A Study of Emotion Regulation Difficulties, Repetitive Negative Thinking, and Experiential Avoidance in Adults with Stuttering: A Comparative Study
-
Jafar Sarani Yaztappeh
,
Elahe Lorestani
,
Younes Zaheri
,
Mohsen Rezaei
,
Hiwa Mohammadi
,
Keyvan Kakabaraee
,
Moslem Rajabi
,
Amir Sam Kianimoghadam
,
Saina Fatollahzadeh
,
Mohamad Davood Mohebi
Abstract
Objective: Stuttering is a type of communication and fluency disorder that hurts mental and emotional health. It is also associated with a significant increase in both trait and social anxiety. Studies on stuttering in adults have indicated the nature and impact of this phenomenon. In addition, some psychological aspects of this phenomenon remain vague and need further investigation. Therefore, the present study aimed to compare emotion regulation difficulties, repetitive negative thinking, and experiential avoidance between people who stutter and healthy individuals.
Method: In this study, 101 people who stutter (43 females and 58 males, with a
mean age of 29.55 ± 187 years), as well as 110 healthy individuals (74 females and 36 males, with a mean age of 25.57 ± 489 years) as participants were chosen using the convenience sampling method among those who referred to the speech therapy clinics of Tehran, Iran. Research instruments including the repetitive negative thinking inventory, Difficulties in Emotion Regulation Scale, and Acceptance and Action Questionnaire (AAQ-I) were used for data collection. Data were analyzed using multivariate ANOVA test and Multiple Regression Analysis.
Results: The mean age of the participants was 29.55 years in the people who stutter and 25.57 years in the healthy individuals (P < 0.01). The present results indicated that the mean score of experiential avoidance was higher in the people who stutter (M ± SD: 35.74 ± 9.24) compared to the healthy individuals (M ± SD: 8.89 ± 31.11). Additionally, the mean score of emotion regulation difficulties was higher in the people who stutter (M ± SD: 88.75 ± 20.59) compared to the healthy individuals (M ± SD: 64.14 ± 94.94) (P < 0.001). However, there was no significant difference in the mean score of repetitive negative thinking between the people who stutter (M ± SD: 98.45 ± 25.85) and healthy individuals (M ± SD: 93.71 ± 25.24) groups (P > 0.05). There was a significant correlation between experiential avoidance and emotion regulation difficulties in people who stutter (P < 0.01). Experiential avoidance and repetitive negative thinking can significantly predict emotion regulation difficulties in people who stutter (R = 0.65, P < 0.01).
Conclusion: People who stutter obtained higher emotion regulation difficulties and experiential avoidance scores than those without stuttering and A significant correlation between experiential avoidance and emotion regulation difficulties was found. Future studies should consider the role of emotion regulation difficulties and experiential avoidance in people who stutter.
1. Craig A, Hancock K, Tran Y, Craig M, Peters K. Epidemiology of stuttering in the community across the entire life span. J Speech Lang Hear Res. 2002;45(6):1097-105.
2. Yairi E, Watkins R, Ambrose N, Paden E. What is stuttering? J Speech Lang Hear Res. 2001;44(3):585-92.
3. Tichenor SE, Walsh BM, Gerwin KL, Yaruss JS. Emotional Regulation and Its Influence on the Experience of Stuttering Across the Life Span. J Speech Lang Hear Res. 2022;65(7):2412-30.
4. Usler E. Communicative Fluency and the Experience of Stuttering: A Viewpoint. J Speech Lang Hear Res. 2022;65(10):3827-34.
5. Organization WH. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines: WHO; 1992.
6. Ward D. Stuttering and cluttering: frameworks for understanding and treatment: Psychology Press; 2008.
7. Bloodstein O, Bernstein Ratner N. A handbook of stuttering: Thomson Delmar Learning. Clifton Park. 2008.
8. Iverach L, Menzies RG, O'Brian S, Packman A, Onslow M. Anxiety and stuttering: continuing to explore a complex relationship. Am J Speech Lang Pathol. 2011;20(3):221-32.
9. Craig A, Tran Y. Chronic and social anxiety in people who stutter. Adv Psychiatr Treat. 2006;12(1):63-8.
10. O'Brian S, Jones M, Packman A, Onslow M, Menzies R, Lowe R, et al. The Complexity of Stuttering Behavior in Adults and Adolescents: Relationship to Age, Severity, Mental Health, Impact of Stuttering, and Behavioral Treatment Outcome. J Speech Lang Hear Res. 2022;65(7):2446-58.
11. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®) American Psychiatric Pub. 2013.
12. Walden TA, Frankel CB, Buhr AP, Johnson KN, Conture EG, Karrass JM. Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering. J Abnorm Child Psychol. 2012;40(4):633-44.
13. Sadock BJ. Kaplan & Sadock's synopsis of psychiatry: Behav Sci / J Clin Psychiatry: Wolters Kluwer Philadelphia, PA; 2015.
14. Webster RL. The precision fluency shaping program: Speech reconstruction for stutterers: Communications Development Corporation; 1980.
15. Yaruss JS. Assessing quality of life in stuttering treatment outcomes research. J Fluency Disord. 2010;35(3):190-202.
16. Nang C, Hersh D, Milton K, Lau SR. The Impact of Stuttering on Development of Self-Identity, Relationships, and Quality of Life in Women Who Stutter. Am J Speech Lang Pathol. 2018;27(3s):1244-58.
17. Wanberg CR. The individual experience of unemployment. Annu Rev Psychol. 2012;63:369-96.
18. Mardani N, Ataei Z, Lakzian S, Sohani Rad D, Ghaemi H, Jamali J. An Investigation of the Effect of Stuttering on Personality Characteristics in Adult Men. Journal of Paramedical Sciences & Rehabilitation. 2015;4(2):24-30.
19. Connery A, McCurtin A, Robinson K. The lived experience of stuttering: a synthesis of qualitative studies with implications for rehabilitation. Disabil Rehabil. 2020;42(16):2232-42.
20. Hong D, Zhu Y, Yu M. How health anxiety affected obsessive-compulsive symptoms during the COVID-19 pandemic in China: The mediation of difficulties in emotion regulation and the moderation of pathological personality traits. Pers Individ Dif. 2022;185:111254.
21. Kramer U, Timulak L. The emotional underpinnings of personality pathology: Implications for psychotherapy. Clinical Psychology: Science and Practice. 2022.
22. Dadfarnia S, Hadianfard H, Rahimi C, Aflakseir A. Predicting depression based on cognitive emotion regulation strategies. The Journal of Tolooebehdasht. 2020.
23. Arnold HS, Conture EG, Key AP, Walden T. Emotional reactivity, regulation and childhood stuttering: a behavioral and electrophysiological study. J Commun Disord. 2011;44(3):276-93.
24. Johnson KN, Walden TA, Conture EG, Karrass J. Spontaneous regulation of emotions in preschool children who stutter: preliminary findings. J Speech Lang Hear Res. 2010;53(6):1478-95.
25. Zengin-Bolatkale H, Conture EG, Key AP, Walden TA, Jones RM. Cortical associates of emotional reactivity and regulation in childhood stuttering. J Fluency Disord. 2018;56:81-99.
26. Waheed SA, Khader PSA, editors. IoT based approach for detection of dominating emotions in persons who stutter. 2020 Fourth International Conference on I-SMAC (IoT in Social, Mobile, Analytics and Cloud)(I-SMAC); 2020: IEEE.
27. Guitar B. Stuttering: An integrated approach to its nature and treatment: Lippincott Williams & Wilkins; 2013.
28. Klarin E, Krhen AL, Jakšić SJ. A PRELIMINARY STUDY ON THE UNHELPFUL THOUGHTS AND BELIEFS ABOUT STUTTERING (UTBAS) QUESTIONNAIRE IN CROATIA. Croatian Review of Rehabilitation Research/ HRRI. 2018;54(1).
29. Yaruss JS, Quesal RW. Stuttering and the International Classification of Functioning, Disability, and Health: an update. J Commun Disord. 2004;37(1):35-52.
30. Ehring T, Zetsche U, Weidacker K, Wahl K, Schönfeld S, Ehlers A. The Perseverative Thinking Questionnaire (PTQ): validation of a content-independent measure of repetitive negative thinking. J Behav Ther Exp Psychiatry. 2011;42(2):225-32.
31. Speckens AE, Ehlers A, Hackmann A, Ruths FA, Clark DM. Intrusive memories and rumination in patients with post-traumatic stress disorder: a phenomenological comparison. Memory. 2007;15(3):249-57.
