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EFFECT OF CLASSICAL CONDITIONING AND SEMANTIC GENERALIZATION
OF NOXIOUS STIMULATION ON THE RATIO OF SPEECH
DYSFLUENCIES OF NORMAL SPEAKERS
DISSERTATION
Presented to the Graduate Council of the
North Texas State University in Partial
Fulfillment of the Requirements
For the Degree of
DOCTOR OF PHILOSOPHY
By
Joseph Steven Pachman, B.A., M.A.
Denton, Texas
August, 19 78
Pachman, Joseph Steven, Effect of Classical Conditioning,
and Semantic Generalization of Noxious Stimulation on the
Ratio of Speech Dysfluencies of Normal Speakers, Doctor of
philosophy (Clinical Psychology), August, 1978, 76 pp., 2
tables, references, 152 titles.
The present study investigated a theory of the etiology
and generalization of stuttering behavior. The subjects were
24 male students at a medical center who responded to adver-
tisements requesting participation in a research project on
learning and heart rate. The age range of the subjects was
22-28 years, and the mean age was 22.8 years. Three stimulus
topic words were used in the present study. Two of these
words were semantically equivalent. The independent varia-
bles were the three words that the subjects were instructed
to discuss: neutral word condition, experimentally induced
noxious word condition, and word semantically equivalent to
the noxious word condition. The six dependent measures were
percentage of part-word repetitions, percentage of interjec-
tions, heart-rate beats per minute, electromyographic micro-
volts per minute, galvanic skin response ohms conductance
per minute, and self-report ratings of "state" anxiety.
Physiological assessment was conducted with a Grass Model 7B
polygraph. "State" anxiety measures were derived from a pre-
experimental questionnaire which requested the subjects to
rate the level of anxiety experienced while discussing each
of the topic words. In addition, all the subjects were admin
istered a paper-and-pencil "trait" anxiety test. The data
were analyzed with six separate,one-way, repeated measures
analysis of variance tests.
It was found that when a topical word was classically
conditioned to a noxious stimulus, individuals who discussed
the topic emitted a significantly greater percentage of part-
word repetitions than when they discussed an experimentally
neutral topic. The same effect was not found for a second
class of speech dysfluencies, interjections. Both these find-
ings were interpreted as supporting Brutten and Shoemaker's
(196 7) two-factor theory of stuttering which states that
classical conditioning is responsible for the production of
part-word repetitions, while instrumental avoidance condition-
ing is responsible for the production of interjections.
As predicted, heart rate and a self-report "state"
anxiety measure achieved significance in a pattern correspond-
ing to part-word repetitions. Two other measures of state
anxiety (galvanic skin response and frontalis electromyo-
graphic activity) did not reach significance, although the
results were in the predicted direction. The theory that
"trait" anxiety accounts for susceptibility of fluency failure
under emotional stress was not confirmed. The hypothesis
offered here (that part-word repetitions generalize along a
semantic dimension) received only tentative support. Pis-
cession of the results centered around the demonstration in
the present study of the need for multifaceted treatments
tailored to the individual learning histories of specific
stuttering behaviors, as well as molecular assessments of
stuttering prior to treatment.
TABLE OF CONTENTS
Page
LIST OF TABLES V
Dissertation
Introduction . . . . . . . . 1
Other Theories of Stuttering Noncontingent Stimulation Paradigms Semantic Generalization Physiological Assessments of Anxiety
Electromyographic Activity Galvanic Skin Response Heart Rate
Correlations Between Physiological Measures
Stuttering and Anxiety Stuttering and "State" Anxiety Stuttering and "Trait" Anxiety
Hypotheses
Method . . . 29
Subjects Apparatus Verbal Stimuli Materials Procedure
Training Session Measurement Session
Scoring System
Raters Verbal Measures
Results • • • • • • • . . * • i . . 34
Statistically Significant Hypothesized Findings Statistically Nonsignificant Hypothesized
Findings Nonsignificant Findings Not Explicitly
Hypothesized
iii
TABLE OF CONTENTS—Continued
Page
Corollary Findings
Discussion 38
Appendices . . . . . . 49
References . . . . . . . . . . . . 58
IV
LIST OF TABLES
Table Page
1. Scores on Five Measures of Anxiety on a Three-Step Induced Anxiety Task 36
2. Results of Repeated-Measures Analysis of Variance Tests Across Three Experimental Conditions . . . » . . . . . . . . . 58
v
EFFECT OF CLASSICAL CONDITIONING AND SEMANTIC GENERALIZATION
OF NOXIOUS STIMULATION ON THE RATIO OF SPEECH
DYSFLUENCIES OF NORMAL SPEAKERS
Researchers investigating the clinical disorder commonly
referred to as stuttering have recently begun to study the
phenomenon through the scientific application of experimental
principles of behavior analysis (Goldiamond, 1965? Martin &
Siegel, 1966; Shames & Sherrick, 1963). Unfortunately, not
all researchers have defined the specific verbal or nonverbal
behavior they proposed to manipulate. "Stuttering," "the
moment of stuttering," and "the moment of the stuttering
block" were defining terms which might have been too general
to enhance empirical investigation. More important, there
was considerable evidence that the verbal and nonverbal
behaviors that have been combined and labeled as "stuttering"
did not vary identically and therefore might not have been
unidimensional, A molar definition of stuttering may have
masked meaningful changes in molecular components.
That stuttering behavior acts as an operant, i.e., its
occurrence functions in accordance with the principles of
reinforcement, has not been unequivocably demonstrated.
Inconsistent results may have been due to the failure of
many researchers to employ a molecular definition which
specified the responses to be modified.
Researchers have found changes in the frequency of
stuttering as predicted by the principles of reinforcement
(Flannagan, Goldiamond, & Azrin, 1958; Goldiamond, 1965;
Martin & Seigel, 1966). Other investigators did not. Van
Riper (19 37), for example, found that when individuals were
informed that they would later receive a shock for every word
that they stuttered, stuttering increased. Frick (1955) also
found that the introduction of response-contingent shock
increased the frequency of stuttering. Frederick (1955)
obtained the same results in a similar experiment. Timmons
(1966) made the verbal stimulus "wrong" contingent upon the
"moment of stuttering" and found no change. Cooper, Cady,
and Robbins (1970) observed a reduction in stuttering when
either a negative, positive, or neutral stimulus was deliv-
ered contingently upon stuttering.
At first glance, the results seemed contradictory. As
Sidman (1960) and others have pointed out, when discrepancies
among the findings exist, one should look for differences in
methodology to account for those discrepancies. It appeared
that an outstanding methodological difference in both process
and outcome studies on stuttering was the manner in which the
behavior was defined.
In contrast, when researchers have employed an opera-
tional definition of stuttering, the frequency of occurrence
of certain behaviors, such as facial grimace, voice inflec-
tion, air inhalation, and interjection, have indeed changed
in accordance with the principles of reinforcement (Janseen
& Brutten, 1970; Oelschlaeger & Brutten, 1976; Starkweather,
19 71; Webster, 1969). However, two specific verbal behaviors,
part-word repetitions and prolongations, did not. For example,
Janseen and Brutten demonstrated that prolongations were not
directly affected by contingent stimulation. Webster found
that when head-jaw movements were contingently punished with
the verbal stimulus "wrong," there was a decrement in that
behavior; but, part-word repetitions evidenced no change when
similar stimulation was contingently applied. Starkweather
found no change in the frequency of occurrence of part-word
repetitions in the presence of response contingent stimula-
tion. These results suggested that part-word repetitions
and prolongations should not be conceptualized as operant
behaviors.
According to Brutten and Shoemaker (1967), stuttering
was the disintegration of fluent speech following stimulus
patterns that elicit "conditioned negative emotion." Condi-
tioned negative emotion was tantamount to what most authors
have labeled "conditioned emotional responses" (Brady & Hunt,
1955; Estes & Skinner, 1941). Brutten and Shoemaker hypothe-
sized that classical conditioning, or stimulus substitution
paradigm, resulting from the contiguous presentation of
conditioned and unconditioned stimuli, was responsible for
the production of stuttering, defined exclusively as an
increase in part-word repetitions and prolongations, This
definition of stuttering was consistent with Wingate's (1964)
research which suggested that part-word repetitions and pro-
longations were the only overt characteristics of stuttering
behavior upon which a universal definition could be based.
