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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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.
