Abstract
The study presented in the following verifies some assumptions of the novel ‘unsafe world’ model of selective mutism (SM). According to this model, SM is a stress reaction to situations erroneously experienced via cognition without awareness as ‘unsafe’. It assumes a high sensitivity to unsafety, whereby the nervous system triggers dissociation or freeze mode at relatively low thresholds. We examine whether there is a correlation between SM, sensory-processing sensitivity and dissociation. We compared a sample of 28 children and adolescents with SM (mean age 12.66 years; 18 females) to 33 controls without SM (mean age 12.45 years; 21 females). Both groups were compared using a medical history sheet, the ‘Selective Mutism Questionnaire’ (SMQ), a ‘Checklist for Speaking Behaviour’ (CheckS), the ‘Highly Sensitive Person Scale’ (HSPS), the ‘Child Dissociative Checklist’ (CDC), the ‘Adolescent Dissociative Experience Scale’ (A-DES) and the ‘Social Phobia and Anxiety Inventory for Children’ (SPAIK). Appropriate parametric and non-parametric tests were conducted to examine differences between groups. The results indicate that sensory-processing sensitivity was significantly higher in the group of children and adolescents with SM [X2(1) = 7.224, p = 0.0007; d = 1.092]. Furthermore, dissociative symptoms were more common in children and adolescents with SM than in controls [F(1, 33) = 13.004, p = 0.001; d = 0.986]. The results indicate that sensory-processing sensitivity and dissociation are important factors of SM that may hold important implications for the treatment.Trial Registration This study is registered with the ClinicalTrials.gov number NCT04233905.
Highlights
Selective mutism (SM) is characterized by an absence of speech in selected situations in which children are expected to speak, a physical disability to speak is not present (American Psychiatric Association 2013)
Our study presents the ‘unsafe world’ model of SM that tries to broaden the scope of factors which may be relevant for aetiology
SM is a stress reaction to situations experienced via cognition without awareness as ‘unsafe’
Summary
Selective mutism (SM) is characterized by an absence of speech in selected situations in which children are expected to speak, a physical disability to speak is not present (American Psychiatric Association 2013). In other situations they speak quite normally, e.g., to immediate family members or close friends with whom they feel comfortable. They have most difficulty at school, nursery or kindergarten and in unfamiliar social situations. The disorder usually begins in transitional situations from parental home to kindergarten and elementary school. (Muris and Ollendick 2021). SM is a relatively rare disorder with a prevalence rate of around 1% (Muris and Ollendick 2015)
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