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Nudelman CJ, Bottalico P, van Mersbergen M, Nanjundeswaran C. Toward Enhanced Voice-Related Self-Reports: Translation, Cross-Cultural Adaptation, and Validity. J Voice 2024:S0892-1997(24)00089-4. [PMID: 38582724 DOI: 10.1016/j.jvoice.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Revised: 03/14/2024] [Accepted: 03/15/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE This article provides a commentary on voice-related self-reports and presents various shortcomings endemic in the development and validation of these measures. Emphasis is placed on issues of construct validity, translation, and cross-cultural adaptation. Finally, a demonstration is provided to elucidate the importance of cross-cultural adaptation. METHODS An example of a voice-related self-report that lacks cross-cultural adaptation is provided, and a linguistic translation and cross-cultural adaptation process is outlined and demonstrated. A bilingual voice scientist, a bilingual speech-language pathologist (SLP), and two experts in voice-related self-reports completed a multistep linguistic translation and cross-cultural adaptation process and obtained back-translations from five SLPs native to the self-report's source culture. RESULTS Analyses of the back-translations demonstrated that the mean BiLingual Evaluation Understudy (BLEU) scores of the adapted items were higher overall than the back-translations of the original English items. CONCLUSIONS Unvalidated translations of voice-related self-reports are commonly used as a baseline to further translate the measure, and this deteriorates cross-cultural health equity. Cross-cultural adaptation is a crucial, but often overlooked process when translating and adapting self-reports. The present article calls for standardized methodologies with an emphasis on the necessity of careful translation methods and cultural adaptation processes.
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Affiliation(s)
- Charles J Nudelman
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois.
| | - Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, Illinois
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee
| | - Chaya Nanjundeswaran
- Department of Audiology & Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Cortez-Aoyagi M, Gufstason E, Murphy A, van Mersbergen M. A Measure of Swallow Effort Using the Borg Category Ratio 10 Perceived Exertion Scale. Am J Speech Lang Pathol 2023; 32:2846-2857. [PMID: 37713539 DOI: 10.1044/2023_ajslp-23-00090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/17/2023]
Abstract
PURPOSE With the emphasis on patient-centered care, tools to adequately measure the experience of swallowing are an important part of clinical care. Swallowing effort is one such experience. However, few measurement tools capture swallowing effort in the moment of swallowing to quantify effort. The Borg Category Ratio 10 Perceived Exertion Scale (Borg CR 10), designed to track effort in a variety of tasks from lifting, breathing, and running, appears to be a likely candidate to measure swallowing effort in the moment of swallowing. METHOD In a quasi-random design, 32 healthy individuals, ages 40-80 years (average age: 63 years), consumed seven bolus consistencies in both small and large quantities, three times. Following each individual swallow, they rated the amount of effort it took to swallow each bolus using an adapted Borg CR 10 for swallowing effort. RESULTS Results showed significantly greater reports of swallowing effort on the Borg CR 10 for more adhesive consistencies, larger quantities, and increased number of swallows. CONCLUSION Results suggest that the Borg CR 10 is a reasonable measurement tool to capture patient-perceived effort in swallowing.
