Personality traits inventory in patients with vocal nodules

Investigation of the Relationship Between Temperament and Personality Traits and Voice Disorders in Religious Officials

OBJECTIVE

Our study aims to determine the presence of voice disorder in religious officials and to examine the differences in temperament and personality traits between religious officials with and without voice disorder.

METHODS AND PROCEDURES

A total of 87 religious officials between the ages of 18 and 65 were included in the study. For the objective evaluation of the voice of all individuals, a videolaryngostroboscopic examination was performed by a specialist Ear Nose Throat physician using a rigid endoscope. For temperament and personality assessments, each participant completed the TEMPS-A Temperament Rating Scale Turkish version and the Big Five-50 Personality Test Turkish Form (B5KT-50-Tr). All individuals were divided into groups according to the presence of voice disorder.

RESULTS

Sixty-five of 87 individuals were found to have normal voice health, and 22 individuals were diagnosed with voice disorder. While there was a significant difference between the groups with and without voice disorder in terms of extraversion and emotional stability scores on the B5KT-50-Tr scale (P < 0.05), there was no significant difference in TEMPS-A temperament scale scores.

CONCLUSIONS

There was no discernible disparity in the temperament traits of religious officials with and without voice disorders. It should be emphasized that religious officials who suffer from voice disorders exhibit personality traits such as low extroversion and emotional stability. The improvement of more effective intervention strategies can be boosted by considering the temperament and personality traits of these individuals while planning the voice assessment and therapy processes of these religious officials.

Relations Between Dysphonia and Personality: An Approximation From Gray' Theories

Our study sought to show the relation between dysphonia and personality traits as explained by Gray's theories. Personality traits were analyzed in a patient group of 141 patients who showed functional and congenital voice disorders. The results were compared to the control group made up of 99 vocally healthy individuals. Their objective voice quality was measured by using the Dysphonia Severity Index, Voice Handicap level was measured using the VHI-10, and a perceptive analysis was conducted with a listening jury. The results showed significant differences in Introversion and Neuroticism and a greater tendency for activating the behavioral inhibition system in the patient group. Such an influence was also evident in voice quality measures. The results were similar to specialized literature.

Voice Disorders and Personality: New Steps on an Old Path

OBJECTIVES

This study examined the association between voice disorders and personality by comparing a heterogenic group of dysphonic patients to non-dysphonic speakers using the NEO-FFI big-five personality inventory.

METHODS

A group of 100 dysphonic patients diagnosed with 24 different pathologies was compared to 149 non-dysphonic speakers. Inter-group differences on the five NEO-FFI scales were evaluated using three analysis approaches, a general comparison between the dysphonic and non-dysphonic groups and arranging pathologies using a categorical and a continuous approach.

RESULTS

Of the five NEO-FFI scales, Openness emerged as the single personality trait that yielded a statistically significant difference between the dysphonic group and the non-dysphonic group (P < 0.001). Moreover, when the 24 pathologies were arranged categorically, people with structural pathologies were lower on the Openness scale than non-dysphonic speakers (P < 0.001). Similarly, when pathologies were arranged continuously, people with pathologies characterized by high organicity were low on the Openness scale compared to the non-dysphonic group (P < 0.001).

CONCLUSIONS

This study represents a new approach to examining the association between voice disorders and personality. Openness emerged as the single personality trait that repeatedly and consistently differentiated between dysphonic and non-dysphonic people and among specific pathologies, using all analysis approaches. Our findings suggest that examining a spectrum of pathologies, rather than focusing on a particular pathology, provides a new perspective and sheds light on the complex association between voice disorders and personality.

Clinical Psychology and Voice Disorders: A Meta-Analytic Review of Studies Assessing Psychological Characteristics Across Individuals With and Without Voice Disorders

OBJECTIVES

Clinical voice disorders are heterogenous conditions capturing problems with voice production and control. Psychological conceptualizations of voice disorders posit that mood, anxiety, and personality characteristics contribute to the development and maintenance of voice symptoms. This review brings together research comparing these psychological characteristics across groups with and without voice disorders, with the aim of profiling group differences.

METHODS

A systematic search of PubMed, CINAHL, Ovid (PsycInfo, MEDLINE, Embase), and Web of Science databases was conducted, with studies required to assess psychological characteristics between samples with and without voice disorders. Relative study quality and risk of bias were formally evaluated, synthesizing results via meta-analysis (estimating standardized mean difference; SMD) and narrative synthesis.

