Investigating Past Trauma in Laryngoresponders Versus Non-Laryngoresponders: Piloting New Methods in an Exploratory Study



      This exploratory pilot study aimed to probe the relationship between past experiences of trauma in people who self-identify as “laryngoresponders” compared to those who do not. It also explored the communicative context of past traumatic events in laryngoresponders versus non-laryngoresponders.

      Study Design

      Prospective, within-subjects experimental design.


      29 vocally healthy cisgender women (ages 19 to 56) completed a battery of validated self-report measures relating to their past traumatic experiences. Participants also completed two original self-report measures designed to provide insight about (1) where stress tends to manifest in their body and (2) communicative settings of participants’ past trauma.


      Six participants (21%) self-identified a predictable laryngeal and/or vocal response to acute stress and thus comprise the laryngoresponders group. Laryngoresponders exhibited worse scores on 75% of all trauma-related variables compared to non-laryngoresponders, and Emotional Neglect was disproportionately represented in laryngoresponders. Participants with a reported history of childhood Emotional Neglect (83% of laryngoresponders, 35% of nonlaryngoresponders) reported quantitatively “less ideal” communication experiences in the context of past traumatic experiences.


      Other investigators identify the larynx as a “vulnerable body pathway” for some women. This pilot study of adult women without voice complaints revealed several commonalities amongst self-reported laryngoresponders, and compels further exploration of the voice-trauma relationship.

