Stutter
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Stuttering, also known as stammering, is a speech disorder characterized externally by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses called blocks in which the person who stutters is unable to produce sounds. Almost 80 million people worldwide stutter, about 1% of the world's population, with a prevalence among males at least twice that of females. Persistent stuttering into adulthood often leads to outcomes detrimental to overall mental health, such as social isolation and suicidal thoughts.
Stuttering is not connected to the physical ability to produce phonemes (i.e. it is unrelated to the structure or function of the vocal cords). It is also unconnected to the structuring of thoughts into coherent sentences inside sufferers' brains, meaning that people with a stutter know precisely what they are trying to say (contrast with alternative disorders like aphasia). Stuttering is purely a neurological disconnect between intent and outcome during the task of expressing each individual sound. While there are rarer neurogenic (e.g. acquired during physical insult) and psychogenic (e.g. acquired after adult-onset mental illness or trauma) variants, the typical etiology, development, and presentation is that of idiopathic stuttering in childhood that then becomes persistent into adulthood.
Acute nervousness and stress do not cause stuttering but may trigger increased stuttering in people who have the disorder. There is a significant correlation between anxiety, particularly social anxiety, and stuttering, but stuttering is a distinct, engrained neurobiological phenomenon and thus only exacerbated, not caused, by anxiety. Anxiety consistently worsens stuttering symptoms in acute settings in those with comorbid anxiety disorders.
Living with a stigmatized speech disability like a stutter can result in high allostatic load (i.e. adverse pathophysiological sequelae of high and/or highly variable nervous system stress). Despite the negative physiological outcomes associated with stuttering and its concomitant stress levels, the link is not bidirectional: neither acute nor chronic stress has been shown to cause a predisposition to stuttering.
The stutterer, when he is alone, in the privacy of his room, never stutters. It is the impact with the other that triggers a whole series of ideas that then condition the emotional and behavioral component. From an underlying sense of self-depreciation, a feared judgment of others is triggered and proceeds with a control over the word, in the irrational idea of being able to better manage the situation. Incorrect cognitive elements that once learned can remain in adulthood, negatively conditioning normal verbal fluency.
The concept of radicality of stuttering, which some authors see as the organicity of the problem, lies in the depth and complexity of the symptom itself and can represent a symbolic cover for a conflict of an eminently psychological nature.
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מילים - 2020-12-29 00:00:00
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