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Principal Investigator: Seth Tichenor
Organization: DUQUESNE UNIVERSITY
Fiscal Year: 2024
Award: $390,959
Funding agency: National Institute on Deafness and Other Communication Disorders
PROJECT SUMMARY
The term adverse impact refers to the negative personal reactions, broader speech- or communication-related
consequences, and overall life challenges that adults who stutter may experience as a result of their speaking
difficulties. Though the risk of broader life impact is widely acknowledged, prior investigations have solely
evaluated this risk via surface severity, which does not strongly relate with negative cognitive-affective
reactions (negative thoughts and feelings). This limits the ability of clinicians and researchers to
accurately identify whether specific individuals are at risk for broader life consequences associated
with their stuttering. Similarly, most investigations of speech neurophysiology in people who stutter rely
exclusively on surface severity to group and interpret data using tasks with low ecological validity (e.g.,
speaking alone in a scanner). This raises questions about whether the field’s current understanding of
speech neurophysiology is applicable to real-world environments where people who stutter speak and,
as a result, experience negative cognitive-affective reactions.
The PI’s previous studies suggest that considering sub-group differences in cognitive-affective reactions (how
speakers experience, manage, and cope with stuttering) can predict how speakers let stuttering manifest in
their life. Pilot data collected for this proposal suggest that such sub-group differences can also predict broader
life negative outcomes, such as social isolation. However, it is unknown if other negative life outcomes often
associated with higher rates of mortality in the general population can be predicted from such sub-group
perspectives. Therefore, for Aim 1, sub-group differences in speaker management strategies will be used to
identify risk factors for social isolation, characteristics of depression, and characteristics of anxiety. For Aim 2,
we will examine patterns in neurophysiology during speech and stuttering using ecologically valid speaking
situations (speaking in front of a virtual audience, interviewing for a job), while simultaneously accounting for
sub-group differences in one negative cognitive-reaction common in AWS, Repetitive Negative Thinking (RNT,
i.e., Rumination). Engaging in RNT to high degrees activates right hemisphere attention areas that overlap with
speech motor control, which may impact how well AWS compensate to speech motor deficits during speech.
Overall impact: We will reconceptualize stuttering severity beyond surface features to account for cognitive-
affective reactions when identifying broader life impact and employ this reconceptualization in studies of speech
neurophysiology in ecologically valid communication. Discoveries from this research will, for the first time, directly
connect knowledge of the underlying impairment (neurophysiological differences in speech and language
production) and adverse impact (cognitive-affective reactions). Findings will increase the understanding of
stuttering neurophysiology and lead to more effective and targeted treatment for personalized interventions to
reduce health disparities and increase wellbeing in AWS.
Terms: <21+ years old><Accounting><Adult><Adult Human><Affective><Anxiety><Area><Attention><Behavior><Behavioral><Characteristics><Clinical><Clinical Skills><Cognitive><Communication><Compensation><Correlation Studies><Data><Data Analyses><Data Analysis><Death Rate><Decrease health disparities><Disease><Disorder><Disparate><Dysfunction><Education><Educational aspects><Employment><Environment><Feeling><Feeling suicidal><Frequencies><Functional disorder><General Population><General Public><Goals><Health disparity mitigation><Health disparity reduction><Impairment><In Situ><Individual><Interview><Investigation><Investigators><Jobs><Knowledge><Language><Left><Life><Lived experience><Lived experiences><Lower health disparities><Measurement><Measures><Mental Depression><Mitigate health disparities><Motor><Occupations><Outcome><Participant><Patient Self-Report><Pattern><Personal Satisfaction><Persons><Physiopathology><Production><Professional Positions><Reaction><Reading><Reduce health disparities><Research><Research Activity><Research Personnel><Researchers><Risk><Risk Factors><Self-Report><Service provision><Severities><Social isolation><Specific qualifier value><Specified><Speech><Stammering><Statistical Correlation><Stress><Students><Stuttering><Subgroup><Suicidal thoughts><Surface><Survey Instrument><Surveys><Testing><Thinking><Time><United States><Universities><Work><adulthood><behavior measurement><behavioral measure><behavioral measurement><comparator group><comparison group><coping><data interpretation><depression><effective therapy><effective treatment><experience><fNIRS><feelings><functional near infrared spectroscopy><hemodynamics><improved><mortality rate><mortality ratio><motor control><motor deficit><neural><neurophysiological><neurophysiology><pathophysiology><personalized health intervention><personalized intervention><precision interventions><response><ruminate><rumination><ruminative><social anxiety><social stigma><socially anxious><stigma><suicidal ideation><suicidal thinking><suicide ideation><targeted drug therapy><targeted drug treatments><targeted therapeutic><targeted therapeutic agents><targeted therapy><targeted treatment><thoughts><thoughts about suicide><virtual><well-being><wellbeing>