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Josep VR, Laura GS, Jesús VG. Relations Between Dysphonia and Personality: An Approximation From Gray' Theories. J Voice 2024; 38:542.e1-542.e7. [PMID: 34782228 DOI: 10.1016/j.jvoice.2021.09.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022]
Abstract
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.
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Affiliation(s)
- Vila-Rovira Josep
- Facultat de Psicologia i Ciències de l'Educació i de l'Esport, Universitat Ramon Llull, Barcelona, Spain.
| | - González-Sanvisens Laura
- Facultat de Psicologia i Ciències de l'Educació i de l'Esport, Universitat Ramon Llull, Barcelona, Spain
| | - Valero-Garcia Jesús
- Facultat de Psicologia i Ciències de l'Educació i de l'Esport, Universitat Ramon Llull, Barcelona, Spain
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Lodhavia A, Kempster GB. Fidelity to the Consensus Auditory-Perceptual Analysis of Voice (CAPE-V): A Pilot Study. J Voice 2024:S0892-1997(23)00394-6. [PMID: 38185581 DOI: 10.1016/j.jvoice.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVES Auditory-perceptual measurements of voice are among the most common diagnostic tools used during a voice evaluation and are considered a gold standard for documenting voice disorders. The goal of this pilot study was to examine the fidelity of clinicians in the administration of the Consensus Auditory-Perceptual Evaluation of Voice (CAPE-V) and its published protocol. This investigation aimed to determine how the CAPE-V is being used by clinicians and researchers and the extent to which users deviate from the published procedure. STUDY DESIGN Survey METHODS: Data were collected by surveying a group (N = l7) of speech-language pathologists who regularly evaluate and treat patients with voice disorders. Survey results revealed that few of the sampled speech-language pathologists follow exactly the standardized instructions for administering the CAPE-V. Considerable variability in CAPE-V administration, including tasks and stimuli examined, was found across respondents. CONCLUSIONS This exploratory project may be used to develop a larger national survey study investigating fidelity to the CAPE-V and to motivate recommendations for possible revisions to the instrument and its protocol for administration.
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Affiliation(s)
- Anjli Lodhavia
- Department of Communication Disorders and Sciences, College of Health Sciences, Rush University, Rush University Medical Center, Chicago, Illinois; Department of Neurology, Division of Speech-Language Sciences and Disorders, Henry Ford Health, West Bloomfield, Michigan
| | - Gail B Kempster
- Department of Communication Disorders and Sciences, College of Health Sciences, Rush University, Rush University Medical Center, Chicago, Illinois; Associate Professor, Emerita, Department of Communication Disorders and Sciences, College of Health Sciences, Rush University, Rush University Medical Center, Chicago, Illinois.
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Gartling GJ, van Mersbergen M, Crow K, Lewandowski A, Smith LJ, Gartner-Schmidt JL. The Patient Experience: The Relationship Between Vocal Handicap, Congruency, Perceived Present Control, and Mood Across Four Voice Disorders. J Voice 2024; 38:244.e15-244.e27. [PMID: 34615615 DOI: 10.1016/j.jvoice.2021.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The potential for negative sequalae in psychosocial well-being presents clinical importance to the assessment of voice disorders. Despite the impairment voice disorders cause in the psychosocial domain, the clinical assessment of these disorders relies heavily on visual perceptual judgments of the larynx, audio-perceptual, as well as acoustic and aerodynamic measures. While these measures aid in accurate diagnosis and are necessary for standard of care, they present little insight into the patient experience of having a voice disorder. DESIGN Retrospective between-subject, non-experimental design. METHODS Data from 335 patients from the University of Pittsburgh Voice Center were collected from scores of the Voice Handicap Index-10 (VHI-10) and two recent questionnaires, the Voice Present Perceived Control scale (VPPC), and the Vocal Congruency Scale (VCS). Examining how these voice-specific scales related to three mental health screeners for stress (Perceived Stress Scale-4), anxiety (Generalized Anxiety Disorder-7) and depression (Patient Health Questionnaire-9) were also examined. Patient diagnoses included primary muscle tension dysphonia (pMTD), unilateral vocal fold paralysis (UVFP), vocal fold atrophy, and mid membranous vocal fold lesions. RESULTS There were significant differences in scores from the voice-specific scales between diagnostic groups with UVFP being the highest (worst) in VHI-10 and UVFP being the lowest (worst) in VCS compared to healthy controls. There was no significant difference in VPPC scores between diagnostic groups. Results showed statistically significant inverse relationships between the VHI-10 and the VPPC and between the VHI-10 and VCS for all diagnostic groups. A significant direct relationship was found between the VPPC and the VCS for patients diagnosed with MTD, UVFP and Lesions. In sum, patients with UVFP presented with the most frequent and sometimes strongest relationships between voice and mental health measures. DISCUSSION This study marks an initial investigation into the nuanced patient experience of having a voice disorder. Three theoretically unrelated voice constructs: handicap, perceived control, and sense of self, were measured via self-report. Results from this study describe the patient experience correlating to these constructs with weak correlations to stress, anxiety, and depression. Findings also clearly suggest that patient experience varies among diagnostic groups, as well as varying constructs. Measures of multiple constructs of patient perception provide valuable insight into a patient's experience of their voice disorder, guidance on the direction of voice treatment, and justification for such treatments.
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Affiliation(s)
- Gary J Gartling
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
| | - Karen Crow
- Louisville Center for Voice Care, Louisville, Kentucky
| | - Ali Lewandowski
- University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Libby J Smith
- University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jackie L Gartner-Schmidt
- Communication Science and Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania; University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.
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Amir O, Noam G, Primov-Fever A, Epstein R, Alston M, Gutman I. Voice Disorders and Personality: New Steps on an Old Path. J Voice 2023:S0892-1997(23)00359-4. [PMID: 37980210 DOI: 10.1016/j.jvoice.2023.10.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 10/31/2023] [Accepted: 10/31/2023] [Indexed: 11/20/2023]
Abstract
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.
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Affiliation(s)
- Ofer Amir
- Department of Communication Disorders, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Israel.
| | - Gaya Noam
- Department of Communication Disorders, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Hearing, Speech, and Language Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Adi Primov-Fever
- Department of Otolaryngology, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Department of Otorhinolaryngology, Head & Neck Surgery, Sheba Medical Center, Tel-Hashomer, Israel
| | - Ruth Epstein
- Department of Speech and Language Therapy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Marion Alston
- Department of Speech and Language Therapy, University College London Hospitals NHS Foundation Trust, London, UK
| | - Idit Gutman
- School of Psychological Sciences, Tel Aviv University, Tel-Aviv, Israel
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Rubino M, Dietrich M, Abbott KV. Initial Theoretical Discussion of Identity as Barrier and Facilitator in Voice Habilitation and Rehabilitation. J Voice 2023:S0892-1997(23)00295-3. [PMID: 37867071 DOI: 10.1016/j.jvoice.2023.09.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/20/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVES The purpose of this paper is to review seminal identity theories grounded in social psychology and one concept from voice science and explain how this group may point to identity factors facilitating or impeding voice habilitation and rehabilitation. METHODS Identity theories from the social psychology literature (Dramaturgical Theory, Self-Categorization Theory, Self-Determination Theory, Identity Negotiation Theory) and vocal congruence are described. Concepts are synthesized with voice science research to explore potential identity-behavior relations at play in voice habilitation and rehabilitation. RESULTS Applicable concepts from social psychology and voice science suggest identity-related processes by which a client may or may not develop a voice difference/disorder, seek intervention, and achieve goals in intervention. A bidirectional relationship between identity and behavior has been well-established in the social psychology literature. However, the relevance of vocal behavior has yet to be formally examined within this literature. Importantly, although connections between behavioral tendencies and voice disorders as well as the contribution of identity to gender-affirming voice treatment have been established in the voice science literature, the consideration of identity's possible role in voice habilitation and rehabilitation in cis gender individuals has thus far been scant. CONCLUSIONS Research into identity and voice habilitation and rehabilitation may help to improve voice intervention outcomes. A possible adjunct to human studies is agent-based modeling or other computational approaches to assess the myriad factors that may be relevant within this line of inquiry.
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Affiliation(s)
- Marianna Rubino
- Department of Communication Sciences and Disorders, University of Houston, Houston, Texas.
| | - Maria Dietrich
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Germany
| | - Katherine Verdolini Abbott
- Department of Linguistics and Cognitive Science, University of Delaware, Newark, Delaware; Department of Communication Sciences and Disorders, University of Delaware, Newark, Delaware
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Yuksel P, Maxwell P, Sataloff RT. An Evaluation of Voice Hygiene in High School Choir Singers. J Voice 2023:S0892-1997(23)00205-9. [PMID: 37598065 DOI: 10.1016/j.jvoice.2023.06.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/27/2023] [Accepted: 06/28/2023] [Indexed: 08/21/2023]
Abstract
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.
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Affiliation(s)
- Pelin Yuksel
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Philip Maxwell
- Department of Otolaryngology - Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Robert T Sataloff
- Department of Otolaryngology-Head and Neck Surgery, Senior Associate Dean for Clinical Academic Specialties, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
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Mayne GV, Namazi M. Social Determinants of Health: Implications for Voice Disorders and Their Treatment. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:1050-1064. [PMID: 37059074 DOI: 10.1044/2023_ajslp-21-00183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
PURPOSE Adverse childhood experiences (ACEs) and related conditions, such as discrimination, are social determinants of health (SDOHs). Critical race theory (CRT) is a lens through which to understand SDOHs in a way that may impact our clinical care. When prolonged or chronic, SDOHs might cause toxic stress and trauma, which, in turn, adversely affect health and are shown to be relevant for some voice disorders. The goals of this tutorial are to (a) review the literature on SDOHs that potentially contribute to disparities; (b) discuss explanatory models and theories that describe how psychosocial factors influence health; (c) relate the foregoing information to voice disorders, highlighting functional voice disorders (FVDs) as a particular case in point; and (d) describe how trauma-informed care can improve patient outcomes and advance health equity for vulnerable populations. CONCLUSIONS This tutorial concludes with a call for heightened awareness of the role that SDOHs such as structural and individual discrimination may play in voice disorders, and a call for research into SDOHs, traumatic stress, and health disparities in this patient population. A call is also made for more universal practice of trauma-informed care in the clinical voice domain.
