Impact of stuttering severity on adolescents' domain-specific and general self-esteem through cognitive and emotional mediating processes

Purpose: The theory that self-esteem is substantially constructed based on social interactions implies that having a stutter could have a negative impact on self-esteem. Specifically, self-esteem during adolescence, a period of life characterized by increased self-consciousness, could be at risk. In addition to studying mean differences between stuttering and non-stuttering adolescents, this article concentrates on the influence of stuttering severity on domain-specific and general self-esteem. Subsequently, we investigate if covert processes on negative communication attitudes, experienced stigma, non-disclosure of stuttering, and (mal)adaptive perfectionism mediate the relationship between stuttering severity and self-esteem. Methods: Our sample comprised 55 stuttering and 76 non-stuttering adolescents. They were asked to fill in a battery of questionnaires, consisting of: Subjective Screening of Stuttering, Self-Perception Profile for Adolescents, Erickson S-24, Multidimensional Perfectionism Scale, and the Stigmatization and Disclosure in Adolescents Who Stutter Scale. Results: SEM (structural equation modeling) analyses showed that stuttering severity negatively influences adolescents' evaluations of social acceptance, school competence, the competence to experience a close friendship, and global self-esteem. Maladaptive perfectionism and especially negative communication attitudes fully mediate the negative influence of stuttering severity on self-esteem. Group comparison showed that the mediation model applies to both stuttering and non-stuttering adolescents. Conclusion: We acknowledge the impact of having a stutter on those domains of the self in which social interactions and communication matter most. We then accentuate that negative attitudes about communication situations and excessive worries about saying things in ways they perceive as wrong are important processes to consider with regard to the self-esteem of adolescents who stutter. Moreover, we provide evidence that these covert processes also need to be addressed when helping adolescents who are insecure about their fluency in general. (C) 2015 Elsevier Inc. All rights reserved.