicated that independent self-construal was positively associated with the internal locus of hope, while interdependent self-construal was positively associated with the external locus of hope. Internal locus and external locus of hope related to family and friends were positively associated with adjustment, but spiritual hope was not. Implications and directions for future research are discussed.     

Systematic studies of modified vocalization: speech production changes during a variation of metronomic speech in persons who do and do not stutter

The most common way to induce fluency using rhythm requires persons who stutter to speak one syllable or one word to each beat of a metronome, but stuttering can also be eliminated when the stimulus is of a particular duration (e.g., 1 second [s]). The present study examined stuttering frequency, speech production changes, and speech naturalness during rhythmic speech that alternated 1 s of reading with 1 s of silence. A repeated-measures design was used to compare data obtained during a control reading condition and during rhythmic reading in 10 persons who stutter (PWS) and 10 normally fluent controls. Ratings for speech naturalness were also gathered from naïve listeners. Results showed that mean vowel duration increased significantly, and the percentage of short phonated intervals decreased significantly, for both groups from the control to the experimental condition. Mean phonated interval length increased significantly for the fluent controls. Mean speech naturalness ratings during the experimental condition were approximately “7” on a 1–9 scale (1 = highly natural; 9 = highly unnatural), and these ratings were significantly correlated with vowel duration and phonated intervals for PWS. The findings indicate that PWS may be altering vocal fold vibration duration to obtain fluency during this rhythmic speech style, and that vocal fold vibration duration may have an impact on speech naturalness during rhythmic speech. Future investigations should examine speech production changes and speech naturalness during variations of this rhythmic condition.Educational objectives: The reader will be able to: (1) describe changes (from a control reading condition) in speech production variables when alternating between 1 s of reading and 1 s of silence, (2) describe which rhythmic conditions have been found to sound and feel the most natural, (3) describe methodological issues for studies about alterations in speech production variables during fluency-inducing conditions, and (4) describe which fluency-inducing conditions have been shown to involve a reduction in short phonated intervals.     

Causality, criticality, and reading words: distinct sources of fractal scaling in behavioral sequences

The finding of fractal scaling (FS) in behavioral sequences has raised a debate on whether FS is a pervasive property of the cognitive system or is the result of specific processes. Inferences about the origins of properties in time sequences are causal. That is, as opposed to correlational inferences reflecting instantaneous symmetrical relations, causal inferences concern asymmetric relations lagged in time. Here, I integrate Granger-causality with inferences about FS. Four simulations illustrate that causal analyses can isolate distinct FS sources, whereas correlational techniques cannot. I then analyze three simultaneous sequences of responses from a database of word-naming trials. I find that two, or perhaps three, distinct sources account for the presence of FS in these sequences, but FS is not a general property of the system. This suggests that FS arises due to the properties of a limited number of identifiable psychological and/or neural processes. Finally, I reanalyze a previously published dataset of acoustic frequency spectra using the new tools. The causality/criticality combination introduced here offers a new important perspective in the study of cognition.     

Bibliography of literature pertaining to the onset,development, and treatment of stuttering during the preschool years

This bibliography consists of clinical, experimental, and theoretical papers pertaining to the onset, development, and treatment of stuttering in children five- years old and younger. It is a downward extension of Silverman, F.H., Bibliography of literature pertaining to stuttering in elementary-school children, Journal of Fluency Disorders, 1978, 3, 87–102.     

Characteristics of patients in routine psycho-oncological care,and changes in outcome variables during and after their treatment

Objective: The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions.

Design: During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later.

Results and conclusions: Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.     

The interpretation of negative social events in social phobia: changes during treatment and relationship to outcome

Catastrophic interpretations of negative social events are considered to be an important factor underlying social phobia. This study investigated the extent to which these interpretative biases change during cognitive-behavioural treatment for social phobia, and examined whether within-treatment changes in different types of interpretations predict longer-term treatment outcome. Results showed that treatment was associated with decreases in various types of maladaptive interpretations of negative social events, but that social phobia symptoms 3 months after treatment were independently predicted only by within-treatment reductions in the degree to which individuals personally believed that negative social events were indicative of unfavourable self-characteristics. These findings are discussed in relation to cognitive models of the maintenance of social anxiety, and implications for treatment are considered.     

Prospective associations between changes in mental health symptoms and health-related quality of life in veterans seeking posttraumatic stress disorder residential treatment

Background and Objectives: This study examined prospective associations between changes in mental health symptoms (posttraumatic stress disorder [PTSD], depression) and health-related quality of life (physical health, psychological well-being) for veterans with PTSD. Design: This study focused on 139 patients who completed a residential treatment program for PTSD in the Veterans Health Administration. Methods: Patients completed the veteran-specific, 12-item Medical Outcomes Study Short Form, PTSD Checklist – Military version, and Beck Depression Inventory at pre-treatment, discharge, and a four-month follow-up. When accounting for demographic factors, combat exposure, and baseline scores on the respective outcome variables (e.g. mental health, physical health, PTSD, and depressive symptoms), a series of multivariate analyses were conducted for treatment-related changes in mental and physical health on the outcome measures. Results: Reductions in PTSD symptomatology during the treatment period were prospectively linked with better health-related outcomes at the four-month follow-up. In addition, improved physical health and psychological well-being during treatment were each similarly associated with better PTSD and depression outcomes in the months following treatment. Conclusions: Addressing concerns in mental and physical health might have synergistic effects across both domains, supporting the need for holistic models and integrated health care strategies for treating veterans with PTSD.