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Affiliation(s)
| | - Erin Gufstason
- Northern Illinois University, DeKalb
- UW Health in Northern Illinois, Rockford
| | - Amanda Murphy
- Northern Illinois University, DeKalb
- Chicago Public Schools, IL
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Irineu RDA, Ribeiro VV, Sebastião TF, Crow K, van Mersbergen M, Behlau M. Cross-cultural adaptation to Brazilian Portuguese of the Vocal Congruence Scale and Transgender Congruence Scale. Codas 2023; 36:e20230050. [PMID: 37909548 DOI: 10.1590/2317-1782/20232023050pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 05/21/2023] [Indexed: 11/03/2023] Open
Abstract
PURPOSE to carry out the cross-cultural adaptation of the Vocal Congruence Scale (VCS) and the Transgender Scale Congruence (TSC) instruments into Brazilian Portuguese. METHODS the study was developed in two stages: cross-cultural adaptation and pre-test. 1. Cross-cultural adaptation: it was composed of a team of two speech therapists and two non-speech therapists, being responsible for the translation of the instruments into Portuguese (a speech therapist and a non-speech therapist native to Brazilian Portuguese - BP and English speakers, independently, with subsequent consensus achieved by the researchers; back-translation of the instruments into English (a speech therapist and a non-speech therapist who are native speakers of English and speakers of BP); analysis of the final version by a committee (a translator, a methodologist, and three speech therapists). Data were analyzed descriptively and inferentially. RESULTS In the cross-cultural adaptation process of the VCS there were adjustments in five items of the questionnaire, four of them in terms of form and one in terms of content. necessary adjustments regarding form in five items. In the pre-test, for all VCS and TSC items, the non-applicable option had a significantly lower proportion than the instrument response key options (p<0.001, for all). Finally, a translated and adapted version for Brazilian Portuguese of the Vocal Congruence Scale (VCS) and the Transgender Scale Congruence (TSC) instruments was obtained. CONCLUSION The VCS and TSC were transculturally adapted to Brazilian Portuguese and named as Vocal Congruence Scale and Transgender Person Congruence Scale.
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Affiliation(s)
| | | | | | - Karen Crow
- School of Communication Sciences and Disorders, The University of Memphis, Memphis (TN), United States of America
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis (TN), United States of America
| | - Mara Behlau
- Centro de Estudos da Voz - CEV - São Paulo (SP), Brasil
- Universidade Federal de São Paulo - UNIFESP - São Paulo (SP), Brasil
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Abstract
INTRODUCTION Voice production is a complex process involving the coordination of various anatomical structures and physiologic systems. The Voice Range Profile (VRP) is an established acoustic measure for evaluating voice production that examines minimum and maximum intensity across the frequency range. This pilot study sought to establish a consistent, efficient, and accessible VRP elicitation method. One primary research question was addressed: Does the proposed Short method provide at least as much information as a full, discrete-steps method, which is generally accepted in the literature? METHODS In this quasi-repeated measures design, twenty-four singers completed a full VRP based on accepted methods from the literature, and the same participants returned within one to three weeks to complete the proposed Short VRP protocol. The full VRP consisted of steady state productions at every semitone within a participant's range for both minimum and maximum intensities. The Short VRP consisted of steady state productions at every octave and perfect fifth across the semitone range for both minimum and maximum intensities. Additional sampling was completed between points when a 7 dB or greater difference was found between consecutive points. Analysis compared each protocol's average elicitation time differences, average semitone range differences, visual examination of the average VRP graph, and examination of average intensity differences between protocols at specific semitone points. Male and female results were analyzed separately. RESULTS The proposed Short protocol produced similar or better intensity ranges when compared with the accepted full elicitation method. The Short protocol produced intensities with 95% or greater similarity to the Full Protocol for male maximum intensity curve, female minimum intensity curve, and female maximum intensity curve. CONCLUSIONS When compared with a Full VRP, a Short VRP protocol appears to generate similar minimum and maximum intensity curves allowing for a time-efficient substitute.
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Affiliation(s)
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, TN
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van Mersbergen M, Marchetta J, Foti D, Pillow E, Dasgupta A, Cain C, Morvant S. Comparison of Aerosol Emissions during Specific Speech Tasks. J Voice 2023:S0892-1997(23)00156-X. [PMID: 37423794 DOI: 10.1016/j.jvoice.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 07/11/2023]
Abstract
OBJECTIVES/HYPOTHESIS Recent investigations into the behavior of aerosolized emissions from the oral cavity have shown that particulate emissions do indeed occur during speech. To date, there is little information about the relative contribution of different speech sounds in producing particle emissions in a free field. This study compares airborne aerosol generation in participants producing isolated speech sounds: fricative consonants, plosive consonants, and vowel sounds. STUDY DESIGN Prospective, reversal experimental design, where each participant served as their own control and all participants were exposed to all stimuli. METHODS While participants produced isolated speech tasks, a planar beam of laser light, a high-speed camera, and image software calculated the number of particulates detected over time. This study compared airborne aerosols emitted by human participants at a distance of 2.54 cm between the laser sheet and the mouth. RESULTS Statistically significant increases in particulate count over ambient dust distribution for all speech sounds. When collapsed across loudness levels, emitted particles in vowel sounds were statistically greater than consonants, suggesting that mouth opening, as opposed to the place of vocal tract constriction or manner of sound production, might also be influential in the degree to which particulates become aerosolized during speech. CONCLUSIONS The results of this research will inform boundary conditions for computational models of aerosolized particulates during speech.
