The Association Between Possible Stress Markers and Vocal Symptoms

The interaction between voice disorders and stress for work ability of teachers

OBJECTIVE

Less attention has been paid to the interaction between voice disorders, stress, and indoor environmental quality for work ability in teachers. Therefore, our aim was to study whether lower work ability associated more strongly when the variables of voice disorders and stress at work were combined as opposed to evaluating these two factors separately.

METHODS

We conducted a questionnaire study including validated self-assessment of work ability and a technical assessment of school buildings utilizing a sample of 1198 and a subsample (n = 538) of Finnish teachers.

RESULTS

When combined, voice disorders and stress at work had a stronger association to decreased work ability than when they were evaluated separately. The occurrence of stress was more prevalent in poor and moderate work ability than the occurrence of voice disorders. Nine out of 10 of the teachers who had neither voice disorders nor stress reported good work ability, while four out of 10 of the teachers who suffered from both voice disorders and stress had poor work ability. As regards the background variables, nearly half of the subjects working in the non-problem buildings have neither stress nor voice disorders.

DISCUSSION

We recommend offering support for reducing stress at work to improve teachers' work performance. The findings also support the maintenance of school buildings and keeping them in good condition. Follow-up studies are needed to investigate the possible effects of voice disorders and the associated variables on work ability.

Effects of Age-Dependent Hormonal Changes and Estrogen Supplementation on Voice in Girls with Anorexia Nervosa-Preliminary Report

INTRODUCTION

Human development includes lots of physical and emotional changes. The human voice depends on age. Voice production is a complex physiological and acoustic phenomenon that depends on many factors such as structure, hormone level, degree of fatigue or nutrition and hydration of the body, systemic diseases, and emotional state. All these factors can be present in anorexia nervosa (AN), such as excessive weight loss, generated hydro-electrolytic changes, nutritional deficiencies, hormonal disturbances in the function of the hypothalamic-pituitary-adrenal axis, the hypothalamic-pituitary-thyroid axis, the hypothalamic-pituitary-ovarian axis, and emotional distress. The prevalence of AN ranges between 0.3% and 3%, and it is the third most common chronic disease affecting adolescent girls. However, voice changes related to AN have not been fully investigated.

OBJECTIVE

The purpose of this study was to evaluate the impact of AN on age-related changes in the voice of adolescent women-before and after puberty, particularly through acoustic analysis. An additional objective was to evaluate estrogen substitution in female patients with AN in order to investigate their effect on voice condition.

MATERIALS AND METHODS

126 girls diagnosed with AN (15.32 ± 2.12 years, range 12-19, BMI = 14.38 ± 1.67), were assessed for the condition of the voice such as perceptual voice evaluation on the GRBAS scale, maximal phonation time (MPT), laryngoscopy, with special attention to voice acoustic analysis-Multi-Dimensional Voice Program (MDVP). The control group (B) included 93 girls without eating disturbances (aged 12-19, mean age 15.52 ± 2.40, BMI = 21.50 ± 1.54). Perceptual voice assessment, aerodynamic test MPT, and acoustic parameters were analyzed in age groups (≤16 years and >16 years). The human vocal tract is sensitive to sex hormones, so the analysis was carried out in the group up to the age of 16 and above 16 to check possible effects.

