The Relationship between
Stuttering and Feelings of
Inferiority and Alexithymia in
Students
Soodeh Moharrami1*, Abolghasem Isamorad2
1
Department of Clinical Psychology, University of Allame
Tabatabai, Tehran, Iran
2
Faculty Member, Department of Clinical Psychology,
University of Allame Tabatabai, Tehran, Iran
*
Corresponding Author Email: [email protected]
ABSTRACT Stuttering disorder has many complexities and
there are great emotional- mental issues with it. Inferiority
feeling and alexithymia is an example of these disorders.
Hence the paper has been done with the aim to investigate
the relationship between stuttering and feelings of
inferiority and alexithymia in students 7 to 12 years old of
Shahre Rey of Tehran. The method of research is
descriptive in terms of operational aim and collection of
information and correlative of operation method and was
type of basic researches. The population in the study
consists of all 7 to 12 years students with stuttering in Rey
was formed in 2015 which the population was evaluated as
250 people. The investigation of students with stuttering in
the research is done by field observation, clinical
observation, reviewing the medical records and inquiring of
the students' parents. Volume of the sample was
determined based on Morgan Krejcie table 148 persons and
available sampling method. The information collection main
tools of the study included standard questionnaires of
inferiority (Eysenck, 1988) and alexithymia (Tronto 20FTAS). Data were analyzed by use of correlation which
results showed that there is significant relationship between
alexithymia and its dimensions; difficulty in identifying
feelings, difficulty in describing feelings and objective
thinking with stuttering. Also, was seen a significant
relationship between inferiority and stuttering.
KEYWORDS
Stuttering.
130
Inferiority
Feeling, Students, Alexithymia,
JOURNAL OF
JPBS
PSYCHOLOGY &
BEHAVIORAL STUDIES
Vol 4(4): 130-136
http://www.jpbsjournal.com
ISSN: 2148-0664
Copyright©2016
J. Psych. Beh. Stud. Vol., 4 (4), 130-136, 2016
INTRODUCTION
Speech is not a simple process. It requires coordinated, fast and intricate movements of
speech members such as tongue, lips, jaw, vocal cords and teeth. In addition, precise
timing of muscles is necessary to breathe and produce of face to speak. Many factors
can disrupt the process. Most of the children aged 2 to 5 years which their vocabulary
extent are growing rapidly, may experience kind of disruption in in speech. The
disruption occurs when child is in trouble to put the sound together in order to produce
words. Stuttering is one of several disorders in speech fluency which remain in person
and becomes chronic. Stuttering is known as repetition or involuntary dragging sounds
or syllables which is usually at the start of the word and sudden stop of speech
members. The repetition and dragging words often are accompanied to lateral behaviors
which its repetition is called stuttering (Eslami, 2009).Speak fluently make a person
confident and similarly a person speaks fluently who has more confidence. Thus, stress
caused by confidence could effect on increasing stuttering of the person. A person who
has confidence speaks with special relaxation. Thus, low confidence will lead to various
failures in speaking. People who have stuttering may less speak among others due to the
fear of being ridiculed. The inferiority feeling prevents proper relationship and away from
stuttering for these people (Toozandehjani, 2011).
Done researches in the field of stuttering and anxiety suggests that stress and anxiety,
increase stuttering and creates frustration, low self-esteem, disability in social
functioning and cause person avoids some conditions which requires to speak for
example speak among others (DSM-IV), hence he/she feels some inferiority over the
time. The sense is influenced by emotions; hence it is alexithymia with variables which
are in relation to stuttering. Disability in cognitive processing of emotional information
and regulating emotions is called alexithymia. Alexithymia is a multi-faceted structure
consists of difficulty in feelings identification and distinguishing between feelings and
physical agitation related to emotional arousal, difficulty in description of feelings for
others, limited power of visualization which is determined based on imagination poverty.
Researches have shown that alexithymia has relationship with pain in group of patients
with chronic pain (Huber et al., 2009).
