Self-Stigma of Stuttering: Implications for Communicative Participation and Mental Health

Purpose: The purpose of this study was to determine if self-stigma–related vari-ables predicted communicative participation and mental health in adults who stutter. A progressive model of self-stigma was theorized and tested. Method: Adults who stutter (N = 344) completed a survey that included mea-sures of communicative participation, global mental health, and a variety of self-stigma–related variables including perceived enacted stigma, stigma awareness, anticipated stigma, felt stigma, stereotype agreement, and stigma application, in addition to demographic and speech-related variables. Hierarchical regression was performed to test whether self-stigma–related variables progressively explained significant variance in both communicative participation and global mental health.c Results: After controlling for demographic and speech-related variables, stigma-related variables were found to be significant predictors of both commu-nicative participation and global mental health among adults who stutter. Most self-stigma–related variables entered later in the model predicted additional unique variance in the outcome variables than the self-stigma–related variables entered in previous steps, thus supporting the trickle-down and progressive nature of the self-stigma model theorized. Conclusions: Accounting for self-stigma in the assessment and treatment of individuals who stutter may identify and ultimately reduce environmental and personal barriers to communicative functioning and well-being in people who stutter. The self-stigma terminology and model described in this study will help practitioners, researchers, and the public better understand the process of self-stigma and how it may be associated with adverse outcomes experienced by people who stutter.