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Affiliation(s)
- Miriam van Mersbergen
- School of Communication Sciences and Disorders, University of Memphis, Memphis, Tennessee; Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee; Institute for Intelligent Systems, University of Memphis, Tennessee.
| | - Jeffrey Marchetta
- Department of Mechanical Engineering, University of Memphis, Memphis, Tennessee
| | - Daniel Foti
- Department of Mechanical Engineering, University of Memphis, Memphis, Tennessee
| | - Eric Pillow
- Department of Mechanical Engineering, University of Memphis, Memphis, Tennessee
| | - Apratim Dasgupta
- Department of Mechanical Engineering, University of Memphis, Memphis, Tennessee
| | - Chandler Cain
- Department of Mechanical Engineering, University of Memphis, Memphis, Tennessee
| | - Stephen Morvant
- Department of Otolaryngology, Head and Neck Surgery, University of Tennessee Health Sciences Center, Memphis, Tennessee
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Nanjundeswaran C, van Mersbergen M, Banks R, Hunter E. Vocal Fatigue Index in Teachers Using Mokken Analysis. J Voice 2023; 37:298.e1-298.e9. [PMID: 33526304 PMCID: PMC8319213 DOI: 10.1016/j.jvoice.2020.12.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 12/15/2020] [Accepted: 12/21/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Vocal fatigue (VF) is a primary vocal symptom experienced by professional voice users, such as teachers, whose voice is an occupational tool. The study determines the utilization of the Vocal Fatigue Index (VFI), a 19-item scale in identifying symptoms of VF and its severity in teachers. METHODS Using responses of 695 teachers who completed the VFI, Mokken scaling was conducted on the items to identify the experiences of VF and its associated hierarchical nature of VF symptoms in teachers. Mokken scaling was completed on a total of four groups: (a) Total teachers group, (b) No VF group, (c) Low VF group, and (d) High VF group. RESULTS Results revealed differences in item hierarchies between total teachers and across the separate groups of VF severity. Item hierarchy for teachers highlighted items from physical discomfort at the mild end of the hierarchy to items from symptom improvement with rest at the severe end of the hierarchy. Items related to avoidance presented as a separate scale for teachers presenting with high VF. DISCUSSION Mokken scaling in teachers provides insight into the underlying complexity of the experience of VF symptoms and reliance on differential behavioral strategies in its management, suggesting the heterogenous nature of latent trait for VF in this specific population.
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Affiliation(s)
- Chaya Nanjundeswaran
- Department of Audiology & Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee.
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders; Institute for Intelligent Systems; University of Memphis, Memphis Tennessee
| | - Russell Banks
- Massachusetts General Hospital Institute of Health Professions, Boston, MA
| | - Eric Hunter
- Department of Communicative Sciences and Disorders, Michigan State University, Michigan
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Pointer NF, van Mersbergen M, Nanjundeswaran CD. Listeners' Attitudes Towards Young Women With Glottal Fry. J Voice 2022:S0892-1997(22)00281-8. [PMID: 36229279 DOI: 10.1016/j.jvoice.2022.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Glottal fry is an increasingly prevalent voice type in young female speakers. The purpose of this study was to identify employers' perceptions toward young female speakers presenting with glottal fry and the impact on hirability. METHODS Sixty employers responsible for hiring at their business in the Southeast region of the United States completed a survey developed to capture employers' perceptions toward young women using glottal fry. Employers listened to three voice samples of young women with varying levels of glottal fry and rated the voice on 14 semantic differential items. The semantic differential items were derived from the hiring constructs literature to capture perceptions related to mental capability, personality tendencies, and applied social skills. Additionally, questions related to hirability were captured at the end of the survey. RESULTS Employers were able to identify continuous glottal fry compared to nonglottal fry voice samples. Employers rated voice samples with glottal fry more negatively (eg, less trustworthy, less competent, less educated) compared to nonglottal fry voice samples and were less likely to hire female speakers with continuous glottal fry. CONCLUSION This study highlights the impact of negative perceptions toward glottal fry on hirability of young female speakers. Such information can provide insight to increase awareness of the impact of a voice type on listener perceptions and communication among young female speakers.
