Beliefs and practices of therapists who practice sexual reorientation psychotherapy

There is currently controversy regarding whether sexual reorientation or conversion therapies are ethical and effective forms of treatment for dissatisfied homosexually oriented people. We present the results of a survey of 206 psychotherapists who practice sexual conversion therapy. 187 therapists said they believed homosexuality is a developmental disorder and that the 1973 decision by the American Psychiatric Association to "depathologize" homosexuality was politically motivated and unscientific. The therapists believe that the majority of dissatisfied homosexually oriented clients who seek conversion therapy benefit from it, experiencing both changes in their sexual orientation and improved psychological functioning. We conclude that therapists who persist in providing reorientation therapy do so because they believe it is an effective and ethical treatment option for their clients.     

虚拟现实技术在执行功能评估中的应用

执行功能反映了个体对自身的认知过程进行调节和控制的能力,其评估在儿童认知能力发展水平和特殊人群认知功能损伤程度的评定中起着重要作用。虽然执行功能的评估自20世纪初就开始被实施和应用,但传统评估方法仍存在着生态效度不高、不易操纵实验环境的复杂性、不易操纵被试觉醒水平等缺陷。近年来,虚拟现实技术以其有限的成本和快速的发展被越来越多地应用于执行功能评估,并被证实具有生态效度高、实验条件高度可控等显著优点。     

Nonword repetition skills in young children who do and do not stutter

The purpose of this study was to assess the nonword repetition skills of 24 children who do (CWS; n = 12) and do not stutter (CWNS; n = 12) between the ages of 3;0 and 5;2. Findings revealed that CWS produced significantly fewer correct two- and three-syllable nonword repetitions and made significantly more phoneme errors on three-syllable nonwords relative to CWNS. In addition, there was a significant relationship between performance on a test of expressive phonology and nonword repetition for CWS, but not CWNS. Findings further revealed no significant fluctuation in fluency as nonwords increased in length. Taken together, findings lend support to previous work, suggesting that nonword repetition skills differ for CWS compared with CWNS, and that these findings cannot be attributed to (a) weak language performance on the part of CWS, or (b) the occurrence of stuttering in the course of nonword production. EDUCATIONAL OBJECTIVES: After reading this article, the learner will be able to: (a) describe one common means of assessing phonological working memory in children; (b) summarize the performance differences of children who stutter compared to peers on a nonword repetition task; (c) compare the results of the present study with previous work in this area.     

Nonword repetition and phoneme elision in adults who do and do not stutter

The purpose of the present study was to explore the phonological working memory of adults who stutter through the use of a non-word repetition and a phoneme elision task. Participants were 14 adults who stutter (M=28 years) and 14 age/gender matched adults who do not stutter (M=28 years). For the non-word repetition task, the participants had to repeat a set of 12 non-words across four syllable lengths (2-, 3-, 4-, and 7-syllables) (N=48 total non-words). For the phoneme elision task, the participants repeated the same set of non-words at each syllable length, but with a designated target phoneme eliminated. Adults who stutter were significantly less accurate than adults who do not stutter in their initial attempts to produce the longest non-words (i.e., 7-syllable). Adults who stutter also required a significantly higher mean number of attempts to accurately produce 7-syllable non-words than adults who do not stutter. For the phoneme elision task, both groups demonstrated a significant reduction in accuracy as the non-words increased in length; however, there was no significant interaction between group and syllable length. Thus, although there appear to be advancements in the phonological working memory for adults who stutter relative to children who stutter, preliminary data from the present study suggest that the advancements may not be comparable to those demonstrated by adults who do not stutter. EDUCATIONAL OBJECTIVES: At the end of this activity the reader will be able to (a) summarize the nonword repetition data that have been published thus far with children and adults who stutter; (b) describe the subvocal rehearsal system, an aspect of the phonological working memory that is critical to nonword repetition accuracy; (c) employ an alternative means to explore the phonological working memory in adults who stutter, the phoneme elision task; and (d) discuss both phonological and motoric implications of deficits in the phonological working memory.     

Recurrent involuntary imagery in people who stutter and people who do not stutter

Objective

To compare intrusive memories in groups of people who do (PWS), and who do not (PWNS), stutter.

Method

Twenty-one participants who stuttered and 21 matched controls were given a semi-structured interview which explored imagery in speaking situations. The data were analyzed using a Content Analysis approach. Other outcome measures were the Beck Anxiety Inventory, the Beck Depression Inventory, the Post Traumatic Stress Disorder, PTSD, Symptom Scale: Self-Report Version.

