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Stuttering anxiety: Speech and Anxiety Management With Persistent Stuttering: Current Status and Essential Research


Stuttering in relation to anxiety, temperament, and personality: review and analysis with focus on causality

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Elsevier Science

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. 2014 Jun;40:5-21.

doi: 10.1016/j.jfludis.2014.01.004.

Epub 2014 Feb 8.

Per A Alm 



  • 1 Department of Neuroscience, Speech and Language Pathology, Uppsala University, Sweden. Electronic address: [email protected].
  • PMID:


  • DOI:



Per A Alm.

J Fluency Disord.

2014 Jun.

. 2014 Jun;40:5-21.

doi: 10. 1016/j.jfludis.2014.01.004.

Epub 2014 Feb 8.


Per A Alm 


  • 1 Department of Neuroscience, Speech and Language Pathology, Uppsala University, Sweden. Electronic address: [email protected].
  • PMID:


  • DOI:



Anxiety and emotional reactions have a central role in many theories of stuttering, for example that persons who stutter would tend to have an emotionally sensitive temperament. The possible relation between stuttering and certain traits of temperament or personality were reviewed and analyzed, with focus on temporal relations (i.e., what comes first). It was consistently found that preschool children who stutter (as a group) do not show any tendencies toward elevated temperamental traits of shyness or social anxiety compared with children who do not stutter. Significant group differences were, however, repeatedly reported for traits associated with inattention and hyperactivity/impulsivity, which is likely to reflect a subgroup of children who stutter. Available data is not consistent with the proposal that the risk for persistent stuttering is increased by an emotionally reactive temperament in children who stutter. Speech-related social anxiety develops in many cases of stuttering, before adulthood. Reduction of social anxiety in adults who stutter does not in itself appear to result in significant improvement of speech fluency. Studies have not revealed any relation between the severity of the motor symptoms of stuttering and temperamental traits. It is proposed that situational variability of stuttering, related to social complexity, is an effect of interference from social cognition and not directly from the emotions of social anxiety. In summary, the studies in this review provide strong evidence that persons who stutter are not characterized by constitutional traits of anxiety or similar constructs.

Educational objectives:

This paper provides a review and analysis of studies of anxiety, temperament, and personality, organized with the objective to clarify cause and effect relations. Readers will be able to (a) understand the importance of effect size and distribution of data for interpretation of group differences; (b) understand the role of temporal relations for interpretation of cause and effect; (c) discuss the results of studies of anxiety, temperament and personality in relation to stuttering; and (d) discuss situational variations of stuttering and the possible role of social cognition.


ADHD; Anxiety; Social cognition; Stuttering; Temperament.

Copyright © 2014 Elsevier Inc. All rights reserved.

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The Link Between Social Anxiety and Stuttering | Heuser Hearing Institute

It is with sadness and heavy hearts that we inform you of the death of our colleague and friend, Tiffanie Fuller. READ MORE

Posted on by Heuser Hearing Institute

Recent research has shown a link between social anxiety disorder (SAD) and childhood-onset fluency disorder (stuttering), with a rate of overlap as high as 75 percent.

What Is Social Anxiety Disorder?

Social anxiety disorder is more than simply being nervous or shy. SAD, also known as a social phobia, causes people to avoid all social contact because certain aspects of everyday interactions, like small talk and eye contact, make them so uncomfortable.

Symptoms of SAD are triggered by social interactions, and may include:

  • Fear of being judged, embarrassed, humiliated or offending someone
  • Rapid heartbeat
  • Muscle tension
  • Dizziness
  • Gastrointestinal problems
  • Shortness of breath

Symptoms may occur when thinking about social interactions, during social interactions or even after social interactions have passed.

What Is Childhood-Onset Fluency Disorder?

Stuttering is a speech disorder that causes problems with fluency and speech flow. People who stutter know what they are trying to say but have a difficult time getting the words out. While common in young children learning how to speak, the condition can persist into adulthood without early intervention.

Symptoms of stuttering include:

  • Trouble starting a word, phrase or sentence
  • Prolonging sounds within a word
  • Repetition of a sound, syllable or word
  • Silence between syllables or words
  • Addition of filler words
  • Tension or tightness in the face

While less common, stuttering can be accompanied by:

  • Rapid eye blinks
  • Tremors of the lips or jaw
  • Facial tics
  • Head jerks
  • Clenched fists

The Link Between Stuttering & SAD

It is important to note that, while feelings of stress, anxiety or embarrassment are common for people who stutter, SAD is not diagnosed unless these symptoms are debilitating to some degree and occur for reasons beyond the stutter.