32. Kashdan TB, Roberts JE. Social anxiety, depressive symptoms, and post-event rumination: affective consequences and social contextual influences. J Anxiety Disord. 2007;21(3):284-301.
33. Langlois F, Freeston MH, Ladouceur R. Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 1. Behav Res Ther. 2000;38(2):157-73.
34. Chu SY, Sakai N, Mori K, Iverach L. Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter. J Fluency Disord. 2017;51:1-7.
35. Tichenor S, Yaruss JS. Repetitive Negative Thinking, Temperament, and Adverse Impact in Adults Who Stutter. Am J Speech Lang Pathol. 2020;29(1):201-15.
36. Bleek B, Reuter M, Yaruss JS, Cook S, Faber J, Montag C. Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life. J Fluency Disord. 2012;37(4):325-33.
37. Iancu I, Bodner E, Joubran S, Lupinsky Y, Barenboim D. Negative and Positive Automatic thoughts in Social Anxiety Disorder. Isr J Psychiatry Relat Sci. 2015;52(2):129-35.
38. Farpour S, Shafie B, Salehi A, Karimi H. Relationship of unhelpful thoughts and beliefs about stuttering with anxiety and depression in Persian-speaking adults who stutter. JRRS. 2013;8(7):1173-85.
39. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: Guilford press New York; 1999.
40. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64(6):1152-68.
41. Chawla N, Ostafin B. Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review. J Clin Psychol. 2007;63(9):871-90.
42. Hershenberg R, Mavandadi S, Wright E, Thase ME. Anhedonia in the daily lives of depressed Veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. J Affect Disord. 2017;208:414-7.
43. Lorestani E, Esmaeilinasab M, Ahmadi F. Social Reactions Affecting the Severity of Stuttering among Adults who Stutter: A Qualitative Study. J Qual Res Health Sci. 2020;8(3):271-9.
44. Palangi A, Habibi Y, GhasemiNejad M. Comparing social stress and sensitivity to rejection in children with and without stuttering. J Sch Psychol. 2016;5(3):24-38.
45. Watson JB. Exploring the attitudes of adults who stutter. J Commun Disord. 1995;28(2):143-64.
46. Ishizu K, Shimoda Y, Ohtsuki T. The reciprocal relations between experiential avoidance, school stressor, and psychological stress response among Japanese adolescents. PLoS One. 2017;12(11):e0188368.
47. First M. Structured Clinical Interview for the DSM (SCID). The Encyclopedia of Clinical Psychology John Wiley & Sons. Inc[Google Scholar]. 2014.
48. Zakiei A, Khazaie H, Rostampour M, Lemola S, Esmaeili M, Dürsteler K, et al. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel). 2021;11(2).
49. Davoodi I, Neisi A, Khazei H, Arshadi N, Zakiei A. The roles of some cognitive and emotional factors in predicting insomnia. J Maz Univ Med. 2017;27(150):107-21.
50. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26:41-54.
51. McEvoy PM, Mahoney AE, Moulds ML. Are worry, rumination, and post-event processing one and the same? Development of the repetitive thinking questionnaire. J Anxiety Disord. 2010;24(5):509-19.
52. Khaleghi, S, R Liaghat, and Y Ganjdanesh. The Repetitive Thinking Questionnaire: Psychometric Properties in Iranian Students and Relationship with Depression, Anxiety and Social Anxiety. 2nd international conference on psychiatry and psychotherapy-PSYCHO, 2011.
53. Hayes SC, Strosahl K, Wilson KG, Bissett RT, Pistorello J, Toarmino D, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychol Rec. 2004;54:553-78.
54. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88.
55. Abasi E, Fti L, Molodi R, Zarabi H. Psychometric properties of Persian version of acceptance and action questionnaire–II. Psychological Methods and Models. 2012;3(10/Winter 2013):65-80.
56. Karrass J, Walden TA, Conture EG, Graham CG, Arnold HS, Hartfield KN, et al. Relation of emotional reactivity and regulation to childhood stuttering. J Commun Disord. 2006;39(6):402-23.
57. Xavier A, Cunha M, Pinto-Gouveia J. Daily peer hassles and non-suicidal self-injury in adolescence: Gender differences in avoidance-focused emotion regulation processes. JCFS. 2018;27:59-68.
