Predictive Factors of Listeners’ Attitudes Related to Dysphonic Voices in Native Brazilian Portuguese

  • Deyverson da Silva Evangelista
    Graduate Program in Linguistics Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
    Search for articles by this author
  • Giorvan Ânderson dos Santos Alves
    Graduate Program in Linguistics Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil

    Department of Speech Therapy Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
    Search for articles by this author
  • Anna Alice Almeida
    Department of Speech Therapy Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
    Search for articles by this author
  • Leonardo Wanderley Lopes
    Address correspondence and reprint requests to: Leonardo Wanderley Lopes, Departamento de Fonoaudiologia, Centro de Ciências da Saúde, Cidade Universitária-Campus I, Bairro Castelo Branco, João Pessoa Paraíba, Brazil, CEP: 58051-900.
    Graduate Program in Linguistics Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil

    Department of Speech Therapy Federal University of Paraíba (Universidade Federal da Paraíba-UFPB), João Pessoa, Paraíba, Brazil
    Search for articles by this author
Published:December 13, 2022DOI:



      To verify whether there are differences in the judgments of listeners’ attitudes as a function of the presence, severity, and type of vocal deviation, and to identify the predictive factors of listeners’ attitudes toward dysphonic voices in Brazilian Portuguese speakers.


      A sample of CAPE-V sentences was used from 44 subjects of both genders. The samples presented different severities of vocal deviation (general grade - GG) (healthy, mild, moderate, and severe) and different degrees of roughness (GR), breathiness (GB), and strain (GS), characterized by a perceptual-auditory judgment performed by speech therapists. The samples were presented to 152 listeners of both genders who performed the judgment of 12 attitudes inserted in a semantic differential scale previously validated for this study. Here, we used a Logistic Regression Model.


      There was no association between listener's gender and the judgment of attitudes. Subjects with vocal quality deviation were judged more negatively in relation to vocally healthy individuals. We observed that higher the GG, higher the negative judgment of listeners in relation to the speakers. Listeners judged breathy and strained voices as more negative. In the general model for female and male voices, the increase in GB and GG reduced the chance of a voice being evaluated positively by 16 and 20%, respectively. For female voices, GB and GS reduced the chance of a female voice being evaluated positively by 36 and 19%, respectively. GG reduces the chance of a male voice being evaluated positively by 46%, while GR increases the chance of a male voice being judged positively by 62 %.


