Systematic review on applications of mindfulness and compassion interventions to people who stutter

The literature search on English and Japanese reports was conducted on 10 November

Applications of mindfulness and/or compassion interventions for people who stutter: A systematic review

Introduction: People who stutter (PWS) often suffer from psychological difficulties in addition to stuttering symptoms. Recently, mindfulness and compassion interventions have been applied to PWS to ameliorate these difficulties. The present study aimed to systematically review the applications of these interventions. Methods: Empirical studies applying mindfulness and/or compassion to PWS were included. Database (PubMed, CiNii), registry (CENTRAL, ICTRP, ClinicalTrials.gov), Google scholar, citation, and manual searches were conducted (last searched on November 10, 2021). Adjusted standardized mean differences (SMDs) were presented through forest plots. Risk of bias was assessed through a tool developed by the National Institutes of Health. Results: Eighteen studies (n = 195, excluding controls) were included. Ten studies, all of which showed some risk of bias, allowed calculation of SMDs of pre-post comparison. Some SMDs calculated in certain studies which were potentially less affected by bias appeared consistent with those in previous studies. Mindfulness has been used in several different treatments including speech treatments. A clinical trial of self-compassion is ongoing. Discussion: Mindfulness interventions have been applied to PWS in several treatment approaches and can have beneficial impacts. However, there is a risk of bias, including bias potentially caused by questionable research practices and publication and/or reporting bias

A multilevel meta-analysis on effects of psychological interventions for adults who stutter

Introduction: It is recommended that empirically-supported psychological interventions should be provided for adults who stutter (AWS). A meta-analysis on efficacy of psychological interventions for AWS was conducted in the present study. Method: Studies which conducted psychological interventions were identified through a database (MEDLINE through PubMed) and other sources including previous reviews. Studies where pre-post effect sizes can be estimated were extracted and bias was assessed quantitatively. Then, multilevel meta-analysis was conducted where outcomes were nested within studies. Furthermore, multilevel moderation (meta-regression) analyses were conducted to investigate relationships between intervention effects and outcome and treatment types. Results and discussions: Cognitive behavioral therapy or mindfulness and/or acceptance interventions were applied for AWS in majority of included studies. When excluding studies or outcomes potentially affected by bias, overall intervention effects were equivalent between them. Exploratory moderation analyses suggested that effects of these interventions may depend on outcome types. The present multilevel meta-analysis should be updated to obtain more reliable results in the future

Factors predicting satisfaction with communication in daily lives of adults who stutter: An experience sampling study

Purpose: Improving satisfaction with communication (SC) is one of the issues in treatments of adults who stutter (AWS). SC can be influenced by self-rated stuttering severity (SS), negative/positive emotions, and emotion regulations and they are variable in daily communications. The present study aimed to explore factors predicting SC in daily communications of AWS, considering their variabilities and speaking contexts. Method: Twenty-seven AWS were surveyed by trait questionnaires and then by experience sampling method (ESM) seven times per day for 2 weeks, reporting speaking contexts and subjective experiences, including SC, SS, negative/positive emotions, and emotion regulations. Intra- and inter- individual variabilities and relationships of the variables were investigated. Results: Speaking contexts were summarized by unofficial/official communications. SC, SS, and emotion regulations in unofficial communications were less variable and SC was more strongly related to trait questionnaires. Items of the ESM loaded on three latent factors in each communication type, including (1) negative emotion, (2) stuttering and associated reactions (including SS and stuttering-and anxiety-related behaviors and cognitions), and (3) positive emotion and attending to communication. SC was more strongly associated with (3) than (2) in unofficial communications while the opposite trend was found in official communications. Conclusions: SC, SS, and stuttering-and anxiety-related emotion regulations in unofficial communications are more trait-like. Not only negative emotion regulations but also positive emotion regulations should be treated to improve SC in AWS, considering speaking contexts

Situational factors influencing social anxiety in treatment-seeking adults who stutter: An exploratory factor analysis

Purpose: Adults who stutter (AWS) often show high levels of social anxiety. Stuttering is a speech disorder, making the latent factors influencing social anxiety potentially different from those in individuals with a social anxiety disorder (SAD) or general populations. This study aims to examine the situational factors influencing social anxiety in AWS. Methods: We analyzed data of 351 AWS using the fear/anxiety scale in the Japanese self-report version of the Liebowitz Social Anxiety Scale (LSAS). We conducted exploratory factor analysis and investigated subscale scores. Results: We extracted five factors: (i) eating, drinking, and party, (ii) telephone, (iii) observation or non-speech, (iv) interaction with strangers, and (v) public speaking. The factor for telephone was newly extracted, and anxiety in telephone situations was poorly explained by the total score of fear/anxiety of the LSAS. On the other hand, the other four factors are similar to those previously extracted in individuals with SAD and general populations, and more than 60% of the variance of the subscale constructs was explained by the total score. Preliminary comparisons revealed that AWS had saliently higher anxiety in telephone situations and lower anxiety in observation or non-speech situations than individuals with anxiety disorders and Japanese university students. Conclusions: The factor for telephone was uniquely extracted in AWS, and the severity of anxiety in telephone situations was not explained well by the overall severity of social anxiety as a whole. Telephone situations have specific impacts on social anxiety in AWS

Heterogeneity of social anxiety in treatment-seeking adults who stutter: A latent profile analysis

Purpose: Adults who stutter (AWS) often experience social anxiety. Social anxiety is explained by several situational factors, one of which is a factor for telephone, which is unique to AWS. This unique social anxiety, which has not been observed in individuals with social anxiety disorder (SAD), may lead to heterogeneity or distinct subtypes of AWS. The present study aimed to investigate the heterogeneity of social anxiety in AWS in terms of feared social situations. Methods: Social anxiety was measured using the fear/anxiety scale of the Liebowitz Social Anxiety Scale (LSAS). The scores of the five subscales in the LSAS in 562 AWS were analyzed using latent profile analysis. First, the number of latent classes (subtypes) was determined through statistical criteria and interpretability. Next, the profiles of social anxiety, demographic data, communication attitudes, and the overall severity of social anxiety of the subtypes were investigated. Results: Five latent class solutions led to good classifications. About one-quarter of AWS (156) were included in a subtype with sub-clinical levels of overall severity of social anxiety but severe social anxiety in telephone situations. Among them, 100 AWS showed severe social anxiety only in telephone situations. Psychosocial factors, including employment status and communication attitude, were related to extracted subtypes. Conclusions: Some AWS have severe social anxiety specific to telephone situations, which is not proportional to the overall severity of social anxiety. The telephone-specific subtype of social anxiety has not been empirically extracted in principal diagnosis of SAD and can be unique in AWS