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Affiliation(s)
- Geneva V Mayne
- School of Communication Disorders and Deafness, Kean University, Union, NJ
| | - Mahchid Namazi
- School of Communication Disorders and Deafness, Kean University, Union, NJ
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Ostermann TA, Fuchs M, Hinz A, Engel C, Berger T. Associations of Personality, Physical and Mental Health with Voice Range Profiles. J Voice 2023:S0892-1997(22)00377-0. [PMID: 36599716 DOI: 10.1016/j.jvoice.2022.11.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/17/2022] [Accepted: 11/18/2022] [Indexed: 01/03/2023]
Abstract
OBJECTIVES There is evidence in the literature that voice characteristics are linked to mental and physical health. The aim of this explorative study was to determine associations between voice parameters measured by a voice range profile (VRP) and personality, mental and physical health. STUDY DESIGN Cross-sectional population-based study. METHODS As part of the LIFE-Adult-Study, 2639 individuals aged 18-80 years, randomly sampled from the general population, completed both speaking and singing voice tasks and answered questionnaires on depression, anxiety, life satisfaction, personality and quality of life. The voice parameters used were fundamental frequency, sound pressure level, their ranges and maximum phonation time. The associations were examined with the help of correlation and regression analyses. RESULTS Wider ranges between the lowest and highest frequency, between the lowest and highest sound pressure level and longer maximum phonation time were significantly correlated with extraversion and quality of life in both sexes, as well as openness and agreeableness in women. Smaller ranges and shorter maximum phonation time were significantly correlated with depression. Neuroticism in men was inversely correlated with the maximum phonation time. In the speaking VRP, the associations for sound pressure level were more pronounced than for the fundamental frequency. The same was true in reverse for the singing VRP. Few associations were found for anxiety, life satisfaction and conscientiousness. CONCLUSIONS Weak associations between voice parameters derived from the VRP and mental and physical health, as well as personality were seen in this exploratory study. The results indicate that the VRP measurements in a clinical context are not significantly affected by these parameters and thus are a robust measurement method for voice parameters.
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Affiliation(s)
- Thomas A Ostermann
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Michael Fuchs
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany
| | - Andreas Hinz
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Department of Medical Psychology and Medical Sociology, University of Leipzig, Leipzig, Germany
| | - Christoph Engel
- LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany; Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Thomas Berger
- Phoniatrics and Audiology, Department of Otorhinolaryngology, University of Leipzig, Leipzig, Germany; LIFE Leipzig Research Centre for Civilization Diseases, University of Leipzig, Leipzig, Germany.
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Becker DR, Shelly S, Kavalieratos D, Maira C, Gillespie AI. Immediate Effects of Mindfulness Meditation on the Voice. J Voice 2022:S0892-1997(22)00342-3. [PMID: 36428173 DOI: 10.1016/j.jvoice.2022.10.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/23/2022] [Accepted: 10/24/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The benefits of mindfulness meditation are well documented. This study evaluated the immediate effects of mindfulness meditation (MM) on the voice and voice user. STUDY DESIGN Prospective experimental study. METHODS Participants: 19 vocally healthy (VH) individuals, and 26 individuals with common voice disorders (CVD; benign lesions and hyperfunctional muscle tension) deemed stimulable for voice therapy. Exclusionary criteria: prior training or regular meditation practice. Participants recorded speech samples before and after a 11.5-minute prerecorded session of MM. PRIMARY OUTCOMES phonatory aerodynamics and participants' self-reported experience of voice. SECONDARY OUTCOMES self-reported anxiety, vocal acoustics, speech breathing patterns, and auditory-perceptual outcomes. Baseline self-reported measures of voice (Voice Handicap Index-10 - VHI-10), breathing (Dyspnea Index - DI), stress (Perceived Stress Scale - PSS), and trait mindfulness (Cognitive and Mindfulness Scale - Revised, CAMS-R, Five Facet Mindfulness Questionnaire - FFMQ) were compared between groups. RESULTS At baseline, CVD had significantly higher VHI-10 (P< 0.001) and DI (P= 0.0014), and lower trait mindfulness (CAMS-R, P= 0.02). No difference between groups for PSS or FFMQ. Changes postMM: decreased CPP for all-voiced sentences for VH (P= 0.003), decreased mean SPL (P= 0.012) on sustained vowel for VH, increased mean phonatory airflow during sustained vowel for CVD (P = 0.012). VH demonstrated a decrease in CPP on the all-voice sentence, and CVD demonstrated an increase, resulting in a significant between group difference (P= 0.013). Participants reported improvements in voice, emotional and physical states. State anxiety decreased for both groups (= < 0.001). No other objective outcomes reached significance. CONCLUSIONS After a brief MM, participants experienced improvement in physical, emotional, and cognitive states, and in their perceptions of their voice. Results indicate that a brief, single session of MM may be beneficial for some, but not sufficient to override habitual voice and speech patterns. Given the benefits of MM, future work should evaluate MM in a standard voice therapy protocol.
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Affiliation(s)
| | - Sandeep Shelly
- Emory Healthcare, Department of Otolaryngology, Atlanta, Geogia
| | - Dio Kavalieratos
- Division of Palliative Medicine, Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, Geogia
| | - Carissa Maira
- Emory Healthcare, Department of Otolaryngology, Atlanta, Geogia
| | - Amanda I Gillespie
- Emory Healthcare, Department of Otolaryngology, Atlanta, Geogia; Department of Otolaryngology, Emory University School of Medicine, Atlanta, Geogia
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Desjardins M, Apfelbach C, Rubino M, Verdolini Abbott K. Integrative Review and Framework of Suggested Mechanisms in Primary Muscle Tension Dysphonia. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:1867-1893. [PMID: 35446683 PMCID: PMC9559660 DOI: 10.1044/2022_jslhr-21-00575] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/14/2021] [Accepted: 01/12/2022] [Indexed: 05/26/2023]
Abstract
PURPOSE Despite the high prevalence of primary muscle tension dysphonia (MTD-1), its underlying mechanisms and their interrelationships have yet to be fully identified. The objectives of this integrative review were (a) to describe and classify the suggested underlying mechanisms for MTD-1, (b) to appraise the empirical evidence supporting each of the proposed mechanisms, and (c) to summarize the information in an integrative model. METHOD PubMed, Scopus, and CINAHL were searched for all publications pertaining to muscle tension dysphonia. Papers were retained if they included theoretical or empirical data pertaining to underlying mechanisms of MTD-1. A total of 921 papers initially qualified for screening, of which 100 remained for consideration in this review. Underlying mechanisms of MTD-1 were extracted using a consensus approach. RESULTS Seven broad categories of putative mechanisms involved in MTD-1 were identified: psychosocial, autonomic, sensorimotor, respiratory, postural, inflammatory, and neuromuscular. These categories were further divided into 19 subcategories detailed in the body of this review article. Based on the reviewed evidence, our proposed integrative model presents MTD-1 as an idiosyncratic motor adaptation to physiological perturbation or perceived threat. Under this model, physiologically or psychologically aversive stimuli can instigate a series of motor adaptations at multiple levels of the nervous system, ultimately disturbing muscle activation patterns and their biomechanical outcomes. Importantly, these adaptations appear to have the potential to become chronic even after threatening stimuli are withdrawn. CONCLUSIONS The proposed model highlights the importance of personalized rehabilitation in MTD-1 treatment. Limitations of the literature are discussed to provide guidance for future research aimed at improving our understanding of MTD-1. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.19586065.
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Affiliation(s)
- Maude Desjardins
- Department of Communication Sciences & Disorders, University of Delaware, Newark
| | | | - Marianna Rubino
- Department of Communication Sciences & Disorders, University of Delaware, Newark
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Ahmadi N, Moein N, Tarameshlu M, Ghelichi L, Kamali M, Jenabi MS. The effect of breathing exercises combined with manual therapy on muscle tension dysphonia in traditional singers: a blinded randomized controlled trial. Eur Arch Otorhinolaryngol 2022; 279:2989-2996. [DOI: 10.1007/s00405-021-07237-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 12/22/2021] [Indexed: 12/01/2022]
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Toles LE, Roy N, Sogg S, Marks KL, Ortiz AJ, Fox AB, Mehta DD, Hillman RE. Relationships Among Personality, Daily Speaking Voice Use, and Phonotrauma in Adult Female Singers. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2021; 64:4580-4598. [PMID: 34731578 PMCID: PMC9150681 DOI: 10.1044/2021_jslhr-21-00274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/21/2021] [Accepted: 07/19/2021] [Indexed: 05/12/2023]
Abstract
PURPOSE This study sought to determine whether personality traits related to extraversion and impulsivity are more strongly associated with singers with nodules compared to vocally healthy singers and to understand the relationship between personality and the types of daily speaking voice use. METHOD Weeklong ambulatory voice recordings and personality inventories were obtained for 47 female singers with nodules and 47 vocally healthy female singers. Paired t tests investigated trait differences between groups. Relationships between traits and weeklong speaking voice measures (vocal dose, sound pressure level [SPL], neck surface acceleration magnitude [NSAM], fundamental frequency, cepstral peak prominence [CPP], and the ratio of the first two harmonic magnitudes [H 1 -H 2]) were examined using pairwise Pearson r coefficients. Multiple regressions were performed to estimate voice parameters that correlated with two or more traits. RESULTS Singers with nodules scored higher on the Social Potency scale (reflecting a tendency toward social dominance) and lower on the Control scale (reflecting impulsivity) compared to the vocally healthy singers. In vocally healthy singers, vocal dose measures were positively correlated with a combination of Wellbeing (i.e., happiness) and Social Potency, mean SPL was positively correlated with Wellbeing, SPL variability was positively correlated with Social Potency and negatively with Harm Avoidance, and CPP mean was positively correlated with Wellbeing. Singers with nodules had a negative correlation between NSAM skewness and Social Potency. Both groups had negative correlations between H 1 -H 2 mean and Social Potency and Social Closeness. CONCLUSIONS Singers with nodules are more socially dominant and impulsive than vocally healthy singers. Personality traits are related to daily speaking voice use, particularly in vocally healthy singers. Individuals with higher levels of traits related to happiness and social dominance and lower Harm Avoidance tended to speak more, with higher laryngeal forces, with more SPL variability, and with more pressed glottal closure, which could increase risk of phonotrauma.