Results

Significantly more stuttering participants than control participants indicated both recurrent imagery and associated memories. Content Analysis revealed themes of disfluency, anxiety, negative social evaluation, self-focus and pressure to speak that were common to both groups’ reports. Additional themes of helplessness, shame, sadness and frustration were found only in the images and memories of the stuttering group. No group differences were evident for the number of sensory modalities involved in images and memories, or for ratings of their vividness or strength of associated emotions, or on self-reports of depression, anxiety and trauma.

Conclusions

Recurrent imagery about events in childhood is a potent factor in the memories of PWS. It is worth modifying interventions that have been successfully applied for treating social anxiety for use with people who stutter.Educational objectives: After reading this article, participants will be able to: (a) identify the role of intrusive memories in psychiatric disorders and stuttering; (b) investigate how DSM criteria can be employed with people who stutter; (c) employ anxiety instruments used for assessing psychiatric disorders for stuttering; (d) distinguish between the intrusive memories experienced by people who stutter, and people who do not stutter; (e) apply treatments for intrusive memories in psychiatric disorders to work with people who stutter.     

Head-mounted displays for clinical virtual reality applications: pitfalls in understanding user behavior while using technology.

The use of virtual environments with head-mounted displays (HMDs) offers unique assets to the evaluation and therapy of clinical populations. However, research examining the effects of this technology on clinical populations is sparse. Understanding how wearers interact with the HMD is vital. Discomfort leads to altered use of the HMD that could confound performance measures; the very measures which might be used as tools for clinical decision making. The current study is a post-hoc analysis of the relationship between HMD use and HMD comfort. The analysis was conducted to examine contributing factors for a high incidence of simulator sickness observed in an HMD-based driving simulator. Pearson correlation analysis was used to evaluate objective and subjective measures of HMD performance and self-reported user comfort ratings. The results indicated weak correlations between these variables, indicating the complexity of quantifying user discomfort and HMD performance. Comparison of two case studies detailing user behavior in the virtual environment demonstrates that selected variables may not capture how individuals use the HMD. The validity and usefulness of the HMD-based virtual environments must be understood to fully reap the benefits of virtual reality (VR) in rehabilitation medicine.     

Nonword repetition and nonword reading abilities in adults who do and do not stutter

Purpose

In the present study a nonword repetition and a nonword reading task were used to investigate the behavioral (speech accuracy) and speech kinematic (movement variability measured as lip aperture variability index; speech duration) profiles of groups of young adults who do (AWS) and do not stutter (control).

Method

Participants were 9 AWS (8 males, Mean age = 32.2, SD = 14.7) and 9 age- and sex-matched control participants (Mean age = 31.8, SD = 14.6). For the nonword repetition task, participants were administered the Nonword Repetition Test ( Dollaghan & Campbell, 1998). For the reading task, participants were required to read out target nonwords varying in length (6 vs. 11 syllables). Repeated measures analyses of variance were conducted to compare the groups in percent speech accuracy for both tasks; only for the nonword reading task, the groups were compared in movement variability and speech duration.

Results

The groups were comparable in percent accuracy in nonword repetition. Findings from nonword reading revealed a trend for the AWS to show a lower percent of accurate productions compared to the control group. AWS also showed significantly higher movement variability and longer speech durations compared to the control group in nonword reading. Some preliminary evidence for group differences in practice effect (seen as differences between the early vs. later 5 trials) was evident in speech duration.

Conclusions

Findings suggest differences between AWS and control groups in phonemic encoding and/or speech motor planning and production. Findings from nonword repetition vs. reading highlight the need for careful consideration of nonword properties.Educational objectives At the end of this activity the reader will be able to: (a) summarize the literature on nonword repetition skills in adults who stutter, (b) describe processes underlying nonword repetition and nonword reading, (c) summarize whether or not adults who stutter differ from those who do not in the behavioral and kinematic markers of nonword reading performance, (d) discuss future directions for research.     

A comparison of children who receive and who do not receive permission to participate in research

In a study examining children's social competence in elementary school settings, the authors had the opportunity to compare children who received parental permission to participate to children who did not receive permission. Results indicated that children who were not involved in the study were more likely to be viewed by teachers as having unsatisfactory relationships with peers than children who were in the study. The present results suggest that investigators begin reporting the number of children who do not participate in a given study and begin examining whether minors who receive parental permission differ on important dimensions from minors who do not receive such permission. Ethical considerations of the present study are discussed.     