RESULTS

GRBAS scale was higher in girls with AN compared to the control group for breathiness (B) (P = 0.0002) and asthenia (A) (P < 0.05). The median GRBAS scale for the older group of anorexic women was the highest (2.0). The mean MPT for group A was significantly lower (15.40 ± 3.51 seconds). Comparing age subgroups there was a prolongation of MPT in the healthy group (in groups ≤16 years and >16 years respectively 21.13 seconds versus 25.40 seconds) and a shortening in the anorectic group (≤16 years versus >16 years: 17.06 seconds versus 14.17 seconds). There was no difference between groups A and C up to 16 years of age, but above 16 years of age appeared (14.17 seconds versus 25.40 seconds). Acoustic analysis revealed lower F0 values in group A and C in older subgroups (215,85 Hz versus 236,01 Hz-statistically significant), as well as between subgroups both groups (A: 251,38 Hz versus 215,85 Hz; C: 248,20 Hz versus 236,01 Hz). A narrowing of the vocal range in girls over 16 years in group A was observed. There were no statistically significant differences in F0 between subgroups ≤16 years in groups A and C (251.38 Hz versus 248.20 Hz). The ENT study found that more than half of the girls (54.55%) over the age of 16 who took hormone supplementation manifested laryngeal structure that was normal for their age, there was no effect of hormone supplementation on any of the MDVP parameters between the drug-taking and non-drug-taking groups.

CONCLUSIONS

The acoustic results of the voice in MDVP measurements in adolescent women with AN are not within the normal range and do not mimic the normal developmental changes of the voice. The most important acoustic characteristics of the voice are changes in the fundamental frequency F0 and the range of the voice tended to be more severe in anorectic women >16 years of age and to increase with age, indicating a possible cumulative effect of malnutrition-related disorders as well as hormonal dysfunctions. MDVP can be considered a simple, non-invasive method of assessing the voice organ in AN. MPT differentiated the study groups well: statistically significant differences were noted both between the groups, as well as between age groups. There was no significant effect of oral hormone supplementation on any parameters of the voice. In conclusion, body mass and fat volume in AN may be related to voice production/physiology, affecting voice quality, voice acoustic parameters, voice aerodynamics, and phonatory range in an age-dependent manner. Future studies are needed to assess the long-term efficacy of estrogen treatment in AN.

Validating the efficacy and value proposition of mental fitness vocal biomarkers in a psychiatric population: prospective cohort study

Background

The utility of vocal biomarkers for mental health assessment has gained increasing attention. This study aims to further this line of research by introducing a novel vocal scoring system designed to provide mental fitness tracking insights to users in real-world settings.

Methods

A prospective cohort study with 104 outpatient psychiatric participants was conducted to validate the "Mental Fitness Vocal Biomarker" (MFVB) score. The MFVB score was derived from eight vocal features, selected based on literature review. Participants' mental health symptom severity was assessed using the M3 Checklist, which serves as a transdiagnostic tool for measuring depression, anxiety, post-traumatic stress disorder, and bipolar symptoms.

Results

The MFVB demonstrated an ability to stratify individuals by their risk of elevated mental health symptom severity. Continuous observation enhanced the MFVB's efficacy, with risk ratios improving from 1.53 (1.09-2.14, p=0.0138) for single 30-second voice samples to 2.00 (1.21-3.30, p=0.0068) for data aggregated over two weeks. A higher risk ratio of 8.50 (2.31-31.25, p=0.0013) was observed in participants who used the MFVB 5-6 times per week, underscoring the utility of frequent and continuous observation. Participant feedback confirmed the user-friendliness of the application and its perceived benefits.

Conclusions

The MFVB is a promising tool for objective mental health tracking in real-world conditions, with potential to be a cost-effective, scalable, and privacy-preserving adjunct to traditional psychiatric assessments. User feedback suggests that vocal biomarkers can offer personalized insights and support clinical therapy and other beneficial activities that are associated with improved mental health risks and outcomes.

A Review of Factors Associated with Voice Problems in the Fitness Instructor Population

There is a high prevalence of reported dysphonia symptomology in the fitness instructor population. This is concerning as these reported symptoms of dysphonia, aphonia, and vocal fatigue can significantly compromise quality of life. The purpose of this review is to explore key factors that may contribute to voice problems in the fitness instructor population. Voicing with concurrent phonation and exercise may be influenced by (1) the increased cardiovascular requirement during exercise, (2) the increased cognitive load associated with dual tasking, (3) the altered hydration state associated with prolonged exercise, and (4) the phonatory dose associated with continued voicing with loud background music. This manuscript will explore the literature on these key factors (ie, phonatory dose, dehydration, metabolic bioenergetics, cognitive load, and psychosocial stress) as they pertain to fitness instructors.