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Affiliation(s)
- Laura E. Toles
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
| | | | - Stephanie Sogg
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
| | - Katherine L. Marks
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
| | | | - Annie B. Fox
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
| | - Daryush D. Mehta
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
| | - Robert E. Hillman
- Massachusetts General Hospital, Boston
- MGH Institute of Health Professions, Boston, MA
- Harvard Medical School, Boston, MA
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Park Y, Wang F, Díaz-Cádiz M, Vojtech JM, Groll MD, Stepp CE. Vocal fold kinematics and relative fundamental frequency as a function of obstruent type and speaker age. THE JOURNAL OF THE ACOUSTICAL SOCIETY OF AMERICA 2021; 149:2189. [PMID: 33940922 PMCID: PMC8018794 DOI: 10.1121/10.0003961] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 03/02/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
The acoustic measure, relative fundamental frequency (RFF), has been proposed as an objective metric for assessing vocal hyperfunction; however, its underlying physiological mechanisms have not yet been fully characterized. This study aimed to characterize the relationship between RFF and vocal fold kinematics. Simultaneous acoustic and high-speed videoendoscopic (HSV) recordings were collected as younger and older speakers repeated the utterances /ifi/ and /iti/. RFF values at voicing offsets and onsets surrounding the obstruents were estimated from acoustic recordings, whereas glottal angles, durations of voicing offset and onset, and a kinematic estimate of laryngeal stiffness (KS) were obtained from HSV images. No differences were found between younger and older speakers for any measure. RFF did not differ between the two obstruents at voicing offset; however, fricatives necessitated larger glottal angles and longer durations to devoice. RFF values were lower and glottal angles were greater for stops relative to fricatives at voicing onset. KS values were greater in stops relative to fricatives. The less adducted vocal folds with greater KS and lower RFF at voicing onset for stops relative to fricatives in this study were in accordance with prior speculations that decreased vocal fold contact area and increased laryngeal stiffness may decrease RFF.
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Affiliation(s)
- Yeonggwang Park
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Feng Wang
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Manuel Díaz-Cádiz
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
| | - Jennifer M Vojtech
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Matti D Groll
- Department of Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts 02215, USA
| | - Cara E Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, 635 Commonwealth Avenue, Boston, Massachusetts 02215, USA
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The Evaluation of Beck Anxiety Scale, Voice Handicap Index, and Brief Symptom Inventory on Treatment of Patients With Vocal Fold Nodules. J Voice 2021; 37:470.e1-470.e6. [PMID: 33642132 DOI: 10.1016/j.jvoice.2021.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 01/21/2021] [Accepted: 01/26/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Vocal fold nodules are benign lesions that cause hoarseness in all age groups including children, adolescents, and adults. These nodules may be caused either by singing or other causes of tension in vocal activity. OBJECTIVE The aim of this study was to evaluate the psychological symptoms of adult patients with hoarseness and to investigate the relationship in psychological symptoms before and after voice therapy. METHODS 23 Patients who were admitted with a voice complaint and diagnosed with vocal fold nodules and a matched control group were evaluated. Two inventories recommended by our psychiatrist (The Beck Anxiety Inventory, Brief Symptom Inventory) and Voice Handicap Index-10 (VHI-10), were completed to evaluate the treatment outcomes and psychosocial properties of the patients before and after voice therapy. RESULTS A significant difference was observed in the BAI and BSI scores between the nodule (+) group and the control group at the beginning of the study, before voice therapy. A significant difference was found between the mean scores on the BAI and the BSI before and after therapy in the vocal fold nodules group. CONCLUSION Patients with vocal fold nodules should be evaluated more extensively using psychological assessment scales, such as the BSI, and a psychiatric consultation should be added in cases of abnormal findings.
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15
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Helou LB, Gartner-Schmidt JL, Hapner ER, Schneider SL, Van Stan JH. Mapping Meta-Therapy in Voice Interventions onto the Rehabilitation Treatment Specification System. Semin Speech Lang 2021; 42:5-18. [PMID: 33596600 PMCID: PMC7935442 DOI: 10.1055/s-0040-1722756] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Meta-therapy refers to the clinical dialogue via which direct and indirect voice treatments are introduced and discussed, and which helps build a useful conceptual framework for voice therapy. Meta-therapy was idiosyncratically defined in previous work. However, the current colloquial narrative of meta-therapy is not standardized or specific enough to be reliably taught, rigorously studied, or clinically delivered with high fidelity. Therefore, this article uses a standard framework (the Rehabilitation Treatment Specification System or RTSS) to further articulate and operationalize meta-therapy in vocal rehabilitation. Meta-therapy's conceptual framework generally aligns with the RTSS's treatment theory and associated concepts; e.g., the treatment component and its underlying ingredients, mechanisms of action, and target. Because the treatment theories in meta-therapy most frequently involve mechanisms of action related to information processing, they primarily map onto the RTSS's Representations treatment components. The treatment targets in meta-therapy are often focused on changes in the patient's cognitions, knowledge, beliefs, attitudes, intentions, and/or awareness regarding voice-related modifications. The ingredients in meta-therapy are frequently clinician actions conveying information with the goal of appropriately shaping the patient's mental representations, and are delivered with verbal cues, stories, analogies, etc. This manuscript provides specific examples of how meta-therapy is applied in clinical voice practice. Considerations for future investigation of meta-therapy are proposed.
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Affiliation(s)
- Leah B. Helou
- Department of Communication Science & Disorders, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jacqueline L. Gartner-Schmidt
- University of Pittsburgh Voice Center, Department of Otolaryngology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Edie R. Hapner
- Department of Otolaryngology, UAB Voice Center, University of Alabama, Birmingham, Birmingham, Alabama
| | - Sarah L. Schneider
- UCSF Voice and Swallowing Center, Department of Otolaryngology Head and Neck Surgery, University of California, San Francisco
| | - Jarrad H. Van Stan
- Department of Surgery, Harvard Medical School, Boston, Massachusetts
- Massachusetts General Hospital, Center for Laryngeal Surgery and Voice Rehabilitation, Boston, Massachusetts
- Department of Communication Sciences and Disorders, MGH Institute of Health Professions, Boston, Massachusetts
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16
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Berger T, Meuret S, Engel C, Vogel M, Kiess W, Fuchs M, Poulain T. [Detection of relevant changes in the speaking voice of women measured by the speaking voice profile]. Laryngorhinootologie 2020; 101:127-137. [PMID: 33327005 DOI: 10.1055/a-1327-4275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND A healthy voice serves us as a basis for communication and an indispensable tool in a modern society with a growing number of vocal-intensive professions. There are indications that the average frequency of the speaking voice of women has decreased in recent years and is approaching that of men in the sense of sociophony. An epidemiological prospective cohort study will investigate the influences of age, personality traits and socio-demographic factors on the speaking voice of women. MATERIAL AND METHODS Within the framework of a standardized examination procedure, the speaking voice of 2478 voice-healthy female participants between 5 and 83 years of age was registered in 4 different intensity levels (softest voice, conversational voice, classroom voice and shouting voice). Subsequently, the collected values for frequency and loudness of the different intensity levels were examined for correlation with age and results from questionnaires on personality (FFFK and BFI-10), on (mental) health (Patient-Health-Questionnaire - PHQ) and on socio-economic status (SES). RESULTS Significant age-related influences on the speaking voice could be demonstrated for all voice intensities. For the personality traits investigated, significant positive correlations between the volume of the calling and speaking voice and extraversion were found. For the frequency of the softest voice and speaking voice, significant correlations were found for the personality traits of extraversion and tolerance. While no significant associations were found between the voice parameters of the speaking voice and the PHQ, it was found that the SES has a significant influence on both frequency and intensity. CONCLUSION In addition to age-related changes, relevant influences of personality traits and the SES on speaking voice parameters in women were confirmed, which should be considered in clinical care of dysphonia.
