Am J Psychiatry 1996; 153:278-280
Copyright © 1996 by American Psychiatric Association
Social phobia in adults with stuttering
MB Stein, A Baird and JR Walker
Department of Psychiatry, St. Boniface General Hospital, University of Manitoba, Winnipeg.
OBJECTIVE: 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. METHOD: 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. RESULTS: 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. CONCLUSIONS: 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.
