Fluency disorders and life quality: Subjective wellbeing vs. health-related quality of life

It seems intuitive that people with a fluency disorder, such as stuttering, must experience a low life quality. Yet this is not necessarily so. Whether measured life quality is lower depends on several factors, the most important of these being methodological. This is because the disciplines of medicine and the social sciences utilize quite different technologies to measure the construct. Within medicine, health-related quality of life (HROOL) is measured through constellations of perceived symptoms. Thus, if the symptoms chosen to represent HRQOL match the pathological characteristics of the fluency disorder, the relationship is self-fulfilling. Psychology, on the other hand, uses subjective wellbeing to represent life quality. Here, the relationship between symptoms and perceived life quality is much less certain. It is proposed that this partial disconnection is due to the presence of a homeostatic system which manages subjective wellbeing in an attempt to keep it positive. The paper that follows examines the construct of life quality from both disciplinary perspectives, and then reports on the findings from each discipline in relation to fluency disorders. It is concluded there is no necessary link between fluency disorders and life quality provided subjective wellbeing is used as the indicator variable. Educational objectives: : The reader will be able to describe: (i) contemporary issues in quality of life measurement; (ii) the relationship between fluency disorders and life quality; (iii) the conceptual limitations of health-related quality of life. (c) 2010 Elsevier Inc. All rights reserved.