A systematic review of the relationship between death anxiety, capability for suicide, and suicidality.

This systematic review aimed to examine the relationship between death anxiety and suicidality in adults, and the impact of death anxiety interventions on the capability for suicide and suicidality. MEDLINE, PsycINFO, PubMed, and Web of Science were extensively searched using purpose-related keywords from the earliest to July 29th, 2022. A total of 376 participants were included across four studies which met inclusion. Death anxiety was found to relate significantly and positively with rescue potential, and although weak, negatively with suicide intent, circumstances of attempt, and a wish to die. There was no relationship between death anxiety and lethality or risk of lethality. Further, no studies examined the effects of death anxiety interventions on the capability for suicide and suicidality. It is imperative that future research implements a more rigorous methodology to establish the relationship between death anxiety and suicidality and establish the impacts of death anxiety interventions on the capability for suicide and suicidality.

Lidcombe Program translation to community clinics in Australia and England.

BACKGROUND: Early intervention is essential healthcare for stuttering, and the translation of research findings to community settings is a potential roadblock to it. AIMS: This study was designed to replicate and extend the Lidcombe Program community translation findings of O'Brian et al. (2013) but with larger participant numbers, incorporating clinicians (speech pathologists/speech anlanguage therapists) and their clients from Australia and England. METHODS & PROCEDURES: Participants were 51 clinicians working in public and private clinics across Australia (n = 36) and England (n = 15), and 121 of their young stuttering clients and their families. Outcome measures were percentage of syllables stuttered (%SS), parent severity ratings at 9 months post-recruitment, number of clinic visits to complete Stage 1 of the Lidcombe Program, and therapist drift. OUTCOMES & RESULTS: Community clinicians in both countries achieved similar outcomes to those from randomized controlled trials. Therapist drift emerged as an issue with community translation. Speech and language therapists in England attained outcomes 1.0%SS above the speech pathologists in Australia, although their scores were within the range attained in randomized trials. CONCLUSIONS & IMPLICATIONS: Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice. The long-term impact of therapist drift in community clinical practice with the Lidcombe Program has yet to be determined. WHAT THIS PAPER ADDS: What is already known on the subject The Lidcombe Program is an efficacious early stuttering intervention. Translation to clinical communities has been studied with one Australian cohort. What this paper adds to existing knowledge A larger translation cohort is studied, comprising community clinicians and children in Australia and England. What are the potential or actual clinical implications of this work? Community clinicians from Australia and England can attain Lidcombe Program outcome benchmarks established in randomized trials. This finding is reassuring in light of the controlled conditions in clinical trials of the Lidcombe Program compared with its conduct in community practice.

Overcoming death anxiety: a phase I trial of an online CBT program in a clinical sample.

BACKGROUND: Growing research indicates that death anxiety is implicated in many mental health conditions. This increasing evidence highlights a need for scalable, accessible and cost-effective psychological interventions to reduce death anxiety. AIMS: The present study outlines the results of a phase I trial for one such treatment: Overcome Death Anxiety (ODA). ODA is the first CBT-based online intervention for fears of death, and is an individualised program requiring no therapist guidance. METHOD: A sample of 20 individuals with various mental health diagnoses commenced the ODA program. Death anxiety was assessed at baseline and at post-intervention. Depression, anxiety and stress were also measured. RESULTS: In total, 50% (10/20) reached the end of the program and completed post-treatment questionnaires. Of these, 60% (6/10) showed a clinically reliable reduction in their overall death anxiety, and 90% (9/10) showed a reduction on at least one facet of death anxiety. There were no adverse events noted. CONCLUSIONS: ODA appears to be a safe and potentially effective treatment for death anxiety. The findings have provided initial evidence to support a randomised controlled trial using a larger sample, to further examine the efficacy of ODA.

OCD, death anxiety, and attachment: what's love got to do with it?

