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The relationship between mental health disorders and treatment outcomes among adults who stutter
Abstract
Unlabelled The ability to reduce stuttering in everyday speaking situations is the core component of the management plan of many who stutter. However, the ability to maintain the benefits of speech-restructuring treatment is known to be compromised, with only around a third of clients achieving this [Craig, A. R., & Hancock, K. (1995). Self-reported factors related to relapse following treatment for stuttering. Australian Journal of Human Communication Disorders, 23, 48-60; Martin, R. (1981). Introduction and perspective: Review of published research. In E. Boberg (Ed.), Maintenance of fluency. New York: Elsevier]. The aim of this study was to determine whether the presence of mental health disorders contributes to this failure to maintain fluency after treatment. Assessments for mental health disorders were conducted with 64 adults seeking speech-restructuring treatment for their stuttering. Stuttering frequency, self-rated stuttering severity and self-reported avoidance were measured before treatment, immediately after treatment and 6 months after treatment. Stuttering frequency and situation avoidance were significantly worse for those participants who had been identified as having mental health disorders. The only subgroup that maintained the benefits of the treatment for 6 months was the third of the participants without a mental health disorder. These results suggest that prognosis for the ability to maintain fluency after speech restructuring should be guarded for clients with mental health disorders. Further research is needed to determine the benefits of treating such disorders prior to, or in combination with, speech-restructuring.Educational objectives The reader will (1) evaluate the impact of one or more mental health disorders on medium-term outcomes from speech-restructuring treatment for stuttering, (2) describe how this finding affects prognosis for certain groups of stuttering clients, (3) evaluate how these finding are consistent with estimates of post-treatment relapse after speech-restructuring treatment, (4) describe two test instruments for detecting mental health disorders, and (5) outline the findings about the relation between pre-treatment stuttering severity and mental health disorders.
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“Stuttering is routinely treated directly by a speech therapist (“direct” treatment); however, according to the literature, this kind of treatment is less effective as an exclusive treatment and may be beneficially combined with”
From Inquiry based stress reduction (Ibsr) improves overall stuttering experience among adults who stutter: A randomized controlled trial (2021) · cites this paper as [10]
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“Some authors have suggested that all PWS receiving speech therapy should also receive psychological treatment (23), given findings that mental health conditions can disrupt the progress made from speech therapy (72).”
BackgroundThe Five Factor Model of personality applied to adults who stutter
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“It may also help solidify the maintenance of benefits from speech therapy, which can suffer from experiencing comorbid stuttering and mental health conditions (18, 31).”
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“…reduced educational and vocational attainment (Gerlach et al., 2018; McAllister et al., 2012), increased incidence of bullying and social rejection (Langevin et al., 2009), and increased anxiety-related mental health issues in children and adults (Briley et al., 2021; Iverach et al., 2016, 2009).”
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Safety behaviors and speech treatment for adults who stutter.
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“Furthermore, social anxiety was higher in PWS compared to people who do not stut-ter, with at least one quarter of adults who stutter meeting criteria for social anxiety disorder (Chu et al., 2020; Iverach, O ’ Brian, et al., 2009; Kraaimaat et al., 2002).”
The Comprehensive Stuttering Program and Its Evidence Base
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Rodgers, N. H., Lau, J. Y. F., & Zebrowski, P. M. (2021) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2021.106179 · Cited by 12
Effortful control and adaptive functioning in school-age children who stutter
Hollister, J., Zebrowski, P. M., Horne, A. O. V., McGregor, K., Vispoel, W., & Walden, T. A. (2015) · doi:10.17077/etd.1z9h6ynb · Cited by 10
“Previous studies have noted high rates of anxiety in both children and adults who stutter (e.g. Blood & Blood, 2007; Blumgart, Tran, & Craig, 2010;; Iverach et al., 2009;; Iverach, Menzies, O’Brian, Packman, & Onslow, 2011).”
What Do Adults Who Stutter Think About the Nature of Stuttering Treatment?
Vanryckeghem, M., & Eerdenbrugh, S. V. (2024) · Perspectives of the ASHA Special Interest Groups · doi:10.1044/2023_persp-23-00030 · Cited by 9
Personality Dimensions of Speech-Language Pathologists Who Work With Clients Who Stutter
Freud, D., Zukerman, G., & Icht, M. (2019) · Communication Disorders Quarterly · doi:10.1177/1525740119886538 · Cited by 9
“Therefore, a recommended therapeutic approach typically combines speech-restructuring strategies and interventions that address the cognitive and emotional aspects of stuttering (e.g., Iverach et al., 2009).”