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Affiliation(s)
- Natalie Foulks Pointer
- Department of Audiology & Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, Institute for Intelligent Systems, University of Memphis, Memphis, Tennessee
| | - Chaya D Nanjundeswaran
- Department of Audiology & Speech Language Pathology, East Tennessee State University, Johnson City, Tennessee.
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Harper S, Hazelton K, van Mersbergen M. Pregnancy and the Singing Voice: A Survey of What Singers Report. J Voice 2022:S0892-1997(22)00085-6. [PMID: 35637057 DOI: 10.1016/j.jvoice.2022.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/18/2022] [Accepted: 03/20/2022] [Indexed: 11/20/2022]
Abstract
Pregnancy has profound effects on a variety of body systems by way of hormonal and physical changes. Many of these changes directly affect body systems involved in singing. Assumptions exist about what can happen to a person's voice during pregnancy, but these assumptions are based on theoretical predictions leaving little knowledge of the lived experiences of voice changes during pregnancy. An anonymous mixed-method survey was given to 321 professional singers to gain insights on the lived experiences of pregnant singers. This investigation explored what people were told about the effects of pregnancy on the voice in comparison to what they actually experienced. Results show that about half of the respondents' experience matched what they were told for respiration. For phonation and vocal quality less than 25% respondent's experience matched what they were told. In addition, most of the information respondents received came from friends, colleagues, and teachers compared to medical professionals suggesting a need for more interdisciplinary education to best prepare vocalists who are contemplating becoming pregnant.
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Affiliation(s)
| | - Kiley Hazelton
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee.
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Baker J, Barnett C, Cavalli L, Dietrich M, Dixon L, Duffy JR, Elias A, Fraser DE, Freeburn JL, Gregory C, McKenzie K, Miller N, Patterson J, Roth C, Roy N, Short J, Utianski R, van Mersbergen M, Vertigan A, Carson A, Stone J, McWhirter L. Management of functional communication, swallowing, cough and related disorders: consensus recommendations for speech and language therapy. J Neurol Neurosurg Psychiatry 2021; 92:1112-1125. [PMID: 34210802 DOI: 10.1136/jnnp-2021-326767] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 05/25/2021] [Indexed: 12/14/2022]
Abstract
Communication problems (eg, dysphonia, dysfluency and language and articulation disorders), swallowing disorders (dysphagia and globus), cough and upper airway symptoms, resulting from functional neurological disorder (FND), are commonly encountered by speech and language professionals. However, there are few descriptions in the literature of the most effective practical management approaches. This consensus document aims to provide recommendations for assessment and intervention that are relevant to both adults and young people. An international panel of speech and language professionals with expertise in FND were approached to take part. Participants responded individually by email to a set of key questions regarding best practice for assessment and interventions. Next, a video conference was held in which participants discussed and debated the answers to these key questions, aiming to achieve consensus on each issue. Drafts of the collated consensus recommendations were circulated until consensus was achieved. FND should be diagnosed on the basis of positive clinical features. Speech and language therapy for FND should address illness beliefs, self-directed attention and abnormal movement patterns through a process of education, symptomatic treatment and cognitive behavioural therapy within a supportive therapeutic environment. We provide specific examples of these strategies for different symptoms. Speech and language professionals have a key role in the management of people with communication and related symptoms of FND. It is intended that these expert recommendations serve as both a practical toolkit and a starting point for further research into evidence-based treatments.