BACKGROUND: Death anxiety has been empirically implicated in obsessive compulsive disorder (OCD). Research has shown that secure attachments appear to protect against fear of death, and are also associated with reduced risk of mental illness. However, few studies have investigated the moderating effect of attachment style in the relationship between death anxiety and OCD. AIMS: The present study sought to explore whether attachment style moderates the relationship between death anxiety and OCD symptoms among a treatment-seeking sample of individuals diagnosed with OCD. METHOD: Following a structured diagnostic interview, a number of measures were administered to 48 participants. These included the Multidimensional Fear of Death Scale, Vancouver Obsessive Compulsive Inventory, and Experiences in Close Relationships-Revised. RESULTS: As expected, death anxiety was a strong predictor of OCD severity, and other markers of psychopathology. However, contrary to hypotheses, neither anxious nor avoidant attachment style moderated the association between fear of death and OCD severity. CONCLUSIONS: The current findings add further support to the role of death anxiety in OCD. Given the absence of a moderating effect of attachment between death fears and OCD severity, it is possible that this proposed buffer against death anxiety may potentially be insufficient in the presence of this disorder. Further research is needed to clarify whether attachment style may moderate the relationship between death anxiety and symptom severity in other disorders.

Searching for Lidcombe Program mechanisms of action: Inter-turn speaker latency.

The Lidcombe Program is a well-established and efficacious treatment for early stuttering, but little is currently known about its mechanisms of action. The present report explores the possibility that inter-turn speaker latency might be associated with such mechanisms of action. Inter-turn speaker latency was measured in audio recordings of children, parents, and clinicians conversing, taken during Lidcombe Program treatment consultations. Five clinicians reduced their inter-turn speaker latencies during clinical consultations when they were speaking to children, in comparison with when they were speaking to parents. It is possible that inter-turn speaker latency is associated with the Lidcombe Program treatment process vicariously, and this possibility requires further research.

Predictors of Lidcombe Program treatment dropout and outcome for early stuttering.

BACKGROUND: Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts treatment prognosis. AIMS: To investigate the predictors of treatment dropout and treatment outcome for children who were treated for early stuttering with the Lidcombe Program (N = 277). METHODS & PROCEDURES: A total of 32 variables were used as predictors in regression analyses of short- and medium-term Lidcombe Program outcome, and of treatment dropout. OUTCOMES & RESULTS: Regression analyses associated children who have better language skills and easy temperament with better treatment outcome, although only a small portion of the variance of treatment outcome was accounted for by these variables. There was an association between treatment dropout and parental scores on a personality screening tool relating to their impulsivity. CONCLUSIONS & IMPLICATIONS: Variables identified as predictors of Lidcombe Program treatment outcome were statistically significant, but not clinically significant. They did not account for a clinically substantive portion of treatment outcomes. Findings about parental impulsivity and their relationship with intervention drop-out require replication with prospective methods and comprehensive assessment of parent psychological status. This is particularly important because parents are involved in conducting all early interventions. What this paper adds What is already known on the subject Information is available about what predicts Lidcombe Program treatment time, but nothing is known about what predicts Lidcombe Program treatment outcome. What this paper adds to existing knowledge There are predictors of Lidcombe Program treatment outcome that are statistically significant, but none are clinically significant. What are the potential or actual clinical implications of this work? Clinicians can tell parents that nothing has been found that can assist with making prognostic indications about treatment outcome for their children.

Evaluating a Web-Based Social Anxiety Intervention Among Community Users: Analysis of Real-World Data.

BACKGROUND: Social anxiety is both harmful and prevalent. It also currently remains among the most undertreated major mental disorders, due, in part, to socially anxious individuals' concerns about the stigma and expense of seeking help. The privacy and affordability of computer-aided psychotherapy interventions may render them particularly helpful in addressing these concerns, and they are also highly scalable, but most tend to be only somewhat effective without therapist support. However, a recent evaluation of a new self-guided, 7-module internet-delivered cognitive behavioral therapy intervention called Overcome Social Anxiety found that it was highly effective. OBJECTIVE: The initial evaluation of Overcome Social Anxiety revealed that it led to significant reductions in symptom severity among university undergraduates. The aim of this study was to extend the results of the initial study and investigate their generalizability by directly evaluating the intervention's effectiveness among a general community sample. METHODS: While signing up for Overcome Social Anxiety, users consented to the usage of their anonymized outcome data for research purposes. Before and after completing the intervention, users completed the Fear of Negative Evaluation Scale (FNE), which we employed as the primary outcome measure. Secondary outcome measures included the Depression Anxiety Stress Scales (DASS) and 2 bespoke questionnaires measuring socially anxious thoughts (Thoughts Questionnaire) and avoidance behaviors (Avoidance Questionnaire). RESULTS: Participants who completed the intervention (102/369, 27.7%) experienced significant reductions in the severity of their symptoms on all measures employed, including FNE (P<.001; Cohen d=1.76), the depression subscale of DASS (P<.001; Cohen d=0.70), the anxiety subscale of DASS (P<.001; Cohen d=0.74), the stress subscale of DASS (P<.001; Cohen d=0.80), the Thoughts Questionnaire (P<.001; Cohen d=1.46), and the Avoidance Questionnaire (P<.001; Cohen d=1.42). CONCLUSIONS: Our results provide further evidence that Overcome Social Anxiety reduces the severity of social anxiety symptoms among those who complete it and suggest that its effectiveness extends to the general community. The completion rate is the highest documented for a fully automated intervention for anxiety, depression, or low mood in a real community sample. In addition, our results indicate that Overcome Social Anxiety reduces the severity of symptoms of depression, physiological symptoms of anxiety, and stress in addition to symptoms of social anxiety.

