Journal of Fluency Disorders 29 (2004) 201–212

Social anxiety in stuttering: measuring negative

social expectancies
Michelle Messengera , Mark Onslowa,∗ ,
Ann Packmana , Ross Menziesb
a Australian Stuttering Research Centre, The University of Sydney,
P.O. Box 170, Lidcombe, NSW 1825, Australia
b School of Behavioural and Community Health Sciences, The University of Sydney,
P.O. Box 170, Lidcombe, NSW 1825, Australia

Received 3 June 2003; received in revised form 26 April 2004; accepted 26 June 2004

Abstract

Much research has suggested that those who stutter are likely to be anxious. However, to date,
little research on this topic has addressed the role of expectancies of harm in anxiety, which is a
central construct of anxiety in modern clinical psychology. There are good reasons to believe that
the anxiety of those who stutter is related to expectancies of social harm. Therefore, in the present
study, 34 stuttering and 34 control participants completed the Fear of Negative Evaluation (FNE)
Scale and the Endler Multidimensional Anxiety Scales-Trait (EMAS-T). The FNE data showed a
significant difference between the stuttering and control participants, with a large effect size. Results
suggested that, as a group, a clinical population of people who stutter has anxiety that is restricted to
the social domain. For the EMAS-T, significant differences between groups were obtained for the two
subtests that refer specifically to people and social interactions in which social evaluation might occur
(Social Evaluation and New/Strange Situations) but not for the subtests that contained no specific
reference to people and social interactions (Physical Danger and Daily Routines). These results were
taken to suggest that those who stutter differ from control subjects in their expectation of negative
social evaluation, and that the effect sizes are clinically significant. The findings also suggest that the
FNE and the EMAS-T are appropriate psychological tests of anxiety to use with stuttering clients in
clinical settings. The clinical and research implications of these findings are discussed, in terms of
whether social anxiety mediates stuttering or is a simple by-product of stuttering. Possible laboratory

∗ Corresponding author. Tel.: +61-2-9351-9767; fax: +61-2-9351-9392.

E-mail address: m.onslow@fhs.usyd.edu.au (M. Onslow).

0094-730X/$ – see front matter © 2004 Elsevier Inc. All rights reserved.
doi:10.1016/j.jfludis.2004.06.002
202 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212

explorations of this issue are suggested, and potential Cognitive Behavior Therapy packages for
stuttering clients who might need them are discussed.
Educational objectives: The reader will be able to: (1) explain why expectancy of social threat
or harm may be associated with stuttering; (2) name and describe two psychological tests that are
suitable for assessment of the social threat or harm that may be associated with stuttering; and (3)
explain how findings for the EMAS-T test in the present results suggest that expectancy of social
threat or harm, but not other kinds of negative expectancy, are associated with stuttering.
© 2004 Elsevier Inc. All rights reserved.

Keywords: Stuttering; Anxiety; Social; Threat; Measurement

1. Introduction

Early writings about the disorder of stuttering contain references to anxiety (e.g., Despert,
1946; Goodstein, 1958; Honig, 1947; Schultz, 1947), and a belief that anxiety is common
among those who stutter is reflected in writings of modern authorities (Andrews et al., 1983;
Bloodstein, 1995; Brutten & Shoemaker, 1971; Ingham, 1984; Johnson, 1955; Van Riper,
1982). For example, in one of the more widely used and cited textbooks on stuttering, Guitar
(1998) refers many times to anxiety and anxiety management. The link between anxiety and
stuttering has been described from the viewpoint of those who stutter and their clinicians
by Lincoln, Onslow, and Menzies (1996), who showed that the majority of both groups
reported that those who stutter commonly report and/or experience speech anxiety. Lincoln
et al. also found that a third of clinicians surveyed reported using anxiety management
procedures with their stuttering clients.
Although the research literature on this topic is methodologically problematic and has
produced inconsistent results, some of its findings have been nonetheless consistent (for a
complete review, see Menzies, Onslow, & Packman, 1999). In the case of state anxiety, Craig
(1990) and Ezrati-Vinacour and Levin (2004), for example, showed that a clinical sample
of stuttering subjects scored higher than controls. Further, stuttering has been shown to vary
under conditions intuitively associated with state anxiety, such as the size of an audience
and the perceived status of a conversational partner (Porter, 1939; Siegel & Haugen, 1964).
The Speech Situations Checklist (SSC) (Brutten, 1975) elicits responses about speaking
situations that directly and indirectly relate to state anxiety. Bakker (1995) reported that
a 31-item subset of SSC was able to provide statistically powerful distinctions between
stuttering and control subjects, independent of speech data about stuttering rate or severity.
In the case of trait anxiety, Craig (1990) and Ezrati-Vinacour and Levin (2004) also found
higher scores for stuttering subjects than controls, and Craig and colleagues subsequently
replicated this finding with a large population sample (Craig, Hancock, Tran, & Craig,
2003). There have also been some consistent physiological findings about stuttering and
anxiety. Leanderson and Levi (1967) found that those who stutter may have higher levels of
catecholamine excretion than control subjects, and physiological arousal has been shown to
correlate with stuttering severity (Weber & Smith, 1990). In a review of the area, Alm (2004)
formed the interesting conclusion, based on available data, that those who stutter appear to
 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212 203