      There is an association between the presence, severity, and type of vocal deviation and listeners’ attitudes. We identified a predictive model of listeners' attitudes related to dysphonic voices among Brazilian Portuguese speakers. In general, GG and GB were predictors of negative attitudes toward listeners. GB and GS were predictors of negative attitudes toward female voices. The GG is a predictor of negative attitudes toward male voices, while the GR increases the chance of positive judgments.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Journal of Voice
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Cohen SM.
        Self-reported impact of dysphonia in a primary care population: an epidemiological study.
        Laryngoscope. 2010; 120: 2022-2032
        • Bestelmeyer P
        • Rouger J
        • Debruine L
        • et al.
        Auditory adaptation in vocal affect perception.
        Cognition. 2010; 117: 217-223
        • Latinus M
        • Crabbe F
        • Belin P.
        Learning-induced changes in the cerebral processing of voice identity.
        Cere Cor. 2011; 21: 2820-2828
        • Verdolini K
        • Ramig LO.
        Review: occupational risks for voice problems.
        Logoped Phoniatr Vocol. 2001; 26: 37-46
        • Titze IR
        • Lemke J
        • Montequin D.
        Populations in the U.S. workforce who rely on voice as a primary tool of trade: a preliminary report.
        J Voice. 2022; 11 (1997 September 1 Cited November 3): 254-259
        • Williams NR.
        Occupational groups at risk of voice disorders: a review of the literature.
        Occu Med. 2003; 53: 456-460
        • Korn GP
        • Pontes AAdeL
        • Abranches D
        • et al.
        Voice DAJ of, 2015 undefined. Hoarseness and risk factors in university teachers.
        J Voice. 2015; 29: 518e21-518e28
        • Rumbach A
        • Khan A
        • Brown M
        • et al.
        Voice problems in the fitness industry: factors associated with chronic hoarseness.
        Int J Speech Lang Pathol. 2015; 17: 441-450
        • Villar ACNWB
        • Korn GP
        • Azevedo RR.
        Perceptual-auditory and acoustic analysis of air traffic controllers’ voices pre- and postshift.
        J Voice. 2016; 30: 768e11-768e15
        • Kyriakou K
        • Petinou K
        • Phinikettos I.
        Risk factors for voice disorders in university professors in Cyprus.
        J Voice. 2018; 32: 643e1-643e9
        • Porcaro C
        • Evitts P
        • King N
        • et al.
        Effect of dysphonia and cognitive-perceptual listener strategies on speech intelligibility.
        J Voice. 2020; 34: 806e7-806e18
        • Isetti D
        • Xuereb L
        • Eadie TL.
        Inferring speaker attributes in adductor spasmodic dysphonia: ratings from unfamiliar listeners.
        Am J Speech Lang Pathol. 2014; 23: 134-145
        • Angelillo M
        • di Maio G
        • Costa G
        • et al.
        Prevalence of occupational voice disorders in teachers.
        J Prev Med Hyg. 2009; 50: 26-32
        • van Houtte E
        • Claeys S
        • Wuyts F
        • et al.
        The impact of voice disorders among teachers: vocal complaints, treatment-seeking behavior, knowledge of vocal care, and voice-related absenteeism.
        J Voice. 2011; 25: 570-575
        • da Costa V
        • Prada E
        • Roberts A
        • et al.
        Voice disorders in primary school teachers and barriers to care.
        J Voice. 2012 January 1; 26: 69-76
        • Maidment JA.
        The phonetic description of voice quality.
        J Int Phonet Asso. 1981; 11: 78-84
        • Ma EP
        • Yu CH.
        Listeners’ attitudes toward children with voice problems.
        J Speech Lang Hear Res. 2013; 56 (Accessed November 3 2022) (Accessed November 3 2022): 1409-1415
        • Amir O
        • Levine-Yundof R.
        Listeners’ attitude toward people with dysphonia.
        J Voice. 2013 July 1; 27 (524.e1-524.10.10.1016/j.jvoice.2013.01.015)
      1. Morsomme D, Minel L,Verduyckt I. Impact of teachers'voice quality on children's language. 2011. [Internet].

        • Altenberg EP
        • Ferrand CT.
        Perception of individuals with voice disorders by monolingual English, bilingual Cantonese–English, and bilingual Russian-English women.
        J Speech Lang Hear Res. 2022; 49 (2006 August 1 Cited August 5): 879-887
      2. Rogerson J, Voice BDJ of. 2005 undefined. Is there an effect of dysphonic teachers’ voices on children's processing of spoken language? Accessed November 3 2022; 2005. Elsevier [Internet].

        • Allard ER
        • Williams DF.
        Listeners’ perceptions of speech and language disorders.
        J Commun Disord. 2008 March 1; 41: 108-123
        • van Borsel J
        • Janssens J
        • Bodt MD.
        Breathiness as a feminine voice characteristic: a perceptual approach.
        J Voice. 2009; 23: 291-294
        • Irani F
        • Abdalla F
        • Hughes S.
        Perceptions of voice disorders: a survey of Arab adults.
        Logoped Phoniatr Vocol. 2014; 39: 87-97
        • Waaramaa T
        • Lukkarila P
        • Järvinen K
        • et al.
        Impressions of personality from intentional voice quality in Arabic-speaking and native Finnish-speaking listeners.
        J Voice. 2022; 35 (2021 March 1 Cited August 5): 326.e21-326.e28
      3. Fraccaro P, O'Connor J, Re D, et al. 2013 Undefined. Faking it: deliberately altered voice pitch and vocal attractiveness.

      4. Puts DA, Barndt JL, Welling LLM, et al. Intrasexual competition among women: vocal femininity affects perceptions of attractiveness and flirtatiousness. Accessed November 3 2022. Elsevier [Internet].

        • Ghio A
        • Cantarella G
        • Weisz F
        • et al.
        Is the perception of dysphonia severity language-dependent? A comparison of French and Italian voice assessments.
        Logoped Phoniatr Vocol. 2015; 40: 36-43
      5. Chaves C, Campbell M. Voice AGJ of, 2017 undefined. The influence of native language on auditory-perceptual evaluation of vocal samples completed by Brazilian and Canadian SLPs. Accessed November 3 2022. Elsevier [Internet].

