The social and communication impact of stuttering on adolescents and their families

Purpose

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.

Method

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.

Results

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.

Conclusion

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.     

Hydrocortisone infusion exerts dose- and sex-dependent effects on attention to emotional stimuli

Glucocorticoid administration has been shown to exert complex effects on cognitive and emotional processing. In the current study we investigated the effects of glucocorticoid administration on attention towards emotional words, using an Affective Go/No-go task on which healthy humans have shown an attentional bias towards positive as compared to negative words. Healthy volunteers received placebo and either low-dose (0.15 mg/kg) or high-dose (0.45 mg/kg) hydrocortisone intravenously during two separate visits in a double-blind, randomized design. Seventy-five minutes post-infusion, the subjects performed tests of attention (Rapid Visual Information Processing [RVIP]), spatial working memory (Spatial Span) and emotional processing (Affective Go/No-go task [AGNG]). On the attention task, performance was impaired under both hydrocortisone doses relative to placebo, though the effect on error rate was not significant after controlling for age; Spatial Span performance was unaffected by hydrocortisone administration. On the AGNG task, relative to the placebo condition the low-dose hydrocortisone infusion decreased response time to emotional words while high-dose hydrocortisone increased response time. In the females specifically, both high and low dose hydrocortisone administration attenuated the normal attentional bias toward positively valenced words. These data suggest that, in healthy women, the modulation of attention by the emotional salience of stimuli is influenced by glucocorticoid hormone concentrations.     

Testing the limits of cognitive plasticity in older adults: application to attentional control

Laboratory based training studies suggest that older adults can benefit from training in tasks that tap control aspects of attention. This was further explored in the present study in which older and younger adults completed an adaptive and individualized dual-task training program. The testing-the-limits approach was used [Lindenberger, U., & Baltes, P. B. (1995). Testing-the-limits and experimental simulation: Two methods to explicate the role of learning in development. Human Development, 38, 349-360.] in order to gain insight into how attentional control can be improved in older adults. Results indicated substantial improvement in overlapping task performance in both younger and older participants suggesting the availability of cognitive plasticity in both age groups. Improvement was equivalent among age groups in response speed and performance variability but larger in response accuracy for older adults. The results suggest that time-sharing skills can be substantially improved in older adults.     

The management of sexual issues in adolescent treatment programs

Disturbed adolescents confined to inpatient treatment settings present special problems for the management of sexual behaviors. Ego impaired, delinquent, and autonomy-seeking adolescents provoke unique conflicts among their peers and staff. Staff's sexual anxiety caused by societal stereotypes of adolescents, inexperience with the techniques of unbiased observation and limit-setting, ignorance of normal adolescent development, and countertransference may lead to inadequate or inappropriate interventions. The authors describe the goals of a training program to reduce staff sexual anxiety: to develop a body of knowledge about the interaction between normal sexual development and psychopathology; to promote awareness about the staff's own feelings and the ways they influence observation and interaction; to lessen anxiety about self-exposure in the group setting; and to gain mutual support. Specific guidelines regarding effective staff interventions at an individual and group level are described. Alertness to the broad implications of sexuality in staff and patients and the necessity for careful monitoring of ward anxiety is emphasized.     

Fertility, menstrual characteristics, and contraceptive practices among white, black, and Southeast Asian refugee adolescents

This study compares fertility and menstrual characteristics and contraceptive practices of white, black, and Southeast Asian refugee adolescents participating in the Minneapolis Health Department's Maternal and Infant Care Program between 1980 and 1982. Mean ages were similar among all racial groups; however, half the Hmong adolescents had a live birth as compared to less than 25% of the other racial groups. More than 75% of the Hmong and other Southeast Asian adolescents were married as compared to 11% of the whites and 8% of the blacks. Menarche was significantly later (2 years) for Hmong and other Southeast Asians, and the interval between menarche and first pregnancy was significantly shorter for the Hmong. While more than half of the whites and blacks previously used contraception, 14% of the Hmong and 29% of the other Southeast Asians had used contraception. Oral contraceptives were the most frequently used method for whites, blacks, and Southeast Asians; the Hmong were equally likely to choose oral contraceptives or barrier methods. The Hmong were less likely to choose contraception postpartum than were the other groups.     

Compassion without illusion

This paper describes the present crisis in the mental health system relative to the chronically mentally ill. It asks how we can apply our usual social contract with the sick to noncompliant mental patients. The paper identifies some American assumptions about freedom and individualism that undermine a more effective response and offers alternative assumptions based on the Judeo-Christian tradition that may help resolve some difficulties.     

VIOLATIONS OF BRANCH INDEPENDENCE IN JUDGMENTS OF THE VALUE OF GAMBLES

Abstract —Branch independence is weaker than Savage's "sure thing" principle. It requires that judgments of gambles with a common outcome produced by the same probability-event must not reverse order when that common outcome is changed. Subjects judged 168 gambles from viewpoints of both buyer (highest buying price) and in both viewpoints. Violations also changed systematically between viewpoints, consistent with the theory that viewpoint affects configural weighting but not the utility function. Violations of branch independence were opposite those predicted by the model of cumulative prospect theory. The middle of three equally likely outcomes received the most weight in the seller's viewpoint. In the buyer's, lower outcomes received greater weights. In both viewpoints, the ratio of weights of the middle outcome to the highest outcome exceeded the ratio of weights of the lowest outcome to the middle outcome.