RESULTS

Thirty-nine studies (N = 4740) were reviewed. Marked psychological differences were observed between case-control groups, including significantly higher self-reported features of depression (SMD = 0.50), state anxiety (SMD = 0.58), trait anxiety (SMD = 0.52), health anxiety (SMD = 0.57), and neuroticism (SMD = 0.47) in voice disorder groups. However, less consistent patterns of difference were observed between voice disorder types, including minimal quantitative differences between functional and organic diagnoses.

CONCLUSIONS

Findings underline and formulate the psychological features associated with experiencing a voice disorder, indicating individuals with voice disorders present with considerable psychological needs that may benefit from clinical psychology input.

Tekrarlayan ve düzelen multipl sklerozda mizaç ve karakter: klinik faktörler ve psikiyatrik bozukluklarla ilişkisi

Amaç: Yaşam kalitesi üzerindeki etkilerine rağmen, multipl sklerozda mizaç ve karakter yeterince araştırılmamıştır. Mizaç ve karakter boyutlarını, i, bunların klinik özelliklerle ilişkisini ve depresyon şiddetini etkileyen faktörleri tekrarlayan ve düzelen multiple skleroz (TDMS) hastalarında incelemeyi amaçladık. Gereç ve Yöntem: Bu kesitsel çalışmaya, elverişli örnekleme yöntemiyle 67 hasta (erkek/kadın=12/55) (medyan yaş=30 (18-53)) ve yaş ve cinsiyet açısından eşleştirilmiş 50 sağlıklı kontrol (SK) (erkek/kadın=16/34) (medyan yaş= 26.5 (18-60)) alındı. Mizaç ve Karakter Envanteri, Beck Depresyon ve Beck Anksiyete Envanterleri, DSM-Eksen I Bozuklukları için Yapılandırılmış Klinik Görüşme uygulandı. Bulgular: Hasta grubu içinde, psikiyatrik komorbiditesi olan 45 (MSP), psikiyatrik komorbiditesi olmayan (MSO) 22 hasta bulunuyordu. MSP grubu, MSO grubuna ve SK’lere göre daha yüksek kendilik kaybı gösterdi. MSP grubu ve MSO grubu toplam zarardan kaçınma puanları SK’lere kıyasla yüksekti. Toplam kendini yönetme puanları MSP grubunda SK’lerden düşüktü. EDSS, hastalık süresi, toplam nüks sayısı depresyon şiddetini etkilemezken; yüksek anksiyete (Β=0,416) ve düşük amaçlılık düzeyleri (Β=-1,565) depresyon düzeyini anlamlı derecede etkilemekteydi (R2=0.50, F=32.459). Sonuç: Komorbid psikiyatrik bozukluğu olan ve olmayan hastalar arasında mizaç ve karakter özellikleri açısından farklılıklar gözlendi. Artmış anksiyete düzeyleri; anlamlı hedefler belirleme ve bunlara ulaşmada güçlük, artmış depresyon düzeyleriyle ilişkili olabilir. Gelecek çalışmalar, daha geniş örneklemlerde, baş etme, sağlık davranışları ve dayanıklılığın kendilik kaybı ve psikiyatrik bozukluklar arasındaki aracı ve düzenleyici rolünü inceleyerek, psikiyatrik bozukluklara yönelik müdahalelerin tanımlanmasına yardımcı olabilir. Anksiyete belirtilerinin etkin tedavisi ve yaşam amaçlarının ele alınması, davranışsal müdahalelerin planlanması için olası hedeflerdir.

Hoarseness: its spectrum, associations and management in a tertiary care centre in India

Objective

To determine the demographic, aetiopathological and diagnostic profiles of patients presenting with hoarseness to a laryngology unit of a tertiary care centre in India.

Methods

A retrospective observational study was conducted.

Results

The 1033 patients who presented with dysphonia showed a male predominance (70 per cent), high rates of malignancy (18 per cent), late presentation (mean, 24 months) and poor follow-up trends (53 per cent with 3 months’ follow up), which contrasts with data from developed countries. The patient population hailed from different states in India and neighbouring countries around India, serving as a good sample for the subcontinent. The majority (67 per cent) were managed conservatively; however, surgical management was the preferred choice for those who presented with airway stenosis (91 per cent) and laryngeal trauma (75 per cent). Significant associations between vocal professionalism level and co-morbidities and dysphonia aetiopathologies are discussed.

