Clinical and Psychosocial Predictors of Post-event Processing in Adults who Stutter

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Project Abstract Stuttering is a neurophysiological disorder that is genetically transmitted, yet, there is a pervasive assumption that stuttering is the result of being nervous or anxious. This misconception results in deleterious quality-of-life consequences, with many persons who stutter experiencing communication exchanges in which they are mocked, discriminated against, and stigmatized. Adults who stutter are at increased risk for developing social anxiety disorder, leading to depression, social withdrawal, and/or suicidal ideation. One contributor to the persistence of social anxiety that has yet to be examined among adults who stutter is post-event processing, a cognitive process defined by excessive and intrusive self-criticism following a stressful communication event. Distinct from repetitive negative thinking, which is one’s general tendency to ruminate and could apply to a variety of issues unrelated to communication, post-event processing specifically occurs following a communication exchange and is linked to anticipatory anxiety and avoidance of subsequent communication situations. Given the adverse, quality-of-life consequences of post-event processing and recent research citing self-compassion as a protective factor, the proposed research study will evaluate how clinical markers of stuttering (i.e., the speaker’s experience of stuttering, self-rated stuttering severity, observer-rated stuttering severity) and self-compassion contribute to post-event processing in adults who stutter. This study will identify clinical predictors of post-event processing in adults who stutter and evaluate self-compassion as a protective factor through three specific aims. In Aims 1 and 2, we will determine the influence of the speaker’s experience of stuttering (i.e., self-reported impact of stuttering on quality of life; Aim 1) and self-rated stuttering severity (Aim 2) on post-event processing. Aims 1a and 2a will investigate self-compassion as a protective factor against post-event processing. We hypothesize that adults with more negative experiences of stuttering and higher self-rated stuttering severities will engage in more post-event processing. We also hypothesize that adults with higher self-compassion will engage in less post-event processing, regardless of stuttering experience or self-rated severity. In Aim 3, we will assess the influence of observer- rated stuttering severity on post-event processing. We hypothesize that observer-rated severity will not predict post-event processing in adults who stutter. To achieve these aims, participants will self-report their experience of stuttering and self-compassion, engage in a standardized communication stressor task, and self- report stuttering severity and post-event processing. Objective stuttering severity will be collected via unbiased listeners. Analyses will include a moderated linear regression with relevant covariates. This proposal is responsive to NIDCD’s priority areas 2 and 3 and therefore is relevant to public health, as the intended aims will 1) identify clinical and psychosocial factors associated with post-event processing in adults who stutter, and 2) inform assessment and treatment for adults who stutter, an understudied population.