Summary
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.
Key Words
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References
- Self-reported impact of dysphonia in a primary care population: an epidemiological study.Laryngoscope. 2010; 120: 2022-2032
- Redefining the survival of the fittest: communication disorders in the 21st century.Int J Pediatr Otorhinolaryngol. 2000; 49: 241-245
- Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report.J Voice. 1997; 11: 254-259
- Direct health care costs of laryngeal diseases and disorders.Laryngoscope. 2012; 122: 1582-1588
- Quality-of-life impact of non-neoplastic voice disorders: a meta-analysis.Ann Otol Rhinol Laryngol. 2006; 115: 128-134
- The frequency of perceived stress, anxiety, and depression in patients with common pathologies affecting voice.J Voice. 2008; 22: 472-488
- Psychological distress in patients with benign voice disorders.Folia Phoniatr Logop. 2011; 63: 281-288
- Psychosocial distress in patients presenting with voice concerns.J Voice. 2014; 28: 753-761
- New perspective on psychosocial distress in patients with dysphonia: the moderating role of perceived control.J Voice. 2016; 30: 172-176
- Brief report: perceived control and voice handicap in patients with voice disorders.Health Psychol. 2017; 36: 1105-1108
- Development and validation of the voice handicap index-10.Laryngoscope. 2004; 114: 1549-1556
- Temperament, speech and language: an overview.J Commun Disord. 2013; 46: 125-142
- Encouragement to increase the use of psychosocial skills in the diagnosis and therapy of patients with functional dysphonia.J Voice. 2016; 31132,e1-132.e7https://doi.org/10.1016/j.jvoice.2015.11.021
- Classification Manual for Voice Disorders—I.Lawrence Erlbaum, Mahwah, NJ2006: 249
- Multi-institutional study of voice disorders and voice therapy referral: report from the CHEER network.Otolaryngol Head Neck Surg. 2016; 155: 33-41
- Documents of Life 2: An Invitation to a Critical Humanism.Sage Publishing, London2001
- Validity, reliability, and generalizability in qualitative research.J Family Med Prim Care. 2015; 4: 324-327
- Effects of components of protection-motivation theory on adaptive and maladaptive coping with a health threat.J Pers Soc Psychol. 1987; 52: 596-604
- Sample size and saturation in PhD studies using qualitative interviews.Forum Qual Soc Res. 2010; 11
- How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective.Perspect Psychol Sci. 2011; 6: 537-559
- The emerging field of emotion regulation: an integrative review.Rev Gen Psychol. 1998; 2: 271
- Mindfulness and emotion regulation: insights from neurobiological, psychological, and clinical studies.Front Psychol. 2017; 8: 220
- Changing perceived control in patients with physical disabilities: an intervention study with patients receiving rehabilitation.Br J Clin Psychol. 1992; 31: 89-94
- A randomized controlled trial of a web-based intervention to reduce distress among students with a history of interpersonal violence.Psychol Violence. 2015; 5: 444
- Interdisciplinary approach to functional voice disorders: the psychiatrist's role.Otolaryngol Head Neck Surg. 1993; 108: 643-647
- Personality traits and psychological factors in voice pathology: a foundation for future research.J Speech Lang Hear Res. 2000; 43: 737-748
- Vocal function in introverts and extraverts during a psychological stress reactivity protocol.J Speech Lang Hear Res. 2012; 55: 973-987
- Intrinsic laryngeal muscle activity in response to autonomic nervous system activation.Laryngoscope. 2013; 123: 2756-2765
- Vocal control: is it susceptible to the negative effects of self-regulatory depletion?.J Voice. 2016; 30638,e21-31https://doi.org/10.1016/j.jvoice.2015.07.016
- Vocal responses in heighted states of arousal.J Voice. 2016; 31127,e13-127.e19https://doi.org/10.1016/j.jvoice.2015.12.011
- Testing moderator and mediator effects in counseling psychology research, sample size and saturation in PhD studies using qualitative interviews.J Couns Psychol. 2004; 51: 115
- The health belief model and sick role behavior.Health Educ Monogr. 1974; 2: 409-419
- Historical origins of the health belief model.Health Educ Monogr. 1974; 2: 328-335
- The theory of planned behavior.Organ Behav Hum Decis Process. 1991; 50: 179-211
- Self-Efficacy: The Exercise of Control.W.H. Freeman, New York1997
- Functional dysphonia: strategies to improve patient outcomes.Patient Relat Outcome Meas. 2015; 6: 243-253
- Perceived past, present, and future control and adjustment to stressful life events.J Pers Soc Psychol. 2011; 100: 749-765
- Perceived control and psychological adjustment in gay men with AIDS.J Appl Soc Psychol. 1993; 23: 791-824
- Presenting and evaluating qualitative research.Am J Pharm Educ. 2010; 74: 141
- Checklists for improving rigour in qualitative research: a case of the tail wagging the dog?.BMJ. 2001; 322: 1115-1117
Article Info
Publication History
Published online: May 11, 2018
Accepted:
April 4,
2018
Footnotes
Disclosures: Research reported in this publication was supported by the National Institute on Deafness and other Communication Disorders of the National Institutes of Health under award number K23DC016335 (S. Misono). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.
Identification
Copyright
© 2018 The Voice Foundation. Published by Elsevier Inc. All rights reserved.