      6. Kreiman J. Phonetics BGJ of, 2010 undefined. Effects of native language on perception of voice quality. Accessed November 3 2022. Elsevier [Internet].

      7. Gobl C. sciences ACT handbook of phonetic, 2010 undefined. 11 Voice source variation and its communicative functions. [Internet]. Accessed November 3 2022.

        • Lallh AK
        • Rochet AP.
        The effect of information on listeners’ attitudes toward speakers with voice or resonance disorders.
        J Speech Lang Hear Res. 2000; 43: 782-795
      8. Wilson D. Pragmatics TWJ of, 2006 undefined. Relevance and prosody. Accessed November 3 2022; 2006. Elsevier [Internet].

        • Eadie TL
        • Rajabzadeh R
        • Isetti DD
        • et al.
        The effect of information and severity on perception of speakers with adductor spasmodic dysphonia.
        Am J Speech Lang Pathol. 2017 May 1; 26: 327-341
      9. Lyberg-Åhlander V, … MH… journal of speech. 2015 undefined. Does the Speaker's Voice Quality Influence Children's Performance on a Language Comprehension Test? Cited November 3 2022.; 2015 February 1. Taylor & Francis [Internet]:17(1):63.

      10. Levitt AG, Lucas M. The effects of four voice qualities on the perception of a female voice. 2016. Accessed November 3 2022.

      11. Poon M, Chan K. 9th EYP of the, 2018 undefined. The relationship between speech rate, voice quality and listeners’ purchase intentions. [Internet]. Accessed November 3 2022.

        • Maryn Y
        • Debo K.
        Is perceived dysphonia related to perceived healthiness?.
        Logoped Phoniatr Vocol. 2015; 40: 122-128
      12. Parker M. Voice SBJ of, 2018 undefined. Judgments of intelligence and likability of young adult female speakers of American English: the influence of vocal fry and the surrounding acoustic-prosodic context. Accessed November 3 2022; 2017. Elsevier [Internet].

        • Verduyckt I
        • Morsomme D.
        Vocal beauty: a mediating variable in the negative stereotyping of dysphonic speakers.
        Logoped Phoniatr Vocol. 2022; 45 (2020 October 1 Cited August 5): 164-171
        • Ruscello DM
        • Lass NJ
        • Podbesek J.
        Listeners’ perceptions of normal and voice-disordered children.
        Folia Phoniatr Logop. 2022; 40 (1988 Cited November 3): 290-296
        • Blood GW
        • Mahan BW
        • Hyman M.
        Judging personality and appearance from voice disorders.
        J Commun Disord. 1979; 12: 63-67
        • Krauss RM
        • Freyberg R
        • Morsella E.
        Inferring speakers’ physical attributes from their voices.
        J Exp Soc Psychol. 2002; 38: 618-625
        • Coleman RO.
        A comparison of the contributions of two voice quality characteristics to the perception of maleness and femaleness in the voice.
        J Speech Hear Res. 2022; 19 (1976 Cited August 5): 168-180
        • Kissel I
        • D'haeseleer E
        • Meerschman I
        • et al.
        Listeners’ attitudes toward voice disorders: an interaction between auditory and visual stimuli.
        J Commun Disord. 2022; 99106241
      13. Anders L, Hollien H, Hurme P, … ASF. 1988 undefined. Perception of hoarseness by several classes of listeners. [Internet]. Accessed August 5 2022.

      14. Barkat-Defradas M, … CB… sur la parole et. 2012 undefined. dimension esthétique des voix normales et dysphoniques: approches perceptive et acoustique. [Internet]. Accessed August 4 2022.

      15. Bruckert L, Bestelmeyer P, Latinus M. biology JRC, 2010 undefined. Vocal attractiveness increases by averaging. Accessed November 3 2022. Elsevier [Internet].

        • Bebout L
        • Arthur B.
        Cross-cultural attitudes toward speech disorders.
        J Speech Hear Res. 1992; 35: 45-52
      16. Garrett P. Attitudes to language [Internet]. Accessed August 5 2022; 2010.