Alexithymia has relationship with a lot of mental and physical disorders such as
psychosomatic diseases, chronic physical and mental disorders, anxiety disorders, mood
disorders, eating disorders, physical and emotional (Taylor, 2004). Alexithymia has
relationship with strengthening physical symptoms that defined as tend to focus on the
physical sensations. For this reason, people with alexithymia are focused on physical
protests related to their excitation and subsequently proceed to incorrect interpretation
of these feelings (Besharat, 2011). People with alexithymia enlarged normal physical
excitements and misinterpreted physical symptoms of emotional arousal, show
emotional distress through physical complaints and they are seeking to treatment
actions of physical symptoms (Lane et al, 1997). People with stuttering often are
avoided to speak in public due to fear of being ridiculed by others, hide their feelings.
Hence they are experiencing a type of inferiority.
Inferiority or as the Persian ' sense of inferiority' is of feelings and emotions which each
person experience it as a form routinely nearly all the human beings are involved with
this sense more or less. A person who get humiliated, find himself with a bad sense.
Disrespected to him and have doubted his/her prestige. Sometimes he/she feels such
folly and shame and miss his/her pride that may adopt inferior behavior. Inferiority may
be a source of physical or psychological defect. Every incapable, detective, mentally
retarded child or teenager with physical problem or frail and mentally retarded in fact
suffers from insufficiency two times, one time due to he/she is in inferior position in
his/her environment and other time due to be ridiculed by peers, friends and others.
According Adler inferiority complex is seen in three groups of people that include
following cases: misshapen people mean particularly who had physical defect from their
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childhood and always this defect has caused to find themselves more incapable and
down among peers, like a children who cannot participate in public game because of
paralysis of hands or feet, or cannot speak such the peers due to defect in speech
(Mehranfar, 2012). So if stuttering problem left untreated leads to many consequences,
including the inferiority and alexithymia. Thus, this study sought to examine the
stuttering problem and to seek answer to the question that what relationship is there
between stuttering with inferiority and alexithymia?
MATERIALS AND METHODS
According to the purpose of study based on "the relationship between stuttering and
feelings of inferiority and alexithymia in the students 7 to 12 years old in Shahre Ray of
Tehran ", the research method in terms of purpose was applied, and in terms of data
collection was descriptive, in terms of method performance was correlation, was of the
type of basic research. The statistical population in this study consisted of all students 7
to 12 years old with stuttering in Shahre Ray in 2015, that the conducted survey of
statistical population has been estimated over 250 people. The sample size was
determined 148 people based on Kerjersy Morgan table, and with available sampling
method was determined. The data collection tool in this study was included the standard
questionnaires on feelings of inferiority (Eysenck, 1988) and alexithymia (Toronto 20FTAS).
It should be noted that the investigation stuttering of students in this study was done
through field observations, clinical observation, examining medical history of each of the
participants in this study and inquiry of these children parents. SPSS software was used
to analyze the data of this study, and descriptive and inferential statistics were utilized
to describe the data, descriptive statistics involves the central indexes such as mean,
standard deviation, skewness and kurtosis of the frequency distribution tables, graphs,
and the one-sample t test was used for statistical analysis of research at the inferential
statistics. The full information of questionnaires is as follows:
Questionnaire of alexithymia (Toronto 20- FTAS)
Toronto Alexithymia Scale is a test with 20 questions, and measures three subscales of
difficulty in identifying feelings (including 7 articles), difficulty in describing feelings
(including 5 articles), and objective thought (including 8 articles), at the size of five
degree Likert, from the score of 1 (completely disagree) to score of 5 (completely
agree).A total score is calculated from the sum of the scores of three subscales for
general alexithymia. Psychometric characteristics of Toronto alexithymia scale - 20 has
been reviewed and approved in several researches.
In the Persian version of the Toronto Alexithymia Scale-20 (Besharat, 2012), Cronbach's
alpha coefficients for the total alexithymia, and three subscales of difficulty in identifying
feelings, difficulty in describing feelings, and objective thought were calculated 0.85,
0.82, 0.75, 0.72 respectively, which indicates good internal consistency of the scale.
