The role of social anxiety and attentional focus in a virtual reality environment on articulatory control in adults who stutter.
Kim R Bauerly, Antje Mefferd
In adults who stutter, higher self-reported anxiety and greater skin conductance during a socially stressful speaking task predicted more variable lip movements, but where attention was directed did not.
In fluent speakers, none of these factors predicted variability.
Key findings
1In adults who stutter, self-reported anxiety and the change in skin conductance from the low-stress to the high-stress condition significantly predicted lip aperture variability, but self-reported attentional focus did not.
2In adults who do not stutter, none of the three predictors—self-reported anxiety, skin conductance change, or attentional focus—significantly predicted lip aperture variability.
3Neither self-reported anxiety, skin conductance change, nor attentional focus significantly predicted movement duration in either the stuttering or the fluent group.
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What it does not show
Most of the adults who stutter had very mild to mild stuttering severity, with only five in the moderate-to-severe range, so the findings may not generalise to people with more severe stuttering. The speaking task was repeating two fixed sentences in a virtual-reality café, which is far from everyday conversation and may not capture the same attentional and anxiety processes that occur in real social interactions. Attentional focus was measured by a 10-item self-report questionnaire completed after the task, not by eye-tracking or other objective measures, and the questionnaire has not undergone full reliability testing. Attention was undirected (no cues given), unlike previous studies that cued internal or external focus, so the effect size for attention may have been diluted. The anxiety and attention questionnaires could only be administered after the high-stress condition, not the low-stress condition, limiting within-subject comparison. The sample was small (17 adults who stutter, 23 fluent speakers) and drawn from a single university and community, and the VR environment may not elicit the same level of social anxiety as a real audience.
Declared interests
The authors declare no conflict of interest and no known competing financial interests or personal relationships that could have influenced the work.
The easy way to misread this
Do not read the null finding on attentional focus as proof that attention does not matter in stuttering under stress. The study used undirected attention (no cues), a self-report measure that has not been fully reliability-tested, a small sample of mostly mild stutterers, and a virtual-reality café with sentence repetition rather than natural conversation. The significant anxiety finding also comes from a single lab, a single VR environment, and a task that does not resemble everyday speaking, so it should not be treated as settled evidence for how anxiety drives articulatory breakdown in all contexts.
Summarised by AI from the full paper, without a clinician reviewing it. Check it against the source before it changes what you do. Read it on PubMed →