Brutten and Shoemaker did not suggest that classical con-
ditioning accounts for all behavioral acquisition in speech
dysfluency. They hypothesized that dysfluent verbal behaviors
(interjections, revisions, and whole-word repetitions), as
well as nonverbal concomitant behaviors (voice inflections,
air inhalations, and facial grimaces), were instrumentally
conditioned avoidance responses. That is, they are learned
as adjustive behaviors that are utilized to cope with the
noxious state produced by fluency failure. This hypothesis
was consistent with the position adopted by many writers
(Bloodstein, 1969; Van Riper, 1954; Wingate, 1964) that
instrumental activity occurs in the later course of the
development of stuttering and was not present at the onset
of the disorder. Bloodstein (1960) and Brutten and Shoemaker
(1967) suggested that clinically meaningful stuttering behav-
ior may occur despite the absence of instrumental responses.
Generally, the etiological belief system has been con-
sistent concerning stuttering and the choice of therapeutic
intervention. Thus, those who have accepted the theoreti-
cal position of Brutten and Shoemaker have usually attempted
to "desensitize" the various noxious stimuli (Adams, 1972)
or, more recently, have attempted to provide the stutterer
with some control over his autonomic functioning (Pachman,
Oelschlaeger, Hughes, & Hughes, 1978).
Other Theories of Stuttering
Since the advent of psychoanalysis, a variety of theories
have proposed that stuttering was a symptom rooted in unre-
solved, unconscious conflicts. Although differing slightly
in their emphasis, psychoanalytic theories of stuttering have
been offered by Coriat (1931), Barbara (1954), and Murphy and
Fitzsimmons (1960). These writers all hypothesized that stut-
tering was the result of faulty personality development. As
a result, the focus of these theories was shifted from the
behavior of stuttering to the stutterer himself.
Coriat (19 31) suggested that the stutterer was an indi-
vidual who fixated in the oral stage of development, generally
because of overindulgence or frustration during infant nurs-
ing. As a result, the individual continued to overindulge
in gratification, expressed as excessive verbal behavior.
He hypothesized that stuttering behavior provided the stut-
terer with perverted oral pleasures that were symbolic of
the sucking and biting reaction of the infant. In direct
contrast to the hypothesis that was tested in the present
investigation, Coriat explicitly argued that the anxiety
experienced by stutterers was not situation-specific.
Barbara (1954) has presented a detailed analysis of the
stutterer's personality by employing the concepts of Horney
and Adler. According to Barbara, the basis for the later
development of stuttering was established if the parents
behavior toward the child was characterized by either exces-
sive perfectionistic demands or by lack of consistent loving
care. He suggested that this manner of parenting often pro-
duced competing needs to comply, to avoid, or to behave
aggressively. Barbara hypothesized that because these needs
were incompatible with one another, ambivalence resulted and
anxiety was produced. He concluded that as speech was the
primary vehicle for the acquisition of interpersonal rela-
tionships, this ambivalence and anxiety was reflected as
verbal hesitancy, and ultimately, as stuttering.
Murphy and Fitzsimmons (1960) have presented a similar
theory based on Sullivanian interpretation of stuttering.
These authors hypothesized that a child initially stuttered
because of domination and rejection by significant others
and the consequent failure to integrate his/her self-concept.
They suggested that feelings of anxiety caused by this faulty
self-concept were responsible for the child being hesitant
in interactions with others. In verbal behavior, this inter-
personal hesitancy was reflected as stuttering. Murphy and
Fitzsimmons viewed stuttering as a "learned, nonintegrative,
self-defensive reaction to anxiety or fear of threatening
circumstances with which the person feels incapable of
coping" (p. 170). As such, their theory was generally in
accord with the theory examined in the present study.
Although the two theories differ somewhat in their focus,
one might expect identical predictions to be generated based
on either interpretation.
Psychodynamic theories of stuttering overlapped with, the
theory to be advanced here in that nearly all such theories
assumed that behavior developed as a result of experience or
learning, and that anxiety was quite often a basic tenet.
Within the context of psychodynamics, it was often assumed
that frustrating situations might lead to learned patterns
of behavior which were characteristic of personality predis-
positions (Fisher, 1970). However, psychodynamic theories
of stuttering have not often addressed the specific anteced-
ent conditions in the learning process or the parameters of
acquisition (Bloodstein, 1969, p. 40). A notable exception
was the theory advanced by Murphy and Fitzsimmons (1960).
Sheehan (1954) attempted an amalgamation of the psycho-
analytic and learning theories of stuttering. Employing the
conflict model of Dollard and Miller (1950), Sheehan viewed
stuttering as an approach-avoidance conflict, with the stut-
tering repetitions representative of the tenuous equilibrium
that existed between the drive to speak and the drive to
remain silent. According to Sheehan, this conflict gener-
ated anxiety, and stuttering was maintained by the anxiety
reduction that occurs following an instance of stuttering.
He stated that unconscious and nonspecific guilt was respon-
sible for the stutterer's drive to avoid speaking.
8
Theorists such as Froeschels (1943), Bluemel (1932), and
Van Riper (1954) have focused on the developmental changes
that occur in stuttering. These authors depicted the devel-
opment of stuttering as a disorder that was initially char-
acterized by simple, effortless repetitions—"primary
stuttering." They suggested that a "secondary" stage of
stuttering (consisting of physical effort, anxious anticipa-
tion, and,finally, fear or avoidance of specific words or
situations) was generated when the child was made aware that
the speech disorder was a social defect. This approach bore
considerable resemblance to Brutten and Shoemaker's (1967)
two-factor learning theory, if "secondary stuttering" was
seen as similar to "operant dysfluencies,"
Johnson (1942) proposed a semantic theory of stuttering
more readily incorporated into the theoretical framework
tested here. He hypothesized that stuttering was produced
by a parent's diagnosis of normal dysfluencies in the child s
speech as "stuttering." Thus, if dysfluency was followed
regularly by the use of the term "stuttering" and the impli-
cation of unacceptability, the individual would attempt to
avoid dysfluency. Although Johnson maintained that individ-
uals learned to stutter as a result of the anxiety caused
by negative reactions to dysfluent speech, he did not delin-
eate the type of learning involved in establishing the
relationship between the misdiagnosis of speech and stutter-
ing.
9
Various cybernetic models of stuttering proposed that
stuttering was a failure of the automacity of the speech
process. Lee's (1950) findings concerning the effects of
delayed auditory feedback spurred interest in the development
of perceptual theories of stuttering. He reported that when
normal speakers heard their own speech a fraction of a second
after it was spoken, their speech became disrupted. Under
these same conditions, Goldiamond (1965) noted that stutterers
learned to speak in a slow and fluent manner. The striking
similarity between certain aspects of stuttering and the
speech of normal speakers under conditions of delayed feed-
back led some writers (Soderberg, 1968) to hypothesize that
stuttering was the result of a disturbance in the feedback
loop that maintained the automatic flow of speech.
Martin (19 70) proposed a theory of stuttering that com-
bined the perceptual disturbance model with a signal detec-
tion theory (Green & Swets, 1966) which suggested that the
setting of an excessively stringent perceptual criterion
might have blocked the perception of a signal when the sig-
nal was weak and delayed the perception when the signal was
strong. With respect to a model of dysfluency, Martin
argued that the stutterer might initially have been overly
critical of unintelligibility in his/her speech. The result
of establishing an excessively stringent criterion of flu-
ency might have been a delay in the feedback loop which
resulted in the production of dysfluent speech similar to
10
the speech that occurred under conditions of delayed auditory
feedback.
Theories of stuttering that shifted the frame of refer-
ence in a physiogenic direction have been developed by West
(1958) and Eisenson (1958). West viewed the primary antece-
dent of stuttering as epileptiform seizures that produced
involuntary disruptions of the automatic control of speech.
Eisenson equated stuttering with a perseverative response
similar to the perseverative motor behavior sometimes estab-
lished by brain-injured individuals.
Literature on stuttering for the last 20 years has been
overwhelmingly behavioral in nature. In addition to the two-
factor learning theory advanced by Brutten and Shoemaker
(1967), a Hullian theory of stuttering has been detailed by
Sheehan (1958), and an orthodox operant theory by Shames
(1972). Despite a proliferation of behavioral research,
useful developments based on the behavioral/learning model
have proceded at a much slower pace than had been expected
(Van Riper, 1973). Lanyon (1978) suggested this was primar-
ily because the focus of research efforts has been on the
development of treatment technologies rather than on a basic
understanding of the disorder. A similar viewpoint was
expressed by Patterson (1975), who observed that many con-
temporary researchers in the field of stuttering seemed to
have made the implicit assumption that a complete theory of
human behavior was not a necessary prerequisite to the
11
development of a technology of behavior change. Lanyon con-
cluded that since a variety of unsuccessful treatment packages
for stuttering had been advanced, it was likely that a more
adequate theoretical understanding would be necessary before
a fully satisfactory treatment procedure could be developed.
