Stuttering in daily life: an ecological momentary assessment

Abstract

The stuttering severity of an individual who stutters varies from situations to situations and from day to day. Stuttering variation is a source of frustration for many adults who stutter (AWS). However, very few studies investigated how stuttering severity varies together with emotions, i.e., Positive and Negative Affect (PA/NA), social anxiety, within individual AWS in daily situations outside of a lab. Therefore, the current dissertation consists of a pilot study and a three-part original study. The pilot study tested the ecological momentary assessment (EMA) study design and data analysis methods through investigating: (a) whether AWS’ self-reported emotions (NA/PA) during social interactions were associated with self-reported momentary stuttering severity both within- and between-individuals, and (b) whether within- and between-person associations between stuttering severity and emotions (NA/PA) differed in magnitude and/or direction. AWS (n = 9) were compliant during 21 days of measurement, finishing about 66% of all the momentary surveys. The first part of the main EMA study investigated the experience of stuttering in everyday life among AWS, and how is that experience shaped by personal (i.e., trait social anxiety) and situational factors (i.e., social partner reaction, communication channel type, social closeness, stuttering knowledge). Results indicated that having high (vs. low) trait social anxiety was associated with a tendency to experience high NA, low PA, and high self-reported stuttering severity among AWS. A range of situational factors also significantly influenced the within- person variation of NA, PA, and self-reported stuttering severity in everyday life. The second part of the main EMA study investigated the association between social anxiety and stuttering severity among AWS at between- and within-person levels of analysis. At the between-person level, percent syllables stuttered (%SS) and person mean Self-Reported Stuttering Severity (iSRSS) were both significantly correlated with trait social anxiety, but not above and beyond the effects of neuroticism, extraversion, the overall impact of stuttering, and avoidance behaviors. At the within-person level, when AWS self-reported to stutter more than they usually do on average, they also tended to exhibit higher levels of social anxiety than they usually did, regardless of the amount of avoidance behaviors exhibited at those moments. The within-person effect between stuttering severity and social anxiety was also significantly mediated by avoidance behaviors. The third part of the main EMA study examined how AWS’ stuttering severity varied from one day to the next and whether the use of speech techniques influenced such day-to-day variation. The study had two main findings. First, the autoregressive effects for both the daily average self-reported stuttering severity (SRSS) and speech techniques were statistically significant, which suggested that the day-to-day variation for the two variables had carryovers from the previous day. Second, the cross-lagged effect was statistically significant for the previous days’ use of speech techniques to the next day’s daily average SRSS, but not the other way around. In other words, when individuals used more speech management techniques than usual, they tended to exhibit higher, rather than reduced, levels of stuttering than usual on the subsequent day as well. Together, the current dissertation provided data to the momentary and daily variation of stuttering severity and emotions among AWS in daily life.