Anxiety and Stuttering: A Critical Review

This report critically evaluates a study on the relationship between anxiety and stuttering, focusing on a multidimensional approach. The study used questionnaires and statistical methods like MANOVA and Pearson correlation to analyze data from a sample of male participants, both fluent and disfluent speakers. The report identifies strengths such as a large sample size and in-depth analysis, and limitations such as the exclusion of female participants and the use of older literature. The findings suggest a strong correlation between anxiety and stuttering severity, particularly in speech-related tasks, and highlight the need for future research to include diverse populations and consider a broader range of emotional factors.

SPSS
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Table of Contents
INTRODUCTION AND SUMMARY OF THIS REVIEW.................................................................3
LITERATURE REVIEW.....................................................................................................................4
AIMS....................................................................................................................................................4
SAMPLE..............................................................................................................................................5
INSTRUMENT FOR DATA COLLECTION......................................................................................5
STATISTICAL METHODS AND FINDINGS....................................................................................6
DISCUSSION.......................................................................................................................................7
CONCLUSION....................................................................................................................................7
REFERENCES.....................................................................................................................................9
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INTRODUCTION AND SUMMARY OF THIS REVIEW
Anxiety is a complicated psychological construct that incorporates three elements that are
verbal-cognitive, psychological and behavioural. During the last decade, this topic gained wider
attention of the academicians and scholars to examine the relationship between anxiety level and
stuttering. The present assignment will critically investigate the relationship between anxiety and
stuttering in both the clinical as well as empirical perspective. This is a quite interesting field or area
of study that will critically evaluate and examine the multidimensional interaction framework of
anxiety. Owing to this, an article on “The relationship between anxiety and stuttering: A multi
dimensional approach” has been selected. This study covered two elements that are trait anxiety and
state-traint anxiety. Former is regarded as inherent anxiety of a member, whilst, later refers to a
situation-specific anxiousness that take into consideration both the personality as well as situational
factor in order to estimate the movement in anxiety level.
In order to gather data, 94 males under the age range of 18 to 43 was selected, out of these,
50% was fluent speakers while rest of the member was disfluent speakers. All the chosen
participants were asked to fill two questionnaire inventories that are Trait Anxiety Inventory and
Speech Situation Checklist as well. Along with this, with regards to non-speech task, level of
anxiety has been evaluated on the basis of a subjective scale that is labelled as Task-Related
Anxiety.
The present report aims at making a critical evaluation of the study to identify the key
strength as well as discover shortcoming or limitations. The main strength of this research is that
reliable and valid data has been gathered from large as well as balanced sample size between fluent
and disfluent speakers. Moreover, this study covered an in-depth evaluation of the research problem
by taking into account solid measures that are state anxiety inventory, task-related anxiety,
emotional reaction, speech disruption and many more. Further, comparatical analysis has been made
regards to the score of people stuttered and not-stuttered. However, the main limitation is that
researcher gathered data only from the mail candidates and female candidate was not involved as
the researcher thought that adult women are not too much stuttered.
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LITERATURE REVIEW
In the literature review session, scholar has critically argued point of view of different
authors. In such regards, two kind of anxiety that consists of trait and state anxiety has been taken
into consideration by the scholar. The analysis investigated that if a person is able to perceive things
positively and able to cope-up with the situation will never experience any stressful conditions ain
any circumstances. Moreover, researcher has focused on latest or modern concept of anxiety
covering multidimensional approach. In this, four types of situations have been founded that are
social examination, ambiguity, physical danger and regular routine. All these factors have been
identified with the associated inter-relationship with each other.
This part of the study covered analysis of perpetuating, precipitating, aggravating factors
and communication disturbance to identify the accurate relationship between both the anxiety and
stuttering. The research fully availed the positive relationship among both the factors founded in
various studies by providing accurate evidences. However, the argument also has been discovered
by several studies as several scholars investigated that both the elements are not in relationship with
each other (Levin and Vinacour, 2004). Thus, this study covered both the views and its critical
discussion regards to the developed aims and objectives. But still, the multidimensional model is the
main topic of the study, however, it is not clear and well defined and differentiated from the
traditional model of anxiety.
However, self-reported questionnaire, Attitude scale, Communication Attitude, subjective
experience, social desirability, Trait Anxiety Index has been studied to discover the gap in the
earlier studies, as, none of the research has been conducted historically on multidimensional
approach (Weinberg and Abramowitz, 2016). It facilitates researcher to developing an inter-
connection or linkage between anxiety and stuttering.
Although LR section founded in-depth analysis relevant to the topic, but still, the main
limitation of this is wide range of studies have been discovered by the investigator were from before
the period of 1990. Therefore, it can be argued that researcher fails to provide updated and recent
findings concerning the topic of the study.