58. Alipour F, Hasani J, Bodaghi E, Mohtashmirad F, Saeidpour S. Cognitive Emotion Regulation Strategies, Metacognition, and Early Maladaptive Schemas in Students with Stuttering and Normal Students. Quarterly Journal of Child Mental Health. 2016;3(2):41-54.
59. Hayes S, Strosahl K, Wilson K. Acceptance and commitment therapy: APA. Washington, DC[Google Scholar]. 2009.
60. Mohammadkhani P, Abasi I, Pourshahbaz A, Mohammadi A, Fatehi M. The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation. Iran J Psychiatry Behav Sci. 2016;10(3):e5047.
61. Mohammadkhani P, Abasi I, Pourshahbaz A, Mohammadi A, Fatehi M. The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation. Iran J Psychiatry Behav Sci. 2016;10(3):e5047.
62. Moroz M, Dunkley DM. Self-critical perfectionism and depressive symptoms: Low self-esteem and experiential avoidance as mediators. Pers Individ Diffe. 2015;87:174-9.
63. Fernández de la Cruz L, Landau D, Iervolino AC, Santo S, Pertusa A, Singh S, et al. Experiential avoidance and emotion regulation difficulties in hoarding disorder. J Anxiety Disord. 2013;27(2):204-9.
64. Karami J, Zakiei A, Hatamian P, Baghri A. The comparison of emotional regulation destruction and emotional styles in people with nicotine dependence and non nicotine dependence. Studies in Medical Sciences. 2017;27(10):848-55.
65. Lowe R, Guastella AJ, Chen NT, Menzies RG, Packman A, O'Brian S, et al. Avoidance of eye gaze by adults who stutter. J Fluency Disord. 2012;37(4):263-74.
66. Menzies RG, O'Brian S, Onslow M, Packman A, St Clare T, Block S. An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering. J Speech Lang Hear Res. 2008;51(6):1451-64.
67. Reddy RP, Sharma MP, Shivashankar N. Cognitive behavior therapy for stuttering: a case series. Indian J Psychol Med. 2010;32(1):49-53.
68. Gunn A, Menzies RG, O'Brian S, Onslow M, Packman A, Lowe R, et al. Axis I anxiety and mental health disorders among stuttering adolescents. J Fluency Disord. 2014;40:58-68.
69. Karimi J, Homayouni A, Homayouni F. The prediction of health anxiety based on experiential avoidance and anxiety sensitivity among non-clinical population. Journal of Research in Psychological Health. 2019;12(4):66-79.
2. Yairi E, Watkins R, Ambrose N, Paden E. What is stuttering? J Speech Lang Hear Res. 2001;44(3):585-92.
3. Tichenor SE, Walsh BM, Gerwin KL, Yaruss JS. Emotional Regulation and Its Influence on the Experience of Stuttering Across the Life Span. J Speech Lang Hear Res. 2022;65(7):2412-30.
4. Usler E. Communicative Fluency and the Experience of Stuttering: A Viewpoint. J Speech Lang Hear Res. 2022;65(10):3827-34.
5. Organization WH. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines: WHO; 1992.
6. Ward D. Stuttering and cluttering: frameworks for understanding and treatment: Psychology Press; 2008.
7. Bloodstein O, Bernstein Ratner N. A handbook of stuttering: Thomson Delmar Learning. Clifton Park. 2008.
8. Iverach L, Menzies RG, O'Brian S, Packman A, Onslow M. Anxiety and stuttering: continuing to explore a complex relationship. Am J Speech Lang Pathol. 2011;20(3):221-32.
9. Craig A, Tran Y. Chronic and social anxiety in people who stutter. Adv Psychiatr Treat. 2006;12(1):63-8.
10. O'Brian S, Jones M, Packman A, Onslow M, Menzies R, Lowe R, et al. The Complexity of Stuttering Behavior in Adults and Adolescents: Relationship to Age, Severity, Mental Health, Impact of Stuttering, and Behavioral Treatment Outcome. J Speech Lang Hear Res. 2022;65(7):2446-58.
11. Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®) American Psychiatric Pub. 2013.