Retest reliability of Toronto alexithymia scale-20 in the sample of 67 persons on two
occasions at a distance four weeks from r = 0.80 to r = 0.87 was confirmed for the total
alexithymia and different subscales. Concurrent validity of this scale was reviewed and
approved based on correlation between this test subscales and the scales of emotional
intelligence, psychological well-being and psychological inability. The results of Pearson
correlation coefficients showed that there is a significant correlation between the
subjects scores in the total alexithymia score with emotional intelligence (r = - 0.80, P <
0.001), psychological well-being (r = - 0.87, P< 0.001), and inability (r = 0.44, P<
0.001).The correlation coefficients between the subscales of alexithymia and the above
variables were also significant. Confirmatory factor analysis findings also confirmed
three factors of difficulty in identifying feelings, difficulty in describing feelings, and
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objective thought in Persian version of the Toronto Alexithymia Scale - 20 (Besharat,
2014).
Eysenk Questionnaire of Feelings of Inferiority
Eysenk questionnaire of feelings of inferiority has been performed on 12,000 people, has
a reliability coefficient of 0.67, and is a valid questionnaire which has been used to
assess feelings of inferiority. This questionnaire has 30 questions that 12 questions of it
are scored reversely.A way of scoring has been coded in terms of zero and one, that the
zero code is applied for the weak feelings of inferiority, and the code 1 is applied for the
strong feelings of inferiority, that the total scores sum for each individual is indicative of
the amount of feelings of inferiority in that person.
RESULTS
One-sample t-test was used to investigate the relationship between alexithymia and
stuttering, (Table 1).Based on the obtained value of t from reviewing the test for the
difficulty in identifying feelings is equal to 39.119, the difficulty in describing feelings is
equal to 46.774, and objective thought is equal to 82.951, and the total score of
alexithymia is equal to 66.407.Since these values is higher than critical values ± 1.96 ,
thus null hypothesis has been rejected, and the researcher hypothesis based on the
relationship between alexithymia and its dimensions; difficulty in identifying feelings,
difficulty in describing feelings and objective thought with stuttering is accepted in
confidence level of 99% (sig = 0.001) .According to the obtained results, it can be
concluded that there is a significant relationship between alexithymia and its
dimensions; difficulty in identifying feelings, difficulty in describing feelings, and
objective thought with stuttering.
Table 1. t Test Results.
Variables
Difficulty in identifying
feelings
Difficulty describing feelings
Objective thinking
Total score of alexithymia
t
30.119
df
147
Sig.
0.001
46.774
82.951
66.407
147
147
147
0.001
0.001
0.001
One-sample T test was used to investigate the relationship between feelings of inferiority
with stuttering.
Table 2. Results of one-sample t test to investigate the relationship between feelings of
inferiority with stuttering.
T test results
306.38
df
147
Sig.
0.001
According to Table 2, the t value obtained from reviewing the tests for feelings of
inferiority is equal to 38.306, and since this value is higher than the critical value of ±
1.96; thus null hypothesis has been rejected, and the researcher hypothesis based on
the relationship between feelings of inferiority and stuttering is accepted in the
confidence level 99% (sig = 0.001). According to the obtained results, it can be
concluded that there is a significant relationship between feelings of inferiority and
stuttering.
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DISCUSSION AND CONCLUSION
The study showed that there is a relationship between alexithymia with stuttering. We
can say that there is a significant relationship between alexithymia and its dimensions;
difficulty in identifying feelings, difficulty in describing feelings and objective thinking
with stuttering. Moreover, the result also showed that there is a relationship between
senses of inferiority with stuttering and can say that there is a significant relationship
between inferiority and stuttering. To explain the results can say that stuttering in
teenagers and adults place an obstacle to social and education and professional life of
person due to communication problems creation and can make the issue more
complicated. In some cases may be serious trauma such as depression and social
phobia.
