Speech Disfluency Patterns and Cognitive Failures in Young Adults with Generalized Anxiety Disorder: A Cross-sectional Study: Speech Disfluency in Young Adults with Anxiety

Syeda Sania  Khalid; Shumaila Atif; Tahmeena  Tabish; Sarah Jehangir

Authors

Syeda Sania Khalid Ziauddin University, Karachi, Pakistan
Shumaila Atif Ziauddin University, Karachi, Pakistan
Tahmeena Tabish Ziauddin University, Karachi, Pakistan
Sarah Jehangir Ziauddin University, Karachi, Pakistan

Keywords:

Cognitive Failures, Generalized Anxiety Disorder, Speech Disfluency, Working Memory, Young Adults

Abstract

Background: Generalized Anxiety Disorder (GAD) affects approximately 3-6% of young adults and is characterized by persistent worry and anxiety. While cognitive impairments in GAD are well-documented, the relationship between speech fluency and cognitive performance remains understudied. To examine the patterns of speech disfluency and their association with cognitive failures in young adults diagnosed with GAD compared to healthy controls.

Methodology: A cross-sectional study was conducted with 128 participants (64 GAD patients, 64 controls) aged 18-25 years. Speech samples were collected during structured narrative tasks and analyzed for disfluency patterns. Cognitive failures were assessed using the Cognitive Failures Questionnaire (CFQ) and working memory was measured using the digit span test.

Results: GAD participants demonstrated significantly higher rates of filled pauses (p < 0.001), repetitions (p < 0.01), and false starts (p < 0.05) compared to controls. Strong correlations were found between speech disfluency measures and cognitive failure scores (r = 0.67-0.82). Working memory deficits were the strongest predictor of speech disfluency patterns (β = 0.54, p < 0.001).

Conclusion: Young adults with GAD exhibit distinct speech disfluency patterns that correlate with cognitive failures, particularly in working memory domains. These findings suggest speech analysis may serve as a non-invasive marker for cognitive impairment in GAD.

DOI: https://doi.org/10.59564/amrj/03.03/010

Author Biographies

Syeda Sania Khalid, Ziauddin University, Karachi, Pakistan

Lecturer/Lab Psychologist, College of Clinical Psychology

Shumaila Atif, Ziauddin University, Karachi, Pakistan

Senior Lecturer/Clinical Psychologist, College of Clinical Psychology

Tahmeena Tabish , Ziauddin University, Karachi, Pakistan

Assistant Professor/Speech Language Pathologist, College of Speech Language and Hearing Sciences

Sarah Jehangir, Ziauddin University, Karachi, Pakistan

Principal, College of Clinical Psychology

References

Kessler RC, Chiu WT, Demler O, Walters EE. Prevalence, severity, and comorbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Arch Gen Psychiatry. 2005;62(6):617–27.

DOI: https://doi.org/10.1001/archpsyc.62.6.617

Leonard K, Abramovitch A. Cognitive functions in young adults with generalized anxiety disorder. Eur Psychiatry. 2019;56:1–7.

DOI: https://doi.org/10.1016/j.eurpsy.2018.10.008

Abramovitch A, Short T, Schweiger A. The C Factor: Cognitive dysfunction as a transdiagnostic dimension in psychopathology. Clin Psychol Rev. 2021;86:102007.

DOI: https://doi.org/10.1016/j.cpr.2021.102007

Beloe P, Derakshan N. Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents. Dev Sci. 2020;23(4):e12831.

DOI: https://doi.org/10.1111/desc.12831

Majeed NM, Chua YJ, Kothari M, Kaur M, Quek FY, Ng MH, et al. Anxiety disorders and executive functions: A three-level meta-analysis of reaction time and accuracy. Psychiatry Res Commun. 2023;3(1):100100.

DOI: https://doi.org/10.1016/j.psycom.2022.100100

McIntyre RS, Alsuwaidan M, Baune BT, Berk M, Demyttenaere K, Goldberg JF, et al. Treatment-resistant depression: definition, prevalence, detection, management, and investigational interventions. World Psychiatry. 2023;22(3):394–412.

DOI: https://doi.org/10.1002/wps.21120

Seufert T, Wagner F, Westphal J. The effects of different levels of disfluency on learning outcomes and cognitive load. Instr Sci. 2017;45(2):221–38.