12. Walden TA, Frankel CB, Buhr AP, Johnson KN, Conture EG, Karrass JM. Dual diathesis-stressor model of emotional and linguistic contributions to developmental stuttering. J Abnorm Child Psychol. 2012;40(4):633-44.
13. Sadock BJ. Kaplan & Sadock's synopsis of psychiatry: Behav Sci / J Clin Psychiatry: Wolters Kluwer Philadelphia, PA; 2015.
14. Webster RL. The precision fluency shaping program: Speech reconstruction for stutterers: Communications Development Corporation; 1980.
15. Yaruss JS. Assessing quality of life in stuttering treatment outcomes research. J Fluency Disord. 2010;35(3):190-202.
16. Nang C, Hersh D, Milton K, Lau SR. The Impact of Stuttering on Development of Self-Identity, Relationships, and Quality of Life in Women Who Stutter. Am J Speech Lang Pathol. 2018;27(3s):1244-58.
17. Wanberg CR. The individual experience of unemployment. Annu Rev Psychol. 2012;63:369-96.
18. Mardani N, Ataei Z, Lakzian S, Sohani Rad D, Ghaemi H, Jamali J. An Investigation of the Effect of Stuttering on Personality Characteristics in Adult Men. Journal of Paramedical Sciences & Rehabilitation. 2015;4(2):24-30.
19. Connery A, McCurtin A, Robinson K. The lived experience of stuttering: a synthesis of qualitative studies with implications for rehabilitation. Disabil Rehabil. 2020;42(16):2232-42.
20. Hong D, Zhu Y, Yu M. How health anxiety affected obsessive-compulsive symptoms during the COVID-19 pandemic in China: The mediation of difficulties in emotion regulation and the moderation of pathological personality traits. Pers Individ Dif. 2022;185:111254.
21. Kramer U, Timulak L. The emotional underpinnings of personality pathology: Implications for psychotherapy. Clinical Psychology: Science and Practice. 2022.
22. Dadfarnia S, Hadianfard H, Rahimi C, Aflakseir A. Predicting depression based on cognitive emotion regulation strategies. The Journal of Tolooebehdasht. 2020.
23. Arnold HS, Conture EG, Key AP, Walden T. Emotional reactivity, regulation and childhood stuttering: a behavioral and electrophysiological study. J Commun Disord. 2011;44(3):276-93.
24. Johnson KN, Walden TA, Conture EG, Karrass J. Spontaneous regulation of emotions in preschool children who stutter: preliminary findings. J Speech Lang Hear Res. 2010;53(6):1478-95.
25. Zengin-Bolatkale H, Conture EG, Key AP, Walden TA, Jones RM. Cortical associates of emotional reactivity and regulation in childhood stuttering. J Fluency Disord. 2018;56:81-99.
26. Waheed SA, Khader PSA, editors. IoT based approach for detection of dominating emotions in persons who stutter. 2020 Fourth International Conference on I-SMAC (IoT in Social, Mobile, Analytics and Cloud)(I-SMAC); 2020: IEEE.
27. Guitar B. Stuttering: An integrated approach to its nature and treatment: Lippincott Williams & Wilkins; 2013.
28. Klarin E, Krhen AL, Jakšić SJ. A PRELIMINARY STUDY ON THE UNHELPFUL THOUGHTS AND BELIEFS ABOUT STUTTERING (UTBAS) QUESTIONNAIRE IN CROATIA. Croatian Review of Rehabilitation Research/ HRRI. 2018;54(1).
29. Yaruss JS, Quesal RW. Stuttering and the International Classification of Functioning, Disability, and Health: an update. J Commun Disord. 2004;37(1):35-52.
30. Ehring T, Zetsche U, Weidacker K, Wahl K, Schönfeld S, Ehlers A. The Perseverative Thinking Questionnaire (PTQ): validation of a content-independent measure of repetitive negative thinking. J Behav Ther Exp Psychiatry. 2011;42(2):225-32.
31. Speckens AE, Ehlers A, Hackmann A, Ruths FA, Clark DM. Intrusive memories and rumination in patients with post-traumatic stress disorder: a phenomenological comparison. Memory. 2007;15(3):249-57.
32. Kashdan TB, Roberts JE. Social anxiety, depressive symptoms, and post-event rumination: affective consequences and social contextual influences. J Anxiety Disord. 2007;21(3):284-301.