      17. Battle D. Communication disorders in multicultural populations [Internet]. Accessed August 5 2022; 2012.

        • Sauter DA
        • Eisner F
        • Ekman P
        • et al.
        Cross-cultural recognition of basic emotions through nonverbal emotional vocalizations.
        Proc Natl Acad Sci U S A. 2022; 107 (2010 February 9 Cited August 5): 2408-2412
      18. Osgood C, Suci G, Tannenbaum P. The measurement of meaning. 1957. Accessed November 3 2022.

      19. measurement DHA, 1970 undefined. The semantic differential and attitude research. [Internet] Cited November 3 2022.; 1970:235-253.

      20. Consensus auditory-perceptual evaluation of voice … - Google Acadêmico [Internet]. Accessed November 3 2022.

      21. Ugulino A, Oliveira G. de MBJ da SB, 2012 undefined. disfonia na percepção do clínico e do paciente cited november 3 2022;24:113–21.; 2012. Brasil: SciELO [Internet].

        • Karnell MP
        • Melton SD
        • Childes JM
        • et al.
        Reliability of clinician-based (GRBAS and CAPE-V) and patient-based (V-RQOL and IPVI) documentation of voice disorders.
        J Voice. 2022; 21 (2007 September Cited November 6): 576-590
        • Hughes SM
        • Mogilski JK
        • Harrison MA.
        The perception and parameters of intentional voice manipulation.
        J Nonverbal Behav. 2014; 38: 107-127
      22. Waaramaa T, Lukkarila P, Järvinen K. Voice AGJ of, 2021 undefined. Impressions of personality from intentional voice quality in Arabic-speaking and native Finnish-speaking listeners. Accessed November 3 2022. Elsevier [Internet].

        • Langlois JH
        • Kalakanis L
        • Rubenstein AJ
        • et al.
        Maxims or myths of beauty? A meta-analytic and theoretical review.
        Psychol Bull. 2000; 126: 390-423
      23. Hughes S., Personal NMJ of S and, 2016 undefined. What sounds beautiful looks beautiful stereotype: the matching of attractiveness of voices and faces. [Internet] Cited November 3 2022.; 2016 November 1;33:984-996.

        • Lewis JW
        • Talkington WJ
        • Walker NA
        • et al.
        Human cortical organization for processing vocalizations indicates representation of harmonic structure as a signal attribute.
        J Neurosci. 2022; 29 (2009) (Accessed November 3): 2283-2296
      24. Listeners’ perceptions of females with hoarse and … - Google Acadêmico [Internet]. Accessed November 3 2022.

        • McAleer P
        • Todorov A
        • Belin P.
        How do you say “hello”? Personality impressions from brief novel voices.
        PLOS ONE. 2014; 9
        • Stoklasa J
        • Talášek T
        • Stoklasová J.
        Semantic differential for the twenty-first century: scale relevance and uncertainty entering the semantic space.
        Qual Quant. 2019; 53: 435-448
      25. Belin P, Zatorre R. Research PACB, 2002 undefined. Human temporal-lobe response to vocal sounds. Accessed November 3 2022. Elsevier [Internet].

      26. Belin P. Neuroreport RZ, 2003 Undefined. Adaptation to speaker's voice in right anterior temporal lobe. [Internet]. Accessed November 3 2022.

      27. Smith E, Verdolini K, Gray S, et al. Effects of voice disorders on quality of life. 2016 December 13 Cited August 5 2022;4:223-244. [Internet].

        • Noar JH.
        Questionnaire survey of attitudes and concerns of patients with cleft lip and palate and their parents.
        Cleft Palate Craniofac J. 1991; 28: 279-284
      28. Gobl C. communication ACS, 2003 Undefined. The role of voice quality in communicating emotion, mood and attitude. Accessed November 3 2022. Elsevier [Internet].

      29. Liu X. ICPhS YX, 2011 undefined. What Makes à Female Voice Attractive? [Internet] Cited November 3 2022.; 2011;17-21.

      30. Kreiman J, Today DSA. 2011 undefined. Voices and listeners: toward a model of voice perception. [Internet]. Accessed November 3 2022.

      31. Hughes S, Dispenza F. Behavior GGJE and H, 2004 undefined. Ratings of voice attractiveness predict sexual behavior and body configuration Cited November 3 2022.; 2004. Elsevier [Internet];25:295-304.