An Evaluation of Voice Hygiene in High School Choir Singers

BACKGROUND/OBJECTIVES

Voice hygiene, including proper hydration and limiting phonotraumatic behaviors and refluxogenic foods when appropriate, is essential to voice care for singers. The purpose of this study was to evaluate voice care practices, knowledge, and factors correlating with improved voice hygiene and knowledge in adolescents, an understudied demographic within the singing population.

METHODS

214 high school choir singers, ages 14 through 18, responded to a voice health questionnaire, which included questions about phonotraumatic behaviors and other lifestyle measures regarding voice care, perceived knowledge of the voice, and potential correlational factors such as past singing experience, having a friend or family member when is a professional voice user or possesses an in-depth knowledge of the voice, use of the Internet to sing better or improve understanding of the voice, and other factors. These data were analyzed using descriptive statistics and multivariable linear regressions.

RESULTS

Results showed poor voice hygiene. Phonotraumatic behaviors were frequent and the mean daily water intake was only 5.24 cups. However, 94.4% of the respondents warmed up their voices before rehearsals or performances. The mean total knowledge score, from 0 to 6, was only 2.09. In addition, feeling that one took care of his/her voice well, and use of Internet to sing better or advance knowledge of the voice, were correlated with improved knowledge or measures of voice health.

CONCLUSION

Data suggest that improved instruction regarding voice health in the high school setting is necessary and that the Internet or social media may be valuable resources for reaching adolescent singers.

Voice Disorders and Mental health of Basic Education Teachers in a Brazilian Municipality

OBJECTIVE

To identify associations with voice disorders in elementary school teachers of a Brazilian municipality STUDY DESIGN: This was a quantitative cross-sectional and analytical study with probability sampling carried out in the 2016 school year METHOD: Self-report of vocal complaints was used for the dependent variable vocal disorder. The independent variables were sociodemographic and occupational characteristics, working conditions that generate discomfort, habits and behaviors, mental health and self-perception of health. For the evaluation of the Burnout Syndrome (BS), the questionnaire Cuestionário para la Evaluación del Syndrome de Quemarse por el Trabajo (CESQT) was used and, for depression, the Beck Depression Inventory (BDI) scale instrument. Multiple fit models were used applying the Binary Logistic Regression RESULTS: A total of 634 teachers participated in this study. There was a predominance of women (85.3%) with mean age 40.6 years (SD ±9.5); 62.1% were married, 70.2% had children and a mean teaching time of 12.9 years (SD ±8.4); 19.3% had voice disorders; 14.5% experienced BS and 24.0% depression. Voice disorders were associated with women (OR=2.30) working longer weekly hours (OR=1.75), with psycho-emotional problems, with burnout (OR=1.95) and depressive symptoms (OR=1.70), and were also associated with women who reported negative self-perception of health (OR= 1.97) CONCLUSION: Voice disorders appear to be strongly associated with mental health problems, mainly in women, in those with a longer working week and those who reported a negative perception of health. Public policies are required to prevent psycho-emotional problems and for vocal health promotion of the teaching category.

Self-reported voice disorders of teachers and indoor air quality in schools: a cross-sectional study in Finland

OBJECTIVE

We aimed to study the association between self-reported voice disorders among teachers and indoor air quality in school buildings.

METHODS

We performed a questionnaire study of 538 Finnish teachers working in 67 school buildings utilizing both perceived and technical evaluations; the agreement between these two assessments was also studied. The technical assessment was provided by technical experts.

RESULTS

Teachers with voice disorders reported significantly more complaints from indoor air than those without voice disorders. The results also indicated a possible connection between the technical assessment and voice disorders. After adjustment for sex, stress and asthma, the prevalence of voice disorders was 47% higher in teachers working in renovated buildings compared to those working in the non-problem buildings (aRR1.47; CI 95% 1.11-1.95). The prevalence of voice disorders was 28% higher among teachers working in buildings with problems compared to those working in non-problem buildings (aRR 1.28; 95% CI 0.99-1.64).