      Key words

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        • Tassinary LG
        • Cacioppo JT
        • Vanman EJ.
        The somatic system.
        Handbook of Psychophysiology. 4th Ed. Cambridge Handbooks in Psychology. Cambridge University Press, 2017: 151-182
        • Johnson EO
        • Kamilaris TC
        • Chrousos GP
        • et al.
        Mechanisms of stress: a dynamic overview of hormonal and behavioral homeostasis.
        Neurosci Biobehav Rev. 1992; 16: 115-130
        • Henningsen P.
        Management of somatic symptom disorder.
        Dialogues Clin Neurosci. 2018; 20: 23-31
        • Van den Bergh O
        • Witthöft M
        • Petersen S
        • et al.
        Symptoms and the body: taking the inferential leap.
        Neurosci Biobehav Rev. 2017; 74: 185-203
        • Mussell M
        • Kroenke K
        • Spitzer RL
        • et al.
        Gastrointestinal symptoms in primary care: prevalence and association with depression and anxiety.
        J Psychosom Res. 2008; 64: 605-612
        • Piontek K
        • Wiesmann U
        • Apfelbacher C
        • et al.
        The association of childhood maltreatment, somatization and health-related quality of life in adult age: results from a population-based cohort study.
        Child Abuse Negl. 2021; 120105226
        • Waldinger RJ
        • Schulz MS
        • Barsky AJ
        • et al.
        Mapping the road from childhood trauma to adult somatization: the role of attachment.
        Psychosom Med. 2006; 68: 129-135
        • Rubin JJ.
        Psychosomatic pain: new insights and management strategies.
        South Med J. 2005; 98 (quiz 1111-1112, 1138): 1099-1110
        • Iloson C
        • Möller A
        • Sundfeldt K
        • et al.
        Symptoms within somatization after sexual abuse among women: a scoping review.
        Acta Obstet Gynecol Scand. 2021; 100: 758-767
        • Giddens CL
        • Barron KW
        • Clark KF
        • et al.
        Beta-adrenergic blockade and voice: a double-blind, placebo-controlled trial.
        J Voice Off J Voice Found. 2010; 24: 477-489
        • Helou LB
        • Rosen CA
        • Wang W
        • et al.
        Intrinsic laryngeal muscle response to a public speech preparation stressor.
        J Speech Lang Hear Res. 2018; 61: 1525-1543
        • Butcher P.
        Psychological processes in psychogenic voice disorder.
        Eur J Disord Commun J Coll Speech Lang Ther Lond. 1995; 30: 467-474
        • Aronson A.
        Clinical Voice Disorders: An Interdisciplinary Approach.
        Thieme Medical Publishers, Inc., 1990
        • Roy N.
        Functional dysphonia.
        Curr Opin Otolaryngol Head Neck Surg. 2003; 11: 144-148
        • Verdolini K
        • Rosen C
        • Branski R
        Classification Manual for Voice Disorders.
        I. Lawrence Erlbaum & Associates, 2006
        • Cohen SM
        • Pitman MJ
        • Noordzij JP
        • et al.
        Management of dysphonic patients by otolaryngologists.
        Otolaryngol Neck Surg. 2012; 147: 289-294
        • Garrett CG
        • Cohen SM.
        Otolaryngological perspective on patients with throat symptoms and laryngeal irritation.
        Curr Gastroenterol Rep. 2008; 10: 195-199
        • Baker J.
        Psychogenic voice disorders and traumatic stress experience: a discussion paper with two case reports.
        J Voice Off J Voice Found. 2003; 17: 308-318
        • House A
        • Andrews HB.
        The psychiatric and social characteristics of patients with functional dysphonia.
        J Psychosom Res. 1987; 31: 483-490
        • Butcher P
        • Elias A
        • Cavalli L.
        Understanding and Treating Psychogenic Voice Disorder: A CBT Framework.
        John Wiley & Sons Ltd, 2007
        • Roy N
        • Bless D.
        Toward a theory of the dispositional bases of functional dysphonia and vocal nodules: exploring the role of personality and emotional adjustment.
        in: Kent R Ball M Voice Quality Measurement. Singular, 2000
        • Roy N
        • Bless DM
        • Heisey D.
        Personality and voice disorders: a superfactor trait analysis.
        J Speech Lang Hear Res JSLHR. 2000; 43: 749-768
        • Roy N
        • Bless DM.
        Personality traits and psychological factors in voice pathology: a foundation for future research.
        J Speech Lang Hear Res JSLHR. 2000; 43: 737-748
        • Dietrich M
        • Verdolini Abbott K.
        Psychobiological framework of stress and voice.
        in: Izdebski K Emotions in the Human Voice. Plural Publishing, Inc., 2008: 159-178
        • Dietrich M.
        • Andreatta RD
        • Jiang Y
        • et al.
        Limbic and cortical control of phonation for speech in response to a public speech preparation stressor.
        Brain Imaging Behav. May 2, 2019; (Published online)
        • Roy N
        • Dietrich M
        • Blomgren M
        • et al.
        Exploring the neural bases of primary muscle tension dysphonia: a case study using functional magnetic resonance imaging.
        J Voice Off J Voice Found. 2019; 33: 183-194
        • Dietrich M
        • Andreatta RD
        • Jiang Y
        • et al.
        Preliminary findings on the relation between the personality trait of stress reaction and the central neural control of human vocalization.
        Int J Speech Lang Pathol. June 15, 2012; (Published online)
        • Richter-Levin G
        • Sandi C.
        Title: “Labels matter: iss it stress or is it trauma?.
        Transl Psychiatry. 2021; 11: 1-9
        • Monti E
        • D'Andrea W
        • Freed S
        • et al.
        Does self-reported childhood trauma relate to vocal acoustic measures? Preliminary findings at trauma recall.
        J Nonverbal Behav. 2021; (Published online January 22)
        • Rosen D.
        • Sataloff J.
        • Sataloff R.
        Psychology of Voice Disorders.
        2nd ed. Plural Publishing, 2021
        • Monti E
        • Kidd DC
        • Carroll LM
        • et al.
        What's in a singer's voice: the effect of attachment, emotions and trauma.
        Logoped Phoniatr Vocol. 2017; 42: 62-72
        • van der Kolk BA.
        The neurobiology of childhood trauma and abuse.
        Child Adolesc Psychiatr Clin N Am. 2003; 12 (ix): 293-317
      1. Ford J, Courtois C, eds. In: Treating Complex Traumatic Stress Disorders in Adults: Scientific Foundations and Therapeutic Models. 2nd ed. Guilford Press; 2020. Accessed May 11, 2022.

