Social Phobia in Adults With Stuttering

Stein, Murray B. MD
Baird, Allison MA, CCC-Sp
Walker, John R. PhD

Received April 27, 1995; revision received Sept. 1, 1995; accepted Oct. 20, 1995. From the Anxiety Disorders Research Program, Department of Psychiatry, and the Division of Communications Disorders, St. Boniface General Hospital, University of Manitoba, Winnipeg. Address reprint requests to Dr. Stein, Department of Psychiatry (0603), Anxiety and Traumatic Stress Disorders Research Program, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 92093-0603.
The authors thank Susan Stratford, MA., C.C.C.-Sp., for assistance with the fluency assessments and Laura D. Dengler for assistance with the data analysis.

American Journal of Psychiatry 153(2):p 278-280, February 1996.

Objective

The authors evaluated features of social anxiety in a group of adult stutterers to explore the soundness of the DSM-IV requirement that social phobia not be diagnosed in patients who stutter if their phobia relates to their stuttering. Method: They conducted diagnostic interviews and verbal fluency assessments with 16 consecutive adults seeking speech therapy for stuttering. Patients also completed scales measuring social phobia symptoms and associated disability. Results: When DSM-IV criteria were modified to permit a diagnosis of social phobia if phobic symptoms were clearly excessive in relation to the severity of stuttering, seven of the 16 patients were given a diagnosis of social phobia. All seven identified social anxiety as an important source of role impairment. Three of the seven patients entered cognitive-behavioral group therapy and benefited from this intervention. Conclusions: Many adults seeking treatment for stuttering have salient difficulties with social anxiety that may prove amenable to cognitive-behavioral interventions. By precluding a diagnosis of social phobia in these patients, DSM-IV may hinder the identification of social anxiety as a source of disability and may limit access to treatment.

(Am J Psychiatry 1996; 153:278-280)