Elective mutism

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Elective mutism is an outdated term which was defined as a refusal to speak in almost all social situations (despite normal ability to do so), while selective mutism was considered to be a failure to speak in specific situations and is strongly associated with social anxiety disorder. [1] In contrast to selective mutism, it was thought someone who was electively mute may not speak in any situation, as is usually shown in books and films. Elective mutism was often attributed to defiance or the effect of trauma. Those who are able to speak freely in some situations but not in others are now better described by selective mutism. [2]

Contents

History

In 1877, a German physician named the disorder aphasia voluntaria to describe children who were able to speak normally but often "refused" to. [3]

In 1980, a study by Torey Hayden identified four "subtypes" of Elective Mutism: [4]

The Diagnostic and Statistical Manual of Mental Disorders (DSM), first published in 1952, first included Elective Mutism in its third edition, published in 1980. Elective mutism was described as "a continuous refusal to speak in almost all social situations" despite normal ability to speak. While "excessive shyness" and other anxiety-related traits were listed as associated features, predisposing factors included "maternal overprotection", intellectual disability, and trauma. Elective mutism in the third edition revised (DSM III-R) is described similarly as in the third edition except for specifying that the disorder is not related to social anxiety disorder.

In 1994, the fourth edition of the DSM reflected the name change to selective mutism and redefined the disorder.

Cultural references

Though elective mutism is no longer recognized by most psychiatrists, it is a popular character element or plot point in stories and movies. Many characters choose to stop speaking, for various reasons. Even more commonly, there are also characters who stop speaking after a traumatic incident. In both these cases, often, and almost always in the second, the character is silent in all situations. This is therefore not selective mutism, and anxiety is very rarely involved. Selective mutism itself is almost nonexistent in pop culture.

The following are a few references to stories including a character who does not speak despite being physically able to:

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Selective mutism (SM) is an anxiety disorder in which a person who is otherwise capable of speech becomes unable to speak when exposed to specific situations, specific places, or to specific people, one or multiple of which serving as triggers. This is caused by the freeze response. Selective mutism usually co-exists with social anxiety disorder. People with selective mutism stay silent even when the consequences of their silence include shame, social ostracism, or punishment.

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References

  1. Harris, Holly F. (January 1996). "Elective Mutism: A Tutorial". Language, Speech, and Hearing Services in Schools. 27 (1): 10–15. doi:10.1044/0161-1461.2701.10. ISSN   0161-1461.
  2. Johnson, Maggie; Wintgens, Alison (2016). The Selective Mutism Resource Manual (2nd ed.). Routledge & CRC Press. ISBN   9781909301337.
  3. "Selective Mutism - What is Selective Mutism?". Archived from the original on 2007-12-14. Retrieved 2023-11-19.
  4. Hayden, Torey L. (1980-12-01). "Classification of Elective Mutism" (PDF). Journal of the American Academy of Child Psychiatry. 19 (1): 118–133. doi:10.1016/S0002-7138(09)60657-9. ISSN   0002-7138. PMID   7365164.
  5. Andrews, V.C. (31 July 2001). Ice. Pocket. ISBN   9780671039943.