Phase I trial of a standalone internet social anxiety treatment for adolescents who stutter: iBroadway.

BACKGROUND: iGlebe is a fully automated internet treatment program for adults who stutter that has been shown, in some cases, to reduce anxiety and effectively manage social anxiety disorder for many participants. No such automated internet treatment program exists for adolescents who stutter. AIMS: The present paper reports a Phase I trial of an adolescent version of the adult program: iBroadway. METHODS & PROCEDURES: Participants were 29 adolescents in the age range 12-17 years who were seeking cognitive-behaviour therapy (CBT) for anxiety associated with stuttering. The design was a non-randomized Phase I trial with outcome assessments at pre-treatment and immediately post-treatment after 5 months of access to the program. No contact by a clinical psychologist occurred during participant use of the program. Outcomes were a range of psychological, quality-of-life and stuttering severity measures. OUTCOMES & RESULTS: The compliance rate for the seven iBroadway modules over 5 months was extremely favourable for internet CBT, at 52.4%. There was evidence of treatment effects for (1) the number of DSM-IV mental health diagnoses with the Diagnostic Interview Schedule for Children; (2) the Unhelpful Thoughts and Beliefs About Stuttering scale; (3) the Subjective Units of Distress Scale; and (4) parent-reported speech satisfaction. CONCLUSIONS & IMPLICATIONS: Further development of iBroadway, the adolescent version of iGlebe, with Phase II trialling is warranted.

Terror mismanagement: evidence that mortality salience exacerbates attentional bias in social anxiety.

Death anxiety is a basic fear underlying a range of psychological conditions, and has been found to increase avoidance in social anxiety. Given that attentional bias is a core feature of social anxiety, the aim of the present study was to examine the impact of mortality salience (MS) on attentional bias in social anxiety. Participants were 36 socially anxious and 37 non-socially anxious individuals, randomly allocated to a MS or control condition. An eye-tracking procedure assessed initial bias towards, and late-stage avoidance of, socially threatening facial expressions. As predicted, socially anxious participants in the MS condition demonstrated significantly more initial bias to social threat than non-socially anxious participants in the MS condition and socially anxious participants in the control condition. However, this effect was not found for late-stage avoidance of social threat. These findings suggest that reminders of death may heighten initial vigilance towards social threat.

Assessing attentional biases with stuttering.

BACKGROUND: Many adults who stutter presenting for speech treatment experience social anxiety disorder. The presence of mental health disorders in adults who stutter has been implicated in a failure to maintain speech treatment benefits. Contemporary theories of social anxiety disorder propose that the condition is maintained by negative cognitions and information processing biases. Consistent with cognitive theories, the probe detection task has shown that social anxiety is associated with an attentional bias to avoid social information. This information processing bias is suggested to be involved in maintaining anxiety. Evidence is emerging for information processing biases being involved with stuttering. AIMS: This study investigated information processing in adults who stutter using the probe detection task. Information processing biases have been implicated in anxiety maintenance in social anxiety disorder and therefore may have implications for the assessment and treatment of stuttering. It was hypothesized that stuttering participants compared with control participants would display an attentional bias to avoid attending to social information. METHODS & PROCEDURES: Twenty-three adults who stutter and 23 controls completed a probe detection task in which they were presented with pairs of photographs: a face displaying an emotional expression-positive, negative or neutral-and an everyday household object. All participants were subjected to a mild social threat induction being told they would speak to a small group of people on completion of the task. OUTCOMES & RESULTS: The stuttering group scored significantly higher than controls for trait anxiety, but did not differ from controls on measures of social anxiety. Non-socially anxious adults who stutter did not display an attentional bias to avoid looking at photographs of faces relative to everyday objects. Higher scores on trait anxiety were positively correlated with attention towards photographs of negative faces. CONCLUSION & IMPLICATIONS: Attentional biases as assessed by the probe detection task may not be a characteristic of non-socially anxious adults who stutter. A vigilance to attend to threat information with high trait anxiety is consistent with findings of studies using the emotional Stroop task in stuttering and social anxiety disorder. Future research should investigate attentional processing in people who stutter who are socially anxious. It will also be useful for future studies to employ research paradigms that involve speaking. Continued research is warranted to explore information processing and potential biases that could be involved in the maintenance of anxiety and failure to maintain the benefits of speech treatment outcomes.