exhibit an anxiety related “freezing response” of reduced heart rate, rather than increased
heart rate. Further, Kraaimaat, Janssen, and Brutten (1988) reported that autonomic arousal
related to poor treatment outcomes.
In short, there are good reasons to believe that there is a relationship between stuttering
and anxiety that is clinically important, and that clinicians will encounter many stuttering
clients for whom anxiety is an issue. Therefore, as Kraaimaat, Vanryckeghem, and Van
Dam-Baggen (2002) noted, for many clients, management of anxiety is likely to be an
important element in the management of chronic stuttering. However, as Kraaimaat et al.
further argue, it is necessary to know not only the extent to which anxiety is involved in
stuttering, but also precise details of the nature of that involvement. Indeed, as Menzies
et al. (1999) note, on balance, authorities generally are willing to admit that anxiety can be
associated with stuttering, but they are uncertain about the exact nature of that relationship
(Andrews et al., 1983; Bloodstein, 1995; Ingham, 1984). In the continued development of
measurement procedures for anxiety in clients who stutter, then, attention needs to be paid
to exactly what components of anxiety should be measured.
Modern clinical psychology incorporates the notion of “expectancy of harm” as funda-
mental in the construct of anxiety (see Beck & Emery, 1985). In other words, it is generally
thought that anxiety will not be present without such perceived danger or harm. Addition-
ally, recent conceptualizations of trait anxiety from the field of psychology disavow the
notion that it is a monolithic construct, and emphasize different components, such as social
anxiety, novel situation anxiety, and physical anxiety (Endler, Magnusson, Ekehammar, &
Okada, 1976). With regard to these concepts of anxiety, there are good reasons to believe
that the apparent link between stuttering and anxiety would concern expectancy of some
kind of social harm, in the domains of social anxiety and novel situation anxiety, but not
the domain of physical anxiety.
Speech is the fundamental mechanism underpinning day-to-day interactions with others,
around which social and networks are established, developed, and sustained. Expectancy
of social harm, then, might accompany stuttering because the disorder disturbs that basic
social function in a disfiguring way. Accordingly, social anxiety might well be expected
to occur in such circumstances (Poulton & Andrews, 1994). Some data are available to
confirm that normal social and occupational functioning is disturbed with the population of
those who stutter. Data indicate, for example, that those who stutter are evaluated negatively,
particularly by teachers and employers, with considerably deleterious life effects (Cooper
& Cooper, 1996; Cooper & Rustin, 1985; Craig & Calver, 1990; Crichton-Smith, 2002;
Hayhow, Cray, & Enderby, 2002; Silverman & Paynter, 1990). Virtually every adult who
stutters reports that stuttering has negative effects on life during the school years (e.g.,
Crichton-Smith, 2002; Hayhow et al., 2002). Data show that primary school children are
perceived negatively by peers (Langevin & Hagler, 2004), and are rejected by peers more
often than children who do not stutter (Davis, Howell, & Cooke, 2002). Perhaps for these
reasons, primary school children who stutter are more likely to be bullied than their peers
(Langevin, Bortnick, Hammer, & Wiebe 1998).
It is not surprising, then, that there is a set of research findings to suggest that chronic
stuttering in adulthood is associated with social anxiety. Consistent findings have emerged
from self-report inventories of social anxiety (e.g., Kraaimaat, Janssen, & Van Dam-Baggen,
1991; Kraaimaat et al., 2002; Maher & Torosian, 1999). Further, there are case reports in
204 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212