DISCUSSION

In our study, poor perceived indoor air was significantly associated with self-reported voice disorders in teachers and there was an agreement between the perceived and technical assessments. Our results also indicated a possible connection between the technical assessment and voice disorders. Our results imply the need for longitudinal research with technical assessment to study the effect of renovation on voice disorders.

A Randomized Controlled Trial With Female Teachers: Are there Differences Between and Within the Outcomes in Voice Therapy Groups With and Without Carryover Strategies?

PURPOSE

We investigated if outcomes differ between voice therapy groups systematically using carryover strategies (attempts to generalize new vocal skills outside the clinic) and voice therapy with no emphasis on any generalizing process (here referred to as traditional voice therapy).

METHOD

A randomized controlled trial was conducted. Participants (53 female teachers with voice disorders) were randomly allocated into three groups: Carryover (a group receiving voice therapy using carryover strategies), Trad (a group receiving voice therapy with no emphasis on any generalizing process), Controls (a group on an eight-week non-therapy period). Prior to the trial a direct laryngoscopy was performed with a videolaryngostroboscopy system and/or nasofaryngofiberoscope with stroboscopy. Before and after therapy and at follow-up a voice evaluation protocol was implemented consisting of subjective assessments (Questionnaire on Voice Symptoms, and the Voice Activity and Participation Profile; VAPP), and objective measurements (voice sample recordings, acoustic analysis [SPL, sound pressure level; f0, fundamental frequency; alpha-ratio, tilt of the sound spectrum slope]).

RESULTS

No differences were found between the groups. Several significant changes occurred within the groups between initial phase vs. post-therapy and initial phase vs. follow-up. In the Carryover group text reading the alpha-ratio became lower (P = 0.011) and spontaneous speech f0 increased (P = 0.024) after the therapy and [a:] SPL increased (P = 0.042) at follow-up. In the Trad group post-therapy [a:] alpha-ratio became lower (P = 0.012) and spontaneous speech f0 decreased (P = 0.034). After therapy VAPP scores showed improvement in voice-related quality of life in both therapy groups (Carryover P = 0.003; Trad P = 0.01) but only in Carryover at follow-up (P = 0.000). Voice symptoms decreased in the Carryover group post-therapy (P = 0.001) and at follow-up (P = 0.000) and after Controls' eight-week non-therapy period (P = 0.003).

CONCLUSION

The results showed that carryover strategies give no additional advantages in voice therapy. However, the decreasing trend in the Carryover group's voice complaints at follow-up would suggest that carryover strategies may have long-lasting effects. The results also confirm that voice therapy is efficient in improving voice-related quality of life.

Psychological Stress and Vocal Symptoms Among University Professors in Israel: Implications of the Shift to Online Synchronous Teaching During the COVID-19 Pandemic

OBJECTIVES

Psychological stress may have an adverse impact on the voice. The purpose of the present cross-sectional study was to investigate the relationship between the change in levels of perceived psychological stress and vocal symptoms among Israeli academic college professors required to shift to synchronous online teaching during the global COVID-19 pandemic.

METHODS

An online questionnaire was completed by 313 professors (156 men and 157 women) from 14 academic colleges in Israel at the end of the first week of online synchronous teaching during the COVID-19 pandemic, which was assumed to be the most burdened and stressful week of the transition. Participants provided self-reports for the current levels of psychological stress and vocal symptoms during the transition to online synchronous teaching, as well as general psychological stress and general vocal symptoms during previous periods of teaching.

