Social phobia in adults with stuttering.

Abstract

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. 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. 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. 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.