Death anxiety and mental health: Requiem for a dreamer.

Recently, there has been an increased interest in the role of death anxiety in a broad range of mental health disorders. It has been argued that the fear of death may be a transdiagnostic variable contributing to the development and maintenance of many chronic mental health problems. Further, it has been suggested that death anxiety may be responsible for relapse and the emergence of new disorders in patients that have received successful treatment for earlier conditions in their lives. Given this, the purpose of the present selective review is to: (1) explore contemporary theoretical accounts of the role of death anxiety in a broad range of human behaviours; (2) examine evidence for death anxiety as a key variable in mental health disorders; (3) examine evidence on the treatment of death anxiety in both non-clinical and clinical populations; (4) describe the limitations of the current literature, and; (5) provide a detailed description of the critical future directions for this field.

Cost of Illness and Health-Related Quality of Life for Stuttering: Two Systematic Reviews.

PURPOSE: For those who stutter, verbal communication is typically compromised in social situations. This may attract negative responses from listeners and stigmatization by society. These have the potential to impair health-related quality of life across a range of domains, including qualitative and quantitative impacts on speech output, mental health issues, and failure to attain educational and occupational potential. These systematic reviews were designed to explore this matter using traditional health economics perspectives of utility measures and cost of illness. METHOD: Studies were included if they involved children, adolescents, or adults with stuttering as a primary diagnosis. The quality of life search strategy identified 2,607 reports, of which three were included in the quality of life analysis. The cost of illness search strategy identified 3,778 reports, of which 39 were included in the cost of illness analysis. RESULTS: Two of the three studies included in the quality of life analysis had a high risk of bias. When measured using utility scores, quality of life for people who stutter was in the range of those reported for chronic health conditions such as diabetes mellitus, cardiovascular disease, and cancer. However, there is little such evidence of quality of life impairment during the preschool years. Studies included in the cost of illness analysis carried considerable risk of bias overall. CONCLUSIONS: For people who stutter, there are substantive direct and indirect costs of illness. These include impairment, challenges, and distress across many domains throughout life, including income, education, employment, and social functioning. Evidence of quality of life impairment using utility measures is extremely limited. If this situation is not remedied, the lifetime impairment, challenges, and distress experienced by those who stutter cannot be documented in a form that can be used to influence health policy and health care spending. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.24168201.

The impact of climate change on obsessive compulsive checking concerns.

OBJECTIVE: To investigate whether climate change has impacted on the nature of the obsessions or compulsions experienced by patients with obsessive compulsive disorder (OCD). METHODS: The sample comprised 50 patients with OCD checking subtype who had presented at the Anxiety Disorders Clinic at The University of Sydney seeking treatment during the period March 2008 to November 2009. Details of the type of obsessions and compulsions directly related to climate change phenomena were identified. RESULTS: Fourteen of the 50 participants (28%) were identified as having OCD concerns directly related to climate change. The most frequent concerns involved electricity, water and gas wastage. Less frequent concerns included pets dying of thirst and one participant was concerned about house damage due to floors cracking, pipes leaking; roof problems and white ant activity. Compulsions included checking and rechecking pet water bowls, light switches, taps, stoves, skirting boards, pipes, roofs and wooden structures. While these behaviours are not particularly unusual for people with this condition, it was the rationale they provided for carrying them out that was surprising. Instead of checking and rechecking so as to prevent fire or flood, the rituals were specifically performed so as to reduce their global footprint, or respond to climate change-induced negative events. CONCLUSIONS: Our findings demonstrate that the types of obsessions and compulsions experienced by 28% of our sample were directly aligned with the current issue of climate change and the perceived dangers associated with this phenomenon. To our knowledge this represents the first documentation of the significant impact of climate change on the nature of the concerns experienced by people with OCD checking subtype. We suggest that mental health professionals need to be aware of, and assess for the presence of such concerns.