AIMS
The several aims of the study that have been founded are as under:
 To describe the concept of multidimensional anxiety model
 To investigate the model to assess the relationship between stuttering and anxiety
 To evaluate stuttering severity on the anxiety level to assess multi-dimensional model
Research hypothesis:
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 Score of the member who stuttered was not significantly different than the score of fluent
speakers
 Score of the stuttered people is significantly different than the score of fluent speakers.
 There are no significant differences between severe stutters scores and mild-stutters
 There are significant differences exists between score of severe stutters and mild or fluent
speakers
All the research objectives are well designed as they address the overall aim of the
investigation, but still, multiple designed aims can bring hurdles or diverse the main target of the
study. This in turn, quality of investigation get affected and weakened.
SAMPLE
In the study, scholar chosen a sample of 94 male candidates, 47 were adults and stuttered
and 47 normally speakers. All the members were under the age limit of 18 to 43 years. In this, the
sample size is enough large that is the strength of the study. Moreover 100% response rate as all the
selected participants filled-up the designed questionnaire and personal reflection and send back to
the researcher. However, non-involvement of female candidates can be considered as a limitation or
drawback of the study. Moreover, the selection criteria was not clearly standardized as in this, three
criteria has been decided for stuttering that are self-definition, diagnosis of the problem by a speech-
language clinician and reading and speech analysis of 600 syllable speech has been chosen for
quantity and quality analysis (Bauer and et.al., 2016). In this scholar selected those individuals who
met at least two criteria, henceforth, all the members cannot be considered equal, as 2 respondents
have met 2 criteria whereas 45 met all the defined criteria for selection. Additionally, participants
also have been selected on several basis like absence of language issues, central neurological issues
and psychiatric problems as well. Moreover, most of the male candidates were military personnel
which narrowed down and limits the area of the study (Gao and et.al., 2015)
INSTRUMENT FOR DATA COLLECTION
A set of questionnaires have been designed to gather data that encompasses Trait State
Anxiety Inventory (STAI), Speech Situation Checklist (SSC) and Task-related anxiety. (TRA) STAI
includes State as well as Trait Anxiety questionnaire (TAI), among these, only TAI has been used
covering 20 questions that describe emotional situation or conditions. Respondents have been asked
to rank themselves at a 4-level frequency scale. However, Brutten designed SSC questionnaire in
two sub-parts that are Speech Disruption (SD) and Emotional Reaction (ER). In this, different
virtual situations were mentioned that can give rises to the negative emotions such as telephonic
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conversation, food ordering in restaurant and total 51 different situations. Individuals have been
asked to score on a 5-point scale. At the end, TRA is specially focuses on the current aim to
investigate the inter-relationship between anxiety and stutterers. It covers four elements two non-
speech and two speech such as reading passage, silent reading, listening and own conversation.
STATISTICAL METHODS AND FINDINGS
STAI’s reliability has been measured by applying Cronbach Alpha that helps to quantify
internal consistency in order to assess how closely and strongly various set of items are related to
each other as a group. In quantitative analysis of statistical methods and tools, internal consistency
is often used to quantify the correlation between distinguished items applied on a same test or a
same subscale. It is founded under the range of 0.88 to 0.96 demonstrated higher internal
consistencies. However, stuttering severity has been measured by incorporating Pearson correlation
test by two experienced clinicians. In statistics, Pearson correlation is considered as a top most
measure to examine the linear dependencies between two variables (Ahmed, Fowler and McCredie,
2016).
Study examined relationship between stuttering and anxiety by segregating people into two
groups based on severity by the SSI position. A one-way MANOVA (Multivariate analysis of
Variance (MANOVA) has been applied to test or judge distinguish among three factors that are
severe PWS, mild PWS and people who are fluent speakers. All the members are compared on four
basis that are STAI, SSC-ER, TRA and two-speech as well as non-speech activities.
It can be criticised on the basis of the assumption of the tests one of the most important
assumption is that it quantifies two or more dependent variables at interval ratios. Moreover, it only
can be used to analyze categorical independent groups. Further, adequate sample size is the prior
requirement of the application of the test, but still, what sample size can be considered adequate is
unclear (Dufour and et.al., 2016).
Application of MANOVA founded a score of 8.14 reflected that both the PWS scored
greater as compare to fluent speakers. Further, with regards to SSC-ER, it has been founded to
12.12 and for TRA it is 6.62. Result outlined that anxiety is comparatively greater among severe
PWS in comparison to mild PWS and fluent speakers. However, on the other side, study founded no
significant effect with regards to non-speech tasks and activities conducted. Furthermore, Pearson
correlation coefficient for the subjective measures of anxiety and stuttering after reading is
computed to 0.89 while after conversation, it is computed to 0.88. All the applied statistical results
founded stronger relationship between the emotional reaction and stuttering severity (Babbie,
Wagner III and Zaino, 2015).
