Elective mutism


Elective mutism is a now outdated term which was defined as a refusal to speak in almost all social situations, while selective mutism was considered to be a failure to speak in specific situations and is strongly associated with social anxiety disorder. 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 movies. 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.

History

In 1877, a German physician named the disorder aphasia voluntaria to describe children who were able to speak normally but often "refused" to.
In 1980, a study by Torey Hayden identified four "subtypes" of Elective Mutism:
The Diagnostic and Statistical Manual of Mental Disorders, 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", mental retardation, and trauma. Elective mutism in the third edition revised 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.