RESULTS

The results revealed higher levels of psychological stress but not vocal symptoms during the transition to online synchronous teaching compared with previous periods of teaching. Psychological stress during the transition to online synchronous teaching was positively associated with vocal symptoms during this period but this association was moderated by general stress. Although there was a positive association between psychological stress and vocal symptoms for individuals who reported low levels of psychological stress during previous periods of teaching, this association was especially strong for individuals who reported high levels of psychological stress during previous periods of teaching.

CONCLUSIONS

It is important to examine vocal symptoms of professors in specific contexts that are potentially stressful. The psychological stress surrounding the transition to online synchronous teaching was associated with elevated levels of vocal symptoms especially for those who reported high levels of psychological stress during previous periods of teaching. These results with professors accord with the notion that psychological stress may have a negative impact on the voice.

Aerodynamic and Acoustic Voice Measures Before and After an Acute Public Speaking Stressor

Purpose The goal of this study was to determine if differences in stress system activation lead to changes in speaking fundamental frequency, average oral airflow, and estimated subglottal pressure before and after an acute, psychosocial stressor. Method Eighteen vocally healthy adult females experienced the Trier Social Stress Test (TSST) to activate the hypothalamic-pituitary-adrenal axis. The TSST includes public speaking and performing mental arithmetic in front of an audience. At seven time points, three before the stressor and four after the stressor, the participants produced /pa/ repetitions, read the Rainbow Passage, and provided a saliva sample. Measures included (a) salivary cortisol level, (b) oral airflow, (c) estimated subglottal pressure, and (d) speaking fundamental frequency from the second sentence of the Rainbow Passage. Results Ten of the 18 participants experienced a hypothalamic-pituitary-adrenal axis response to stress as indicated by a 2.5-nmol/L increase in salivary cortisol from before the TSST to after the TSST. Those who experienced a response to stress had a significantly higher speaking fundamental frequency before and immediately after the stressor than later after the stressor. No other variable varied significantly due to the stressor. Conclusions This study suggests that the idiosyncratic and inconsistent voice changes reported in the literature may be explained by differences in stress system activation. In addition, laryngeal aerodynamic measures appear resilient to changes due to acute stress. Further work is needed to examine the influence of other stress systems and if these findings hold for dysphonic individuals.

Voice Stress Analysis: A New Framework for Voice and Effort in Human Performance

People rely on speech for communication, both in a personal and professional context, and often under different conditions of physical, cognitive and/or emotional load. Since vocalization is entirely integrated within both our central (CNS) and autonomic nervous system (ANS), a mounting number of studies have examined the relationship between voice output and the impact of stress. In the current paper, we will outline the different stages of voice output, i.e., breathing, phonation and resonance in relation to a neurovisceral integrated perspective on stress and human performance. In reviewing the function of these three stages of voice output, we will give an overview of the voice parameters encountered in studies on voice stress analysis (VSA) and review the impact of the different types of physiological, cognitive and/or emotional load. In the section "Discussion," with regard to physical load, a competition for ventilation processes required to speak and those to meet metabolic demand of exercised muscles is described. With regard to cognitive and emotional load, we will present the "Model for Voice and Effort" (MoVE) that comprises the integration of ongoing top-down and bottom-up activity under different types of load and combined patterns of voice output. In the MoVE, it is proposed that the fundamental frequency (F0) values as well as jitter give insight in bottom-up/arousal activity and the effort a subject is capable to generate but that its range and variance are related to ongoing top-down processes and the amount of control a subject can maintain. Within the MoVE, a key-role is given to the anterior cingulate cortex (ACC) which is known to be involved in both the equilibration between bottom-up arousal and top-down regulation and vocal activity. Moreover, the connectivity between the ACC and the nervus vagus (NV) is underlined as an indication of the importance of respiration. Since respiration is the driving force of both stress and voice production, it is hypothesized to be the missing-link in our understanding of the underlying mechanisms of the dynamic between speech and stress.

