Study Links Stuttering Severity to Heightened Anxiety and Altered Auditory Processing in Adults

A study in *BMC Psychology* reports that adults who stutter show delayed and weaker event-related potentials (ERPs) to simple tones, and that these neurophysiological differences increase with stuttering severity and with both state and trait anxiety levels.

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Stuttering has traditionally been classified as a speech-motor disorder, with therapy focused on articulatory muscles; recent work, including this study, suggests auditory processing and emotional factors also shape its clinical profile.

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Researchers recruited 29 adults who stutter and 30 fluent controls, ages 18–45, matched for age, education, sex; all had normal hearing and were right-handed. Stuttering severity was rated with a standard instrument, anxiety with a validated questionnaire, and EEG recorded while participants heard 250 standard 1000 Hz tones and then a passive oddball task (80 % standard, 20 % deviant 1200 Hz).

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Compared with controls, the stuttering group showed longer ERP latencies and lower amplitudes across early and middle stages; latency and amplitude declined stepwise from mild to severe stuttering. Anxiety scores rose with severity. The mismatch-negativity response to unexpected pitch changes was faster and larger in the severe subgroup, which authors link to anxiety-driven hypervigilance.

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The alignment of auditory-processing deficits with heightened anxiety suggests treatment may benefit from combining sensory-processing training and anxiety-management with conventional motor-focused speech therapy, moving toward more individualized care.

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Lead researcher Agit Simsek said the results reinforce a multidimensional view of stuttering, emphasizing interaction of neurophysiological and emotional factors. He stressed the study shows associations, not causation, and called for larger longitudinal work to clarify directional links and test whether therapy alters the identified brain responses.

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The authors note a modest sample size, cross-sectional design, and use of pure tones rather than speech, limiting ecological validity. Excluding participants with psychiatric diagnoses and not applying statistical corrections for multiple comparisons further constrain confidence. Because the design is correlational, it cannot determine whether anxiety drives auditory changes, whether neurophysiological differences heighten anxiety, or whether a third factor influences both.

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• “Stuttering has traditionally been viewed primarily as a speech motor disorder,” — Agit Simsek, Inönü University

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• “One important message is that stuttering is much more complex than simply ‘getting stuck on words,’” — Agit Simsek

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• “One of the most interesting findings was the strength and consistency of the relationships between stuttering severity, anxiety levels, and neurophysiological measures,” — Agit Simsek

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• “Our long-term goal is to better understand how neurophysiological and emotional factors interact in stuttering across the lifespan,” — Agit Simsek

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Simsek proposes longitudinal studies tracking brain responses before and after speech therapy, expanding samples to children, adolescents, and older adults, and using speech-based auditory stimuli; retaining EEG datasets and applying statistical corrections are also recommended.

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