Past tense marking in the spontaneous speech of preschool children who do and do not stutter

PurposeThe aim of this study was to identify whether different patterns of errors exist in irregular past-tense verbs in children who stutter (CWS) and children who do not stutter (CWNS).MethodSpontaneous language samples of thirty-one age- and gender-matched pairs of children (total N = 62) between the ages of 24 months and 59 months were analyzed.ResultsResults indicated that children who do and do not stutter over-regularize irregular past-tense verbs (i.e., saying runned for ran) with comparable frequency. However, two nonsignificant trends which suggest possible intra-group differences were noted. First, irregular past tense verbs represented a greater portion of total verbs for CWS than for CWNS. Second, CWS appeared to double-mark (i.e., say ranned for ran) more often than CWNS. Results are discussed in light of theories about the acquisition of the irregular past-tense and about differences in language skills between CWS and CWNS.Educational objectives: After reading this article, the reader will be able to: (a) summarize previous findings about connections between stuttering and language in CWS and CWNS; (b) describe similarities and differences between irregular past-tense verb use and errors in CWS and CWNS; (c) discuss possible connections between the declarative–procedural model and stuttering.     

Utility of virtual reality environments to examine physiological reactivity and subjective distress in adults who stutter

PurposeVirtual reality environments (VREs) allow for immersion in speaking environments that mimic real-life interactions while maintaining researcher control. VREs have been used successfully to engender arousal in other disorders. The purpose of this study was to investigate the utility of virtual reality environments to examine physiological reactivity and subjective ratings of distress in persons who stutter (PWS).MethodSubjective and objective measures of arousal were collected from 10 PWS during four-minute speeches to a virtual audience and to a virtual empty room.ResultsStuttering frequency and physiological measures (skin conductance level and heart rate) did not differ across speaking conditions, but subjective ratings of distress were significantly higher in the virtual audience condition compared to the virtual empty room.ConclusionVREs have utility in elevating subjective ratings of distress in PWS. VREs have the potential to be useful tools for practicing treatment targets in a safe, controlled, and systematic manner.     

Lexical access,story re-telling and sequencing skills in adults who clutter and those who do not

Cluttering is a rate-based disorder of fluency, the scope of whose diagnostic criteria currently remains unclear. This paper reports preliminary findings from a larger study which aims to determine whether cluttering can be associated with language disturbances as well as motor and rate based ones. Subtests from the Mt Wilga High Level Language Test (MWHLLT) were used to determine whether people who clutter (PWC) have word finding difficulties, and use significantly more maze behaviours compared to controls, during story re-telling and simple sequencing tasks. Independent t tests showed that PWC were significantly slower than control participants in lexical access and sentence completion tasks, but returned mixed findings when PWCs were required to name items within a semantic category. PWC produced significantly more maze behaviour than controls in a task where participants were required to explain how to undertake commonly performed actions, but no difference in use of maze behaviour was found between the two groups when retelling a story from memory. The implications of these findings are discussed.Educational objectives: (a) To identify issues surrounding the difficulties in diagnosing cluttering, (b) to identify and describe previous accounts of a language component in cluttering, (c) to describe how difficulties with lexical access and maze behaviour might be associated with cluttering, (d) to describe how data from the current research inform our present understanding of theories on cluttering.     

A comparative investigation of the speech-associated coping responses reported by adults who do and do not stutter

The Behavior Checklist, a self-report test procedure, was administered to 42 adults who stutter and 76 who do not in order to investigate the number, frequency of usage, type and nature of the responses that they reportedly employ to cope with the anticipation and/or presence of speech disruption. As a group, the participants who stutter reported a significantly greater number of speech-associated coping responses and a greater use of them than their nonstuttering peers did. Moreover, factor analysis made apparent fundamental between-group differences in the type and nature of certain forms of the coping responses reported by those who stutter and those who do not. This suggests that the quantitative and qualitative differences in the coping responses of those who do and do not stutter are potentially useful with respect to differential diagnostic and therapeutic decision making. EDUCATIONAL OBJECTIVES: (1) The reader will be able to describe differences in the number, frequency and types of coping behaviors used by PWS and PWNS. (2) The reader will be able to list similarities and differences in the type and nature of coping behaviors used by PWS and PWNS. (3) The reader will be able to discuss the features and use of the Behavior Checklist, a self-report procedure for assessing the responses used by adults to cope with the anticipation and occurrence of speech disruption.     