While the nature of the link between these conditions is unclear, studies have shown that the neurotransmitter dopamine plays a role in both stuttering and SAD. In fact, a higher rate of SAD has been found in people with Parkinson’s disease, a disorder involving dopamine production.

Neuroimaging has also shown that people with SAD and a stutter have abnormalities in their dopamine D2 receptor and process dopamine differently than people without these disorders. The amygdala may also play a role in SAD and stuttering.

Treatment Options

Speech therapy with a speech-language pathologist (SLP) is the standard treatment for stuttering and other speech disorders. SAD is often treated with medications such as selective serotonin reuptake inhibitors (SSRIs). People with both conditions benefit greatly from cognitive-behavioral therapy (CBT).

For more information about the link between stuttering and social anxiety disorder, contact the experts at Heuser Hearing Institute today at (502) 584-3573.  

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  • What is a Speech Disorder?
  • Breaking Down the Different Speech Disorders
  • When Should You See a Speech Pathologist?


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causes, symptoms and treatments


  • 1 Neurotic stuttering: causes, symptoms and treatments
    • 1.1 Neurotic stuttering: causes, symptoms and treatment
    • 1.2 What is neurotic stuttering?
    • 1.3 Symptoms of neurotic stuttering
    • 1.4 What causes neurotic stuttering?
    • 1.5 Diagnosis of neurotic stuttering
    • 1.6 How to prevent neurotic stuttering
    • 1. 7 Physical treatments for neurotic stuttering
    • 1.8 Psychological treatments for neurotic stuttering
    • 1.9 Prognosis for life with neurotic stuttering
    • 1.10 Modern treatments for neurotic stuttering
      • 1.10.1 Psych otherapy
      • 1.10.2 Medical treatment
      • 1.10.3 Speech therapy
      • 1.10.4 Using technology in the treatment of neurotic stuttering
    • 1.11 Overcoming neurotic stuttering on your own
    • 1.12 Conclusions about neurotic stuttering
    • 1.13 Related videos:
    • 1.14 Q&A:
        • What is neurotic stuttering?
        • What are the main causes of neurotic stuttering?
        • Is it possible to get rid of neurotic stuttering?
        • How can drugs help in the treatment of neurotic stuttering?
        • How does psychotherapy help with neurotic stuttering?
        • Which breathing exercises are considered effective in neurotic stuttering?

An article about the causes and methods of treatment of neurotic stuttering. Find out how to deal with this problem and regain freedom of speech.

Stuttering is a speech disorder that manifests itself in the repetition of sounds, words or phrases, prolonged blocking and other intermittent speech phenomena. Neurotic stuttering is one of the most common types of stuttering and occurs as a result of nervous or mental tension.

Although neurotic stuttering may not seem serious, it can seriously affect the quality of life and social adaptation of the affected person. Some people even avoid socializing to avoid situations that could trigger stuttering. This can lead to serious communication problems and increased anxiety.

In this article we will look at the causes of neurotic stuttering, its symptoms and treatments. We will also discuss what steps can be taken to improve the quality of life of people suffering from this disorder.

Neurotic stuttering: causes, symptoms and treatment

Stuttering is a speech disorder that manifests itself in the repetition of sounds, words or phrases. Neurotic stuttering is a form of stuttering that is caused by psychological factors.

Symptoms of neurotic stuttering may include repetition of sounds, delay or blocking of sounds, nervous behavior when trying to speak, and stressful situations that worsen the condition.

The causes of neurotic stuttering include emotional states, stress, anxiety, uncertainty, fear, insecurity, low self-esteem, mental problems such as depression, nervous exhaustion, TRAUMATIC SITUATIONS, such as the divorce of parents or the loss of a loved one.

  • Treatment of neurotic stuttering should include advice from a psychologist and/or speech therapist to help the patient cope with stressful situations, practice breathing and speech, and learn various relaxation techniques. It is important to understand that treating stuttering can take a long time and requires patience and perseverance.
  • Medications may also be prescribed to counteract anxiety and other psychological symptoms.
  • A complete cure for stuttering may not be possible, but with the right therapy and exercise, most people can greatly reduce speech problems and improve their lives.

In addition to specialized therapy, it is important to take measures to reduce stress, as it is one of the main causes of neurotic stuttering. Regular exercise, meditation, deep breathing, and the practice of psychological self-management measures can positively influence the patient and help manage stuttering.

What is neurotic stuttering?