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Affiliation(s)
- Thomas Berger
- Klinik für Hals-Nasen-Ohrenheilkunde/Plastische Operationen, Universitätsklinikum Leipzig - AöR
| | - Sylvia Meuret
- Sektion Phoniatrie und Audiologie, Klinik für Hals-Nasen-Ohrenheilkunde/Plastische Operationen, Universitätsklinikum Leipzig - AöR
| | - Christoph Engel
- Institut für Medizinische Informatik, Statistik und Epidemiologie (IMISE), Universität Leipzig
| | - Mandy Vogel
- Medizinische Fakultät, LIFE Forschungszentrum, Universität Leipzig
| | - Wieland Kiess
- Medizinische Fakultät, LIFE Forschungszentrum, Universität Leipzig.,Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Leipzig - AöR
| | - Michael Fuchs
- Sektion Phoniatrie und Audiologie, Klinik für Hals-Nasen-Ohrenheilkunde/Plastische Operationen, Universitätsklinikum Leipzig - AöR
| | - Tanja Poulain
- Medizinische Fakultät, LIFE Forschungszentrum, Universität Leipzig
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Hillman RE, Stepp CE, Van Stan JH, Zañartu M, Mehta DD. An Updated Theoretical Framework for Vocal Hyperfunction. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2020; 29:2254-2260. [PMID: 33007164 PMCID: PMC8740570 DOI: 10.1044/2020_ajslp-20-00104] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 08/07/2020] [Accepted: 08/09/2020] [Indexed: 05/21/2023]
Abstract
Purpose The purpose of this viewpoint article is to facilitate research on vocal hyperfunction (VH). VH is implicated in the most commonly occurring types of voice disorders, but there remains a pressing need to increase our understanding of the etiological and pathophysiological mechanisms associated with VH to improve the prevention, diagnosis, and treatment of VH-related disorders. Method A comprehensive theoretical framework for VH is proposed based on an integration of prevailing clinical views and research evidence. Results The fundamental structure of the current framework is based on a previous (simplified) version that was published over 30 years ago (Hillman et al., 1989). A central premise of the framework is that there are two primary manifestations of VH-phonotraumatic VH and nonphonotraumatic VH-and that multiple factors contribute and interact in different ways to cause and maintain these two types of VH. Key hypotheses are presented about the way different factors may contribute to phonotraumatic VH and nonphonotraumatic VH and how the associated disorders may respond to treatment. Conclusions This updated and expanded framework is meant to help guide future research, particularly the design of longitudinal studies, which can lead to a refinement in knowledge about the etiology and pathophysiology of VH-related disorders. Such new knowledge should lead to further refinements in the framework and serve as a basis for improving the prevention and evidence-based clinical management of VH.
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Affiliation(s)
- Robert E. Hillman
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- MGH Institute of Health Professions, Boston, MA
| | | | - Jarrad H. Van Stan
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- MGH Institute of Health Professions, Boston, MA
| | - Matías Zañartu
- Universidad Técnica Federico Santa María, Valparaíso, Chile
| | - Daryush D. Mehta
- Massachusetts General Hospital, Boston
- Harvard Medical School, Boston, MA
- MGH Institute of Health Professions, Boston, MA
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Dietrich M, Andreatta RD, Jiang Y, Stemple JC. Limbic and cortical control of phonation for speech in response to a public speech preparation stressor. Brain Imaging Behav 2020; 14:1696-1713. [PMID: 31049806 PMCID: PMC7572327 DOI: 10.1007/s11682-019-00102-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Knowledge on brain networks subserving vocalization in vocally healthy individuals under various task conditions is scarce but paramount to understand voice disorders. The aims of our study were to determine (1) the effect of social-evaluative stress on the central neural control of phonation underlying speech production; and (2) the neural signature, personality profile, and aerodynamic vocal function in relation to salivary cortisol responses. Thirteen vocally healthy females underwent an event-related sparse-sampling fMRI protocol consisting of voiced and whispered sentence productions with and without exposure to the social-evaluative stressor public speaking anticipation. Participants completed a personality questionnaire, rating scales of negative emotional state, and provided salivary cortisol samples. In the total sample, the task contrast of voiced productions revealed that stressor exposure resulted in a peak activation in the right caudate with concomitant deactivations in the bilateral pgACC and aMCC, and right IFG, BA 9, BA 10, insula, putamen, and thalamus. There were individual differences in stressor-induced brain activations as a function of stress reactivity with greater cortisol reactivity linked with lower laryngeal motor cortex activity and lower scores on aspects of extraversion. Our data confirm that stress alters the phonatory control for speech production through limbic-motor interactions. The findings support the Trait Theory of Voice Disorders (Roy and Bless 2000) and help provide critical insights to the study of voice disorders such as primary muscle tension dysphonia.
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Affiliation(s)
- Maria Dietrich
- Department of Speech, Language and Hearing Sciences, University of Missouri, 308 Lewis Hall, Columbia, MO 65211 USA
| | - Richard D. Andreatta
- Department of Communication Sciences and Disorders, University of Kentucky, 120 Wethington Bldg, 900 S. Limestone, Lexington, KY 40536 USA
| | - Yang Jiang
- Department of Behavioral Science, University of Kentucky, 113 Medical Behavioral Science Building, Lexington, KY 40536 USA
| | - Joseph C. Stemple
- Department of Communication Sciences and Disorders, University of Kentucky, 120 Wethington Bldg, 900 S. Limestone, Lexington, KY 40536 USA
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19
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Helou LB, Jennings JR, Rosen CA, Wang W, Verdolini Abbott K. Intrinsic Laryngeal Muscle Response to a Public Speech Preparation Stressor: Personality and Autonomic Predictors. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2020; 63:2940-2951. [PMID: 32881649 PMCID: PMC7890219 DOI: 10.1044/2020_jslhr-19-00402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 06/08/2020] [Accepted: 07/06/2020] [Indexed: 05/26/2023]
Abstract
Purpose Laboratory stressors have been shown to impact the activity of the intrinsic laryngeal muscles (ILMs), which may be part of the final causal pathway in some stress-induced voice disorders. Previous research suggests that personality traits such as stress reaction might increase one's susceptibility to these problems. Also, the autonomic nervous system response is implicated in the pathogenesis of voice disorders putatively involving ILM hyperfunction. The purpose of this study was to investigate personality and autonomic nervous system predictors of ILM responses to stressor exposure. Method Thirty-seven physically and vocally healthy female adults completed a personality questionnaire and were subjected to a speech preparation task intended to induce stress. Fine wire electromyography of the ILMs was performed so that the activity of these muscles could be measured prior to and during the stressor. Participants' trait stress reaction was measured as a personality-based predictive variable, as was respiratory-corrected respiratory sinus arrhythmia, a putative measure of vagal outflow to the heart. Results The personality measure trait stress reaction uniquely predicted thyroarytenoid, trapezius, and tibialis activity, whereas respiratory sinus arrhythmia uniquely predicted the activity of all muscles studied. Differences were observed in the autonomic predictor variable as a function of whether or not effects of respiration were accounted for in the variable's calculation. Conclusions This study explores the potential mediating roles of personality and autonomic function in ILM activity during a stressor. Both variables have value in predicting ILM activity during stressor exposure.
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Affiliation(s)
- Leah B. Helou
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | | | - Clark A. Rosen
- Voice and Swallowing Center, Division of Laryngology, Department of Otolaryngology–Head and Neck Surgery, University of California San Francisco
| | - Wei Wang
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO
- Barnes-Jewish Hospital, St. Louis, MO
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20
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van Mersbergen M, Payne AE. Cognitive, Emotional, and Social Influences on Voice Production Elicited by Three Different Stroop Tasks. Folia Phoniatr Logop 2020; 73:326-334. [PMID: 32668434 DOI: 10.1159/000508572] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 05/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The effects of emotion and cognition have been of interest to voice clinicians and research given the known correlations between psychological states and voice disorders. However, most voice research techniques investigate one psychological state at a time and do not necessarily consider other psychological states or the combination of two or more states occurring simultaneously. The purpose of this study is to employ three Stroop tasks, all known to elicit different psychological states, during a voice study to determine whether separate psychological states have a variable effect on vocalizations. METHODS Fifteen female participants were instructed to view a word on a computer screen and say the name of the color of the font of that word. Words were part of a Color Stroop, Emotional Stroop, or Taboo Stroop paradigm and designed to elicit cognitive, emotional, or the combination of cognitive/emotional interference. Behavioral measures of response time and acoustic measures of frequency, intensity, and noise ratio were extracted from each stimulus. RESULTS Participants had significantly greater response times for all experimental conditions compared to baseline. Additionally, intensity range was significantly less, and average fundamental frequency and cepstral peak prominence were significantly greater than baseline. However, there was no distinct pattern of response for any condition. DISCUSSION/CONCLUSION Although there are definite changes in vocalizations when participants were engaged in higher cognitive or emotional processing, no acoustic signatures for these separate conditions exist. These findings suggest that more specific acoustic measures or additional measures such as physiological or self-report may be necessary to parse out the differential effect on the voice in these three conditions.
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Affiliation(s)
- Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee, USA,
| | - Alexis E Payne
- St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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Besser A, Lotem S, Zeigler-Hill V. Psychological Stress and Vocal Symptoms Among University Professors in Israel: Implications of the Shift to Online Synchronous Teaching During the COVID-19 Pandemic. J Voice 2020; 36:291.e9-291.e16. [PMID: 32600872 PMCID: PMC7274605 DOI: 10.1016/j.jvoice.2020.05.028] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 05/20/2020] [Accepted: 05/26/2020] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Avi Besser
- Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel.
| | - Sari Lotem
- Department of Communication Disorders, Hadassah Academic College, Jerusalem, Israel; Hadassah Medical Center, Jerusalem, Israel
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22
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Pereira Dos Santos K, Ribeiro VV, Siqueira LTD, Brugnara LC, Rosa ICB, Dassie-Leite AP. Does Shyness Influence the Self-Perception of Vocal Symptoms, Public Speaking, and Daily Communication? J Voice 2020; 36:54-58. [PMID: 32205031 DOI: 10.1016/j.jvoice.2020.02.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 02/17/2020] [Accepted: 02/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The present study aimed to characterize and to verify the relationship between shyness and self-assessment of vocal symptoms, public speaking, and aspects of daily communication. METHODS This is an observational, analytical, and cross-sectional study. Two hundred and sixty-four male and female participants, with a mean age of 21 years and without any vocal disorder. To measure the outcomes, the participants' scores were measured using the following self-assessment instruments: Revised Cheek and Buss Shyness Scale, Voice Symptom Scale, Self-Statements during Public Speaking Scale, and the Daily Communication Self-evaluation Questionnaire. A descriptive and inferential analysis of the data was performed. RESULTS Shy persons had higher vocal symptomatology scores in the limitation, emotional, and total domain. Furthermore, they scored higher on the negative aspects of public speaking and lower on its positive aspects. In addition, they showed weaker loudness and higher pitch in daily communication, compared with nonshy persons. Statistically significant correlations were found between positive shyness scores and all domains of vocal symptoms, negative aspects of public speaking, and pitch in daily communication. However, negative correlation was found between the positive aspects of public speaking and loudness in daily communication. CONCLUSION Shy persons have a higher self-evaluation with regard to the negative and less positive aspects of public speaking and most vocal symptoms, as well as weaker loudness and higher pitch in daily communication when compared to nonshy persons. The greater the perception of shyness, the greater the self-assessment with regard to daily communication and vocal symptoms and the negative aspects of public speaking.