Comparison of Stuttering Severity and Anxiety During Standard and Challenge Phone Calls.

PURPOSE: This study was designed to answer three questions. (a) Does percentage of syllables stuttered (%SS) differ between standard and challenge phone calls. (b) Does anxiety differ between standard and challenge phone calls. (c) Is there a relationship between %SS and anxiety during standard and challenge phone calls? METHOD: Participants were 230 adults diagnosed with stuttering, who were participants from five clinical trials. Each participant received two 10-min phone calls at pretreatment and a further two phone calls 6 months or 20 weeks postrandomization. One phone call was standard, and the other presented challenge: occasionally disagreeing with, interrupting, and talking over participants, or asking for clarification of their views. RESULTS: Statistically significant, but clinically minor, increases of %SS and anxiety occurred during the challenge phone calls. There was a statistically significant association between %SS and anxiety. CONCLUSIONS: Variable phone call procedures to assess stuttering severity in clinical trials are not likely to spuriously inflate or deflate treatment outcomes to a clinically important extent. Regardless, the present results suggest that there is statistical merit in controlling the nature of phone calls during clinical trials with the simple and replicable method developed in this report. Additionally, there is procedural merit in the challenge phone call procedure; it is a more valid representation of the challenges of everyday speech than the standard procedure. However, a disadvantage of the challenge phone call procedure is the practical issues associated with its use. The clinical and theoretical applications of the results are discussed.

Improving adherence to a web-based cognitive-behavioural therapy program for social anxiety with group sessions: A randomised control trial.

Individuals with social anxiety disorder (SAD) commonly receive non-evidence based, ineffective treatments. Cognitive behaviour therapy (CBT) has been demonstrated to be the gold standard treatment for treating SAD. Scalable web-based CBT programs ensure evidence-based treatment procedures, but low treatment adherence remains problematic. This study aimed to test whether adding group sessions to a fully automated web-based CBT program, Overcome Social Anxiety (OSA), would increase treatment adherence. A total of 69 participants were provided access to a web-based program, and randomly allocated to three conditions: 1) An experimental condition involving an addition of three online group psychoeducation sessions; 2) a placebo condition involving an addition of three online progressive muscle relaxation (PMR) group sessions, or 3) a control condition where participants did not receive group sessions. Adherence was operationalised as number of OSA modules completed. Treatment adherence significantly differed between the conditions. On average, participants assigned to the placebo condition completed significantly more of the program compared to those in the control condition. Further, all conditions produced a significant improvement in BFNE and QOLS. No significant difference in treatment efficacy was found between groups on the SIAS, BFNE or QOLS. The current results indicate PMR can improve treatment adherence for scalable social anxiety interventions.

Stuttering, family history and counselling: A contemporary database.

BACKGROUND: Information about genetic influence is useful to when counselling parents or caregivers who have infants and children at risk for stuttering. Yet, the most comprehensive family aggregate database to inform that counselling is nearly four decades old (Andrews et al., 1983). Consequently, the present study was designed to provide a contemporary exploration of the relationship between stuttering and family history. METHODS: Data were sourced from the Australian Stuttering Research Centre, comprising 739 participants who presented for assessment, treatment, or investigation of stuttering. Reported family history data were acquired from pedigrees collected during assessment. We sought to establish the relation of the following variables to family history of stuttering: incidence, proband sex, parent sex, stuttering severity, age, reported age of stuttering onset, and impact of stuttering. Data were analysed with chi-square tests for independence, logistic and linear regression models. RESULTS: Results were broadly consistent with existing data, but the following findings were novel. Males and females who stutter have the same increased odds of having a father who stutters relative to a mother who stutters. Males had later stuttering onset than females, with genetic involvement in this effect. There was a greater impact of stuttering for females than males with a family history of stuttering. CONCLUSION: These findings have clinical applications. Speech-language pathologists may have infant or child clients known to them who are at risk of beginning to stutter. Information from the present study can be applied to counselling parents or caregivers of such children about stuttering and family history.

Conversational speech of school-age children after syllable-timed speech treatment for stuttering.