Voice Disorders are Associated With Stress Among Teachers: A Cross-Sectional Study in Finland

OBJECTIVES

Voice disorders are considered to be more common among teachers than other occupations. However, epidemiological data are scarce and only a few researchers have studied stress as a risk factor in voice disorders in teachers. This paper presents data from a study on Finnish school teachers which investigated the prevalence of voice disorders and evaluated the risk factors for voice disorders, especially stress.

STUDY DESIGN

A cross-sectional study was conducted among primary and secondary education teachers across Finland.

METHODS

Voice disorders were assessed with a seven-item voice questionnaire and stress at work was measured with a validated single-item question.

RESULTS

The prevalence of voice disorders over the 12-month period was 54% in the sample of 1198 primary and secondary education teachers in Finland. Of the teachers, 81% were female, and they suffered more voice disorders than the males. Stress was the most significant explanatory variable with a 3.6-fold risk as regards voice disorders. The association between voice disorders and stress was even stronger than that of asthma, asthma medication, and allergic rhinitis, which are known to cause serious risks for voice disorders in general.

CONCLUSIONS

Our results hypothesize that stress may be a multi-dimensional problem associated with various risk factors and result in an even more urgent risk of voice disorders in teachers than estimated. Longitudinal research is needed to investigate the causality between voice disorders and stress among teachers. In addition, it is recommended that in the occupational health care of teachers' consideration should be given to the fact that voice disorders and stress may have a multi-dimensional association.

Voice Disorders and Voice Knowledge in Choir Singers

OBJECTIVES

Singers have reported higher prevalence of vocally harmful behaviors, vocal symptoms, and voice disorders than nonsingers have. The purpose of this study was to investigate the prevalence of voice disorders among choir singers and to discover the risk factors associated with voice disorders. Another purpose was to explore the choir singers' knowledge about the anatomy and physiology of the voice, and voice ergonomics.

METHODS

Three hundred and fifteen adult choir singers, 65% women, and 35% men, completed a web-questionnaire. The questionnaire included demographic questions and questions about vocal symptoms, risk factors for voice disorders, and voice knowledge.

RESULTS

Twenty one percent of the participants experienced two or more frequently occurring vocal symptoms, which was defined as having a functional voice disorder. Choir singers with a vocally demanding profession were almost twice as likely to report several frequently occurring vocal symptoms. Health-related risk factors, such as inhalant allergy and asthma, had a significant relation with the number of vocal symptoms. The overall voice knowledge among the choir singers seemed limited.

CONCLUSIONS

The prevalence of voice disorders among choir singers seems to be similar to the prevalence rate among professional voice users. Choir singers with a vocally demanding profession are at a higher risk of developing a functional voice disorder. The results of this study raise the importance of educating choir singers about the voice, in order to prevent development of voice disorders.

Effect of teacher's working conditions on voice disorder in Korea: a nationwide survey

Background

Korean teacher’s working conditions are deteriorating. There is concern about the deterioration of teachers’ health and voice disorder is one of the most common problems. Teacher’s vocal health is important for them and their students. The aim of the present study was to investigate working conditions that may affect voice disorders.

Methods

In all, 79 primary and secondary schools were randomly selected for a nationwide school system survey (N = 3345). In 64 schools, 1617 (48.3%) teachers participated via a postal self-report questionnaire from June 2016 to August 2016. After applying inclusion and exclusion criteria, data from 1301 teachers’ were used for analysis. Multiple logistic regression was used to investigate the associations between general, work-related factors, and frequent voice disorders (fVDs) to estimate the adjusted odds ratio(aOR).

Results

Teachers who reported voice symptoms more than once a week (fVD) made up 11.6%. In a multiple logistic regression, fVD was significantly associated with female, difficulty in applying for sick leave as needed, music teachers (primary school), and less than 6 h of sleep per day (primary school). The aOR for fVD was 2.72 (0.83–8.10) in the longest working hours group (> 52 h/wk) among the primary school teachers, and 1.90 (0.80–4.73) in the longest class hour group (≥ 20 h/wk), 1.52 (0.90–2.62) in homeroom teachers among the secondary school teachers, but not statistically significant.