BackgroundAnxiety, Social Phobia, Depression, and Suicide among People Who Stutter; A Review Study
Rezaeian, M., Akbari, M., Shirpoor, A. H., moghadasi, Z., zadeh, N. C., Nikdel, Z., & Hejri, M. (2020) · Journal of Occupational Health and Epidemiology · doi:10.29252/johe.9.2.98 · Cited by 9
“…Inventory 38.5(9.6) 35.8(7.0) Ezrati-Vinacour et al. (2004) 47/M/18-43 47/M/18-43 Spielberger State-Trait Anxiety Inventory 42.9(8.8) 34.6(7.8) Iverach et al. (2009) 94/72M/18-73 102/82M/18-75 Spielberger State-Trait Anxiety Inventory 41.9(10.4) 35.8(7.0) Blumgart et al. (2010)…”
BackgroundInfluentialO’Brian, S., Jones, M., Packman, A., Onslow, M., Menzies, R. G., Lowe, R., Cream, A., Hearne, A., Hewat, S., Harrison, E., et al. (2022) · Journal of Speech Language and Hearing Research · doi:10.1044/2022_jslhr-21-00452 · Cited by 9
Coping Strategies and Adolescents: Learning to Take Care of Self and Stuttering during Treatment
Blood, G. W., Blood, I. M., Dorward, S., Boyle, M., & Tramontana, G. M. (2011) · Perspectives on Fluency and Fluency Disorders · doi:10.1044/ffd21.3.68 · Cited by 9
Brown, L., Wilson, L. S., Packman, A., Halaki, M., Onslow, M., & Menzies, R. G. (2016) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2016.09.001 · Cited by 9
Response to Walter Manning and J. Gayle Beck: Comments concerning Iverach, Jones et al. (2009a)
Iverach, L., Jones, M., Menzies, R. G., O’Brian, S., Packman, A., & Onslow, M. (2010) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2010.11.001 · Cited by 9
Comparison of Stuttering Severity and Anxiety During Standard and Challenge Phone Calls
O’Brian, S., Onslow, M., Jones, M., Lowe, R., Packman, A., & Menzies, R. G. (2022) · Journal of Speech Language and Hearing Research · doi:10.1044/2021_jslhr-21-00365 · Cited by 8
Ingham, R. J. (2012) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2011/11-0136 · Cited by 8
Stuttering and Neurodiversity Across the Lifespan: A Moveable Feast
Onslow, M. (2025) · American Journal of Speech-Language Pathology · doi:10.1044/2025_ajslp-25-00089 · Cited by 7
Mohammadi, H., Maazinezhad, S., Lorestani, E., Zakiei, A., Dürsteler, K. M., Brühl, A., Sadeghi-Bahmani, D., & Brand, S. (2022) · Journal of Clinical Medicine · doi:10.3390/jcm12010161 · Cited by 8
“In addition, given that stuttering may increase as a function of a person’s subjective importance of a social interaction and its related social anxiety, social anxiety management appeared to be a promising intervention for a better management of the disorder in adults who stutter (AWS) [13].”
BackgroundObserver perspective imagery with stuttering
Lowe, R., Menzies, R. G., Packman, A., O’Brian, S., & Onslow, M. (2015) · International Journal of Speech-Language Pathology · doi:10.3109/17549507.2015.1010580 · Cited by 8
Azarinfar, M., Karimi, H., Jowkar, F., & Shafiei, B. (2022) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2022.106251 · Cited by 6
The experiences of adolescents who stutter: a scoping review
Alharbi, E., Hewat, S., Walters, J., & Unicomb, R. (2025) · Speech Language and Hearing · doi:10.1080/2050571x.2024.2429899 · Cited by 7
“Adults who stutter are also at greater risk of developing a generalized anxiety disorder, major depression, mood disorder and anxiety and non-anxiety-related personality disorders (Iverach et al., 2009, 2010).”
A novel approach for measuring social participation in adults who stutter
Mendes, L., Dacakis, G., Block, S., & Erickson, S. (2015) · Journal of Fluency Disorders · doi:10.1016/j.jfludis.2015.02.001 · Cited by 6
Dsouza, A. J., Manivannan, V., & Maruthy, S. (2023) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2023.106388 · Cited by 8
Psychological Health and Coping Strategies of Adolescents with Chronic Stuttering
Blood, G. W. (2015) · Journal of Child and Adolescent Behaviour · doi:10.4172/2375-4494.1000194 · Cited by 6
“Iverach, Jones, O’Brian et al [17] reported a high co-occurrence of one or more Personality Disorders (PD) for 92 adults who stutter.”
BackgroundBauerly, K. R., & Jones, R. M. (2021) · Journal of Communication Disorders · doi:10.1016/j.jcomdis.2021.106084 · Cited by 6
Metadata
- Authors
- Iverach, L., Jones, M., O’Brian, S., Block, S., Lincoln, M., Harrison, E., Hewat, S., Cream, A., Menzies, R. G., Packman, A., & Onslow, M.
- Affiliations
- The University of Sydney (AU)
- The University of Queensland (AU)
- La Trobe University (AU)
- Macquarie University (AU)
- University of Newcastle Australia (AU)
- Corresponding author
- Onslow, Mark
- ORCID
- Venue
- Journal of Fluency Disorders
- Publisher
- Elsevier BV
- Published
- 2009-03
- Volume
- 34
- Issue
- 1
- Pages
- 29-43
- ISSN
- 0094-730X (ISSN-L)
- OpenAlex
- W1973924569
- Cited by
- 155
- References
- 48
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 5 · 2023: 8 · 2022: 13 · 2021: 13 · 2020: 5 · 2019: 5 · 2018: 4 · 2017: 8 · 2016: 8 · 2015: 15 · 2014: 6 · 2013: 11 · 2012: 11
- FWCI
- 13.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Fluency Disorders (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Health and Medical Research Council
- National Medical Research Council
- Topics
- Social Sciences › Psychology › Clinical Psychology › Stuttering Research and Treatment
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- stuttering, mental illness, maintenance of treatment effects, relapse, stuttering frequency, stuttering severity, prognosis, adults who stutter
- MeSH terms
- Adolescent, Adult, Aged, Mental Disorders, Female, Humans, Longitudinal Studies, Male, Middle Aged, Neuropsychological Tests, Severity of Illness Index, Speech, Speech Production Measurement, Speech Therapy, Stuttering, Treatment Outcome, Young Adult
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