The Relationships between Communication and Depression Among People with Speech Disability in South Korea : The Mediation Effect of Attitudes of Others

Background and Purpose:

Speech disability refers to a deficiency in using and understanding language to communicate with others due to congenital or acquired reasons. Speech disability may lead to emotional problems as well as verbal communication problems, which may significantly impact their social participation. Indeed, clinical depression rates among persons with speech disability are known to be higher than in the general population. Meanwhile, the association between communication problems and depression remains unclear. One possible factor for this relation is the attitudes of others (e.g., lack of respect from others and feeling that self-determination is not guaranteed) due to slow, slurred pronunciation. Indeed, previous studies have shown that slurred pronunciation or accents cause stigma among the public. Communication difficulties may also have indirect effects on depression via poorer social self-efficacy and reassurance of worth among older adults. Thus, the mental health problems of people with speech disabilities may be caused by social factors rather than medical factors. In South Korea, the relation between speech disability and mental health has less attracted the interest of researchers and policymakers compared to mobility disability. Accordingly, this study aimed to examine the relationship between communication and depression among people with speech disability in South Korea and identify the mediating role of attitudes of others.

Methods:

In December 2022, a cross-sectional survey was conducted to collect data from people with disabilities residing in Seodaemun-gu, a district in Seoul, South Korea, aged 18 years and older. This survey included 182 people with speech disability, including congenital speech disability (e.g., lesions of the brain), 93 cases, and acquired speech disability (e.g., hearing and speech disorders), 89 cases.

Communication was measured using six items on a scale of 1 (Excellent) to 5 (Terrible). Attitudes of others consisting of 2 sub-concepts (self-determination opportunities and feeling respected by others) were measured using 11 items on a scale of 1 (Completely) to 5 (Not at all). Depression was measured using the 2-item PHQ-2 (Patient Health Questionnaire-2). Sex, age, disability type, disability status, ADL, married status, religion, and subjective health status were used as control variables. Parallel mediation analyses were conducted using SPSS 26.0 and PROCESS macro v.4.0 (model 6).

Results:

The results of the Parallel mediation analyses showed that communication difficulties increase depression through feelings irrespective of others. However, self-determination opportunities cannot mediate the relationships between communication and depression. A contrasting effect analysis indicated that the mediation effect of feeling irrespective of others is stronger than that of self-determination opportunities.

Conclusions and Implications:

Our findings suggest that in addition to providing speech therapy to people with speech disabilities, helping them improve smooth relationships with others is also an effective way to improve depression.