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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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