Conclusions

Korean teachers’ working conditions are associated with fVDs. The school health system must take steps to prevent and treat voice disorders of teachers.

Investigating the Role of Salivary Cortisol on Vocal Symptoms

PURPOSE

We investigated whether participants who reported more often occurring vocal symptoms showed higher salivary cortisol levels and if such possible associations were different for men and women.

METHOD

The participants (N = 170; men n = 49, women n = 121) consisted of a population-based sample of Finnish twins born between 1961 and 1989. The participants submitted saliva samples for hormone analysis and completed a web questionnaire including questions regarding the occurrence of 6 vocal symptoms during the past 12 months. The data were analyzed using the generalized estimated equations method.

RESULTS

A composite variable of the vocal symptoms showed a significant positive association with salivary cortisol levels (p < .001). Three of the 6 vocal symptoms were significantly associated with the level of cortisol when analyzed separately (p values less than .05). The results showed no gender difference regarding the effect of salivary cortisol on vocal symptoms.

CONCLUSIONS

There was a positive association between the occurrence of vocal symptoms and salivary cortisol levels. Participants with higher cortisol levels reported more often occurring vocal symptoms. This could have a connection to the influence of stress on vocal symptoms because stress is a known risk factor of vocal symptoms and salivary cortisol can be seen as a biomarker for stress.

Assessment practices of Irish speech and language therapists in the evaluation of voice disorders

It is commonly accepted that the evaluation of voice disorders ought to include extensive perceptual, psychometric, and instrumental measurements. This serves to encapsulate the wide-reaching effects of such a disorder, from the physical impairment in voice production to the psycho-social impact of having a dysphonic voice. In spite of this, no international gold standard exists by which voice disorders should be evaluated, and so speech and language therapists (SLTs) are often tasked with developing an assessment battery for use in their own clinics. The purpose of this study is to determine whether the evaluation of voice disorders by Irish SLTs on a national scale is suitably comprehensive, with particular reference to the guidelines published by the European Laryngological Society. A total of 49 SLTs working in a variety of settings responded anonymously to an electronic survey regarding their assessment practices. Results indicate that therapists are comprehensive in non-instrumental evaluation of voice, but lack both access to and training in instrumental assessment techniques.

A case study of vocal features associated with galvanic skin response to stressors in a clinical interaction

OBJECTIVE

We investigated vocal characteristics associated with physiologically determined stressful episodes by means of post-hoc acoustic analyses of speech recorded in a clinical setting. Our research addressed the understudied question of which vocal features may serve as cues naturally occurring stress and is the first to explore this issue in a pitch accent language.

METHODS

The vocal profile of a single female patient interacting with a physician was analyzed with standard speech analysis software for acoustic indicators of stress-related arousal determined by galvanic skin response measurements.

RESULTS

Vocal jitter, representing an aspect of voice quality perceived as hoarseness, appeared to increase during and immediately after skin conductance response intervals. Skin conductance levels during the response intervals were negatively correlated with acoustic features used to approximate the perception of voice unsteadiness (slope and standard deviation of fundamental frequency).

CONCLUSION

An acoustic analysis of vocal properties of speech uttered during independently detected skin conductance response intervals revealed individual patterns for some acoustic features linked to stress in earlier studies.

PRACTICE IMPLICATIONS

Non-invasive methods of arousal detection in physician-patient communication based on acoustic analyses of vocal profiles may, in combination with other analyses, help identify stressful events and thus improve the process of medical information gathering and decision-making.