Noncontingent Stimulation Paradigms
Few researchers have attempted to determine the effect
of noncontingent noxious stimulation on speech dysfluency.
Stassi (1962) introduced the word "wrong" continuously in a
spontaneous speech situation, and in other conditions, deliv-
ered it 0, 33, and 66% of the time, independent of the sub-
jects' responses. The word "right" was introduced in an
identical fashion to another group of subjects as a control
procedure. A significantly greater amount of dysfluency was
judged to have occurred when the noxious stimulation was con-
tinuously present than when it was absent or present only
part of the time. There was no change in fluency patterns
in the control group. Stassi suggested that the etiology of
stuttering was associated with the occurrence of noxious
stimulation in a manner akin to a "learned anxiety reaction"
(p. 361).
Brookshire (1969) introduced 95 decibel bursts of white
noise in the second of three consecutive reading periods.
He found that the frequency of part-word repetitions during
the experimental, or stimulated, period was significantly
higher than during the before and after unstimulated, control
periods.
12
Meyer (1972) introduced auditory stimuli previously
determined to be noxious into a spontaneous speaking situa-
tion with nonstuttering subjects. He found significantly
more part-word repetitions displayed by individuals in that
group than in a comparable nonstimulation group. Meyer lik-
ened the experimental conditions (which increased the fre-
quency of fluency failures) to those that existed at the
onset of stuttering.
The preceding three studies suggested that a malfunction
in the speech process can be produced by the introduction of
noxious stimulation into the speaking environment. While
classical conditioning may have occurred, this learning pro-
cess was not assessed. The following two studies, which
investigated a conditioning process, were more germane to
the present investigation.
Hill (1954) investigated the degree of dysfluency result-
ing from the classical conditioning of noxious stimulation
to a previously neutral stimulus in a spontaneous speaking
situation. The nonstuttering subjects were first instructed
to compose sentences for a series of six trials in the
presence of experimentally neutral lights. Subsequently,
those lights were paired with shock for a series of six
trials. Hill suggested that resultant speech was "quite
indistinguishable from what is generally termed stuttering"
(p. 302) . He also found that obtained electromyographic
levels "quite closely paralleled the measures of disorgani-
zation" (p. 302).
13
Savoye (1959) introduced a 10-second tone after each
minute and 50 seconds of a 1-hour reading session for control
and experimental nonstutterers. The tone had been previously
paired with shock for only the subjects in the experimental
group. He found that during the 10-second time periods which
preceded, were concurrent with, and immediately followed the
presentation of the tone alone,the experimental subjects dis-
played significantly more dysfluency than subjects in the
control group.
The results of the Hill (1954) and Savoye (1959) studies
suggested that certain initially neutral stimuli may have
become noxious to the point of disrupting the speech process.
One might have hypothesized that the words speakers used also
became noxious stimuli and, hence, resulted in speech disor-
ganization. This hypothesis was consistent with the early
findings of Johnson and Millsaps (19 37), in that a symbol of
past-word difficulty (i.e., a diagonal line) increased the
degree of dysfluency in a stutterer. Shumak (1955) stated
that the frequency of reported stuttering was significantly
correlated with the graded emotional reaction to various
speech stimuli.
Other studies which correspondedto the above findings
were discussed by Mahl (1956, 1959). He found that indi-
viduals displaying significantly greater judged anxiety
(both experimentally induced and occurring naturally) pro-
duced significantly more speech dysfluencies, Two of the
14
verbal categories which increased during these periods of
heightened arousal were "repetitions" and "stutters," the
latter defined as tantamount to prolongations. One class
of dysfluency which did not increase with anxiety was the
interjections—Mahl's "ah" category. He proposed the pro-
portion of "non-ah" disturbances in a sample of speech as a
meaningful anxiety index.
Geer (1966} compared a group of subjects who reported
becoming anxious during public speaking to a group who
reported remaining calm when speaking before others. The
subjects were all instructed to speak before a one-way screen
and were informed they would be observed. Analysis of the
speech samples revealed that the high-anxiety subjects demon-
strated a higher "non-ah" ratio.
Feldstein, Brenner, and Jaffee (196 3) asked psychother-
apy patients to discuss their presenting problems. Horowitz,
Weckler, Saxon, Livaudais, and Boutacoff (1977) requested
their subjects to describe four different experiences that
made them angry. In both the above studies, frequency of
speech disruptions was greater when the subjects were dis-
cussing arousing material. The results of these studies
and others (Dibner, 1956; Krause & Pilisuk, 1961) demon-
strated that increased speech disruptions were produced in
normal-speaking subjects when they were asked to speak of
unpleasant subjects.
15
Brutten and Shoemaker (1967) suggested that words and
topics were some of the conditioned stimuli associated with
speaking. Although originally neutral, speech-associated
stimuli could be classically conditioned by pairing with
noxious stimuli. The emitted conditioned emotional responses
to the speech-associated stimuli would result in speech dis-
organization and involuntary part-word repetitions. Inter-
jections, in contrast, were voluntary adjustive behaviors
that need not occur in the presence of noxious stimuli nor
be related to clinically significant stuttering behavior.
Semantic Generalization
The terms "semantic generalization" and "semantic condi-
tioning" have been applied to a variety of experimental
findings and have given rise to an abundance of theorizing
about language and other forms of symbolic behavior (Feather,
1965). Most semantic conditioning and generalization experi-
ments have confirmed the original findings of Razran (1939)
that when a word was used as a conditioned stimulus, the
conditioned response generalized along a dimension of seman-
tic meaning rather than along a dimension of phonetic or
physical similarity (Lerner, 1968).
Cofer and Foley (1942) did an early review of research
in this area and offered a theoretical analysis of verbal
behavior based on generalization of the conditioned response
along the dimensions of phonetic and semantic homogeneity.
They suggested that a conditioned response to a designated
16
word would generalize to synonymous words as well as homophon-
ous words, and hypothesized that this generalization might be
expected to include synonyms and homophones of the synonyms
and homophones, and so on.
Cofer and Foley (1942) adopted Hull's (19 39) theoretical
analysis of stimulus equivalence in explaining this phenome-
non. They viewed semantic generalization as follows:
Upon the pre-experimental conditioning of CSl. , .
CSn to Rx, each of these stimuli is also condi-
tioned to an implicit, fractional, kinesthetic rx,
which invariably occurs with each pre-experimental
reinforcement of Rx. In the later, experimental
situation, CSl is conditioned to Ry. But during
each reinforcement of this conditioning, CSl
evokes rx, the proprioceptive stimulation (sx)
from which also becomes conditioned to Ry. Now
when CS2 . . . CSn is presented alone for testing
mediated generalization, it will evoke rx, whose
sx will in turn elicit Ry. (p. 522)
Although this type of theoretical interpretation has
undergone major modification, it was nonetheless generally
representative of one of the two present—day interpretations
of semantic generalization (Maltzman, 1968). While Sousfield
(1961) provided a more sophisticated variation of this common-
reponse interpretation, the basic tenets remain the same.
17
Less explicitly stated than the above position was the
common-categorization interpretation of semantic generaliza-
tion. This view, favored by Razran (1949), Osgood (1953),
and Maltzman (1968), was cognitive in the sense that the
cardinal construct was a recognition of stimuli similarity,
as opposed to some fractional response. This position sug-
gested that the individual responded to a stimulus "as per-
ceived" rather than to some "pure" external stimulus (Mahoney,
1974).
Although many of the major theoretical issues have not
yet been resolved, there was general acceptance of the fact
that transfer of classically conditioned responses on the
basis of meaning existed. The original work was performed
in Russia in the 1930!s (Smolenskaya, 1934). The signifi-
cance of these early studies was difficult to evaluate due
to the then prevalent Russian practice of providing incom-
plete descriptions of methodology and of publishing only a
sampling of individual protocols (Hartman, 1968).