Neurotic stuttering is a type of dysarthria that occurs due to psychological problems. A person suffering from neurotic stuttering has difficulty with words that are perceived as broken or stuck. Neurotic stuttering is different from physiological stuttering or motor dyslalia, which is due to physical causes such as related changes in the structure of the vocal cords.

Many people suffer from neurotic stuttering, and although it is not life-threatening, it can cause serious social problems for them. The best way to overcome this condition is with professional help, including psychological therapy and other behavioral therapy techniques.

  1. Neurotic stuttering is a type of dysarthria in which a person has difficulty with words
  2. Neurotic stuttering is different from physiological stuttering, which occurs due to physical causes
  3. Symptoms of neurotic stuttering may include impaired speech, increased anxiety, fear of large numbers of people, etc.
  4. The best way to overcome neurotic stuttering is professional help, including psychological therapy and other behavioral therapy techniques.

Symptoms of neurotic stuttering. He can repeat sounds, words or phrases, increasing the pauses between them. Symptoms can vary from intensity to frequency, depending on the degree of stress.

Some of the typical symptoms of neurotic stuttering include:

  • Repetition of sounds: the person may repeat a sound or sounds, especially when trying to start a phrase.
  • Pauses: people can make long pauses between words and phrases.
  • Tension and Stress: A stutterer may feel tension and stress in their voice, face and body.
  • Avoidance: a stutterer may avoid certain words or situations that are expected to cause stuttering.

Neurotic stuttering can limit a person’s ability to express their thoughts and feelings and affect their life, work and relationships.

What causes neurotic stuttering?

Neurotic stuttering is a complex condition that can be caused by various factors. One of the main reasons is psychological pressure. Worry, anxiety, fear and depression can lead to this condition.

Also, neurotic stuttering can be caused by brain injuries, dysfunction of the nervous system, and diseases of the throat and mouth.

Genetic factors and heredity may also play a role in stuttering.

  • Psychological stress: worries, anxiety, fear, depression
  • Brain injuries: strokes, falls, infections
  • Disorders of the nervous system: diseases, diseases, injuries
  • Diseases of the throat and mouth: cysts, tumors, malocclusion
  • Heredity: genetic factors

Diagnosis of neurotic stuttering

Diagnosis of neurotic stuttering is the process of determining the presence and characteristics of stuttering in a person. It includes analyzing symptoms and performing tests and investigations.

The doctor may then perform a physical examination and ask the patient to repeat words and phrases to determine if stuttering is present. Additional tests, such as psychological assessments, may be recommended to further evaluate the patient.

It is important to note that stuttering can be caused by a variety of factors, including stress, anxiety, depression, trauma, or heredity. Therefore, for an accurate diagnosis, you may need to consult a variety of specialists, including neurologists, speech therapists, psychologists, and psychiatrists.

How to prevent neurotic stuttering

Neurotic stuttering can manifest itself due to many factors. Some of them may be associated with emotional stress, while others may be associated with physical problems.

One of the ways to prevent neurotic stuttering is regular relaxation exercises. It can be meditation, yoga, deep breathing. It is important to devote enough time to learning these exercises, as only the correct and regular performance can help in reducing tension and stress, which in turn can reduce speech difficulties.

Audio-visual therapy can also help. It may be helpful to hear other people speak in reducing your fear of speaking, as well as in improving your understanding of how words are spoken normally.

It is also important to eat right and exercise. Avoid stressful situations, follow the schedule of rest and sleep. Preparation before speaking (including preparing arguments, plans, etc.) can reduce the fear of speaking as well as the symptoms of neurotic stuttering.

Tips for preventing stuttering:
  • Regular relaxation exercises
  • Audio-visual therapy
  • Proper nutrition and sports
  • Avoidance of stressful situations
  • Keeping a rest and sleep schedule
  • Preparation before starting a conversation

Physical treatments for neurotic stuttering

Problems with stuttering greatly complicate a person’s life, interfere with his normal conversation and can slow down career growth. A proven way to solve this problem are various physical treatments aimed at reducing the neurotic load on the body.

  • Relaxation – with the help of various techniques, such as meditation or yoga, you can learn to cope with stressful situations and control your breathing. This reduces anxiety levels and improves the pronunciation of words.
  • Breathing Workouts – Breathing exercises can help reduce stuttering. Regular respiratory muscle strengthening exercises can improve breath control and reduce feelings of fatigue and stress.
  • Articulation exercises – special exercises to improve the pronunciation of sounds and words can help people who stutter. Regular exercise helps to improve understanding of the muscles of the mouth and larynx, as well as keep them in shape.
  • Computer programs – Nowadays there are computer programs specially designed for the treatment of neurotic stuttering. They help improve the pronunciation of words and reduce the time between words.

