Stuttering and Social Anxiety Disorder: New Insights and Treatment Possibilities

Main Article Content

Yoshikazu Kikuchi Gerald A Maguire Daisuke Murakami Kazuo Adachi Yumi Yamaguchi Takashi Nakagawa Toshiro Umezaki

Abstract

Stuttering (childhood-onset fluency disorder) is characterized by disruptions in speech fluency. In the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), the diagnosis of social anxiety disorder in people who stutter is prohibited. However, the introduction of the DSM-5 enabled the diagnosis of social anxiety disorder concurrently with stuttering, making the concerns of people who stutter more visible. Understanding the performance-only subtype of social anxiety disorder introduced in DSM-5 can prevent underestimating the concerns of people who stutter and lead to appropriate support. While cognitive-behavioral therapy is effective in treating stuttering, accumulating evidence for pharmacotherapy is also necessary.

Keywords: stuttering, social anxiety disorder, DSM-5, cognitive-behavioral therapy, pharmacotherapy

Article Details

How to Cite
KIKUCHI, Yoshikazu et al. Stuttering and Social Anxiety Disorder: New Insights and Treatment Possibilities. Medical Research Archives, [S.l.], v. 12, n. 7, july 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5561>. Date accessed: 15 nov. 2024. doi: https://doi.org/10.18103/mra.v12i7.5561.
Section
Research Articles