In Razran's (1939) first contribution to the area, four
words (style, urn, freeze, and surf) were presented on a
screen to three subjects who were either chewing gum, suck-
ing lollipops, or eating sandwiches. Tests for generaliza-
tion were begun after the second experimental session and
consisted of measuring salivation to generalization words:
style, fashion, earn, vase, freeze, chill, surf, and wave.
The mean salivation to the synonyms was 59% and to the
18
homophones 37%, leading Razran to conclude that verbal condi-
tioning was primarily semantic 'i.e., through meaning as
opposed to auditory similarity.
Riess (1940) replicated the Razran study and employed
the same set of words, but used the galvanic skin response
as the conditioned response. The results paralleled the
findings of Razran and led Riess to conclude that autonomic
activity was amenable to verbal conditioning. A generaliza-
tion of the heart rate response to rural words, following
the pairing of the word "cow" and electric shock has also
been demonstrated (Lacey & Smith, 1954; Lacey, Smith, &
Green, 1955).
Razran (1949) conditioned salivation responses to three
short sentences ("Poverty is degrading." 'Roosevelt will be
elected." "Socialism is desirable."). He found 41% to 63%
generalization to semantically equivalent sentences, but
only 19% to 39% transfer to sentences that negated the prop-
ositions,
Branca (1957) found significant transfer of the condi-
tioned response (galvanic skin response) from a word to a
related word--"freeze" to "chill," "brook" to "stream."
Mednick (1957) established a conditioned galvanic skin
response to the stimulus word "light" and found greater
generalization to the related words "dark," "lamp," heavy,
and "soft" than to the neutral word "square."
19
Lang, Geer, and Hnatiow (1963) presented subjects with
a series of verbal stimuli , some of which were followed by
electric shock. Subsequently, the subjects were administered
unreinforced verbal stimuli, distributed along a scaled
dimension extending from words similar to those shocked to
neutral words. Although galvanic skin response, heart rate,
and blood-volume changes were recorded, significance was
found for the generalized words only in the galvanic skin
response.
More recent work in the area has focused on methodo-
logical variables, such as reinforcement schedule (Cole &
Williams, 1968) and interstimulus interval (Anderson, 1967) ,
that might influence the degree of semantic generalization.
Feather (1965) suggested that a methodologically sound design
in the area of semantic generalization would include the
presentation of a neutral word which was not related phoneti-
cally or semantically to the conditioned stimuli, and a
balanced presentation of words. Maltzman (1968), in discus-
sing the considerable degree of response specificity which
exists in semantic generalization studies, proposed that the
choice of the conditioned response to be evaluated was an
important methodological consideration.
Cofer and Foley (1942), addressing themselves to the
relationship between semantic generalization and free associ-
ation techniques as a diagnostic method, offered a prophetic
suggestion in terms of the focus of the present investigation:
20
A suggestion may also be made as to the possible
importance of the mechanisms here described in the
case of emotional behavior. If a traumatic exper-
ience (to take a relatively simple example) be
accompanied by a chance event, e.g., the lighting
of a cigarette, a whole series of words may subse-
quently cause anxiety or fear (neurotic) behavior.
Thus, generalization would occur from "match" to
such words as "wedding," "marriage," "wedlock,"
and "nuptial." (p. 538)
Mowrer (1954), and more recently Staats (1972), hypothe-
sized that a central aspect of language was that the individ-
ual acquired a "repertoire" consisting of a large number of
words that become "emotional" stimuli, and that (through
classical conditioning) a word stimulus paired with an uncon-
ditioned stimulus which elicits a negative emotional response
would also come to elicit a negative emotional response.
Physiological Assessments of Anxiety
"Negative emotion," or anxiety, has been viewed as a
state of diffuse arousal following the perception of threat
in which the individual was unable to direct that arousal
into adaptive action for any of a variety of reasons (Szpiler
& Epstein, 1976). Schoenfeld (1950) defined anxiety as "the
relationship between the presentation of SI, after the S1-S2
operation has been sufficiently performed, and certain mea-
surable behavior changes" (p. 74), where SI is a neutral
21
stimulus and S2, a noxious one. Emotionality, or anxiety,
was often gauged by physiological measures which did not
have the limitations inherent in self-report data (Ax, 1953).
Electromyographic activity. Electromyographic activity
was chosen as an assessment device in acknowledgement of a
large body of evidence from therapies such as progressive
relaxation (Jacobson, 1938) and behavior therapy (Wolpe, 1958)
which attested to the therapeutic efficacy of muscle relaxa-
tion in anxiety-related disorders. There have also been
reports (Budzynski & Stoyva, 1972) that electromyographic
activity measured from the frontalis muscle was a highly
sensitive indicator of anxiety. In addition, recent evidence
suggests that electromyographic feedback may be an effective
clinical procedure for facilitating muscle relaxation and
inhibiting anxiety (Loboeuf, 1977). Feedback has typically
been provided from the frontalis muscle because relaxation
to that muscle has been found to aid generalization to other
muscle groups (Loboeuf, 1977).
Sainsbury and Gibson (1954) stated that they were able
to differentiate nonanxious and anxious groups, diagnosed on
the basis of anxiety symptoms, by means of higher electromyo-
graphic levels in the frontalis muscle of the anxious group
during resting states. Similar results differentiating non-
anxious and anxious groups by means of electromyographic
activity have been reported (Malmo, Shagass, & Davis, 1954;
Malmo & Smity, 1955). Ax (1953) found significantly higher
22
levels of frontalis muscle tension in normal subjects under
the highly arousing condition of threat of shock. Hill (1954)
found heightened electromyographic levels under conditions
of experimentally induced anxiety during speech.
Galvanic skin response. Researchers who have used gal-
vanic skin response to measure anxiety have typically either
placed normal subjects in an anxiety-evoking situation or
have placed preselected subjects in contact with an idiosyn-
cratically feared object. Katkin (1965) found significantly
increased galvanic skin response activity during anticipation
of shock in normal subjects. Fenz and Epstein (196 7) demon-
strated that novice parachutists showed a gradient of galvanic
skin response activity which increased as the moment of the
jump approached, and to words which were increasingly associ-
ated with parachuting in a word-association test. Ax (1953)
also found a significantly higher level of galvanic skin
response activity in normal subjects under the highly arous
ing condition of threat of shock.
Heart rate. Several investigators have demonstrated a
relationship between heart rate and anxiety. Ax (1953) found
significant increases in heart rate under a condition of
anticipated shock. Zeaman and Wegner (1954) paired a shock
and a tone, and found that during the period between the pres-
entation of the tone and the shock (anxiety period), the con-
ditioned response appeared as an acceleration in heart rate.
Gaebelein, Taylor, and Bader (19 74) found a significant
23
increase in heart rate of male undergraduates who viewed a
clock for 6 minutes while waiting to receive an electric
shock. This relationship between heart rate and threat of
shock has been confirmed in other studies (Obrist, 1974,
Snortum & Wilding, 1971; Watts, 1975).
Lader and Mathews (19 70) examined three cases of spon-
taneous panic attacks. They determined that in all three
cases, the pulse rate increased a minimum of 40 beats per
minute. Bridges, Jones, and Leak (1968) found that anxiety
associated with academic expectations resulted in significant
increases in heart rate.
Patients suffering from chronic anxiety exhibited sig-
nificantly higher basal levels of heart rate than did all
other groups of psychiatric patients (Kelly, Brown, & Shaffer,
1970; Kelly & Walter, 1968). Gatchel and Proctor (1976)
found that learned control of heart rate significantly reduced
the physiological, verbal, and overt-motor components of pub-
lic speaking anxiety.
Correlations between physiological measures. Intercor-
relations among physiological measures obtained under "anxious
states tend to be either low or insignificant, although
workers such as Gelhorn (1964) have pointed to an association
of somatic and automatic processes due to parallel changes
that occur in sympathetic discharges and muscle activity.
Lacey, Pateman, and Van Lehn (1953) found that although indi-
viduals were consistent over different stressors, they had
24
different patterns of autonomic responsitivity over time.
These findings did not render the psychophysiological moni-
toring of "anxiety" prohibitive. Although several autonomic
measures increased under anxiety-arousing circumstances,
those measures which reflect the greatest or smallest increase
may vary across people (Martin, 1961).