It is important to remember that every person is different, and the treatment of neurotic stuttering should not be universal. Techniques that work for one may not work for another. Therefore, the best solution is to visit the attending physician and develop an individual course of treatment.

Psychological treatments for neurotic stuttering

Neurotic stuttering can be caused by psychological problems such as fear, anxiety, low self-esteem, etc. Therefore, one of the ways to treat neurotic stuttering is psychotherapy.

One of the effective methods used in psychotherapy is cognitive behavioral therapy, which helps people change their negative way of thinking and behaving.

  • As part of cognitive behavioral therapy, the patient is taught techniques to help reduce stress and anxiety that can cause stuttering.
  • A relaxation technique is also used, which is very effective in reducing anxiety and tension.
  • The therapist may suggest breathing exercises to the patient, which can also help reduce nervousness and increase communication confidence.

In addition to CBT, other psychological methods can be used, such as arto-mediation, dance therapy, and others.

However, it is worth remembering that whatever treatment method is chosen, it is important that it is effective and suitable for a particular patient. Therefore, the best solution would be to consult with a specialist who will help you choose the best treatment method.

Prognosis for life with neurotic stuttering

Neurotic stuttering is a critical factor that can affect a person’s quality of life. However, despite this, the prognosis for life with neurotic stuttering can be positive if certain measures are taken.

Second, there are many self-help techniques that can be used to reduce the risk of exacerbating neurotic stuttering. Regular exercise, meditation, deep breathing, and other relaxation techniques can help patients manage their condition and reduce anxiety.

Finally, the environment plays a big role in the prognosis for life with neurotic stuttering. Support from loved ones or colleagues at work, the opportunity to network and participate in social activities can help patients overcome their condition and achieve better results in their lives.

Modern methods of treatment of neurotic stuttering


Psychotherapy is one of the effective methods of treating neurotic stuttering. This technique is aimed at identifying the causes of the disease and helping the patient to overcome psychological problems. The main types of psychotherapy are behavioral therapy, gestalt therapy and cognitive behavioral therapy.

Drug treatment

Neurotic stuttering can be treated with drugs that normalize the level of neurotransmitters in the patient’s body. This improves the functioning of the nervous system and reduces the symptoms of stuttering. Examples of such drugs are enzyme preparations and antidepressants.

Speech therapy

Speech therapy aims to improve the development of speech and correct speech disorders. It helps the patient to find the correct intonation and rhythm of speech, which in turn improves speech diction and helps in overcoming stuttering. The main methods of speech therapy are speech therapy exercises, articulation therapy and melodic intonation speech therapy.

The use of technology in the treatment of neurotic stuttering

Modern technologies can be used in the treatment of neurotic stuttering. For example, the FluencyCoach program helps patients improve their speech by increasing the length of phrases and controlling the speed of speech. There are also applications for smartphones and tablets containing various exercises and workouts aimed at improving speech and overcoming stuttering.

Self-management of neurotic stuttering

Neurotic stuttering is a fairly common speech disorder and can occur in people of any age. Many suffering from this problem try to overcome it on their own, without the help of specialists.

In addition, in order to successfully overcome neurotic stuttering, it is necessary to establish psychological stability and reduce the level of stress and anxiety as much as possible. One of the effective methods to achieve this goal can be meditation, relaxation techniques or therapeutic exercises.

It is important to remember that coping with neurotic stuttering on your own can be a difficult and time-consuming process. Therefore, if preventive measures do not bring the desired results, it is necessary to seek help from specialists – speech therapists, psychotherapists or psychologists.

Conclusions about neurotic stuttering

Neurotic stuttering is a disorder that manifests itself in the form of repetitive words or sounds during speech. According to research, the causes of stuttering can be both physical and psychological.

One of the main causes of neurotic stuttering is nervous tension, which can cause pressure in the mouth and throat. Some people may use stuttering as a defense mechanism to avoid more serious communication problems.

Various methods are used to treat neurotic stuttering, such as therapy, medication or physiological correction. It is important to find a specialist who specializes in the treatment of stuttering and can offer the most effective methods for a particular case.

One of the most important techniques in the treatment of neurotic stuttering is the understanding of the patient’s fears and anxieties. Since stuttering is often associated with emotional discomfort, working with a psychologist can help relieve this tension and reduce the appearance of stuttering.

  • It is important to remember that neurotic stuttering is a disorder that causes physical and emotional discomfort.
  • Treatment should include working with professionals who are experienced in stuttering and who can offer the most effective treatments.
  • A patient with neurotic stuttering must learn to find ways to manage their emotions and anxieties in order to improve their connection and quality of life.

