Attentional Biases in Adults Who Stutter before and following Social Threat Induction

We know that adults who stutter report higher levels of social anxiety [Craig and Tran: J Fluency Disord 2014;40:35-43; Iverach et al.: J Anxiety Disord 2009;23(7):928-34]. What is not clear is whether adults who stutter develop maladaptive attentional shifts, similar to what is observed in socially anxious individuals, in response to social anxiety. The purpose of this study was to investigate the attentional biases in adults who stutter compared to adults who do not stutter before and after social evaluative threat induction and determine whether responses are associated with objective and subjective measures of anxiety.

Twelve adults who stutter and 14 matched adults who do not stutter performed a modified response time paradigm, the dot-probe task, where they responded to a probe appearing behind one of two faces, one emotional (positive or negative) and one neutral. Participant's reaction times were measured before and after a social threat induction task. Skin conductance levels were used as an index of induced stress. Self-reports of trait and social anxiety were used as subjective measures of anxiety.

Adults who stutter compared to controls exhibited an attentional bias towards negative facial expressions following a social evaluative threat induction. This effect remained when covarying for levels of trait and social anxiety. Before social evaluative threat induction, visual inspection of the data showed that adults who stutter compared to adults who do not stutter avoided positive facial expressions as they attended more to the negative facial expressions; however, these differences were not significant.

This study provides evidence for a maladaptive attentional behavior in adults who stutter when undergoing feelings of social evaluative threat. Results provide rationale for research aimed at assessing the use of attention restructuring in highly anxious adults who stutter.