33. Langlois F, Freeston MH, Ladouceur R. Differences and similarities between obsessive intrusive thoughts and worry in a non-clinical population: study 1. Behav Res Ther. 2000;38(2):157-73.
34. Chu SY, Sakai N, Mori K, Iverach L. Japanese normative data for the Unhelpful Thoughts and Beliefs about Stuttering (UTBAS) Scales for adults who stutter. J Fluency Disord. 2017;51:1-7.
35. Tichenor S, Yaruss JS. Repetitive Negative Thinking, Temperament, and Adverse Impact in Adults Who Stutter. Am J Speech Lang Pathol. 2020;29(1):201-15.
36. Bleek B, Reuter M, Yaruss JS, Cook S, Faber J, Montag C. Relationships between personality characteristics of people who stutter and the impact of stuttering on everyday life. J Fluency Disord. 2012;37(4):325-33.
37. Iancu I, Bodner E, Joubran S, Lupinsky Y, Barenboim D. Negative and Positive Automatic thoughts in Social Anxiety Disorder. Isr J Psychiatry Relat Sci. 2015;52(2):129-35.
38. Farpour S, Shafie B, Salehi A, Karimi H. Relationship of unhelpful thoughts and beliefs about stuttering with anxiety and depression in Persian-speaking adults who stutter. JRRS. 2013;8(7):1173-85.
39. Hayes SC, Strosahl KD, Wilson KG. Acceptance and commitment therapy: Guilford press New York; 1999.
40. Hayes SC, Wilson KG, Gifford EV, Follette VM, Strosahl K. Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. J Consult Clin Psychol. 1996;64(6):1152-68.
41. Chawla N, Ostafin B. Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review. J Clin Psychol. 2007;63(9):871-90.
42. Hershenberg R, Mavandadi S, Wright E, Thase ME. Anhedonia in the daily lives of depressed Veterans: A pilot report on experiential avoidance as a moderator of emotional reactivity. J Affect Disord. 2017;208:414-7.
43. Lorestani E, Esmaeilinasab M, Ahmadi F. Social Reactions Affecting the Severity of Stuttering among Adults who Stutter: A Qualitative Study. J Qual Res Health Sci. 2020;8(3):271-9.
44. Palangi A, Habibi Y, GhasemiNejad M. Comparing social stress and sensitivity to rejection in children with and without stuttering. J Sch Psychol. 2016;5(3):24-38.
45. Watson JB. Exploring the attitudes of adults who stutter. J Commun Disord. 1995;28(2):143-64.
46. Ishizu K, Shimoda Y, Ohtsuki T. The reciprocal relations between experiential avoidance, school stressor, and psychological stress response among Japanese adolescents. PLoS One. 2017;12(11):e0188368.
47. First M. Structured Clinical Interview for the DSM (SCID). The Encyclopedia of Clinical Psychology John Wiley & Sons. Inc[Google Scholar]. 2014.
48. Zakiei A, Khazaie H, Rostampour M, Lemola S, Esmaeili M, Dürsteler K, et al. Acceptance and Commitment Therapy (ACT) Improves Sleep Quality, Experiential Avoidance, and Emotion Regulation in Individuals with Insomnia-Results from a Randomized Interventional Study. Life (Basel). 2021;11(2).
49. Davoodi I, Neisi A, Khazei H, Arshadi N, Zakiei A. The roles of some cognitive and emotional factors in predicting insomnia. J Maz Univ Med. 2017;27(150):107-21.
50. Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26:41-54.
51. McEvoy PM, Mahoney AE, Moulds ML. Are worry, rumination, and post-event processing one and the same? Development of the repetitive thinking questionnaire. J Anxiety Disord. 2010;24(5):509-19.
52. Khaleghi, S, R Liaghat, and Y Ganjdanesh. The Repetitive Thinking Questionnaire: Psychometric Properties in Iranian Students and Relationship with Depression, Anxiety and Social Anxiety. 2nd international conference on psychiatry and psychotherapy-PSYCHO, 2011.
53. Hayes SC, Strosahl K, Wilson KG, Bissett RT, Pistorello J, Toarmino D, et al. Measuring experiential avoidance: A preliminary test of a working model. Psychol Rec. 2004;54:553-78.
