{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T18:49:18Z","timestamp":1779907758758,"version":"3.53.1"},"reference-count":35,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T00:00:00Z","timestamp":1722297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Lang &amp;amp; Comm Disor"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>While wearing masks during the pandemic poses communication and social challenges for people in everyday life, those with social anxiety might find them plausible, aligning with contemporary cognitive theories. Social anxiety involves fearing negative assessments and holding a negative self\u2010image. Concealing anxiety symptoms during mask use may contribute to a more positive self\u2010perception.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Given that up to 60% of adults seeking stuttering treatment also meet criteria for social anxiety disorder, this study aims to investigate the complex relationship between communication freedom, self\u2010perceived stuttering and anxiety in adults who stutter (AWS). The unique context of mandatory mask\u2010wearing during the pandemic provides an opportunity to explore these dynamics and understand the conflicting relationships between stuttering, anxiety\u2010related safety behaviours and the need for open communication in AWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Procedures<\/jats:title><jats:p>Twenty AWS participated in interviews, responding to open\u2010ended questions to elucidate their affective, cognitive and behavioural experiences while wearing masks during the COVID\u201019 pandemic. Thematic analysis was used to identify the emerging themes and subthemes based on information\u2010rich quotes, employing a six\u2010phase recursive process. Various speech and anxiety\u2010related measures were used to describe the characteristics of the study participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>Outcomes and Results<\/jats:title><jats:p>Three main themes and sub\u2010themes emerged. The first theme highlights communication challenges for AWS wearing masks, impacting verbal and nonverbal interactions. The second theme reveals AWS wearing masks to conceal stuttering cues, experiencing reduced stress. The third theme indicates that, despite the comfort in concealment, most AWS prefer speaking freely without a face mask.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Implications<\/jats:title><jats:p>The conflict between the desire for authentic, fluent communication and the ease of hiding stuttering symptoms poses a major dilemma for AWS. According to the results of this study, most adults who stutter prioritize open communication. However, there were some individual differences. A major factor influencing their decision was their fear of negative evaluation.<\/jats:p><\/jats:sec><jats:sec><jats:title>WHAT THIS PAPER ADDS<\/jats:title><jats:sec><jats:title>What is already known on the subject<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>The prevalence of social anxiety is higher among adults who stutter (AWS), possibly stemming from their prior negative experiences with stuttering. In response, AWS may adopt adaptive or maladaptive coping behaviours to manage stuttering and mitigate fears of negative evaluation. Maladaptive strategies, like avoiding certain communication situations, can diminish their satisfaction with everyday speaking situations.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What this study adds<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>This study leveraged the mask\u2010wearing mandate during the pandemic to explore the intricate relationship between anxiety\u2010related symptoms and communication. While some participants saw masks as a plausible means to conceal stuttering and anxiety, most preferred open communication without the challenges posed by masks. Our findings offer additional support for the varied emotional, cognitive and behavioural responses that AWS may display in response to changes in daily life, emphasizing the individual differences within this population and highlighting that stuttering goes beyond observable speech dysfluencies.<\/jats:p><\/jats:list-item><\/jats:list><\/jats:p><\/jats:sec><jats:sec><jats:title>What are the clinical implications of this work?<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Our study underscores the need for comprehensive therapeutic interventions addressing both the physical and cognitive\u2010emotional aspects of stuttering in AWS. Recognizing the role of safety behaviours and self\u2010focused attention emphasizes the importance of an integrated approach, enhancing communication efficacy and social well\u2010being for AWS. Addressing speech fluency alone, without considering pertinent cognitive\u2010emotional factors, falls short in providing adequate stuttering treatment.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec><\/jats:sec>","DOI":"10.1111\/1460-6984.13096","type":"journal-article","created":{"date-parts":[[2024,7,30]],"date-time":"2024-07-30T15:25:27Z","timestamp":1722353127000},"page":"2454-2464","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Behind the mask: Stuttering, anxiety, and communication dynamics in the era of COVID\u201019"],"prefix":"10.1111","volume":"59","author":[{"given":"Hamid","family":"Karimi","sequence":"first","affiliation":[{"name":"Faculty of Health Charles Darwin University Darwin Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amir Hossein","family":"Rasoli Jokar","sequence":"additional","affiliation":[{"name":"Department of Communicative Sciences and Disorders Michigan State University East Lansing USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadaf","family":"Salehi","sequence":"additional","affiliation":[{"name":"Department of Communication Sciences and Disorders Wayne State University Detroit USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samira","family":"Aghadoost","sequence":"additional","affiliation":[{"name":"Speech Therapy Department, School of Rehabilitation Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jfludis.2014.01.004"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcomdis.2022.106251"},{"issue":"1","key":"e_1_2_8_4_1","first-page":"1","article-title":"Global trends and predictors of face mask usage during the COVID\u201019 pandemic","volume":"21","author":"Badillo\u2010Goicoechea E.","year":"2021","journal-title":"BMC Public Health [Electronic Resource]"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1159\/000519865"},{"key":"e_1_2_8_6_1","volume-title":"A handbook on stuttering","author":"Bloodstein O.","year":"2021"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/da.20657"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1037\/qup0000196"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-3223(01)01296-3"},{"key":"e_1_2_8_10_1","first-page":"69","volume-title":"Social phobia: diagnosis, assessment and treatment","author":"Clark D.M.","year":"1995"},{"key":"e_1_2_8_11_1","first-page":"1","volume-title":"Thematic analysis: a practical guide","author":"Clarke V.","year":"2021"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0094-730X(02)00161-4"},{"key":"e_1_2_8_13_1","first-page":"1408","article-title":"Are we there yet? 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