Conclusion

These findings give insight into the trends of hoarseness in the developing Indian subcontinent, which can aid understanding and management.

Personality in Children With Vocal Fold Nodules: A Multitrait Analysis

Purpose Vocal fold nodules (VNs) are bilateral, symmetrical, callous-like lesions secondary to phonotrauma and possibly related to specific personality traits. This case-control study examined the relation between personality and VNs in children within the context of the Trait Theory of VNs. Method Parents of children with VNs (N = 39, M = 7.43, SD = 2.01 years) and two medical control groups (i.e., voice disordered controls, but not VNs [VDCs; N = 40, M = 7.09, SD = 2.01 years] and vocally normal controls [VNCs; N = 40, M = 7.6, SD = 1.54 years]) completed the Inventory of Child Individual Differences, a personality instrument that describes the Big Five superfactors as well as 15 lower order personality traits. Results Children with VNs, as compared with VNCs, were (a) emotionally reactive (i.e., higher N-Neuroticism, p < .005, Cohen's d = 0.53), (b) Antagonistic, Strong-Willed, and less Compliant (i.e., lower A-Agreeableness, p < .014, Cohen's d = 0.59), and (c) Distractible and Disorganized (i.e., lower C-Conscientiousness, p < .009, Cohen's d = 0.62). Both voice disordered groups displayed elevated scores on the personality superfactor of Neuroticism (N; and the "Negative Emotions" lower order trait). Conclusions The combination of personality traits identified in this study (i.e., high N, low A and C) may play a central role in VNs development and possibly attenuate voice therapy success. Children with VNs displayed a similar personality typology as women with VNs, with the exception of elevated Extraversion (E), thereby providing support for the relevance of the Trait Theory of VNs in both children and adults. Clinicians treating children with voice disorders, including VNs, should consider their underlying personality traits in assessment and management.

Self-referred personal behavior profile of university professors: association with communicative and vocal self-evaluation

PURPOSE

Describe the self-referred personal behavior profiles of university professors and verify the association of these profiles with the self-assessment of communicative aspects and vocal symptoms.

METHODS

Study conducted with 334 professors at a public university who responded to an online questionnaire regarding voice use in teaching practice. Personal behavior profile classification was the response variable, which was divided into four types: pragmatic, analytical, expressive and affable. Explanatory variables were vocal self-perception, vocal resources, and communicative aspects. Descriptive data analysis was performed with application of the Pearson's Chi-squared and Fisher's Exact tests.

RESULTS

University professors identified themselves more with the affable and expressive personal behavior profiles. Overall, professors presented good self-perception about vocal and communicative aspects, in addition to having reported few vocal symptoms. Profiles differed for some of the assessed variables, namely, pragmatic professors reported high speech velocity and sporadic eye contact; expressive professors demonstrated self-perception about their voice and strong voice intensity; those in the analytical profile self-reported negative perception about vocal quality, weak voice intensity, poor articulation and rapid speaking rate; the other professors mostly reported voice tiredness symptoms and difficulty projecting the voice.

CONCLUSION

University professors identify themselves mostly with the affable and expressive profiles. Self-perception analysis of the personal behavior profile in university professors showed the influence of self-reported personality characteristics on communicative skills in the classroom.

Acoustic correlates of vocal effort: External factors and personality traits

OBJECTIVES

To develop an experimental protocol to study the vocal effort generated by introducing barriers to communication, and its relationship with certain personality traits.

MATERIAL AND METHODS

The experimental protocol consisted of an interactive game in which the subject gave an investigator instructions to adopt various body positions (semi-directed communication situation). The Control situation included no constraints on communication. Then a Distance Constraint (increased distance between subject and investigator) and a Time Constraint (generation of performance stress by putting the subject in competition with others) were introduced. The vocal parameters studied comprised vocal intensity and fundamental frequency in the middle of the vowel of 3 target phonemes. Subjects also took the NEO FFI-R personality test.

RESULTS

The study included 41 women aged between 18 and 52 years. Vocal intensity and fundamental frequency increased significantly with the introduction of the constraints (P<0.05), intensity passing from 75.5dB to 81.8dB and frequency from 249.4Hz to 335.8Hz. No correlations were found between these changes and results for the various personality traits.