Those researchers (Bridges, Jones, & Leak, 1968) who
have simultaneously assessed more than one physiological
concomitant of anxiety, generally confirmed the findings of
Lacey, Pateman, and Van Lehn (1953) that there were varia-
tions across subjects and consistency within subjects in
terms of patterns of autonomic responsiveness, Watson, Grand,
and Marks (1972) found skin conduction fluctuations, heart
rate, and subjective anxiety ratings to be significantly
greater during phobic imagery than during neutral imagery
prior to treatment. Jordan and Sipprelle (1972) reported
significant increases in heart rate and galvanic skin activ-
ity during conditions of experimentally "induced anxiety.
Mathews and Gelder (1969) trained 14 patients in muscu-
lar relaxation, and then conducted physiological assessments
following relaxation training and during a control session.
They found that electromyographic activity from the frontalis
muscle and also skin conductance were significantly lower
during the relaxation condition. Skin conductance activity
correlated most highly with self—assessments of anxiety.
Hyman and Gale (1973) reported a significant agreement between
25
galvanic skin response activity and anxiety ratings for sub-
jects during systematic desensitization.
Stuttering and Anxiety
Historically, stuttering behavior has been associated
both experimentally and clinically with anxiety (Gray &
Harmen, 1967). Wolpe (1969) concluded that anxiety was a
determinant of most stuttering. Bloodstein (1969) suggested
that the concept of anxiety was the cornerstone of nearly all
psychogenic theories of stuttering.
Several investigators (Johnson & Speilberger, 1968;
Speilberger, 1966) emphasized the necessity in anxiety research
for distinguishing between two different constructs, "state
anxiety and "trait" anxiety. According to Johnson and
Speilberger, "A-state" was a transitory condition of tension
which was a reaction to, and dependent upon, a specific stress.
In contrast, "A-trait" was stable over time and was predictive
of the extent to which individuals were prone to manifest
"A-state" under conditions of stress. Employing the Affect
Adjective Check List (Zuckerman, 1960) as a measure of state
anxiety, Korn, Ascough, and Kleeneier (19 72) experimentally
supported the theoretical state-trait position of Johnson
and Speilberger. Here, high trait-anxious individuals were
viewed as prone to considerable anxiety during personally or
universally stressful situations, but were similar to low-
trait anxiety individuals in nonstressful situations.
26
Mischel (196 8) criticized the concept of trait anxiety
because it could lead to reification and was often based on
self-reports only minimally correlated with overt behavior.
Although "states" were hypothetical constructs, as were
"traits," "state" measures were overt responses of interest
in themselves,whereas "trait" measures may have simply
reflected self-labeling habits or retrospective accounts of
past states. Measures of trait were of heuristic value inso-
far as they could predict responses (Zuckerman, 1976). For
example, Fenz and Dronsejko (1969) found that subjects rated
as high trait-anxious reacted to stress with autonomic exci-
tation, but low trait-anxious subjects demonstrated autonomic
inhibition under the same conditions.
Stuttering and "state" anxiety. Most researchers who
have examined the relationship between stuttering behavior
and state anxiety (Ickes & Pierce, 19 73; Kasl & Mahl, 1965;
Walker & Walker, 1973) have focused on the physiological cor-
relates of dysfluency. For example, Kasl and Mahl (1965)
discovered a significant relationship between the number of
disruptions in speech and skin perspiration, the latter
increasing with the number of disruptions, Greenlaw (1970)
found that stutterers averaged 9 heart beats per minute more
than normals during both oral reading and spontaneous speak-
ing. Walker and Walker (19 73) reported stutterers to be more
subject than nonstutterers to autonomic nervous system arousal
under conditions of experimentally induced stress, Ickes and
27
Pierce (1973) reported a significant increase in vasoconstric-
tion as stutterers approached words on which they stuttered.
They concluded that "the data would seem to give evidence of
anxiety for the stutterer as he approached a word on which
he was nonfluent" (p. 16 3).
Stuttering and "trait" anxiety. There are only a few
references to the concept of "trait" anxiety in the literature
on stuttering. Moreover, there is an absence of prospective
reports investigating the relationship between trait anxiety
and dysfluency in specific states. Boland (1953) found a
higher level of trait anxiety in stutterers than in nonstut-
terers as measured by the Taylor Manifest Anxiety Scale
(Taylor, 1953). According to Ingham and Andrews (1968),
Brutten and Shoemaker's (1967) theory of stuttering implied
that "A-trait" accounted for the original susceptibility of
certain individuals to fluency failure under emotional stress
—i.e., the probability that an individual would become a
stutterer was determined by his or her "conditionability"
under conditions of "negative emotion," or "A-state" anxiety.
Hypotheses
The global hypothesis examined in the present study was
that stuttering behavior could be elicited consistent with
Brutten and Shoemaker's (196 7) classical conditioning theory,
with the adjunctive proposition that the emitted ratio of
part-word repetitions and concomitant "state" anxiety measures
would generalize along a gradient of semantic similarity.
28
Accordingly, the following hypotheses were tested.
1. There will be more heart rate, galvanic skin
responses, electromyographic activity, and self-reported
"state" anxiety generated in the presence of classically
conditioned noxious topics than in the presence of topics
that are semantically equivalent to the noxious topics and
topics that are neutral.
2. There will be more heart rate, galvanic skin
responses, electromyographic activity, and self-reported
"state" anxiety generated in the presence of topics that
are semantically equivalent to classically conditioned
noxious topics than in the presence of neutral topics,
3. There will be a higher rate of part-word repeti-
tions to total word count in the presence of classically
conditioned noxious topics than in the presence of topics
that are semantically equivalent to noxious topics and
topics that are neutral.
4. There will be a higher ratio of part-word repeti-
tions to total word count emitted in the presence of topics
that are semantically equivalent to classically conditioned
noxious topics than in the presence of neutral topics»
5. If the total group of subjects is divided in half
on the dimension of trait anxiety scores, then the "high"
trait—anxious subjects will demonstrate a significantly
higher ratio of part—word repetitions in the presence of a
classically conditioned noxious topic than the "low" trait-
anxious subjects.
29
Method
Subjects
The subjects were 24 male students at a medical center
who responded to advertisements requesting participation in
a research project on learning and heart rate. The age range
of the subjects was 22-28 years, with a mean age of 23.8
years. Each subject was paid $2.50 for approximately 75
minutes of participation.
Apparatus
A portable cassette tape recorder was used to record
verbal behavior. Physiological assessment was conducted with
a Grass Model.7B polygraph (Grass Instrument Company). In
addition to four 7DAE Driver Amplifiers, this unit included
a 7P33 Wide Band Pre-Amplifier interfaced with a 7P10 Inte-
grator (EMG component), a 7P1B Low Level Pre-Amplifier (GSR
component), and a 7P4D EKG Tachograph Pre-Amplifier.
A Kodak Carousel 800 projector was used to project words
of approximately 3 X 2 inches on a screen, A LVE III—10
Carousel Control Panel (Lehigh Valley Electronics Company)
was used to coordinate the timing of the carousel projection
and faradic shock. The shock was delivered via a GSC 700
Shock Generator (Grason-Stadler Company).
The following were employed to coordinate the presen-
tation of the various stimuli: a Lehigh Valley LVE 2 35-11
Porbability Gate, a LVE 411-04 counter, two BRS Ti-903 timers
30
(Foringer Company), a BRS Pc-90 3 Pre-Determined Counter, a
GSC E11Q0H timer, a GSC 784 timer, and a 116 GSC Relay Panel.
Verbal Stimuli
The stimulus topic words were book, river, and lake.
The latter two words are semantically equivalent (Palermo &
Jenkins, 1964). All three words are roughly equivalent in
terms of "meaningfulness" as gauged by Thorndike and Large's
(1943) word frequency count. The word "river" served as the
stimulus to be classically conditioned, and "lake" the stim-
ulus for generalization for 12 subjects. The words were
given reverse functions for the other 12 subjects.
Materials
Each subject signed an informed consent form prior to
the onset of the experiment (see Appendix A). All the sub-
jects were administered a Multiple Affect Adjective Check
List (Zuckerman & Lubin, 1965) to assess "trait" anxiety
(see Appendix B). In addition to asking the subjects to
indicate the purpose of the study, a postexperimental ques-
tionnaire had subjects rate the level of pain induced by the
shock and rate the level of anxiety experienced while dis-
cussing each of the topics (see Appendix D).
Procedure
Training session. The experimenter met with each sub-
ject individually. He provided all participants with an
explanation of the function and safety of the equipment being
employed. The informed consent form was then discussed and
31
signed by all subjects. Those who asked about the specific
purpose of the study were informed that such matters would
be discussed following completion of the experiment.