the psychiatric literature of stuttering adults with comorbid social phobia who have been
treated with pharmacological interventions (e.g., Paprocki & Rocha, 1999). Stein, Baird, and
Walker (1996) demonstrated that 44% of clients seeking treatment for stuttering warranted
a comorbid diagnosis of social phobia, having social anxiety to a level clearly excessive
for the severity of their stuttering. Subsequently, Schneier, Wexler, and Liebowitz (1997)
confirmed Stein et al.’s finding that those who stutter can have social anxiety at similar levels
to patients with social phobia. More recently, Kraaimaat et al. (2002) reported that about
50% of the scores of 89 stuttering subjects, on a scale of social discomfort, “fell within the
range of a group of highly socially anxious psychiatric patients” (p. 319).
In short, it appears that comorbid social anxiety and stuttering is common, and that ex-
pectancy of social threat or harm in such anxiety is likely. Therefore, it seems essential
to include measures of such social threat or harm in the search for clinical measures of
anxiety called for by Kraaimaat et al. (2002). However, such measures have not been in-
cluded in anxiety stuttering research to date. The Inventory of Interpersonal Situations (Van
Dam-Baggen & Kraaimaat, 1999) used in the recent Kraaimaat et al. (2002) report focuses
on “discomfort and frequency of occurrence scales, which investigate, respectively, anxiety
and emotional tension in social situations and the frequency with which social responses or
skills are performed” (p. 322). To our knowledge, there has been only one study of stuttering
that has involved direct measures of expectancy of social harm. In the context of a study
of social phobia, Poulton and Andrews (1994) happened to incorporate a control group of
stuttering subjects. Among other tests, these subjects were required to complete the “Neg-
ative Social Evaluation Scale” (Morris-Yates, 1993) before and after giving a speech to an
audience, to describe how they felt during the speech. Items on this scale were “people will
find fault with you,” “people will see you as incompetent and foolish,” “people will see that
you are anxious and not like you,” “people will laugh at you,” and “you will make a scene
in front of others” (Poulton & Andrews, 1994, p. 640). Poulton and Andrews reported that
the scores of the group of stuttering subjects indicated highest appraisal of danger during,
rather than before or after, the speaking task.
In summary, empirical study of the relation between stuttering and anxiety will require
the development of anxiety measurement tools that capture all aspects of the anxiety of
those who stutter. Although there is good reason to implicate expectancy of social harm in
the anxiety associated with stuttering, at present there has been no reported empirical study
of such an effect in a population of people who stutter. Should such an effect exist, the
establishment of a tool for its measurement will be important in the development of clinical
procedures for the disorder. Consequently, the present research was designed to determine
whether expectancy of social harm is associated with speech related anxiety in those who
stutter.

2. Method

2.1. Anxiety measures

Tests of anxiety were selected specifically for the purpose of assessing the level of social
anxiety involving expectancies of harm and negative evaluation in those who stutter. These
 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212 205