        • van der Kolk B.
        Posttraumatic stress disorder and the nature of trauma.
        Dialogues Clin Neurosci. 2000; 2: 7-22
      2. Becker D.R.Vocal Manifestations of Reported Past Trauma. University of Pittsburgh ETD. University of Pittsburgh; 2019. Accessed December 29, 2020.

        • Van Der Veer SN
        • Beukenhorst AL
        • Ali SM
        • et al.
        Development of a mobile digital manikin to measure pain location and intensity.
        Stud Health Technol Inform. 2020; 270: 946-950
        • Bernstein DP
        • Stein JA
        • Newcomb MD
        • et al.
        Development and validation of a brief screening version of the childhood trauma questionnaire.
        Child Abuse Negl. 2003; 27: 169-190
        • Hooper LM
        • Stockton P
        • Krupnick JL
        • et al.
        Development, use, and psychometric properties of the trauma history questionnaire.
        J Loss Trauma. 2011; 16: 258-283
        • Kubany E
        • Haynes S
        • Leisen MB
        • et al.
        Development and preliminary validation of a brief broad-spectrum measure of trauma exposure: the Traumatic Life Events Questionnaire.
        Psychol Assess. 2000; (Published online)
        • Martins RHG
        • do Amaral HA
        • Tavares ELM
        • et al.
        Voice disorders: etiology and diagnosis.
        J Voice Off J Voice Found. 2016; 30 (761.e1-761.e9)
        • Arffa RE
        • Krishna P
        • Gartner-Schmidt J
        • et al.
        Normative values for the Voice Handicap Index-10.
        J Voice Off J Voice Found. 2012; 26: 462-465
        • Patrick CJ
        • Curtin JJ
        • Tellegen A.
        Development and validation of a brief form of the multidimensional personality questionnaire.
        Psychol Assess. 2002; 14: 150-163
      3. Spielberger GD, Gorusch RL, Lushene R, et al. Manual for the state-trait anxiety inventory (form Y, self-evaluation questionnaire). Published online 1983.

        • Terr LC.
        Childhood traumas: an outline and overview.
        Am J Psychiatry. 1991; 148: 10-20
        • Bernstein DP
        • Fink L.
        Childhood Trauma Questionnaire: A Retrospective Self-Report : Manual.
        Psychological Corporation, 1998
        • Felitti VJ
        • Anda RF
        • Nordenberg D
        • et al.
        Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The adverse childhood experiences (ACE) study.
        Am J Prev Med. 1998; 14: 245-258
        • Bernstein EM
        • Putnam FW.
        Development, reliability, and validity of a dissociation scale.
        J Nerv Ment Dis. 1986; 174: 727-735
        • Olsen S
        • Clapp J
        • Parra G
        • et al.
        Factor structure of the dissociative experiences scale: an examination across sexual assault status.
        J Psychopathol Behav Assess. 2013; 35: 394-403
        • Mazzotti E
        • Farina B
        • Imperatori C.
        • et al.
        Is the dissociative experiences scale able to identify detachment and compartmentalization symptoms? Factor structure of the dissociative experiences scale in a large sample of psychiatric and nonpsychiatric subjects.
        Neuropsychiatr Dis Treat. 2016; 12: 1295-1302
        • Pinheiro PS.
        World Report on Violence against Children.
        United Nations Publ, 2006
        • Anda RF
        • Croft JB
        • Felitti VJ
        • et al.
        Adverse childhood experiences and smoking during adolescence and adulthood.
        JAMA. 1999; 282: 1652-1658
        • Teicher MH
        • Samson JA.
        Annual research review: enduring neurobiological effects of childhood abuse and neglect.
        J Child Psychol Psychiatry. 2016; 57: 241-266
        • Tjaden P
        • Thoennes N.
        Extent, Nature, and Consequences of Rape Victimization: Findings From the National Violence Against Women Survey: (513832006-001).
        2006 (Published online)
        • Austin D.
        The Theory and Practice of Vocal Psychotherapy: Songs of the Self.
        Jessica Kingsley Publishers, 2008