Yadegari et al (2005) showed that people with stuttering have more negative
communicative attitude than ordinary ones, and also regarding to involuntary nature and
potentially social problematic, stuttering has negative impact on mental-emotional health
potentially (BloodStein et al, 2008-2014). Mulkay (2008) conducted a study to examine
situation of teenagers with stuttering they resulted that social anxiety in teenagers with
stuttering had been more significantly compared to ordinary teenagers. Pras et al (2008)
are believed secondary performances such as disrupting eyes, disruption of jaw and
involuntary movements of head or hand and feet are accompanied to stuttering, can
make children more concern and lead to fear of speech .
Stuttering is one of several disorders of speech fluency that remains in person and
become chronic and its ratio in childhood and start time in boys is 2 times of girls, but
because percent of girls improvement are more than boys, the ratio of boy to girl is 4 to
1 in maturity. Stuttering may start simply. But most of the time due to reactions,
defense mechanisms and coping strategies used by the person becomes a complex issue
that more difficult its treatment and control. Below are a number of adverse behaviors
mentioned in stuttering. Evident tension and struggle in speech production:







Abnormal movement of the head or member in time of speech
Reduce eye contact while talking
Delay and composure in expressing certain words
Tangible expression of emotions such as embarrassment, excitement or nervousness
Abnormal movements and muscle tremor and blinking
Cramps in the muscles of speech, change in volume
Social phobia and depression
In a case disorder in speech fluency lasts more than 6 months, requires to intervention
of speech and language. Early detection and control is vital for improving speech
disorders. The purpose of the fast medical intervention is to create a proper structure for
speech fluency, before it become chronic and persistent. That is why treatment for
adults is more difficult, because it is rooted in the stuttering pattern. Many of children
are leaving behind stuttering without treatment over time. However, given the different
nature of the emergence of stuttering, it is difficult to predict spontaneous resolution .
Currently there is no certain treatment for stuttering due to unknown nature of the
disorder. However, early intervention and follow-up can even fully control the stuttering
and the result is a fluent and natural speech. Stuttering has known as a changeable
behavior. Speech-language pathologist tries to improve the disharmony between speech
and breathing which is created as result of stuttering so that person again achieve to
fluent speech and without stuttering. During the treatment program person with
stuttering learns to control stuttering phenomenon in his/her speech voluntary using
various treatment methods .
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Most treatment programs have been concentrated on specific methods of speech
includes drag words, reduction of speech speed and ease of start every word (the relax
position of speech muscle, respiratory system appropriate support for the speech start,
exhale slowly and relaxed start of first sound). The aim of these therapy methods is
speech muscle system reprogramming to produce a fluent speech by coordinating
breathing and voice production. Also at the same time it works on dependent
psychological factors such as stress and anxiety and elimination of adverse behaviors
and in fact is done type of behavior therapy. A person, who speaks with stuttering, has a
kind of embarrassment, shame sense and in general his/her inferiority become higher
than excellent people. On the other hand they have a lot of emotional conflict and in
many cases they are lack of emotional effort .
Studies have shown that emotional capability of people, make easy their facing to life
challenges and as result give them more mental health (King Vamunz, 1999). People
with emotional capability determine their feelings, perceive their implications and
express effectively their emotional moods to others. These people are more successful in
getting along with negative experiences and show more appropriate relation to
environment and others compared to people who are not capable of perception and
expression of emotional moods.
It seems that people with alexithymia, don’t understand questions of emotional contents.
They are concentrated on physical feature of emotional arousal. And experience
emotions as improved cognitive emotional moods. Emotional defects consequences of
alexithymia are beyond inter personal problems. Alexithymia also creates disorder in
intra personal problems. Because people with alexithymia show defects in perception and
reaction to others' feelings, their ability was disrupted for empathy. In addition to drastic
emotional disorders of people with alexithymia, they experience deep cognitive
disabilities. Finally in conclusion of mentioned cases can be said that stuttering in
teenagers and adults place an obstacle to social and education and professional life due
to communicative problems and make the problem more complicated. In some cases
there are serious trauma, such as feelings of inferiority and alexithymia.
Conflict of interest
The authors declare no conflict of interest
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