Age of acquisition and repetition priming effects on picture naming of children who do and do not stutter

The effects of age of acquisition and repetition priming on picture naming latencies and errors were studied in 22 children who stutter (CWS) and 22 children who do not stutter (CWNS) between the ages of 3;1 and 5;7. Children participated in a computerized picture naming task where they named pictures of both early and late acquired (AoA) words in two consecutive stages. Findings revealed that all children's picture naming latencies and errors were reduced following repetition priming and in response to early AoA words relative to late AoA words. AoA and repetition priming effects were similar for children in both talker groups, with one exception. Namely, CWS benefitted significantly more, in terms of error reduction, than CWNS from repetition priming for late AoA words. In addition, CWNS exhibited a significant, positive association between linguistic speed and measures of vocabulary, but CWS did not. These findings were taken to suggest that the (a) semantic-phonological connections of CWS may not be as strong as those of CWNS, and (b) existing lexical measures may not be sensitive enough to differentiate CWS from CWNS in lexically related aspects of language production. Educational objectives: After reading this article, the learner will be able to: (a) describe the effects of repetition priming and age of word acquisition in speech production; (b) summarize the performance similarities and differences of children who stutter and children who do not stutter on a computerized picture naming task; and (c) compare the results of the present study with previous work in this area.     

A comparative investigation of the speech-associated attitude of preschool and kindergarten children who do and do not stutter

The data of recent research studies have shown that by 3 years of age children show an awareness of dysfluency and that by at least the age of six, youngsters who stutter have a speech-associated attitude that is more negative than that of their peers. These findings led to the present study in which the KiddyCAT, a self-report measure, was used to compare the attitude toward speech of 45 children, between the age of three and six, who stuttered with that of 63 who did not. The data of this investigation showed that, as a group, the preschool and kindergarten children who stuttered had significantly more in the way of a negative attitude toward their speech than was found among their nonstuttering peers of the same age and gender. This finding is not consistent with the classically held position that the reactive aspects of stuttering do not generally develop until well after its onset. It suggests the need to measure, by standardized means, the speech-associated attitude of incipient stutterers and, when appropriate, to make the assessment and treatment of negative attitude toward speech a meaningful aspect of therapy.

Educational objectives: The reader will be able to: (1) describe the difference in the speech-associated attitude of preschoolers and kindergartners who do and do not stutter; (2) summarize what we currently know about self-report tests used to assess speech-related attitude among children as young as 3; and (3) evaluate the usefulness of assessing the belief system of children whose fluency is considered problematic.     

Application of virtual reality graphics in assessment of concussion.

Abnormal balance in individuals suffering from traumatic brain injury (TBI) has been documented in numerous recent studies. However, specific mechanisms causing balance deficits have not been systematically examined. This paper demonstrated the destabilizing effect of visual field motion, induced by virtual reality graphics in concussed individuals but not in normal controls. Fifty five student-athletes at risk for concussion participated in this study prior to injury and 10 of these subjects who suffered MTBI were tested again on day 3, day 10, and day 30 after the incident. Postural responses to visual field motion were recorded using a virtual reality (VR) environment in conjunction with balance (AMTI force plate) and motion tracking (Flock of Birds) technologies. Two experimental conditions were introduced where subjects passively viewed VR scenes or actively manipulated the visual field motion. Long-lasting destabilizing effects of visual field motion were revealed, although subjects were asymptomatic when standard balance tests were introduced. The findings demonstrate that advanced VR technology may detect residual symptoms of concussion at least 30 days post-injury.     

Effects of concurrent cognitive processing on the fluency of word repetition: comparison between persons who do and do not stutter

This study investigated how silent reading and word memorization may affect the fluency of concurrently repeated words. The words silently read or memorized were phonologically similar or dissimilar to the words of the repetition task. Fourteen adults who stutter and 16 who do not participated in the experiment. The two groups were matched for age, education, sex, forward and backward memory span and vocabulary. It was found that the disfluencies of persons who stutter significantly increased during word repetition when similar words were read or memorized concurrently. In contrast, the disfluencies of persons who do not stutter were not significantly affected by either secondary task. These results indicate that the speech of persons who stutter is more sensitive to interference from concurrently performed cognitive processing than that of nonstuttering persons. It is proposed that the phonological and articulatory systems of persons who stutter are protected less efficiently from interference by attention-demanding processing within the central executive system. Alternative interpretations are also discussed. EDUCATIONAL OBJECTIVES: Readers will learn how modern speech production theories and the concept of modularity can account for stuttering, and will be able to explain the greater vulnerability of stutterer's speech fluency to concurrent cognitive processing.     

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.