DOI: https://doi.org/10.1007/s11251-016-9387-8

Costache ME, Frick A, Månsson K, Engman J, Faria V, Hjorth O, et al. Higher- and lower-order personality traits and cluster subtypes in social anxiety disorder. PLoS One. 2020;15(4):e0232187.

DOI: https://doi.org/10.1371/journal.pone.0232187

Bieling PJ, McCabe RE, Antony MM. Cognitive-behavioral therapy in groups. New York: Guilford Publications; 2022.

Quek TTC, Tam WWS, Tran BX, Zhang M, Zhang Z, Ho CSH, et al. The global prevalence of anxiety among medical students: a meta-analysis. Int J Environ Res Public Health. 2019;16(15):2735.

DOI: https://doi.org/10.3390/ijerph16152735

Teferra BG, Rose J. Predicting generalized anxiety disorder from impromptu speech transcripts using context-aware transformer-based neural networks: model evaluation study. JMIR Ment Health. 2023;10:e44325.

DOI: https://doi.org/10.2196/44325

Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092–7.

DOI: https://doi.org/10.1001/archinte.166.10.1092

Johnson SU, Ulvenes PG, Øktedalen T, Hoffart A. Psychometric properties of the general anxiety disorder 7-item (GAD-7) scale in a heterogeneous psychiatric sample. Front Psychol. 2019;10:1713.

DOI: https://doi.org/10.3389/fpsyg.2019.01713

Rutter LA, Brown TA. Psychometric properties of the generalized anxiety disorder scale-7 (GAD-7) in outpatients with anxiety and mood disorders. J Psychopathol Behav Assess. 2017;39:140–6.

DOI: https://doi.org/10.1007/s10862-016-9571-9

Cole J, Shattuck-Hufnagel S. New methods for prosodic transcription: capturing variability as a source of information. Lab Phonol. 2016;7(1).

DOI: https://doi.org/10.5334/labphon.29

Broadbent DE, Cooper PF, FitzGerald P, Parkes KR. The cognitive failures questionnaire (CFQ) and its correlates. Br J Clin Psychol. 1982;21(1):1–16.

DOI: https://doi.org/10.1111/j.2044-8260.1982.tb01421.x

Wallace JC, Kass SJ, Stanny CJ. The cognitive failures questionnaire revisited: dimensions and correlates. J Gen Psychol. 2002;129(3):238–56. DOI: https://doi.org/10.1080/00221300209602098

Goodman ZT, Timpano KR, Llabre MM, Bainter SA. Revisiting the factor structure and construct validity of the cognitive failures questionnaire. Psychol Assess. 2022;34(7):671–83.

DOI: https://doi.org/10.1037/pas0001127

Wechsler D. Wechsler Adult Intelligence Scale–Fourth Edition (WAIS–IV). San Antonio, TX: Psychological Corporation; 2008.

Gass SM, Behney J, Plonsky L. Second language acquisition: An introductory course. New York: Routledge; 2020.

Bilder RM, Reise SP. Neuropsychological tests of the future: How do we get there from here? Clin Neuropsychol. 2019;33(2):220–45.

DOI: https://doi.org/10.1080/13854046.2018.1521993

Gebreegziabhere Y, Habatmu K, Mihretu A, Cella M, Alem A. Cognitive impairment in people with schizophrenia: an umbrella review. Eur Arch Psychiatry Clin Neurosci. 2022;272(7):1139–55. DOI: https://doi.org/10.1007/s00406-022-01416-6

Moran TP. Anxiety and working memory capacity: a meta-analysis and narrative review. Psychol Bull. 2016;142(8):831–64.

DOI: https://doi.org/10.1037/bul0000051

Tan GX, Soh XC, Hartanto A, Goh AY, Majeed NM. Prevalence of anxiety in college and university students: An umbrella review. J Affect Disord Rep. 2023;14:100658.

DOI: https://doi.org/10.1016/j.jadr.2023.100658

Rost M. Teaching and researching listening. New York: Routledge; 2024.

DOI: https://doi.org/10.4324/9781003390794

Engle RW. Working memory and executive attention: a revisit. Perspect Psychol Sci. 2018;13(2):190–3.

DOI: https://doi.org/10.1177/1745691617720478