Each subject was tested individually and seated in a com-
fortable recliner 3 feet from electrical and ground sources.
The experimental room was dimly lit, air—conditioned, and
lead-insulated. The participants faced a projection screen.
Two electrodes were attached to the surface of the right fore-
arm 2 centimeters apart. The experimenter provided verbal,
procedural instructions (see Appendix C, Part I) and retired
to an adjoining, sound-insulated room connected to the exper-
imental room via a two-way mirror.
The experimenter projected one of two semantically
equivalent words (designated to be the conditioned noxious
topic) to a screen 6 feet in front of the subject. This
occurred 20 times at randomly varied intervals of 30 and 60
seconds. Half the times the word was present, it was fol-
lowed .5 second later by a faradic shock of ,5 second dura-
tion and 4 milliamps intensity. The 10 pairings of shock
were randomly generated for each subject. For the 10 pres-
entations without shock, the stimulus word was present for
.5 second and removed.
Measurement session. Immediately after the training
session, the experimenter returned to the experimental room
and provided all subjects with the next set of verbal, pro-
cedural instructions (see Appendix C, Part II), During this
32
time, the subjects' foreheads and fingers were gently swabbed
with alcohol. Three electrodes were placed approximately 1
inch above the participants1 eyebrows. The two active elec-
trodes were placed approximately 4 inches apart and above
each eye, the ground electrode between them and centered
above the nose, A ground electrode was attached to the right
calf, an active electrode to the left calf, and the other
active electrode to the left forearm. Two galvanic skin
response electrodes were treated with electrode cream and
attached to the second and third fingers of the left hand.
Finally, a microphone was secured around the neck.
Each of the three words (neutral, noxious, or semantic
equivalent) appeared on the screen, one at a time, for 5
minutes. The order of presentation of the three topic words
was counterbalanced across subjects. Two subjects were ran-
domly assigned to each of the 12 possible word-order combi-
nations. The subjects were instructed to discuss each topic
for 5 minutes. The experimenter remained in the adjoining
room during this time, operating the tape recorder and moni-
toring the physiological recording equipment.
Finally, each subject was released from the equipment
and administered the Multiple Affect Adjective Check List
"trait" anxiety test (Zuckerman and Lubin, 1965) and the
postexperimental questionnaire. Each was subject was then
debriefed, instructed to refrain from discussing the pro-
ceedings with anyone, cordially thanked, and paid.
33
Scoring System
Raters. The number of part-word repetitions, interjec-
tions , and total word frequency per 5-minute interval was
assessed by two experimentally blind raters. At the conclu-
sion of each session, the experimenter dubbed a code letter
before each of the three 5-minute periods. In addition, the
experimenter rolled a die, once for each subject. The number
which appeared signified the segment of the tape that was
assigned to the second rater for the purpose of providing a
reliability check. For example, if the number "2" appeared
first, this indicated that the semantic equivalent segment
of the tape designated by code letter would be employed in
the reliability assessment.
Verbal measures. A part-word repetition was defined as
the acoustically perceived reproduction of a single phoneme
or combination of phonemes represented only once in a written
word and not comprising a complete syllable of the written
word nor the whole word itself. This definition excludes
whole-syllable repetitions and whole-word repetitions, with
the exception of "A" and "I" (Oelschlaeger & Brutten, 1976).
An interjection was defined as an acoustically perceived
extraneous sound such as "uh," "er," or "hmmm"~and extrane-
ous words such as "well," which are distinct from sounds and
words associated with the fluent text or with phenomena
included in other categories. An instance of interjection
may include one or more units of the repetition of the
34
interjected material. For example, "er" and "er er er will
each be counted as one instance of interjection (Johnson,
1961, p. 3).
To achieve a dysfluency measure independent of verbal
output, the Speech Disturbance Ratio (Mahl, 1956) was used,
which equaled the quotient of the number of designated speech
dysfluencies divided by the total number of words spoken.
Results
Independent variables are the three experimental condi-
tions: neutral word, noxious word, and word semantically
equivalent to the noxious word (hereafter semantic equivalent)
The six dependent measures are: percentage of part-word
repetitions, percentage of interjections, heart—rate beats
per minute, electromyograph microvolts per minute, galvanic
skin response ohms conductance per minute, and self-report
ratings of "state" anxiety. Significance is evaluated with
six separate,one—way, repeated measures analysis of variance
tests. No significant (£ > .05) main effect is found for
the order of presentation of the three experimental condi-
tions. The results of Cochran's test reveals that the
assumption of homogeneity of variance is satisfied for all
six analyses. The raw galvanic skin response data (ohms of
resistance) is logarithmically transformed to ohms of con-
ductance.
35
Statistically Significant Hypothesized Findings
Table 1 presents scores for all hypothesized comparisons.
(See Appendix E and Appendix F for more specific statistics.)
The analysis of variance of heart-rate beats per minute
reveals a significant condition effect, F (2, 23) = 9.57,
p < .05. Newman-Keuls comparisons reveal a significantly
(p < .05) higher heart rate in the noxious condition than in
the neutral condition. The Neuman-Keuls comparison of the
noxious-word condition versus the semantic-equivalent condi-
tion, as well as the neutral-word condition versus the seman-
tic-equivalent condition, reveals no significant differences.
The order of the means is in the predicted direction, i.e.,
noxious > semantic equivalent > neutral.
A significant condition effect, F (2, 23) = 5,46, p < .05,
is also obtained on the analysis of variance test for the
part—word repetition measure. Neuman—Keuls comparisons indi-
cate that a significantly (p < .05) larger percentage of
part—word repetitions are emitted in the noxious condition
than in the neutral condition. Neuman-Keuls comparisons of
the noxious-word condition versus the semantic-equivalent
condition, and the neutral-word condition versus the seman-
tic-equivalent condition, reveal no significant differences.
The order of the means is, again, in the predicted direction,
i.e., noxious > semantic equivalent > neutral.
The analysis of variance test conducted on the self-
report ratings of state anxiety reveals a significant
36
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37
condition effect, F (2, 23) - 8.22, p < .05. Neuman Keuls
comparisons indicate that the subjects rate themselves as
being significantly more anxious in the noxious-word condi-
tion than in the neutral-word condition. Again, Neuman-Keuls
comparisons reveal no significant differences between the
noxious-word condition versus the semantic-equivalent condi-
tion, and the neutral-word condition versus the semantic-
equivalent condition. The self-report anxiety measure also
places the means of the three experimental conditions in the
predicted direction, i.e., noxious > semantic equivalent >
neutral.
Statistically Nonsignificant Hypothesized Findings
The analyses of variance on the galvanic skin response
measure and the electromyograph measure reveal no statisti-
cally significant findings at an alpha level of .05. However,
as seen above, the order of the electromyograph and galvanic
skin response means is in the predicted direction, i.e.,
noxious > semantic equivalent > neutral.
There is no significant difference on part-word repeti-
tions in the noxious condition between the 12 subjects with
the highest Multiple Affect Adjective Check List trait anxi—
iety scores and the 12 subjects with the lowest trait
anxiety scores (t = .41, p > .05). A Pearson product-moment
correlation between the trait anxiety scores and part-word
repetitions is not significant (r = .28, p > .05).
38
Nonsignificant Findings Explicitly Not Hypothesized
The analysis of variance on interjections reveals no
significant results at an alpha level of .05, This indicates
a lack of any condition of difference on this speech dysflu-
ency measure.
Corollary Findings
An interrater reliability check on the two verbal dys-
fluency measures reveals a Pearson product-moment correlation
of .83 (p < .01) for the part-word repetitions measure and
.85 (p < .01) for the interjections measure. Further analy-
sis of the data provided by the postexperimental questionnaire
indicates the mean scaled rating of the degree of pain induced
by the faradic shock is 4.3, or about midway between "not at
all painful" and "very painful," The postexperimental ques-
tionnaire indicates that none of the subjects is aware of
the purpose of the study.
Discussion
Results confirm the primary hypothesis that if a topic
word is classically conditioned to a noxious stimulus, normal
males will emit part-word repetitions while discussing the
conditioned topic. Results offer only partial support for
the second hypothesis that part-word repetitions would gen-
eralize to topics semantically equivalent to the conditioned
topic, but not to topics semantically unrelated. There is
no significant difference in the percentage of dysfluencies
emitted while discussing the semantically equivalent topic
39
compared to either the noxious or neutral topics. However,
the order of the means is in the predicted direction, i.e.,
noxious > semantic equivalent > neutral.