      32. Blood G, Mahan B. Disorders MHJ of communication, 1979 undefined. Judging personality and appearance from voice disorders. Accessed November 3 2022. Elsevier [Internet].

        • Batstone S
        • Tuomi SK.
        Perceptual characteristics of female voices.
        Lang Speech. 1981; 24: 111-123
        • Šebesta P
        • Kleisner K
        • Tureček P
        • et al.
        Voices of Africa: acoustic predictors of human male vocal attractiveness.
        Anim Behav. 2017; 127: 205-211
      33. Kreiman J, Sidtis D. Foundations of voice studies: An interdisciplinary approach to voice production and perception. 2011. Accessed November 3 2022.

      34. Logopaedica JOFP et, 2009 undefined. Auditory-perceptual evaluation of disordered voice quality. [Internet]. Accessed November 3 2022; 2009.

        • Kreiman J
        • Gerratt BR
        • Ito M.
        When and why listeners disagree in voice quality assessment tasks.
        J Acoust Soc Am. 2007; 122: 2354-2364
        • Lass NJ
        • Ruscello DM
        • Bradshaw KH
        • et al.
        Adolescents’ perceptions of normal and voice-disordered children.
        J Commun Disord. 1991; 24: 267-274
      35. Wolk L, Abdelli-Beruh N. Voice DSJ of, 2012 undefined. Habitual use of vocal fry in young adult female speakers. Accessed November 3 2022. Elsevier [Internet].

      36. Speech IYA. 2010 Undefined. creaky voice: a new feminine voice quality for young urban-oriented upwardly mobile american women? [Internet] Cited November 3 2022.; 2010;85.

        • Henton CG.
        Creak as a sociophonetic marker.
        J Acoust Soc Am. 1986; 80 (S1)-S50: S50
      37. Bruckert L, Bestelmeyer P, Latinus M. biology JRC, 2010 undefined. Vocal attractiveness increases by averaging. Accessed August 4 2022. Elsevier [Internet].

      38. Lett Apicella BC, Feinberg D, Marlowe F. Voice pitch predicts reproductive success in male. [Internet] Cited November 3 2022.∼sherman/sex/Voice%20pitch%202007.pdf; 2007 December 22;3:682-684.

      39. Jones B, Feinberg D, Debruine L. et al., 2010 undefined. A domain-specific opposite-sex bias in human preferences for manipulated voice pitch. Accessed November 3 2022. Elsevier [Internet].

        • Albert G
        • Arnocky S
        • Puts DA
        • et al.
        Can listeners assess men's self-reported health from their voice?.
        Evol Hum Behav. 2021; 42: 91-103
      40. Fraccaro P, Jones B, Vukovic J, … FSJ of. undefined. Experimental evidence that women speak in a higher voice pitch to men they find attractive. [Internet]. Accessed November 3 2022:2011.

      41. McKinnon S, Hess C. Disorders RLJ of C, 1986 undefined. Reactions of college students to speech disorders. Accessed November 3 2022. Elsevier [Internet].

        • Zuckerman M
        • Miyake K.
        The attractive voice: what makes it So?.
        J Nonverbal Behav. 1993; 17: 119-135
        • Zuckerman M
        • Driver RE.
        What sounds beautiful is good: the vocal attractiveness stereotype.
        J Nonverbal Behav. 1988; 13: 67-82
      42. Pisanski K. perception DFO handbook of voice, 2019 undefined. vocal attractiveness. [Internet]. Accessed August 4 2022; 2018.

        • Preddie JP
        • Biernat M.
        More than the sum of its parts: intersections of sexual orientation and race as they influence perceptions of group similarity and stereotype content.
        Sex Roles. 2021; 84: 554-573
        • Biefeld SD
        • Stone EA
        • Brown CS.
        Sexy, thin, and white: the intersection of sexualization, body type, and race on stereotypes about women.
        Sex Roles. 2021; 85: 287-300
        • Landrine H.
        Race × class stereotypes of women.
        Sex Roles. 1985; 13: 65-75
        • Deaux K.
        How basic can you be? The evolution of research on gender stereotypes.
        J Soc Issues. 1995; 51: 11-20