CONCLUSIONS

This ecological protocol enables the impact of both physical and emotional obstacles to communication to be studied. No correlations between vocal effort and personality traits emerged. A larger-scale study would be necessary to analyze the continuum between vocal effort and vocal forcing, to improve speech therapy for dysfunctional dysphonia.

Intervention Outcomes of Two Treatments for Muscle Tension Dysphonia: A Randomized Controlled Trial

Purpose The aim of this study was to test the hypothesis that stretch-and-flow voice therapy (SnF) is noninferior to resonant voice therapy (RVT) for speakers with muscle tension dysphonia. Method Participants with primary muscle tension dysphonia were randomly assigned to 1 of 2 treatment groups. Participants received 6 sessions of either SnF or RVT for 6 weeks (1 session per week). Pretreatment and posttreatment audio recordings of sustained vowels and connected speech were acquired. Response to treatment was assessed using the voice handicap index (VHI) as the primary outcome measure. Secondary outcome measures included the acoustic voice quality index, the smoothed cepstral peak prominence, and scales from the Consensus Auditory-Perceptual Evaluation of Voice instrument. Data were analyzed for 21 participants who completed the study (12 in the SnF group, 9 in the RVT group). Results Direction of change for the primary outcome measure and all 3 secondary outcome measures at posttreatment was in the direction of improvement for both SnF and RVT. Confidence intervals for VHI measures did not cross the null effect line on forest plots, suggesting significant effects for both treatments on the primary outcome measure. The effect sizes for pretreatment to posttreatment changes in VHI were large for both treatment groups. Similar results were found for the secondary acoustic outcome measures. There were statistically significant pretreatment to posttreatment changes in the primary and secondary outcome measures for patients receiving both treatments, indicating significant improvement in response to both RVT and SnF. There were no statistically significant differences in pretreatment to posttreatment changes in the primary outcome measure or any secondary outcome measure between the two groups. The within-group pretreatment to posttreatment changes in Consensus Auditory-Perceptual Evaluation of Voice scales did not reach statistical significance for either RVT or SnF. Conclusions Both SnF and RVT produced positive treatment response in speakers with muscle tension dysphonia, with no statistically significant difference in the outcome measures between the two treatments. This suggests that SnF is noninferior to RVT and that both are effective options for treating vocal hyperfunction. Results from this study also support previous findings documenting the sensitivity of multidimensional acoustic measurements to treatment response.

Personality, Psychological Factors, and Behavioral Tendencies in Children With Vocal Nodules: A Systematic Review

OBJECTIVES

This systematic review examined the evidence linking vocal nodule development in children to personality traits, psychological factors, and associated behavioral tendencies.

METHODS

Four electronic databases-PubMed, Scopus, ScienceDirect, EBSCO Host-as well as the reference lists from articles (including online sources) were searched. After screening for relevance, eight comparative, case-control studies were identified that met inclusion criteria. The quality of each study was evaluated by two raters using a modified, standardized checklist.

RESULTS

Four studies were rated as "good quality" and four were "fair". The questionnaires used to measure personality or psychological factors varied widely among the studies, and the results linking personality dispositions (and associated behavioral inclinations) to vocal nodule development in children were mixed.

CONCLUSIONS

Fair to good quality evidence exists to suggest that psychological factors or personality traits related to extraversion and impulsivity (and their related behavioral inclinations) might predispose children to vocal nodules and deserve further attention. Clinical implications, limitations of the current systematic review, and recommendations for future research are also discussed.

Personality Traits of Children With Vocal Fold Nodules

This is a case-control study investigating the personality profiles of children with vocal fold nodules (VFNs). Personality has been suggested as a contributing factor to VFN in adults and in children. However, previous studies in children have focused on psychopathologic traits and have reported contradictory findings. The aim of our study was to explore whether general, nonpathologic personality structure predicts the presence of VFN in children. Personality traits were measured in 34 children with VFN, aged 6.0-13.6, and 34 age- and sex-matched normophonic controls by means of a pediatric five-factor personality questionnaire. Children with VFN were found to be significantly more extroverted than controls (P = 0.022, d = 0.61), and a binary logistic regression showed that extraversion significantly predicted the presence of VFN in our population (P = 0.027). The clinical implications of the results are discussed.