There are no significant differences between the percent-
age of interjections emitted while discussing the noxious,
neutral, or semantically equivalent topics. This finding
is consistent with the hypothesis based upon Brutten and
Shoemaker's (1967) theory that interjections are not present
in the initial development of stuttering. This is also con-
sistent with Mahl's (1956, 1959) findings that individuals
displaying more judged anxiety emit a greater precentage of
repetitions (part—word repetitions) but do not emit a greater
percentage of interjections.
The hypothesis implied by Brutten and Shoemaker (1967)
that trait anxiety accounts for the original susceptibility
of fluency failure under emotional stress (Ingham & Andrews,
196 8) is not confirmed. This finding is quite consistent
with a number of studies (Bowles, 1974; Cowan, 1968; Mandell,
1969) reporting that paper and pencil measures of trait
anxiety are not related to physiological (galvanic skin
response) conditionability.
Differential,state-anxiety reactions cannot be predicted
with nonsituational, unidimensional trait measures. However,
using a situational specific anxiety trait measure congruent
with the particular stress situation, state anxiety reactions
can be predicted (Kendall, 1978). The Multiple Affect
40
Adjective Check List employed in the present study to assess
trait anxiety is an example of a nonsituational, unidimen-
sional test, The failure here to find differential respon-
siveness to a stress based on trait anxiety scores may be
reflective of the lack of fidelity of this predicting instru-
ment.
As predicted, a significant effect is found for heart
rate in a direction parallel to the emitted percentage of
part-word repetitions. Although no significant effects are
found for electromyograph or galvanic,skin-response measures,
they proceeded in the hypothesized direction in terms of both
conditioning and generalization.
Because the galvanic skin response is an extremely sen-
sitive measure, it is subject to confounding methodological
artifacts, particularly hand movements (Lader, 1975). Despite
instructions to restrict their body movements, subjects were
observed to be engaging in habitual hand gestures while
speaking. Feather (1965), pointing to the controversy over
the general validity of the galvanic skin response in seman
tic generalization studies, suggests that "except when the
GSR is itself the phenomenon of interest, other response
measures would seem to be preferable" (p. 437).
The lack of statistical significance across the experi-
mental conditions in the electromyographic measure might be
reflective of a gender-specific variable. Males tend to
respond to the threat of shock with changes in the autonomic
41
sphere, while women more often respond with changes in the
muscles (Liberson & Liberson, 1975). In the present study,
the subject sample is exclusively male.
The unequal distribution of stutters in an approximately
3:1 male to female ratio has been well established (Louttit &
Halls, 1936; Schlinder, 1955). Attempts are made to explain
this phenomenon in terms of the different ways in which par-
ents might react to the dysfluencies of male as opposed to
female offspring (Johnson, 1959). However, there is no
empirical evidence to support this or any other hypothesis
regarding the unequal sex ratio (Bloodstein & Smith, 1954).
Bloodstein (1969) states this conclusion regarding the sex
distribution: "It would be difficult to think of a theory
of stuttering that could not easily be reconciled with it"
(p. 84) .
It is instructive to compare the present findings (a
correspondence between heart rate and stuttering) and a con-
comitant lesser correspondence between stuttering and muscle
tension (Liberson and Liberson, 1975). When compared, a
sex-linked physiological difference in response to noxious
stimulation is suggested as a possible explanation for the
unequal sex ratio among stutterers. A more definitive
resolution of this hypothesis might be achieved when the
present experimental procedures are extended to a female
population.
42
In the present study, the subjects' quantified self-
report anxiety ratings of the noxious words are significantly
higher than the ratings of the neutral words, as was predicted.
There is no significant difference between the ratings given
for the semantically equivalent words and either the neutral
word or the noxious word. This pattern parallels the findings
of the heart-rate response measure as well as the emitted
percentage of part-word repetitions. This agreement between
cardiac rate and subjective ratings of anxiety is consistent
with the findings of Watts (1975). The lack of correspondence
between the galvanic skin-response scores and the anxiety
ratings is at odds with the findings of Hyman and Gale (1973),
who report significant agreement between the two measures.
The lack of correspondence between the frontalis electromyo-
graphic scores and the self—report anxiety ratings is con-
sistent with previous findings (Lader & Mathews, 1970),
There is no significant difference between the percent-
ages of part-word repetitions emitted while discussing the
semantically equivalent topic and the neutral topic. This
might be due, in part, to the limited power of the analysis
with a relatively small sample of subjects and the stringency
of the Neuman-Keuls post-hoc test employed (Winer, 1971).
However, it should be noted that the order of the means of
the part-word repetitions is in the predicted direction,
i.e., noxious > semantic equivalent > neutral. Also, there
is no significant difference between the percentage of
43
part—word repetitions emitted while discussing the noxious
topic and the semantically equivalent topic. A reasonable
statement of these findings might be that although the results
do not unequivocably support the occurrence of semantic gen-
eralization of part-word repetitions, the existence of the
phenomenon is implied by the data.
The general implication of the results of the present
study is the therapies will be appropriate that specifically
attempt to lessen the heightened autonomic reaction of the
stutterer to troublesome topics. This is consistent with
the relative therapeutic success with stutterers that has
been enjoyed by relaxation-based procedures such as systema-
tic desensitization (Adams, 1972; Barugraff, 1974; Rosenthall,
1968; Tyre, 1973) and also biofeedback {Lanyon, Harrington,
& Newman, 19 76; Pachman, Oelschlaeger, Hughes, & Hughes,
1978) .
It is important that this clinical hypothesis be viewed
in the proper perspective. While the present findings do
implicate heightened autonomic arousal as a causal factor in
speech dysfluency, this does not necessarily suggest that
autonomic arousal is the only active agent in the sequence.
For example, based on the present findings, one cannot rule
out the possibility that heightened autonomic activity results
in increased laryngeal muscular tension and that this tension
is responsible for difficulty with speech. If this is the
actual depiction of the process, then investigators who focus
44
their efforts directly on this alleged muscle tension could
be on target (Hanna, Wilfling, & McNeil, 19 75).
There are immediate applications for the suggestion
that part-word repetitions experimentally made to occur while
subjects discuss classically conditioned noxious topics can
generalize to topics that are semantically equivalent.
Important methodological considerations for systematic desen
sitization therapy with stutterers are implied. Systematic
desensitization is based on the notion that since an individ-
ual cannot be anxious and nonaroused at the same time, the
learned anxiety response to a stimulus can be modified by
arranging events so that the noxious stimulus is presented
(often imaginally) at a time when the anxiety response can-
not occur (Wolpe, 1958). Arousal or feared stimulus classes
are arranged into graded hierarchies so that the stressful
stimuli that are initially presented to the individual are
mild enough to allow the relaxation response to effectively
prevent discomfort.
Therapists who treat stutterers with systematic desen-
sitization procedures typically construct graded hierarchies
based on spatial dimensions—the degree of dysfluency reported
in different situations, such as talking on the telephone or
talking to a large group of people, for example (Burgraff,
1974) ,
An alternative strategy is suggested. Therapists might
conduct an assessment of troublesome words or topics via
45
either designated oral reading or samples of spontaneous
speech. The next step might be to generate words or topics
that are semantically similar and to physiologically assess
the degree to which they arouse the client. Based on the
present findings, it is recommended that heart rate might be
a meaningful assessment measure in these instances. Hier-
archies would then be constructed based on a semantic dimen-
sion, ordered from least arousing and semantically dissimilar
to maximally arousing and semantically similar. The efficacy
of employing semantic as opposed to spatial hierarchies in
systematic desensitization therapy with stutterers needs to
be empirically evaluated.
The finding that two different classes of dysfluency
(part-word repetitions and interjections) do not have the
same learning histories, also has some important clinical
implications. First, the need is indicated for molecular
assessment of stuttering prior to treatment. Second, multi-
faceted treatments should be explored tailored to the indi-
vidual learning histories of specific stuttering behaviors.
In this regard, further research needs to be conducted aimed
at delineating the operations and interrelationships of the
different verbal and nonverbal stuttering behaviors.