References

1. Månsson H. Childhood stuttering. J Fluency Disord. 2000;25:47-57.
2. Reilly S, Onslow M, Packman A, et al. Predicting stuttering onset by the age of 3 years: a prospective, community cohort study. Pediatrics. 2009;123(1):270-277.
3. Reilly S, Onslow M, Packman A, et al. Natural history of stuttering to 4 years of age: a prospective community-based study. Pediatrics. 2013;132(3):460-467.
4. Sakai N, Miyamoto S, Hara Y, et al. Multiple-Community-Based Epidemiological Study of Stuttering among 3-Year-Old Children in Japan. Folia Phoniatr Logop. Published online May 2, 2024.
5. Yairi E, Ambrose NG. Early childhood stuttering I: persistency and recovery rates. J Speech Lang Hear Res. 1999;42(5):1097-1112.
6. Yairi E, Ambrose N. Epidemiology of stuttering: 21st century advances. J Fluency Disord. 2013;38(2):66-87.
7. O’Brian S, Jones M, Packman A, Menzies R, Onslow M. Stuttering severity and educational attainment. J Fluency Disord. 2011;36(2):86-92.
8. Craig A, Blumgart E, Tran Y. The impact of stuttering on the quality of life in adults who stutter. J Fluency Disord. 2009;34(2):61-71.
9. Koedoot C, Bouwmans C, Franken MC, Stolk E. Quality of life in adults who stutter. J Commun Disord. 2011;44(4):429-443.
10. McAllister J, Collier J, Shepstone L. The impact of adolescent stuttering on educational and employment outcomes: evidence from a birth cohort study. J Fluency Disord. 2012;37(2):106-121.
11. Gerlach H, Totty E, Subramanian A, Zebrowski P. Stuttering and Labor Market Outcomes in the United States. J Speech Lang Hear Res. 2018;61(7):1649-1663.
12. Tichenor SE, Palasik S, Yaruss JS. Understanding the Broader Impact of Stuttering: Suicidal Ideation. Am J Speech Lang Pathol. 2023;32(5):2087-2110.
13. Sheehan J. Stuttering; research and therapy. Harper & Row, 1970.
14. Bloodstein O. The Development of Stuttering: II. Developmental Phases. J Speech Hear Disord. 1960;25(4):366-376.
15. American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 5th edition: DSM-5. Washington, DC: American Psychiatric Publications, 2013.
16. Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H -U. Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. Int J Methods Psychiatr Res. 2012;21(3):169-184.
17. Stein MB, Stein DJ. Social anxiety disorder. Lancet. 2008;371(9618):1115-1125.
18. Ruscio AM, Brown TA, Chiu WT, Sareen J, Stein MB, Kessler RC. Social fears and social phobia in the USA: results from the National Comorbidity Survey Replication. Psychol Med. 2008;38(1):15-28.
19. Kessler RC. The impairments caused by social phobia in the general population: implications for intervention. Acta Psychiatr Scand Suppl. 2003;(417):19-27.
20. Ohayon MM, Schatzberg AF. Social phobia and depression: prevalence and comorbidity. J Psychosom Res. 2010;68(3):235-243.
21. Stein MB, Fuetsch M, Müller N, Höfler M, Lieb R, Wittchen HU. Social anxiety disorder and the risk of depression: a prospective community study of adolescents and young adults. Arch Gen Psychiatry. 2001;58(3):251-256.
22. Oberlander E, Schneier F, Liebowitz MR. Treatment of stuttering with phenelzine. Am J Psychiatry. 1993;150(2):355-356.
23. Blumgart E, Tran Y, Craig A. Social anxiety disorder in adults who stutter. Depress Anxiety. 2010;27(7):687-692.
24. Stein MB, Baird A, Walker JR. Social phobia in adults with stuttering. Am J Psychiatry. 1996;153(2):278-280.
25. Schneier FR, Wexler KB, Liebowitz MR. Social phobia and stuttering. Am J Psychiatry. 1997;154(1):131.
26. Iverach L, Rapee RM. Social anxiety disorder and stuttering: current status and future directions. J Fluency Disord. 2014;40:69-82.
27. Menzies RG, O'Brian S, Onslow M, Packman A, St Clare T, Block S. An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering. J Speech Lang Hear Res. 2008;51(6):1451-1464.
28. Iverach L, Menzies R, Jones M, O'Brian S, Packman A, Onslow M. Further development and validation of the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scales: relationship to anxiety and social phobia among adults who stutter. Int J Lang Commun Disord. 2011;46(3):286-299.
29. Iverach L, Jones M, McLellan LF, et al. Prevalence of anxiety disorders among children who stutter. J Fluency Disord. 2016;49:13-28.
30. Kikuchi Y, Kenjo M, Yoshida E, et al. Social anxiety disorder in adolescents who stutter: A risk for school refusal. Pediatr Int. 2023;65(1):e15622.
31. Sumi Y, Kunishige M, Tateno M, Ujie T, Tsutsumi H. Reliability and validity of the Japanese version of the Liebowitz social anxiety scale for children and adolescents. J Jpn Pediatr Soc. 2010;114:1185–93.
32. Menzies RG, Onslow M, Packman A, O'Brian S. Cognitive behavior therapy for adults who stutter: a tutorial for speech-language pathologists. J Fluency Disord. 2009;34(3):187-200.
33. Helgadóttir FD, Menzies RG, Onslow M, Packman A, O'Brian S. A standalone Internet cognitive behavior therapy treatment for social anxiety in adults who stutter: CBTpsych. J Fluency Disord. 2014;41:47-54.
34. Menzies R, O'Brian S, Lowe R, Packman A, Onslow M. International Phase II clinical trial of CBTPsych: A standalone Internet social anxiety treatment for adults who stutter. J Fluency Disord. 2016;48:35-43.
35. Menzies RG, Packman A, Onslow M, O'Brian S, Jones M, Helgadóttir FD. In-Clinic and Standalone Internet Cognitive Behavior Therapy Treatment for Social Anxiety in Stuttering: A Randomized Trial of iGlebe. J Speech Lang Hear Res. 2019;62(6):1614-1624.
36. Gunn A, Menzies RG, Onslow M, et al. Phase I trial of a standalone internet social anxiety treatment for adolescents who stutter: iBroadway. Int J Lang Commun Disord. 2019;54(6):927-939.
37. Schneier FR. Clinical practice. Social anxiety disorder. N Engl J Med. 2006;355(10):1029-1036.
38. Leichsenring F, Leweke F. Social Anxiety Disorder. N Engl J Med. 2017;376(23):2255-2264.
39. Maguire GA, Nguyen DL, Simonson KC, Kurz TL. The Pharmacologic Treatment of Stuttering and Its Neuropharmacologic Basis. Front Neurosci. 2020;14:158. Published 2020 Mar 27.
40. Bögels SM, Alden L, Beidel DC, et al. Social anxiety disorder: questions and answers for the DSM-V. Depress Anxiety. 2010;27(2):168-189.
41. Mitsui N, Fujii Y, Asakura S, et al. Antidepressants for social anxiety disorder: A systematic review and meta-analysis. Neuropsychopharmacol Rep. 2022;42(4):398-409.
42. Maguire G, Franklin D, Vatakis NG, et al. Exploratory randomized clinical study of pagoclone in persistent developmental stuttering: the EXamining Pagoclone for peRsistent dEvelopmental Stuttering Study. J Clin Psychopharmacol. 2010;30(1):48-56.
43. McCall WV. Sertraline-induced stuttering. J Clin Psychiatry. 1994;55(7):316.
44. Christensen RC, Byerly MJ, McElroy RA. A case of sertraline-induced stuttering. J Clin Psychopharmacol. 1996;16(1):92-93.
45. Ekhart C, van Hunsel F, van Harten P, van Baarsen J, Yingying T, Bast B. Drug-Induced Stuttering: Occurrence and Possible Pathways. Front Psychiatry. 2021;12:692568. Published 2021 Aug 25.
46. Hofmann SG, Heinrichs N, Moscovitch DA. The nature and expression of social phobia: toward a new classification. Clin Psychol Rev. 2004;24(7):769-797.
47. Blöte AW, Kint MJ, Miers AC, Westenberg PM. The relation between public speaking anxiety and social anxiety: a review. J Anxiety Disord. 2009;23(3):305-313.
48. Szeleszczuk Ł, Frączkowski D. Propranolol versus Other Selected Drugs in the Treatment of Various Types of Anxiety or Stress, with Particular Reference to Stage Fright and Post-Traumatic Stress Disorder. Int J Mol Sci. 2022;23(17):10099. Published 2022 Sep 3