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Affiliation(s)
- Kariane Pereira Dos Santos
- Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO, Irati, PR, Brazil
| | - Vanessa Veis Ribeiro
- Centro de Estudos da Voz - CEV, São Paulo, SP, Brazil; Speech-Language Pathology Department, Universidade Federal de Sergipe - UFS, Lagarto, SE, Brazil
| | | | - Larissa Cruz Brugnara
- Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO, Irati, PR, Brazil
| | | | - Ana Paula Dassie-Leite
- Speech-Language Pathology Department, Universidade Estadual do Centro-Oeste - UNICENTRO, Irati, PR, Brazil
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Trinite B. Investigating voice differences in teachers with and without self-reported voice disorders, and healthcare workers without self-reported voice disorders. LOGOP PHONIATR VOCO 2020; 46:47-54. [DOI: 10.1080/14015439.2020.1727565] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Baiba Trinite
- Voice and Speech Research Laboratory, Liepaja University, Liepaja, Latvia
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van Mersbergen M, Lanza E. Modulation of Relative Fundamental Frequency During Transient Emotional States. J Voice 2019; 33:894-899. [DOI: 10.1016/j.jvoice.2018.07.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2018] [Revised: 07/18/2018] [Accepted: 07/20/2018] [Indexed: 10/28/2022]
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Misono S, Haut C, Meredith L, Frazier PA, Stockness A, Michael DD, Butcher L, Harwood EM. Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study. J Voice 2019; 33:682-690. [PMID: 29759920 PMCID: PMC6230520 DOI: 10.1016/j.jvoice.2018.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 04/04/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The purpose of this qualitative study was to examine relationships between psychological factors, particularly perceived control, and voice symptoms in adults seeking treatment for a voice problem. METHODS Semistructured interviews of adult patients with a clinical diagnosis of muscle tension dysphonia were conducted and transcribed. Follow-up interviews were conducted as needed for further information or clarification. A multidisciplinary team analyzed interview content using inductive techniques. Common themes and subthemes were identified. A conceptual model was developed describing the association between voice symptoms, psychological factors, precipitants of ongoing voice symptoms, and perceived control. RESULTS Thematic saturation was reached after 23 interviews. No participants reported a direct psychological cause for their voice problem, although half described significant life events preceding voice problem onset (eg, miscarriage and other health events, interpersonal conflicts, and family members' illnesses, injuries, and deaths). Participants described psychological influences on voice symptoms that led to rapid exacerbation of their voice symptoms. Participants described the helpfulness of speech therapy and sometimes also challenges of applying techniques in daily life. They also discussed personal coping strategies that included behavioral (eg, avoiding triggers and seeking social support) and psychological (eg, mind-body awareness and emotion regulation) components. Voice-related perceived control was associated with adaptive emotional and behavioral responses, which appeared to facilitate symptom improvement. CONCLUSIONS In this qualitative pilot study, participant narratives suggested that psychological factors and emotions influence voice symptoms, facilitating development of a preliminary conceptual model of how adaptive and maladaptive responses develop and how they influence vocal function.
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Affiliation(s)
- Stephanie Misono
- Assistant Professor, Otolaryngology, University of Minnesota, Minneapolis, MN, Phone (612) 625-3200, fax (612) 625-2101
| | - Caroline Haut
- Research Coordinator, Psychiatry, University of Minnesota, Minneapolis, MN
| | - Liza Meredith
- Contract Assistant Professor, Psychology, University of Minnesota, Minneapolis, MN
| | - Patricia A. Frazier
- Associate Chair, Distinguished McKnight University Professor, Department of Psychology, University of Minnesota, Minneapolis, MN 55455
| | - Ali Stockness
- Research Manager, Otolaryngology, University of Minnesota, Minneapolis, MN
| | - Deirdre D. Michael
- Assistant Professor, Otolaryngology, University of Minnesota, Minneapolis, MN
| | - Lisa Butcher
- Speech-Language Pathologist - Lions Voice Clinic, Otolaryngology, University of Minnesota Health, Minneapolis, MN
| | - Eileen M. Harwood
- Associate Professor, School of Public Health, Division of Epidemiology and Community Health, University of Minnesota - Twin Cities, Room 381 West Bank Office Building (WBOB), 1300 South Second Street, Minneapolis MN 55454
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Sanssené C, Bardi J, Welby-Gieusse M. Prevalence and Risk Factors of Voice Disorders in French Tour Guides. J Voice 2019; 34:911-917. [PMID: 31171410 DOI: 10.1016/j.jvoice.2019.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/05/2019] [Accepted: 05/08/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE/HYPOTHESIS Voice disorders are frequently observed among professionals using their voice as their main working tool (ie, occupational voice users). The objective of this study is to establish the prevalence of voice disorders in tour guides and to evaluate the risk factors associated with these disorders. STUDY DESIGN An online survey, containing the VHI-10 test, was sent to the metropolitan France guides in November 2017. The results were analyzed using answers of tour guides dispatched in all metropolitan French departments. RESULTS We received 465 replies. Voice disorders were highly prevalent (up to 21.29%) according to the VHI-10 and were comparable to observed rates in other professional categories (teachers and telecommunicators). The proportion of guides complaining about voice disorders episodes (44.94%) is greater than in the overall general population. Specific work-related factors emerged in this study. First, the use of a high-intensity voice for more than 6 hours a week is a factor significantly associated with a higher risk of having a pathological score at VHI-10. Second, a significant proportion of the guides noted that noise pollution and changes in temperature affected their vocal quality. CONCLUSIONS In light of these results, we can conclude that the tour guide profession is subject to voice-related risks. The prevalence of voice disorders is particularly higher than in the general population and risk factors specific to tour guide population exist.
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Affiliation(s)
- Claire Sanssené
- Ecole d'orthophonie de la faculté de Médecine Toulouse-Rangueil, Toulouse, France.
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McKenna VS, Diaz-Cadiz ME, Shembel AC, Enos NM, Stepp CE. The Relationship Between Physiological Mechanisms and the Self-Perception of Vocal Effort. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:815-834. [PMID: 30969902 PMCID: PMC6802880 DOI: 10.1044/2018_jslhr-s-18-0205] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 07/16/2018] [Accepted: 11/30/2018] [Indexed: 05/09/2023]
Abstract
Purpose This study aimed to examine the relationship between a large set of hypothesized physiological measures of vocal effort and self-ratings of vocal effort. Method Twenty-six healthy adults modulated speech rate and vocal effort during repetitions of the utterance /ifi/, followed by self-perceptual ratings of vocal effort on a visual analog scale. Physiological measures included (a) intrinsic laryngeal tension via kinematic stiffness ratios determined from high-speed laryngoscopy, (b) extrinsic suprahyoid and infrahyoid laryngeal tension via normalized percent activations and durations derived from surface electromyography, (c) supraglottal compression via expert visual-perceptual ratings, and (d) subglottal pressure via magnitude of neck surface vibrations from an accelerometer signal. Results Individual statistical models revealed that all of the physiological predictors, except for kinematic stiffness ratios, were significantly predictive of self-ratings of vocal effort. However, a combined regression model analysis yielded only 3 significant predictors: subglottal pressure, mediolateral supraglottal compression, and the normalized percent activation of the suprahyoid muscles (adjusted R 2 = .60). Conclusions Vocal effort manifests as increases in specific laryngeal physiological measures. Further work is needed to examine these measures in combination with other contributing factors, as well as in speakers with dysphonia.
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Affiliation(s)
| | | | - Adrianna C. Shembel
- Department of Otolaryngology–Head and Neck Surgery, New York University Langone Medical Center and Voice Center, New York
| | - Nicole M. Enos
- Department of Biomedical Engineering, Boston University, MA
- Department of Electrical and Computer Engineering, Boston University, MA
| | - Cara E. Stepp
- Department of Speech, Language, and Hearing Sciences, Boston University, MA
- Department of Biomedical Engineering, Boston University, MA
- Department of Otolaryngology–Head and Neck Surgery, Boston University School of Medicine, MA
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Mattei A, Legou T, Cardeau A, Le Goff J, Lagier A, Giovanni A. Acoustic correlates of vocal effort: External factors and personality traits. Eur Ann Otorhinolaryngol Head Neck Dis 2019; 136:151-154. [PMID: 30880033 DOI: 10.1016/j.anorl.2019.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
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.
