The iceberg beneath the surface

Transcription

1 The iceberg beneath the surface Impact of stuttering on self-esteem in adolescents through mediating processes: A comparison of stuttering and non-stuttering adolescents Wim Beyers Ghent University Stefanie Adriaensens University of Antwerp 1

2 Stuttering in adolescence 1% of people is stu stu stuttering, about persons in Belgium (Bloodstein, 1995). Very limited attention in academic research! Strong focus on linguistics: stuttering behavior, speech difficulties Little attention for iceberg beneath surface : shame, social anxiety, negative speeching attitudes, lower life satisfaction and self-esteem These subjective feelings are not part of stuttering in childhood (Green, 1998, 1999), but define a stutterer in adults (Yaruss, 2010). What about adolescence? 2

3 Research Questions Does stuttering in adolescence influence self-esteem? Which domain of self-esteem? Global, school, social, sport, physical, behavior, intimacy? Difference between early (12-14y) and late adolescence (18-21y)? Difference between diagnosed stutterers and controls? 3

4 Research Questions Which variables might explain the link between stuttering severity and decreased self esteem? Negative communication atttitudes (Green, 1998, 1999): stutterers do not like to talk, hesitate to pick up the phone, rather stay silent Stigmatisation by peers and as a consequence introversion (Craig et al., 2000): stutterers are viewed as stupid, ridicule, shy, etc. Perfectionism, particularly maladaptive perfectionism (Amster, 1995; Craig et al., 2000): stutterers develop increased vigilance about speeching, worry about making mistakes, and doubt about speaking correctly, or just speaking at all. 4

5 Research Questions Communication attitudes Stuttering severity Stigmatisation & introversion Self-esteem Perfectionism Age & Group 5

6 Method Sample 55 diagnosed stuttering adolescents (64% male) 76 controls (72% male) 50% early (12-14y) and 50% late (18-20y) adolescents 80% (lower) middle class (Hollingshead ISP) primarily studying youth (95%) 6

7 Method - Measures Stuttering severity: Subjective Screening of Stuttering (SSS; Riley et al. 2004); r with Objective Screening (n = 33):.38** Self-esteem: Self Perception Profile Adolescents (SPPA; Harter, 1988): global self-esteem + 6 specific s: school, social, sports, physical, behavior, intimacy Negative Communication Attitudes (S-24; Andrews & Cutler, 1974): difficulty and anxiety to talk in public Perfectionism: Multidimensional Perfectionism Scale (MPS; Frost et al, 1990): maladaptive & adaptive perfectionism Stigma & introversion: adapted epylepsy stigma measure (Westbrook et al., 1992) 7

8 Stuttering Severity (SSS) 8

9 Analyses Main effects & Mediation Mplus 7 (Muthén & Muthén, 2012) Maximum likelihood Bootstrapped standard errors and 95% confidence intervals, 1000 draws First each mediator separately, later multiple mediators Moderation Multigroup modeling (Bollen, 1989); topdown 9

10 Stuttering severity Main Effects -.19* -.23** -.31** ** Global Selfesteem School Social Sportive Physical Behavioral Intimate 10

11 Mediation Stuttering severity.65***.41*** Negative Communication Attitudes.34*** Maladaptive Perfectionism -.45*** -.28** Global Self-esteem Indirect effects - NCA: -.42 [-.54 ; -.29] - MPE: -.12 [-.20 ; -.04] 11

12 Mediation Stuttering severity.65***.41*** Negative Communication Attitudes.34*** Maladaptive Perfectionism -.31** -.37*** School Indirect effects - NCA: -.20 [-.32 ; -.09] - MPE: -.16 [-.23 ; -.08] 12

13 Mediation Stuttering severity.65***.41*** Negative Communication Attitudes.34*** Maladaptive Perfectionism -.53*** -.19* Social Indirect effects - NCA: -.37 [-.50 ; -.23] - MPE: -.07 [-.14 ; -.01] 13

14 Mediation Stuttering severity.65***.41*** Negative Communication Attitudes.34*** Maladaptive Perfectionism -.29** -.23* Physical Indirect effects - NCA: -.18 [-.33 ; -.03] - MPE: -.10 [-.19 ; -.00] 14

15 Mediation Stuttering severity.65***.41*** Negative Communication Attitudes.34*** Maladaptive Perfectionism -.46*** -.02 Intimacy Indirect effects - NCA: -.30 [-.46 ; -.15] - MPE: -.01 [-.08 ;.06] 15

16 Conclusions & Implications Stuttering undermines self-esteem in adolescents, also for non-diagnosed persons. Not only global, also school, social and intimate! Primary mediators: NCA & MPE! Full mediation! Attitudes that can be treated in therapy! When succesfull, this can undo the impact of stuttering on self-esteem! Stigmatization & introversion are not mediators! Stijn Van Petegem 16

17 Causal Mediation Analysis? No! Cross-sectional data: possible reversed effects at some places in model (e.g. low self-esteem negative communication attitudes) Yes! Strong theoretical rationale for these links! Strong indirect effects! Full mediation! Other possible mediators are related to NCA or MPE! THANKS FOR YOUR ATTENTION! Stijn Van Petegem 17