tests were used to answer the following questions about adults who stutter and who were
seeking treatment, and controls: (1) Do stuttering and control groups differ in fear of being
evaluated negatively in social contexts, and (2) do the groups have differential expectancy
effects in social compared to non-social situations?
The Fear of Negative Evaluation Scale (FNE) was developed by Watson and Friend
(1969) to measure fear of being evaluated negatively in social situations. It comprises 30
true–false questions that deal with: apprehension about evaluation of oneself by others; the
expectation that such evaluations would be negative; and the distress over such negative
evaluations (Watson & Friend, 1969). Watson and Friend reported that the FNE scale cor-
relates significantly with other tests of anxiety, and has satisfactory test-retest reliability.
The validity and reliability of the scale has been replicated in several reports (e.g., Durm
& Glaze, 2001; Garcia-Lopez, Olivares, Hidalgo, Beidel, & Turner, 2001). Respondents to
the FNE are instructed as follows: “Read each of the following statements carefully and in
each case indicate whether or not the statement applies to you by circling either “T” for
true or “F” for false.” The FNE statements include “the opinions that important people have
of me cause me little concern” and “I often worry that I may say or do the wrong things.”
Around 15 min is required to complete the FNE.
The Endler Multidimensional Anxiety Scales-Trait (EMAS-T) (Endler, Edwards, &
Vitelli, 1991) provide a means to distinguish between anxiety related to perceived social
threat and anxiety related to physical threat. The EMAS-T measures four situational di-
mensions of trait anxiety. Endler, Edwards, Vitelli, and Parker (1989) reported satisfactory
reliability and validity for the test. The 60-item inventory consists of 15 responses designed
to elicit information about predisposition to anxiety in four situations: (1) Social Evaluation,
(2) Physical Danger, (3) New/Strange Situations, and (4) Daily Routines.
Each of the four situations listed above is described in the EMAS-T, and for each situation
a response is required to each of 15 statements with a 5-point scale where “0” = “very much”
and “4” = “not at all.” For each section of the EMAS-T, a total score is calculated using these
response values. The EMAS-T statements include “feel relaxed” and “feel tense.” Around
20 min is required to complete the EMAS-T.

2.2. Participants and procedure

Craig et al.’s (2003) report suggests that a population sample of stuttering participants
will have lower levels of anxiety than a clinical sample. Because of the clinical emphasis
of the present investigation, as outlined in the introduction, stuttering participants were
recruited, in order, from the treatment waiting list of a speech pathology clinic at a Syd-
ney metropolitan hospital. Any potential participant who stuttered who reported receiving
treatment for stuttering and/or anxiety during the previous 12 months was excluded from
study. All stuttering participants reported beginning to stutter in early childhood, in a man-
ner consistent with developmental stuttering. Around half of the stuttering participants (17)
reported having previous treatment. Thirteen of these participants reported having treat-
ment in the distant past, more than 10 years previously, and reported no residual benefits
from that treatment. Four reported recently receiving a speech restructuring treatment based
on Prolonged-Speech (2, 3, 7, and 6 years previously) after which complete relapse had
occurred. The stuttering participants represented a range of occupations, including artist,
206 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212

accountant, public servant, secretary, computer technician, student, electrician, plumber,

lawyer, and architect. Control participants were recruited from the non-academic staff of
The University of Sydney, including grounds personnel and administrative office staff. The
administrative office staff had differing levels and types of responsibilities, and different
levels of formal qualification. Care was taken to sample a different range of occupations. An
exclusion criterion for the control participants was any self-reported history of stuttering,
or any sign of stuttering during a screening conversation. An exclusion criterion for both
groups was any difficulty in understanding written English.
Potential participants were approached in person, asking whether they would be pre-
pared to read an information sheet about the study and consider mailing the completed
questionnaires and signed consent form back to the investigator. All individuals who were
approached consented to participate. Participants were neither paid nor compensated for
their time. A total of 39 potential participants who stuttered and 42 controls were approached
in this manner over a period of 2 months. Participant numbers were set at 68 to detect a
large effect size with power set at 0.9 and alpha at 0.05 (Buchner, Faul, & Erdfelder, 1996).
Therefore, recruitment ceased after a period of 2 months, when surveys had been returned
in the mail for 34 participants who stuttered and 34 controls who did not stutter. The age of
participants who stuttered ranged from 19 years to 52 years (mean 32.0 years, S.D. 10.5),
and the ages of control participants ranged from 19 years to 58 years (mean 36.9 years, S.D.
10.0). Participant gender balance was set by the stuttering group, of which 75% were men,
hence the equivalent gender balance was established with the control participants.