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Affiliation(s)
- A Mattei
- AP-HM, CHU La Conception, service d'oto-rhino-laryngologie, Marseille, France; Aix Marseille université, CNRS, LPL, Aix-en-Provence, France.
| | - T Legou
- Aix Marseille université, CNRS, LPL, Aix-en-Provence, France
| | - A Cardeau
- Aix Marseille université, 13000 Marseille, France
| | - J Le Goff
- Aix Marseille université, 13000 Marseille, France
| | - A Lagier
- Aix Marseille université, CNRS, LPL, Aix-en-Provence, France
| | - A Giovanni
- AP-HM, CHU La Conception, service d'oto-rhino-laryngologie, Marseille, France; Aix Marseille université, CNRS, LPL, Aix-en-Provence, France
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Roy N, Dietrich M, Blomgren M, Heller A, Houtz DR, Lee J. Exploring the Neural Bases of Primary Muscle Tension Dysphonia: A Case Study Using Functional Magnetic Resonance Imaging. J Voice 2019; 33:183-194. [DOI: 10.1016/j.jvoice.2017.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Revised: 11/15/2017] [Accepted: 11/16/2017] [Indexed: 01/17/2023]
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Kagan J. Perspectives on two temperamental biases. Philos Trans R Soc Lond B Biol Sci 2019; 373:rstb.2017.0158. [PMID: 29483343 DOI: 10.1098/rstb.2017.0158] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/27/2017] [Indexed: 11/12/2022] Open
Abstract
This paper describes the contribution of two infant temperamental biases to variation in behaviour and biology over the first 18 years in a sample of middle-class Caucasian children. One bias, called high reactive, is defined by frequent display of limb activity and crying in four-month-old infants to unexpected or unfamiliar events. The other, called low reactive, is defined by the opposite pair of behaviours to the same incentives. High reactive infants are likely to display cautious, avoidant responses and signs of an excitable amygdala to unexpected experiences. Low reactives are characterized by a sociable, emotionally spontaneous profile to the same experiences and a minimally excitable amygdala. However, each bias is a better predictor of the future traits that are unlikely to develop than the ones that do. The final pattern of traits is a function of the person's temperaments, life history, and current circumstances.This article is part of the theme issue 'Diverse perspectives on diversity: multi-disciplinary approaches to taxonomies of individual differences'.
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Affiliation(s)
- Jerome Kagan
- Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA
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Gimenez SRML, Madazio G, Zambon F, Behlau M. Análise da timidez na desvantagem vocal percebida em professores. Codas 2019; 31:e20180149. [DOI: 10.1590/2317-1782/20182018149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 10/30/2018] [Indexed: 11/21/2022] Open
Abstract
RESUMO Objetivo Verificar a relação entre a timidez autorreferida e a desvantagem vocal percebida em professores da Educação Infantil e Fundamental I e II. Método 200 professores (média de 41,8 anos), sem queixa vocal atual, preencheram 3 protocolos: uma ficha de identificação pessoal e caracterização do trabalho, composta por 11 questões, elaborada pelo Programa de Saúde Vocal do SinproSP; o Índice de Desvantagem Vocal, instrumento de autoavaliação que investiga a autopercepção do impacto de um problema vocal; e a Escala de Timidez, com 14 itens sobre sentimentos e comportamentos comunicativos relacionados ao cotidiano organizacional. Resultados Do total da amostra, 142 (71%) professores não apresentaram desvantagem vocal, sendo 42% (n=59) professores tímidos e 58% (n=83) não tímidos. Para os 58 (29%) professores que apresentaram desvantagem vocal, houve um maior número de tímidos (64%) do que não tímidos (26%). Entre o total de professores tímidos, houve uma proporção maior destes entre os professores que atuam exclusivamente na Educação Infantil, com faixa etária entre 20-30 anos, formados em até 10 anos e com queixa da presença de ruído na sala de aula. A presença de afecções de vias aéreas superiores foi o único aspecto que diferenciou tímidos com e sem desvantagem vocal, sendo mais frequente nos professores tímidos sem desvantagem vocal. Conclusão Professores tímidos percebem mais desvantagem vocal quando comparados aos não tímidos. Os docentes com faixa etária entre 20 e 30 anos, com até 10 anos de formados e que lecionam para Educação Infantil relatam timidez, porém sem associação com a desvantagem vocal.
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Affiliation(s)
| | | | - Fabiana Zambon
- Centro de Estudos da Voz, Brasil; Sindicato dos Professores de São Paulo, Brasil
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Van Puyvelde M, Neyt X, McGlone F, Pattyn N. Voice Stress Analysis: A New Framework for Voice and Effort in Human Performance. Front Psychol 2018; 9:1994. [PMID: 30515113 PMCID: PMC6255927 DOI: 10.3389/fpsyg.2018.01994] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 09/28/2018] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Martine Van Puyvelde
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- Brain, Body and Cognition, Experimental and Applied Psychology, Department of Psychological and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Clinical and Lifespan Psychology, Department of Psychological and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Xavier Neyt
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
| | - Francis McGlone
- School of Natural Sciences and Psychology, Faculty of Science, Liverpool John Moores University, Liverpool, United Kingdom
| | - Nathalie Pattyn
- VIPER Research Unit, LIFE Department, Royal Military Academy, Brussels, Belgium
- Brain, Body and Cognition, Experimental and Applied Psychology, Department of Psychological and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- MFYS-BLITS, Department of Human Physiology, Vrije Universiteit Brussel, Brussels, Belgium
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Poulain T, Fuchs M, Vogel M, Jurkutat A, Hiemisch A, Kiess W, Berger T. Associations of Speaking-Voice Parameters With Personality and Behavior in School-Aged Children. J Voice 2018; 34:485.e23-485.e31. [PMID: 30391018 DOI: 10.1016/j.jvoice.2018.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 09/27/2018] [Accepted: 09/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES Previous studies suggest a link between voice disorders and personality traits. However, nearly nothing is known about the relationship between personality and voice parameters in healthy children. The present study investigated associations between children's personality and the intensity and frequency of their speaking voice. STUDY DESIGN This is a cross-sectional analysis. METHODS The study participants included 871 German children aged from 7 to 14 who had not yet experienced voice change in puberty. Within the framework of the LIFE Child study, all participants were asked to perform a speaking-voice task at four different intensity levels (quietest, conversational, presentation, and shouting voice). Associations of fundamental frequency and voice intensity with children's personality and behavioral strengths and difficulties (assessed using parent-reported questionnaires) were estimated using multiple linear regression analyses. RESULTS With respect to children's personality, the analyses revealed significant positive associations between speaking-voice intensity and extraversion (eg, for the conversational voice, β = 0.16, P < 0.001) as well as significant negative associations between voice intensity and emotional stability (eg, for the shouting voice, β = -0.15, P = 0.004) and conscientiousness (for the shouting voice, β = -0.10, P = 0.033). Regarding behavioral strengths and difficulties, we observed significant positive associations between voice intensity and peer-relationship problems (eg, for the conversational voice, β = 0.14, P = 0.001) and prosocial behavior (for the conversational voice, β = 0.11, P = 0.015). In contrast, no significant association was found between speaking fundamental frequency and personality or behavioral difficulties/strengths. CONCLUSIONS In children, associations exist between a child's speaking-voice intensity and his or her personality, especially extraversion and emotional stability, and behavioral characteristics.
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Affiliation(s)
- T Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Saxony, Germany.
| | - M Fuchs
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, Leipzig University, Leipzig, Saxony, Germany
| | - M Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Saxony, Germany
| | - A Jurkutat
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany
| | - A Hiemisch
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Saxony, Germany
| | - W Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Women and Child Health, Hospital for Children and Adolescents and Center for Pediatric Research (CPL), Leipzig University, Leipzig, Saxony, Germany
| | - T Berger
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Leipzig, Saxony, Germany; Department of Otorhinolaryngology, Section of Phoniatrics and Audiology, Leipzig University, Leipzig, Saxony, Germany
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Pisanski K, Kobylarek A, Jakubowska L, Nowak J, Walter A, Błaszczyński K, Kasprzyk M, Łysenko K, Sukiennik I, Piątek K, Frackowiak T, Sorokowski P. Multimodal stress detection: Testing for covariation in vocal, hormonal and physiological responses to Trier Social Stress Test. Horm Behav 2018; 106:52-61. [PMID: 30189213 DOI: 10.1016/j.yhbeh.2018.08.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 07/30/2018] [Accepted: 08/31/2018] [Indexed: 11/23/2022]
Abstract
Examining the effects of acute stress across multiple modalities (behavioral, physiological, and endocrinological) can increase our understanding of the interplay among stress systems, and may improve the efficacy of stress detection. A multimodal approach also allows for verification of the biological stress response, which can vary between individuals due to myriad internal and external factors, thus allowing for reliable interpretation of behavioral markers of stress. Here, controlling for variables known to affect the magnitude of the stress response, we utilized the Trier Social Stress Test (TSST) to elicit an acute stress response in 80 healthy adult men and women. The TSST involves an interview-style oral presentation and critical social evaluation, and is highly effective in inducing psychosocial stress. Participants completed the study in individual 2 h sessions, during which we collected voice, polygraph and salivary hormone measures in baseline, stress, and relaxation phases. Our results show sizeable systematic increases in voice pitch (mean, minimum and variation in fundamental frequency, F0), hormone levels (cortisol) and decreases in skin temperature and hand movement during psychosocial stress, with striking similarities between men and women. However, cortisol and skin temperature only weakly predicted changes in voice pitch during stress, in either women or men, respectively. Thus, while our results provide compelling evidence that psychosocial stress manifests itself behaviorally by increasing voice pitch and its variability alongside simultaneous activation of physiological and endocrinological stress systems, our results also highlight a relatively weak degree of intra-individual 'response coherence' across these stress systems, with dissociations among different stress measures related most strongly to sex.