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In order to test multi-dimensional measures, correlation of Pearson has been founded for
SSC-ER, TRA and STAI and founded positive results.
 Value of correlation (r) in SSC-ER and TRA while performing speech tasks is significantly
greater than the value of r in STAI and TRA as the value of Z score was computed to 1.67
which was greater than P value of 0.05. However, regards to fluent speakers, study founded
same correlation.
 In context to the stuttering group, researcher founded no significant correlation between
STAI and TRA as well as SSC-ER and TRA for the non-speech tasks. While, in this case,
correlation between fluent speakers were founded significant.
DISCUSSION
This investigation founded controversial or contradictory results on the point that whether
people who are stuttered are anxious or not. In accordance with the overall finding of the research,
it can be noted that PWS are highly anxious in comparison to other normally fluent speakers. This is
mainly because, they have more anxiety. Thus, this research considered anxiety as a trait of
stuttering. Moreover, the study observed that anxiety between social communications was greater
among severe PWS as compare to mild and fluent speakers on the basis of state anxiety, SSC and
TRA in every speech task performed (Brace, 2016). On the contrary to this, stuttering severity has
no correlation with the STAI but correlated with SSC and TRA. However, in non-speech activities,
no significant level of differences has been founded.
TRA and subjective stuttering measures founded stronger and direct relationship between
anxiety level and stuttering severity in quantitative studies. It advocated that higher the level of
anxiety maximize severity among people or vice-versa. It direct have an impact upon people’s
performance and muscle activation (Elliott and Woodward, 2015).
However, inter-correlation between different factors founded different patterns. As, in the
fluent, no different have been reported on all the four basis, whilst, in PWS, high level of
correlation has been identified in SSC-ER and TRA than STAI and TRA. Contrary to this, study can
be criticised on the basis of the assumption made that considers anxiety as a personality trait for
PWS.
CONCLUSION
The analysis of the article on multidimensional application of anxiety clarified that people
who stuttered are at higher risk of anxiety. While, clinical assessment founded that trait anxiety is an
inherent characteristic and the second is that state social anxiousness is the part of therapeutic
assessment. Deeper and proper understanding and analysis of the study presented a clear
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differences, but still, on the basis of identified weakness, it can be suggested that future scholars
must select both the male and female candidates. Moreover, participants must be asked about their
feeling before they perform activities so that other emotional reactions in addition to anxiety can be
judged like shame, embarrassment and so on. It will lead to effectively address and achieve the
target of the study.
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REFERENCES
Books and Journals
Ahmed, W., Fowler, R. A. and McCredie, V. A., 2016. Does Sample Size Matter When Interpreting
the Fragility Index?. Critical Care Medicine. 44(11). pp.e1142-e1143.
Babbie, E., Wagner III, W. E. and Zaino, J., 2015. Adventures in social research: Data analysis
using IBM® SPSS® Statistics. Sage Publications.
Bauer, M. and et.al., 2016. Quantitative analysis of human centrosome architecture by targeted
proteomics and fluorescence imaging. The EMBO Journal. 35(19). pp.2152-2166.
Brace, N., 2016. Ibm Spss for Psychologists: And Everybody Else. Taylor & Francis.
Dufour, A. and et.al., 2016. Development of synaptic boutons in layer 4 of the barrel field of the rat
somatosensory cortex: a quantitative analysis. Cerebral cortex. 26(2). pp.838-854.
Elliott, A. C. and Woodward, W. A., 2015. IBM SPSS by Example: A Practical Guide to Statistical
Data Analysis. SAGE Publications.
Elliott, A. C. and Woodward, W. A., 2015. IBM SPSS by Example: A Practical Guide to Statistical
Data Analysis. SAGE Publications.
Gao, F. and et.al., 2015. Sample size calculations for the design of cluster randomized trials: A
summary of methodology. Contemporary clinical trials. 42(6). pp.41-50.
Levin, I. and Vinacour, R. E., 2004. The relationship between anxiety and stuttering: A multi-
dimensional approach. Journal of fluency disorder. 12(5). pp. 15-19.
Weinberg, S. L. and Abramowitz, S. K., 2016. Statistics Using IBM SPSS: An Integrative Approach.
Cambridge University Press.
Online
Pearson correlation. 2015. [Online]. Available through: <
http://study.com/academy/lesson/pearson-correlation-coefficient-formula-example-
significance.html>. [Accessed on 20th December 2016].
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