3. Results

Results are presented in Table 1. The FNE data show a significant difference between
the stuttering and control participants, with a large effect size. The maximum score on the
FNE is 30.
In interpreting EMAS-T data, conservative Bonferroni corrections were applied, result-
ing in an alpha of 0.013. There was a significant difference between stuttering and control
participants for Social Evaluation and New/Strange Situations, with large effect sizes for
both. The striking aspect of these results is that significant differences were found for the

Table 1
Means, standard deviations (S.D.), ranges, effect sizes, and P values for the stuttering and control participants for
FNE and EMAS-T scores
Stuttering S.D. Range Control S.D. Range Pooled S.D. Effect P
mean mean size
FNE 15.3 7.1 4–30 10.7 5.7 1–27 6.4 0.75 .005
EMAS-T
Social Evaluation 36.8 10.3 16–52 29.6 10.3 9–46 10.3 0.70 .005
Physical Danger 41.9 10.4 24–60 39.8 12.1 11–56 11.2 0.19 .448
New/Strange Situations 32.1 10.0 14–52 23.2 9.4 1–42 9.7 0.80 .000
Daily Routines 12.1 10.1 0–50 7.4 6.7 0–30 8.9 0.53 .038
 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212 207

two subtests that refer specifically to people and social interactions (Social Evaluation and
New/Strange Situations) but not for the subtests that contain no reference to people and
social interactions (Physical Danger and Daily Routines). The maximum score on a subtest
of the EMAS-T is 60.

4. Discussion

The present results indicate that those who stutter differ from control subjects in their
expectation of negative social evaluation. Effect sizes between the two groups suggested by
these results are large, but further research is needed to verify the existence of these effects
and to establish the extent to which they are clinically significant. Such research methods
might include diagnostic interviews of subjects by a clinical psychologist, in addition to
self-report procedures. Such methods would also best incorporate more careful controls for
socio-economic status than were used in the present study. Nonetheless, the present results
appear to have some validity, considering that significant effects were found for anxiety
in social contexts but not for other contexts: On the EMAS-T scale, significant results
were found for “Social Evaluation” and “New/Strange Situations,” which are situations that
invite social appraisal by others, but no significant results were found for the domains of
“Physical Danger” and “Daily Routines,” which are not normally associated with social
evaluation.
Although the topic of stuttering and anxiety has generated considerable research, with
the exception of Poulton and Andrews (1994) (see Section 1), the present report appears
to be the first study of anxiety and stuttering incorporating the concept of expectancy of
social harm. Its results indicate that, as a group, a clinical population of people who stutter
has anxiety that is restricted to the social domain. Considering the nature of the disorder,
its effects during childhood, and the proportion of stuttering clients who may have social
phobia (see Section 1), this result is intuitive. Naturally, these results await replication, but
the present findings suggest that the FNE and the EMAS-T are appropriate psychological
tests of anxiety to use with stuttering clients in clinical settings.
In addition to the need for replication, the present results raise a number of compelling
directions for further research. Fundamentally, they compel the question of whether social
anxiety mediates stuttering or is simply a by-product of the disorder. Considering the asso-
ciation between speech, anxiety and respiration, it certainly is possible that social anxiety
mediates stuttering in everyday speaking environments, influencing its severity. There are
direct connections from the limbic system to centers in the midbrain that regulate respiration
and vocalization (Larson, 1988). Further, it is well known that anxiety-disordered patients
commonly report shortness of breath and hyperventilation (Marks, 1987), and emotional
states have been shown to influence lung volumes during speech (Davis, Zhang, Winkworth,
& Bandler, 1996). Thus, an emotional state involving a significant degree of social anxiety,
that destabilizes the respiratory system, may also increase the rate and/or severity of stutter-
ing. However, it is also quite possible that social anxiety is an effect of stuttering. Indeed, as
noted above (see Section 1), social anxiety would not be a surprising reaction to stuttering,
considering the likely negative evaluation that those who stutter have experienced at some
time.
208 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212

It would seem to be reasonably straightforward to assess these two scenarios experimen-