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Affiliation(s)
- Katarzyna Pisanski
- Institute of Psychology, University of Wrocław, Poland; Mammal Vocal Communication and Cognition Research Group, School of Psychology, University of Sussex, Brighton, UK.
| | | | - Luba Jakubowska
- Department of Health Promotion, Faculty of Health Sciences, Wroclaw Medical University
| | - Judyta Nowak
- Department of Human Biology, University of Wrocław, Poland
| | - Amelia Walter
- Department of Human Biology, University of Wrocław, Poland
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Helou LB, Rosen CA, Wang W, Verdolini Abbott K. Intrinsic Laryngeal Muscle Response to a Public Speech Preparation Stressor. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:1525-1543. [PMID: 29922837 PMCID: PMC6195061 DOI: 10.1044/2018_jslhr-s-17-0153] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 11/30/2017] [Indexed: 05/09/2023]
Abstract
PURPOSE Research suggests that abnormal levels of intrinsic laryngeal muscle (ILM) contraction is a potential causal factor in stress-induced voice disorders. This study seeks to characterize the ILM stress response in a cohort of vocally healthy women. METHOD The authors used an unblinded, nonrandomized, repeated-measures design. Forty vocally healthy female adults were subjected to a stressful speech preparation task. Measurements of heart rate, blood pressure, trapezius muscle (positive control) activation, and tibialis muscle (negative control) activation were obtained from 37 participants before and during stressor exposure, in a nonvoice and nonspeaking task paradigm, to confirm physiological stress response compared to baseline. Fine wire electromyography of the ILMs (posterior cricoarytenoid, thyroarytenoid/lateral cricoarytenoid muscle complex, and cricothyroid) was performed simultaneously so that the activity of these muscles could be measured prior to and during stressor exposure. RESULTS The protocol successfully elicited the typical and expected physiological stress responses. Findings supported the hypothesis that, in some individuals, the ILMs significantly increase in activity during stress reactions compared to baseline, as do the control muscles. CONCLUSIONS This study characterizes ILM responses to psychological stress in vocally healthy participants. Some of the female adults in this study appeared to be "laryngeal stress responders," as evidenced by increased activity of the ILMs during a silent (i.e., nonvocal, nonspeech) speech preparation task that they considered to be stressful.
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Affiliation(s)
- Leah B. Helou
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Clark A. Rosen
- Department of Communication Science and Disorders, University of Pittsburgh, PA
| | - Wei Wang
- Department of Communication Science and Disorders, University of Pittsburgh, PA
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Holmqvist-Jämsén S, Johansson A, Santtila P, Westberg L, von der Pahlen B, Simberg S. Investigating the Role of Salivary Cortisol on Vocal Symptoms. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:2781-2791. [PMID: 28915296 DOI: 10.1044/2017_jslhr-s-16-0058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 04/19/2017] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
| | - Ada Johansson
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
- Department of Psychology and Speech-Language Pathology, Faculty of Social Sciences, University of Turku, Turku, Finland
| | - Pekka Santtila
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | - Lars Westberg
- Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | | | - Susanna Simberg
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
- Department of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Norway
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Holmqvist Jämsen S, Johansson A, Westberg L, Santtila P, von der Pahlen B, Simberg S. Associations Between Vocal Symptoms and Genetic Variants in the Oxytocin Receptor and Arginine Vasopressin 1A Receptor Gene. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2017; 60:1843-1854. [PMID: 28687839 DOI: 10.1044/2016_jslhr-s-16-0059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Accepted: 12/27/2016] [Indexed: 06/07/2023]
Abstract
PURPOSE Oxytocin and arginine vasopressin are associated with different aspects of the stress response. As stress is regarded as a risk factor for vocal symptoms, we wanted to explore the association between the oxytocin receptor gene (OXTR) and arginine vasopressin 1A receptor gene (AVPR1A) single-nucleotide polymorphisms (SNPs) and vocal symptoms. We also wanted to explore whether such effects might be mediated by cortisol because oxytocin and vasopressin are associated with cortisol levels. METHOD A population-based sample (N = 657) of Finnish twins (born 1961-1989) completed a web questionnaire on the occurrence of vocal symptoms. A total of 170 participants submitted saliva samples for hormone analysis. A total of 20 OXTR and AVPR1A SNPs were analyzed. RESULTS Three OXTR polymorphisms (rs2270465, rs2268493, rs7632287) and 2 AVPR1A polymorphisms (rs1587097, rs1042615) showed nominal effects (p < .05) on vocal symptoms, of which 1 (rs1587097) remained significant after correcting for multiple testing (p = .003). We found potential mediation of the effect of the OXTR rs2268493 polymorphism on vocal symptoms through levels of cortisol. CONCLUSIONS The associations between variants of OXTR and AVPR1A and vocal symptoms indicate that oxytocin and vasopressin might influence vocal symptoms. The effect of oxytocin seems to be partly mediated through cortisol actions.
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Affiliation(s)
| | - Ada Johansson
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, FinlandDepartment of Psychology and Speech-Language Pathology, Faculty of Social Sciences, University of Turku, FinlandDepartment of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Lars Westberg
- Department of Pharmacology, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Pekka Santtila
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, Finland
| | | | - Susanna Simberg
- Faculty of Arts, Psychology and Theology, Åbo Akademi University, Turku, FinlandDepartment of Special Needs Education, Faculty of Educational Sciences, University of Oslo, Norway
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Relations Between Self-Regulation Behavior and Vocal Symptoms. J Voice 2017; 31:455-461. [DOI: 10.1016/j.jvoice.2016.10.010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Revised: 09/21/2016] [Accepted: 10/19/2016] [Indexed: 11/24/2022]
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Behrman A, Akhund A. The Effect of Loud Voice and Clear Speech on the Use of Vocal Fry in Women. Folia Phoniatr Logop 2017; 68:159-166. [DOI: 10.1159/000452948] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Mattei A, Revis J, Giovanni A. Personality traits inventory in patients with vocal nodules. Eur Arch Otorhinolaryngol 2016; 274:1911-1917. [DOI: 10.1007/s00405-016-4421-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 12/02/2016] [Indexed: 10/20/2022]
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Pisanski K, Nowak J, Sorokowski P. Individual differences in cortisol stress response predict increases in voice pitch during exam stress. Physiol Behav 2016; 163:234-238. [PMID: 27188981 DOI: 10.1016/j.physbeh.2016.05.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 05/11/2016] [Accepted: 05/12/2016] [Indexed: 12/20/2022]
Abstract
Despite a long history of empirical research, the potential vocal markers of stress remain unclear. Previous studies examining speech under stress most consistently report an increase in voice pitch (the acoustic correlate of fundamental frequency, F0), however numerous studies have failed to replicate this finding. In the present study we tested the prediction that these inconsistencies are tied to variation in the severity of the stress response, wherein voice changes may be observed predominantly among individuals who show a cortisol stress response (i.e., an increase in free cortisol levels) above a critical threshold. Voice recordings and saliva samples were collected from university psychology students at baseline and again immediately prior to an oral examination. Voice recordings included both read and spontaneous speech, from which we measured mean, minimum, maximum, and the standard deviation in F0. We observed an increase in mean and minimum F0 under stress in both read and spontaneous speech, whereas maximum F0 and its standard deviation showed no systematic changes under stress. Our results confirmed that free cortisol levels increased by an average of 74% (ranging from 0 to 270%) under stress. Critically, increases in cortisol concentrations significantly predicted increases in mean F0 under stress for both speech types, but did not predict variation in F0 at baseline. On average, stress-induced increases in voice pitch occurred only when free cortisol levels more than doubled their baseline concentrations. Our results suggest that researchers examining speech under stress should control for individual differences in the magnitude of the stress response.
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Affiliation(s)
| | - Judyta Nowak
- Department of Human Biology, University of Wrocław, Poland
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van Mersbergen M, Lyons P, Riegler D. Vocal Responses in Heighted States of Arousal. J Voice 2016; 31:127.e13-127.e19. [PMID: 26873422 DOI: 10.1016/j.jvoice.2015.12.011] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Accepted: 12/21/2015] [Indexed: 10/22/2022]
Abstract
OBJECTIVES The purpose of this study was to investigate electroglottography (EGG) contact quotient modulation with emotional state in the presence of increased arousal. STUDY DESIGN A within-subject reversal paradigm using multiple experimental conditions. METHODS A total of 11 healthy undergraduate students underwent emotion induction with intermittent startles to increase physiologic arousal. During emotion induction, they vocalized on the vowel /u/ while EGG was recorded. RESULTS EGG contact quotient was significantly greater for negative emotions compared with positive emotions with increased arousal commensurate with past research. In addition, overall EGG contact quotient was greater with elevated arousal. However, the effect sizes were small. CONCLUSIONS EGG contact quotient appears to increase with elevated arousal and be greater for negative mood states than positive mood states confirming that emotion states directly influence vocal functioning.
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Affiliation(s)
- Miriam van Mersbergen
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois..
| | - Patricia Lyons
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois
| | - Danielle Riegler
- School of Allied Health and Communicative Disorders, Northern Illinois University, DeKalb, Illinois
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Baker J. Functional voice disorders: Clinical presentations and differential diagnosis. HANDBOOK OF CLINICAL NEUROLOGY 2016; 139:389-405. [PMID: 27719859 DOI: 10.1016/b978-0-12-801772-2.00034-5] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In this chapter, an overview of the heterogeneous group of functional voice disorders is given, including the psychogenic voice disorder (PVD) and hyperfunctional or muscle tension voice disorder (MTVD) subgroups. Reference is made to prevalence and demographic data, with empiric evidence for psychosocial factors commonly associated with the onset and maintenance of these disorders. Clinical features that distinguish between the different presentations of PVD and MTVD are described. While there are some shared characteristics, key differences between these two subgroups indicate that PVD more closely resembles the psychogenic movement disorders and a range of other functional neurologic disorders. Assessment procedures and auditory-perceptual features of the voice that distinguish these disorders from the neurologically based voice disorders are discussed, with case examples highlighting ambiguous features that may influence differential diagnosis. The clinical profiles of PVD and MTVD affirm approaches to clinical management by speech-language pathologists that integrate symptomatic behavioral voice therapy with "top-down" models of counseling or psychotherapy. They also support the proposition that PVD may be construed as a subtype of functional neurologic disorders.