54. Bond FW, Hayes SC, Baer RA, Carpenter KM, Guenole N, Orcutt HK, et al. Preliminary psychometric properties of the Acceptance and Action Questionnaire-II: a revised measure of psychological inflexibility and experiential avoidance. Behav Ther. 2011;42(4):676-88.
55. Abasi E, Fti L, Molodi R, Zarabi H. Psychometric properties of Persian version of acceptance and action questionnaire–II. Psychological Methods and Models. 2012;3(10/Winter 2013):65-80.
56. Karrass J, Walden TA, Conture EG, Graham CG, Arnold HS, Hartfield KN, et al. Relation of emotional reactivity and regulation to childhood stuttering. J Commun Disord. 2006;39(6):402-23.
57. Xavier A, Cunha M, Pinto-Gouveia J. Daily peer hassles and non-suicidal self-injury in adolescence: Gender differences in avoidance-focused emotion regulation processes. JCFS. 2018;27:59-68.
58. Alipour F, Hasani J, Bodaghi E, Mohtashmirad F, Saeidpour S. Cognitive Emotion Regulation Strategies, Metacognition, and Early Maladaptive Schemas in Students with Stuttering and Normal Students. Quarterly Journal of Child Mental Health. 2016;3(2):41-54.
59. Hayes S, Strosahl K, Wilson K. Acceptance and commitment therapy: APA. Washington, DC[Google Scholar]. 2009.
60. Mohammadkhani P, Abasi I, Pourshahbaz A, Mohammadi A, Fatehi M. The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation. Iran J Psychiatry Behav Sci. 2016;10(3):e5047.
61. Mohammadkhani P, Abasi I, Pourshahbaz A, Mohammadi A, Fatehi M. The Role of Neuroticism and Experiential Avoidance in Predicting Anxiety and Depression Symptoms: Mediating Effect of Emotion Regulation. Iran J Psychiatry Behav Sci. 2016;10(3):e5047.
62. Moroz M, Dunkley DM. Self-critical perfectionism and depressive symptoms: Low self-esteem and experiential avoidance as mediators. Pers Individ Diffe. 2015;87:174-9.
63. Fernández de la Cruz L, Landau D, Iervolino AC, Santo S, Pertusa A, Singh S, et al. Experiential avoidance and emotion regulation difficulties in hoarding disorder. J Anxiety Disord. 2013;27(2):204-9.
64. Karami J, Zakiei A, Hatamian P, Baghri A. The comparison of emotional regulation destruction and emotional styles in people with nicotine dependence and non nicotine dependence. Studies in Medical Sciences. 2017;27(10):848-55.
65. Lowe R, Guastella AJ, Chen NT, Menzies RG, Packman A, O'Brian S, et al. Avoidance of eye gaze by adults who stutter. J Fluency Disord. 2012;37(4):263-74.
66. Menzies RG, O'Brian S, Onslow M, Packman A, St Clare T, Block S. An experimental clinical trial of a cognitive-behavior therapy package for chronic stuttering. J Speech Lang Hear Res. 2008;51(6):1451-64.
67. Reddy RP, Sharma MP, Shivashankar N. Cognitive behavior therapy for stuttering: a case series. Indian J Psychol Med. 2010;32(1):49-53.
68. Gunn A, Menzies RG, O'Brian S, Onslow M, Packman A, Lowe R, et al. Axis I anxiety and mental health disorders among stuttering adolescents. J Fluency Disord. 2014;40:58-68.
69. Karimi J, Homayouni A, Homayouni F. The prediction of health anxiety based on experiential avoidance and anxiety sensitivity among non-clinical population. Journal of Research in Psychological Health. 2019;12(4):66-79.
| Files | ||
| Issue | Vol 19 No 1 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijps.v19i1.14341 | |
| Keywords | ||
| Adults Emotion Regulation Negative Thinking Speech Disorders Stuttering | ||
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How to Cite
1.
Sarani Yaztappeh J, Lorestani E, Zaheri Y, Rezaei M, Mohammadi H, Kakabaraee K, Rajabi M, Kianimoghadam AS, Fatollahzadeh S, Mohebi MD. A Study of Emotion Regulation Difficulties, Repetitive Negative Thinking, and Experiential Avoidance in Adults with Stuttering: A Comparative Study. Iran J Psychiatry. 2023;19(1):79-88.