tally. For example, to determine whether anxiety mediates stuttering, a time series study
might be designed where social anxiety is manipulated as an independent variable and the
effects on stuttering rate and frequency are observed as dependent variables. Manipulation
of social anxiety might be achieved by means of having subjects speak alone and then to
an audience. To determine whether anxiety is a by-product of stuttering, it may be possible
to reduce stuttering with an innocuous time-out stimulus, and observe the effects of that
stuttering reduction on anxiety levels.
Although challenging, establishing which of these is the case—social anxiety mediates
stuttering or anxiety is a by-product of stuttering, or both—will be of theoretical as well as
clinical import. If it is the case that anxiety mediates stuttering, then, in cases of presentation
of clinically significant social anxiety, clinicians may need with some clients to administer
social anxiety assessment and management procedures. However, if social anxiety were to be
simply a by-product of stuttering, then anxiety assessment and management procedures may
need to play little part in routine clinical practice. In such a scenario, it would be expected
that when stuttering is eliminated with successful treatment, speech related anxiety would
eventually disappear also.
In a scenario where social anxiety is clinically important, the present findings suggest
what might be suitable assessment tools. However, in addition, a clinical strategy to offset
social anxiety would be required. Cognitive-behavior therapy is the most effective psy-
chology intervention available for treating social anxiety (Andrews, Crino, Hunt, Lampe, &
Page, 2003), and has been evaluated extensively for anxiety in the non-stuttering population
(Heimberg, 2002).
Finally, if the present findings were to be replicated, a critical clinical issue would be the
extent to which children who stutter experience related anxiety, and the age at which such
anxiety becomes measurable. Parental reports suggest the possibility that social penalty
might begin soon after stuttering onset, with many children seeming to be aware of their
stuttering at that time (e.g., Ambrose & Yairi, 1994; Packman, Onslow, & Attanasio, 2003).
Packman et al. (2003) provide the following examples of parental reports of stuttering in
preschoolers: interactions where their children are ignored by peers when they attempt to
speak or attempt to enter a play situation; where they are chosen less often as playmates,
and where they are teased.
Further, there is direct evidence that normally fluent children as young as 3 years rec-
ognize stuttering in their peers, and that they may evaluate stuttering negatively as early
as 4 years (Ezrati-Vinacour, Platzky, & Yairi, 2001). In the Ezrati-Vinacour et al. study,
80 children aged 3–7 years watched two puppets, one of which spoke fluently and one
of which stuttered. When asked which puppet they would prefer as a friend, the fluent
puppet was chosen by 46.7% of 3-year-olds, 68.8% of 4-year-olds and 87.5% of 5-year-
olds. Additionally, children who stutter as young as 6 and 7 years have been shown to
have negative self-attitude about communication compared to control children (DeNil &
Brutten, 1991; Vanryckeghem & Brutten, 1996). On balance, then, if the present results of
stuttering and social anxiety were found in replication to be robust, then it would be incau-
tious to assume that they apply only to chronic stuttering. If it is the case that preschool
and school age children may experience social anxiety related to their stuttering, the com-
plex and contentious issue of the timing of early intervention (e.g., Curlee & Yairi, 1998;
 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212 209

Ingham & Cordes, 1998; Packman & Onslow, 1998; Zebrowski, 1997) would need to be
reassessed.
CONTINUING EDUCATION
Social anxiety in stuttering: measuring negative social expectancies

QUESTIONS
1. Research findings about stuttering and anxiety indicate that:
a. every person who stutters experiences anxiety
b. those who stutter experience anticipation of physical harm only
c. there are some consistent findings about trait and state anxiety
d. those who stutter experience anticipation of social danger only
e. the anxiety of those who stutter is constrained to speaking situations
2. The FNE and the EMAS-T:
a. measure trait anxiety
b. measure state anxiety
c. measure state and trait anxiety
d. measure neither state nor trait anxiety
e. measure state and trait anxiety and expectancy of physical danger
3. The authors argued that their findings:
a. suggest that the EMAS-T but not the FNE are suitable clinical tests of anxiety for
those who stutter
b. probably will not have implications for the management of children who stutter
c. suggest that one definitive experiment is necessary in order to establish the role of
anxiety in stuttering
d. were limited by the absence of physiological measures of anxiety
e. none of the above
4. The study found that for the EMAS-T significant differences between groups were
obtained:
a. for all subtests
b. for only one subtest
c. for the two subtests that refer specifically to people and social interactions in which
social evaluation might occur
d. for the two subtests that contained no specific reference to people and social interac-
tions
e. for one of the subtests that refers specifically to people and social interactions in
which social evaluation might occur and one of the subtests that contained no specific
reference to people and social interactions
5. The notion of anxiety according to current psychology is that it is:
a. a variable that is best measured by physiological indices
b. associated with expectancy of harm of some kind
c. cannot be measured with any precision
d. is associated with expectancy of social harm only
e. none of the above
210 M. Messenger et al. / Journal of Fluency Disorders 29 (2004) 201–212

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