Related videos:


What is neurotic stuttering?

Neurotic stuttering is a speech defect that is observed in people suffering from neurosis. They have trouble pronouncing words, have difficulty starting sentences, and may repeat sounds, words, or phrases.

What are the main causes of neurotic stuttering?

The main causes of neurotic stuttering are stress, anxiety, nervous tension, fear, depression and low self-esteem.

Is it possible to get rid of neurotic stuttering?

Yes, there are a number of treatments for neurotic stuttering, including medication, psychotherapy, breathing exercises, and other techniques.

How can drugs help in the treatment of neurotic stuttering?

Medicines can help patients with neurotic stuttering by reducing nervous tension, anxiety and depression. Some medications can also improve word pronunciation and reduce repetition.

How does psychotherapy help with neurotic stuttering?

Psychotherapy can help patients with neurotic stuttering develop anxiety and stress management skills, improve self-esteem and learn to control their speech impediment.

What breathing exercises are considered effective in neurotic stuttering?

Effective breathing exercises that can help patients with neurotic stuttering are deep breathing exercises and meditation. They help reduce anxiety and improve speech control.

Speech anxiety and fear of speech.

Children’s fears, as a rule, are quite specific and for the most part are related to what threatens the life of the child or someone on whom his life depends, for example, parents. With speech, the child develops a more complex relationship. Since speech is not given to a person along with life, the child cannot feel the loss of what else; does not own or owns only to a small extent. In addition, the quality of speech has little effect on the ability to satisfy his vital needs. Only as new, purely human needs are formed, including the need for communication, in obtaining new knowledge, the value of speech increases significantly.

The emergence of feelings about the quality of one’s own speech can be detected already in young children.

But even those who do not have speech impairments may be concerned about the quality of their speech.

Anxiety about one’s speech can change in stutterers depending on different circumstances. So, for example, with increasing age, it is observed; growth, however, as well as the growth of general anxiety.

The severity of speech anxiety depends on the severity of the speech disorder: the more pronounced the stuttering, the higher the anxiety.

Many stutterers, as they develop anxiety about their speech, begin to identify this anxiety with stuttering itself. But with additional questions, it usually turns out that fear is not caused by stuttering itself, but by a possible attitude towards them due to bad speech. Therefore, the degree of experience is largely related to who is the communication partner. And here fear can be very selective, individual.

There is a classification of stuttering according to the degree of fixation on its defect. Fixation on its defect; this is a reflection of an objectively existing speech defect (speech stuttering) in all the psychological activity of a stuttering person. This is the result of the processes of obtaining and processing information about speech difficulties and related troubles, transformed in the mental processes, states and properties of a stutterer and manifested in his interaction with the surrounding social environment.

There are three degrees of painful fixation on one’s defect:

(zero) Indifference to one’s defect combined with a lack of willpower in the fight against it.

At this degree, they do not experience infringement from the consciousness of their inferior speech or even do not notice this inferiority at all. These stutterers willingly come into contact with acquaintances and strangers.

There are no elements of embarrassment, resentment for one’s wrong speech.

(moderate) Moderately restrained attitude towards one’s defect, combined with the presence of strong-willed efforts in the fight against it.

At this degree, unpleasant experiences are experienced in connection with stuttering, stuttering is hidden, compensated by speech tricks.

Nevertheless, awareness of one’s own shortcomings and experiences do not result in a constant painful feeling of one’s own inferiority.

(expressed) A hopelessly-desperate attitude towards one’s defect and the presence of such strong-willed efforts in the fight against it, which develop into obsessive actions and states.

With this degree, stutterers constantly focus on their speech failures, deeply and for a long time experience them. These stutterers make all their activities dependent on speech failures. They are characterized by withdrawal into illness, self-abasement, morbid suspiciousness, obsessive thoughts and a pronounced fear of speech.

With age (or with the experience of stuttering) in stutterers, the degree of fixation on their defect tends to become more complicated.

The positive results of speech therapy work with stutterers are naturally inversely related to the complexity of their fixation on their defect (the greater the fixation, the lower the result). It is the different degree of fixation on one’s defect, and not the experience of stuttering, not its severity, that determines the different results of speech therapy work.

The severity of stuttering is adequate to the degree of fixation on one’s defect.

Fear of speech communication with an obsessive expectation of speech failures – logophobia.

A kind of vicious circle is formed when convulsive hesitations in speech cause strong negative emotional reactions, which intensifies speech disorders.