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Affiliation(s)
- J Baker
- Speech Pathology and Audiology, School of Health Sciences, Flinders University, Adelaide, Australia.
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Smith NR, Rivera LA, Dietrich M, Shyu CR, Page MP, DeSouza GN. Detection of Simulated Vocal Dysfunctions Using Complex sEMG Patterns. IEEE J Biomed Health Inform 2015; 20:787-801. [PMID: 26469789 DOI: 10.1109/jbhi.2015.2490087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Symptoms of voice disorder may range from slight hoarseness to complete loss of voice; from modest vocal effort to uncomfortable neck pain. But even minor symptoms may still impact personal and especially professional lives. While early detection and diagnosis can ameliorate that effect, to date, we are still largely missing reliable and valid data to help us better screen for voice disorders. In our previous study, we started to address this gap in research by introducing an ambulatory voice monitoring system using surface electromyography (sEMG) and a robust algorithm (HiGUSSS) for pattern recognition of vocal gestures. Here, we expand on that work by further analyzing a larger set of simulated vocal dysfunctions. Our goal is to demonstrate that such a system has the potential to recognize and detect real vocal dysfunctions from multiple individuals with high accuracy under both intra and intersubject conditions. The proposed system relies on four sEMG channels to simultaneously process various patterns of sEMG activation in the search for maladaptive laryngeal activity that may lead to voice disorders. In the results presented here, our pattern recognition algorithm detected from two to ten different classes of sEMG patterns of muscle activation with an accuracy as high as 99%, depending on the subject and the testing conditions.
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Ford Baldner E, Doll E, van Mersbergen MR. A Review of Measures of Vocal Effort With a Preliminary Study on the Establishment of a Vocal Effort Measure. J Voice 2015; 29:530-41. [DOI: 10.1016/j.jvoice.2014.08.017] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/28/2014] [Indexed: 11/16/2022]
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Manual therapy and exercise to improve outcomes in patients with muscle tension dysphonia: a case series. Phys Ther 2015; 95:117-28. [PMID: 25256740 PMCID: PMC4295082 DOI: 10.2522/ptj.20130547] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND PURPOSE Muscle tension dysphonia (MTD), a common voice disorder that is not commonly referred for physical therapy intervention, is characterized by excessive muscle recruitment, resulting in incorrect vibratory patterns of vocal folds and an alteration in voice production. This case series was conducted to determine whether physical therapy including manual therapy, exercise, and stress management education would be beneficial to this population by reducing excess muscle tension. CASE DESCRIPTION Nine patients with MTD completed a minimum of 9 sessions of the intervention. Patient-reported outcomes of pain, function, and quality of life were assessed at baseline and the conclusion of treatment. The outcome measures were the numeric rating scale (NRS), Patient-Specific Functional Scale (PSFS), and Voice Handicap Index (VHI). Cervical and jaw range of motion also were assessed at baseline and postintervention using standard goniometric measurements. OUTCOMES Eight of the patients had no pain after treatment. All 9 of the patients demonstrated an improvement in PSFS score, with 7 patients exceeding a clinically meaningful improvement at the conclusion of the intervention. Three of the patients also had a clinically meaningful change in VHI scores. All 9 of the patients demonstrated improvement in cervical flexion and lateral flexion and jaw opening, whereas 8 patients improved in cervical extension and rotation postintervention. DISCUSSION The findings suggest that physical therapists can feasibly implement an intervention to improve outcomes in patients with MTD. However, a randomized clinical trial is needed to confirm the results of this case series and the efficacy of the intervention. A clinical implication is the expansion of physical therapy to include referrals from voice centers for the treatment of MTD.
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Oken BS, Chamine I, Wakeland W. A systems approach to stress, stressors and resilience in humans. Behav Brain Res 2014; 282:144-54. [PMID: 25549855 DOI: 10.1016/j.bbr.2014.12.047] [Citation(s) in RCA: 120] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 12/18/2014] [Accepted: 12/21/2014] [Indexed: 01/02/2023]
Abstract
The paper focuses on the biology of stress and resilience and their biomarkers in humans from the system science perspective. A stressor pushes the physiological system away from its baseline state toward a lower utility state. The physiological system may return toward the original state in one attractor basin but may be shifted to a state in another, lower utility attractor basin. While some physiological changes induced by stressors may benefit health, there is often a chronic wear and tear cost due to implementing changes to enable the return of the system to its baseline state and maintain itself in the high utility baseline attractor basin following repeated perturbations. This cost, also called allostatic load, is the utility reduction associated with both a change in state and with alterations in the attractor basin that affect system responses following future perturbations. This added cost can increase the time course of the return to baseline or the likelihood of moving into a different attractor basin following a perturbation. Opposite to this is the system's resilience which influences its ability to return to the high utility attractor basin following a perturbation by increasing the likelihood and/or speed of returning to the baseline state following a stressor. This review paper is a qualitative systematic review; it covers areas most relevant for moving the stress and resilience field forward from a more quantitative and neuroscientific perspective.
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Affiliation(s)
- Barry S Oken
- Department of Neurology, Oregon Health & Science University, CR-120, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA; Department of Behavioral Neuroscience & Biomedical Engineering, Oregon Health & Science University, CR-120, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Irina Chamine
- Department of Neurology, Oregon Health & Science University, CR-120, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA.
| | - Wayne Wakeland
- Systems Science, Portland State University, P.O. Box 751, Portland, OR 97207, USA.
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Dietrich M, Verdolini Abbott K. Psychobiological stress reactivity and personality in persons with high and low stressor-induced extralaryngeal reactivity. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2014; 57:2076-2089. [PMID: 25087852 DOI: 10.1044/2014_jslhr-s-12-0386] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Accepted: 07/10/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE The purpose of the study was to determine whether persons who responded with high stressor-induced extralaryngeal muscle activity in a stress reactivity protocol differed from those with low muscle activity on measures of emotional and autonomic cardiovascular reactivity and personality. METHOD Thirty-six vocally healthy women (18-35 years) were assigned to high and low extralaryngeal groups based on submental (SM) and infrahyoid (IH) surface electromyography (sEMG) recordings obtained during a stress reactivity protocol (high vs. low sEMGSM and sEMGIH, n = 18 per subgroup; Dietrich & Verdolini Abbott, 2012). Measures included assessments of basic fear and fear of public speaking, rumination, systolic blood pressure (SBP), and personality. RESULTS The high sEMGIH group reported significantly greater basic fear across experimental phases than did the low sEMGIH group (p = .036). However, the high sEMGSM and sEMGIH versus low sEMGSM and sEMGIH groups did not differ on fear of public speaking, rumination, or SBP across phases. Both high sEMGSM and sEMGIH groups were characterized by significantly lower scores on Extraversion (p < .001). CONCLUSION In combination with the authors' previous findings (Dietrich & Verdolini Abbott, 2012), the present findings provided robust evidence that low Extraversion was linked to stressor-induced changes in extralaryngeal functioning and that perceived fear played a contributing role.
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Barsties B, Verfaillie R, Dicks P, Maryn Y. Is the speaking fundamental frequency in females related to body height? LOGOP PHONIATR VOCO 2014; 41:27-32. [PMID: 25090237 DOI: 10.3109/14015439.2014.941928] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The aim of the study was to determine the impact of body height on speaking fundamental frequency (SF0) while controlling for as many as possible influencing factors such as habits, biophysical conditions, medication, diseases, and others. Fifty-eight females were analyzed during spontaneous speech (i.e. explaining driving directions or a cooking recipe) of at least 60 seconds at comfortable pitch and loudness. The subjects showed a moderate negative and significant correlation between body height and SF0 (r = -0.40, P = 0.002). With r(2) = 0.16, however, a reasonable portion (16%) of the variance in SF0 is explained by the variance in body height. In comparison with other factors for which a correlation with SF0 was mentioned in literature (hypothyrodism, hemodialysis, auditory-maleness after female-to-male transsexualism, body weight, body mass index, and body fat), body height accounted for most of the proportion of SF0 in females. It is therefore possible to validate body height as a factor to account for in clinical F0 measurement.
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Affiliation(s)
- Ben Barsties
- a Faculty of Health Care, HU University of Applied Sciences Utrecht , Utrecht , The Netherlands.,b Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp , Belgium
| | - Rudi Verfaillie
- c Department of Speech-Language Therapy , Zuyd University College , Heerlen , The Netherlands
| | - Peter Dicks
- d Vocational School, University Hospital Aix-la-Chapelle , Aachen , Germany
| | - Youri Maryn
- b Faculty of Medicine and Health Sciences, University of Antwerp , Antwerp , Belgium.,e Department of Otorhinolaryngology and Head & Neck Surgery , Speech-Language Pathology and Audiology, Sint-Jan General Hospital , Bruges , Belgium.,f Faculty of Education, Health & Social Work, University College Ghent , Ghent , Belgium
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Holmqvist S, Santtila P, Lindström E, Sala E, Simberg S. The Association Between Possible Stress Markers and Vocal Symptoms. J Voice 2013; 27:787.e1-787.e10. [DOI: 10.1016/j.jvoice.2013.06.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 06/19/2013] [Indexed: 01/26/2023]
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