Purpose: The purpose of this laboratory study was to investigate whether rhythmic speech was primarily responsible for stuttering reductions in four school-aged children after the instatement stage of the Westmead Program of syllable-timed speech (STS) intervention. The study was designed to inform further development of the program. Reduction in variability of vowel duration is a marker of STS, and it was predicted that this would be present in the children's conversational speech after Stage 1 of the program if they were using STS. To strengthen such a finding, it was also predicted that there would be no reduction in articulation rate, sentence complexity, and utterance length after treatment, as there is evidence that reductions in these can reduce stuttering. Perceptual judgments of speech quality after treatment were also made by independent listeners.Method: Participants were four children, ages 8-11 years, who completed Stage 1 of an STS program and whose stuttering had reduced significantly. Pre-treatment (PRE) and post-treatment (POST) within-clinic audio-visual recordings of conversational speech were analysed for percentage of syllables stuttered, variability of vowel duration, articulation rate, and length and complexity of utterance. Four blinded listeners made perceptual judgments of speech quality in the POST recordings.Result: Recordings of all children showed that variability of vowel duration clearly reduced from the PRE to POST speech samples. Importantly, articulation rate and language use were not compromised. Some possible indicators of rhythmicity were identified in one child in the perceptual study.Conclusion: The findings suggest that STS was primarily responsible for the clinically significant reductions in stuttering after Stage 1 of the program. There is an urgent need for more evidence-based interventions for stuttering in this age group and further development of STS interventions is warranted.

The Complexity of Stuttering Behavior in Adults and Adolescents: Relationship to Age, Severity, Mental Health, Impact of Stuttering, and Behavioral Treatment Outcome.

PURPOSE: This study investigated the complexity of stuttering behavior. It described and classified the complexity of stuttering behavior in relation to age, behavioral treatment outcomes, stuttering severity, anxiety-related mental health, impact of stuttering, and gender. METHOD: For this study, a taxonomy was developed-LBDL-C7-which was based on the Lidcombe Behavioral Data Language of stuttering. It was used by five experienced judges to analyze the complexity of stuttering behavior for 84 adults and adolescents before and after speech restructuring treatment. Data were 3,100 stuttering moments, which were analyzed with nominal logistic regression. RESULTS: The complexity of stuttering behavior appears not to change as a result of treatment, but it does appear to change with advancing age. Complexity of stuttering behavior was found to be independently associated with clinician stuttering severity scores but not with percentage of syllables stuttered or self-reported stuttering severity. Complexity of stuttering behavior was not associated with gender, anxiety, or impact of stuttering. CONCLUSION: Clinical and research applications of these findings are discussed.

Further development and validation of the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS) scales: relationship to anxiety and social phobia among adults who stutter.

BACKGROUND: In an initial validation study, the Unhelpful Thoughts and Beliefs About Stuttering (UTBAS I) scale, demonstrated excellent psychometric properties as a self-report measure of the frequency of unhelpful cognitions associated with social anxiety for adults who stutter. AIMS: The aim was to further validate the original UTBAS I scale, and to develop two additional scales to assess beliefs (UTBAS II) and anxiety (UTBAS III) associated with negative thoughts. METHODS & PROCEDURES: A total of 140 adults seeking speech-restructuring treatment for stuttering completed the original UTBAS I scale, the newly developed UTBAS II and III scales, and self-report measures of psychological functioning. Participants also completed a first-stage screener for the presence of anxious personality disorder, and a diagnostic assessment to evaluate the presence of social phobia, according to criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) and the International Classification of Diseases (ICD-10). OUTCOMES & RESULTS: The mean UTBAS I score for the present sample did not differ significantly from the mean score reported in the original UTBAS I validation study. Convergent validity was confirmed by significant correlations between the UTBAS Total score and all anxiety-related measures. Discriminant validity was established by the absence of strong correlations between the UTBAS Total score and some of the self-report measures of unrelated constructs, although it was found to tap into the negative cognitions associated with depression and life problems. Approximately one-quarter of participants met criteria for a diagnosis of DSM-IV or ICD-10 social phobia (23.5% and 27.2% respectively), and nearly one-third met first-stage screening criteria for anxious personality disorder (30%). The mean UTBAS scores for participants who met criteria for these disorders were significantly higher than scores for participants who did not, confirming known-groups validity. CONCLUSIONS & IMPLICATIONS: The present study demonstrates the validity and utility of the UTBAS scales in assessing negative cognitions associated with speech-related anxiety among adults who stutter. Results also confirm previous evidence of a high rate of social phobia among adults who stutter, and reveal that the UTBAS discriminates between adults with and without social phobia. In terms of clinical applications, the UTBAS scales could be used to screen for indicators of social phobia among adults who stutter, and may prove useful in identifying negative cognitions which have the potential to impact treatment outcomes.