The application of fractional Mel cepstral coefficient in deceptive speech detection

The inconvenience operation of EEG P300 or functional magnetic resonance imaging (FMRI) will be overcome, when the deceptive information can be effectively detected from speech signal analysis. In this paper, the fractional Mel cepstral coefficient (FrCC) is proposed as the speech character for deception detection. The different fractional order can reveal various personalities of the speakers. The linear discriminant analysis (LDA) model (which has the ability of global optimal vector mapping) is introduced, and the performance of FrCC and MFCC in deceptive detection is compared when all the data are mapped to low dimensional. Then, the hidden Markov model (HMM) is introduced as a long-term signal analysis tool. Twenty-five male and 25 female participants are involved in the experiment. The results show that the clustering effect of optimal fractional order FrCC is better than that of MFCC. The average accuracy for male and female speaker is 59.9% and 56.2%, respectively, by using the FrCC under the LDA model. When MFCC is used, the accuracy is reduced by 3.2% and 5.9%, respectively, for male and female. The accuracy can be increased to 71.0% and 70.2% for male and female speakers when HMM is used. Moreover, some individual accuracy is increased over 20%, or even more than 85%, when FrCC is introduced. The results show that the deceptive information is indeed hidden in the speech signals. Therefore, speech-based psychophysiology calculating may be a valuable research field.

Autoavaliação vocal de professores de Santa Maria/RS

Resumo:OBJETIVO:associar e correlacionar índice de desvantagem vocal, qualidade de vida e sintomas vocais com sexo, presença de queixas vocais e características profissionais de professores de Santa Maria (RS/Brasil).MÉTODOS:114 indivíduos, entre 20 e 66 anos, 102 mulheres e 12 homens, professores do ensino fundamental das redes de ensino estadual, municipal e particular, que responderam aos instrumentos: Escala de Sintomas Vocais, Índice de Desvantagem Vocal e Qualidade de Vida em Voz, um questionário, elaborado pelos pesquisadores, contendo dados de identificação, de saúde geral, ocupacionais e presença ou ausência de queixas vocais.RESULTADOS:os professores atuavam em média 6,96h por dia, há, em média, 12,7 anos; 72,8% apresentavam queixas vocais; 50% pertenciam à rede de ensino particular, 37,7% à rede estadual e 12,3% à rede municipal. Houve associação entre as escalas de autoavaliação vocal e a presença de queixas vocais, não havendo correlação com idade e características profissionais. Houve maior ocorrência de sintomas vocais em mulheres. A Escala de Sintomas Vocais e o Índice de Desvantagem Vocal mostraram correlação positiva e houve correlação negativa de ambos os protocolos em relação ao Qualidade de Vida em Voz.CONCLUSÃO:professores com queixas apresentaram maior ocorrência de sintomas vocais, maior índice de desvantagem vocal e menor de qualidade de vida relacionada a voz, havendo maior ocorrência de sintomas vocais no sexo feminino. Houve complementaridade entre os instrumentos de autoavaliação vocal.

Vocal Hyperfunction in Parents of Children With Attention Deficit Hyperactivity Disorder

OBJECTIVE

The objective of this study was to evaluate the presence of habits and symptoms of vocal hyperfunction in the parents of children with attention deficit hyperactivity disorder (ADHD).

METHODS

Parents of 24 children with ADHD and 30 children of a control group completed a specific questionnaire to detect the hyperfunctional use of the voice (excessive talking, excessive loudness, talking too fast, and shouting), hoarseness, vocal fatigue, mental and physical fatigue, and the degree of parental concern for the vocal health of their child.

RESULTS

Parents of children with ADHD spoke more often, faster, and stronger than the parents of the control group; in addition, they also used a louder volume than they usually used when they spoke to their children. The parents manifested more vocal, mental, and physical fatigue than the parents of the control group. There was a significant correlation between the "concern" for the vocal health of their children with respect to vocal symptoms of the children, the habits of vocal hyperfunctioning, and the symptoms suffered by the parents.

CONCLUSIONS

These results suggest that the parents of children with ADHD change their vocal attitude when communicating with their children. Most likely, the increased concern of parents with ADHD children and their respective level of stress lead to hyperfunctional vocal usage. This subsequently leads to symptoms of vocal, physical, and mental fatigue at the end of the day.