Although the present findings are primarily interpreted
as supporting a cognitive-behavioral model, the results can
also be discussed in terms of other theoretical vehicles,
For example, based on Barbara's (1954) Adlerian theory of
46
stuttering, one might propose that the uncertainty subjects
experienced (as to whether a shock was forthcoming on a par-
ticular trial) might have produced ambivalence regarding the
noxious topic. The experimental situation in which a word
was followed 50% of the time by shock and 50% of the time by
no shock might be likened to the inconsistent parental pat-
tern that simultaneously demands compliance, avoidance, and
aggression. According to Barbara, this mode of parenting
results in ambivalence, produces anxiety, and is often
reflected as verbal uncertainty and general dysfluency.
Martin's (1970) perceptual disturbance theory might pre-
dict that the reactivity of being a subject in a study might
have caused the participants to establish an excessively
stringent criterion of fluency. In an attempt to avoid the
part-word repetitions produced as a result of this perceptual
stringency, the subjects might have attempted to avoid stut-
tering by setting a still more conservative criterion.
Martin's theory predicts that this strategy would result in
more delay in the feedback loop, speech-related anxiety, and
the production of more stuttering.
Results of the present study also seem reasonable in
the semantic framework proposed by Johnson (1942), who main-
tained that individuals learn to stutter as a result of the
anxiety caused by the negative reactions of others to aspects
of a person's speech. The present situation in which certain
words are at times followed by the delivery of faradic shock
47
might be an experimental analogue to the pairing of spoken
words with the aversive negative reactions of other people.
Finally, Murphy and Fitzsimmon's (I960) Sullivanian
theory of stuttering can be employed to interpret the present
findings. The experimental procedure of delivering shocks
that are not contingent on any response put forth by the sub-
ject may produce a temporary change in the individual's self-
concept (the covert verbal behavior that a person uses to
evaluate his or her own behavior). For example, the subjects
in the present study may have been expected to ask themselves,
"What am I doing wrong that is responsible for my getting
shocked?" or "Why was I so foolish as to participate in a
study like this in which I get shocked?" Murphy and
Fitzsimmons view stuttering as a self-defensive reaction to
anxiety caused by a weakened self-concept or a series of
threatening circumstances in which the individual feels
incapable of coping. The present experimental procedure of
delivering noncontingent, unavoidable shock is certainly an
example of a threatening situation which is difficult to cope
with effectively and impossible to avoid or terminate.
In summary, the present study investigates the etiology
and progression of stuttering behavior. Results indicate
that when a topic is classically conditioned to a noxious
stimulus, normal-speaking males increased the percentage of
part-word repetitions they emitted while discussing the topic.
The same effect is not found for a second class of speech
48
dysfluencies—interjections. Both these findings support
Brutten and Shoemaker's (1967) two-factor theory of stutter-
ing. The hypothesis implied in Brutten and Shoemaker's theory
that "A-trait" anxiety accounts for the original susceptibil-
ity of fluency under emotional stress is not confirmed. The
hypothesis that part-word repetitions generalize along a
semantic dimension is not equivocably supported, although
the data are interpreted as offering some provisionsl support
for the notion. Future research might focus on extending the
present experimental procedures to a female population and
empirically delineating the learning histories of individual
stuttering behaviors.
49
Appendix A
Informed Consent Form
I hereby give consent
t o to perform or supervise
the following investigational procedure: heart rate and mus-
cle tension monitoring and skin conductance monitoring, and
in some cases, introduction of mild electric shock. The
muscle tension monitoring will entail attaching one ground
electrode on the forehead directly above the nose, and two
active electrodes directly over each eye. Heart rate will
be monitored by placing one active electrode on the surface
of the left calf, and ground electrodes on the surface of
the right calf. Skin conductance will be monitored by attach-
ing electrodes to two fingers. The monitoring procedures are
analagous to having your temperature taken with a thermometer.
The electric shock that may be administered is not to be con-
fused with ECT, shock therapy, etc. Rather, individuals who
receive this shock generally describe it as localized and
short-lasting.
I understand that this investigation does not involve
either medical diagnosis or medical or psychological treat-
ment. I also understand that there are no known physical or
psychological risks in participating in this experiment.
I have been informed that I may withdraw my consent for
participation at any time during the experiment without
penalty. I am currently in good health and do not have any
Appendix A—Continued 50
condition which would prohibit the use of heart rate/ skin
conductance, or EMG monitoring or mild electric shock. With
my understanding of this, having received this information
and satisfactory answers to the questions I have asked, I
voluntarily consent to participate in this experiment. I
understand that I will receive $2.50 per hour of participa-
tion and will be informed in full as to the purpose of this
investigation following my participation.
Date
Signed: Signed: Subject Witness
51
Appendix B
Sample Items from the Multiple Affect
Adjective Check Lista
Directions: On this sheet you will find words which
describe different kinds of moods and feelings. [Mark the
words] which describe how you generally feel. Some of the
words may sound alike, but we want you to check all the words
that describe your feelings. Work rapidly.
1. active 17. blue 33. destroyed
2. adventurous 18. bored 34. devoted
3. affectionate 19, calm 35. disagreeable
4. afraid 20. cautious 36. discontented
5. agitated 21. cheerful 37. discouraged
6. agreeable 22. clean 38, disgusted
7. aggressive 23. complaining 39. displeased
8. alive 24. contented 40. energetic
9. alone 25. contrary 41. enraged
10. amiable 26. cool 42. enthusiastic
11. amused 27. cooperative 43. fearful
12. angry 28. critical 44. fine
13. annoyed 29. cross 45. fit
14. awful 30. cruel 46. forlorn
15. bashful 31. daring 47. frank
16. bitter 32. desperate 48. free
Zuckerman and Lubin, 1965
52
Appendix C
Instructions
I. (At beginning of experiment) At various times in
this experiment, you may receive a small shock administered
to your forearm. The shocks will be strong enough for you
to feel them, but will not be strong enough to do you any
harm.
Some words will be projected on the screen in front of
you. Before we start, get as comfortable as possible, because
you will be sitting here for at least the next half hour. For
the first 15 minutes, you will not be required to say or do
anything other than to watch the screen intently and try to
determine the number of times that the same word appears on
the screen. You will be able to write this number down as
soon as this part of the experiment is over. Please don't
move around too much or smoke or chew gum, because these
actions might interfere with the recordings that I will be
making. If you have any questions, please ask them now,
because I will not be able to answer them until this first
part of the experiment is over. I will give you the next
set of instructions at that time. Any questions?
II, (After 15 minutes) The second part of the experi-
ment will begin now. A topic word will be presented on the
screen, and your job will be to discuss this topic for as
long as it appears on the screen, It is important for you
to continue discussing this topic for the entire time that
Appendix C—Continued 5 3
it is displayed in front of you. If you run out of things to
say, you can repeat sentences that you have already spoken
about the topic. Two things are important in this regard:
First, it is important for you to continue talking, and second,
you must always stay on topic. After the first word has been
presented, other words might be presented. The same instruc
tions apply for all of the words that appear. Any questions?
54
Appendix D
Postexperimental Questionnaire
Please rate how painful the shocks that you received were
to you:
1 2 3 4 6
not at all painful
very painful
Please rate how anxious (nervous) you were while you were
discussing the following words:
Book:
not at all nervous
very nervous
River:
not at all nervous
very nervous
Lake:
not at all nervous
very nervous
3. Please indicate in one or two sentences what you think
the purpose of the study was:
55
Appendix E
Results of Repeated-Measures Analysis of Variance Tests Across Three Experimental Conditions
Measure Source SS df MS
Physiological Measures
Heart Rate Condition 156.33 2 78.17 9. 57*
Subject 7479.86 23 325.21
Error 375.67 46 8.17
Total 8230.86 71
EMG Condition 0.36 2 0.18 0. 30
Subject 3963.44 23 172.32
Error 275.43 46 0.60
Total 3991.35 71
GSR Condition 8.08 2 4.04 0. 18
Subject 50448.83 23 2193.43
Error 1010.58 46 21.97
Total 51467.49 71
Verbal Measures
Part-Word Repetitions Condition 201.90 2 100.95 5. 46*
Subject 759.40 23 33.02
Error 851.40 46 18.51
Total 1812.70 71
Appendix E—Continued 56
Measure Source SS df MS F
Interjections Condition 225.01 2 112. 51 1.01
Subject 25874.45 23 1124. 97
Error 5174.99 46 112. 50
Total 31275.45 71
Self-: Report Measures
Self-Report Anxiety Condition 23.69 2 11. 85 8.22*
Subject 29.28 23 1. 27
Error 66. 31 46 1, 44
Total 119.28 71
*p < .05,
57
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