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Affiliation(s)
- Janet Baker
- Speech Pathology, Flinders University, Adelaide, South Australia, Australia
- University of Technology Sydney, Sydney, New South Wales, Australia
| | - Caroline Barnett
- South Warwickshire NHS Foundation Trust, Warwick, Warwickshire, UK
| | - Lesley Cavalli
- Department of Speech & Language Therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, London, UK
- Division of Psychology and Language Sciences, University College London, London, London, UK
| | - Maria Dietrich
- Department of Psychiatry and Psychotherapy, University Hospital Bonn, Bonn, Nordrhein-Westfalen, Germany
| | - Lorna Dixon
- National Hospital for Neurology and Neurosurgery, London, London, UK
| | - Joseph R Duffy
- Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA
| | - Annie Elias
- Speech and Language Therapy, Kent Community Health NHS Foundation Trust, Ashford, Kent, UK
| | - Diane E Fraser
- Department of Clinical Neurosciences, Royal Infirmary of Edinburgh, Edinburgh, Edinburgh, UK
| | | | | | | | - Nick Miller
- Speech Language Sciences, Newcastle University, Newcastle upon Tyne, Tyne and Wear, UK
| | - Jo Patterson
- University of Liverpool, Liverpool, Merseyside, UK
| | - Carole Roth
- Speech Pathology Division, Naval Medical Center San Diego, San Diego, California, USA
| | - Nelson Roy
- Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA
- Division of Otolaryngology - Head and Neck Surgery (Adjunct), The University of Utah, Salt Lake City, Utah, USA
| | | | - Rene Utianski
- Neurology, Mayo Clinic, Rochester, Minnesota, USA
- Speech Pathology and Neurology, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, Institute for Intelligent Systems, The University of Memphis, Memphis, Tennessee, USA
| | - Anne Vertigan
- Speech Pathology, John Hunter Hospital, Newcastle, New South Wales, Australia
- Centre for Healthy Lungs, Hunter Medical Research Institute; School of Medicine and Public Health, The University of Newcastle, Newcastle, New South Wales, Australia
| | - Alan Carson
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | - Jon Stone
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
| | - Laura McWhirter
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Edinburgh, UK
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Hunter EJ, Berardi ML, van Mersbergen M. Relationship Between Tasked Vocal Effort Levels and Measures of Vocal Intensity. J Speech Lang Hear Res 2021; 64:1829-1840. [PMID: 34057833 PMCID: PMC8740752 DOI: 10.1044/2021_jslhr-20-00465] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 01/04/2021] [Accepted: 02/19/2021] [Indexed: 06/12/2023]
Abstract
Purpose Patients with voice problems commonly report increased vocal effort, regardless of the underlying pathophysiology. Previous studies investigating vocal effort and voice production have used a range of methods to quantify vocal effort. The goals of the current study were to use the Borg CR100 effort scale to (a) demonstrate the relation between vocal intensity or vocal level (dB) and tasked vocal effort goals and (b) investigate the repeated measure reliability of vocal level at tasked effort level goals. Method Three types of speech (automatic, read, and structured spontaneous) were elicited at four vocal effort level goals on the Borg CR100 scale (2, 13, 25, and 50) from 20 participants (10 females and 10 males). Results Participants' vocal level reliably changed approximately 5 dB between the elicited effort level goals; this difference was statistically significant and repeatable. Biological females produced a voice with consistently less intensity for a vocal effort level goal compared to biological males. Conclusions The results indicate the utility of the Borg CR100 in tracking effort in voice production that is repeatable with respect to vocal level (dB). Future research will investigate other metrics of voice production with the goal of understanding the mechanisms underlying vocal effort and the external environmental influences on the perception of vocal effort.
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Affiliation(s)
- Eric J. Hunter
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Mark L. Berardi
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
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van Mersbergen M. Book Review of Janet Baker's book, “Psychosocial Perspectives on the Management of Voice Disorders: Implications for Client, Options and Strategies for Clinicians.”. J Voice 2020. [DOI: 10.1016/j.jvoice.2019.06.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Hunter EJ, Cantor-Cutiva LC, van Leer E, van Mersbergen M, Nanjundeswaran CD, Bottalico P, Sandage MJ, Whitling S. Toward a Consensus Description of Vocal Effort, Vocal Load, Vocal Loading, and Vocal Fatigue. J Speech Lang Hear Res 2020; 63:509-532. [PMID: 32078404 PMCID: PMC7210446 DOI: 10.1044/2019_jslhr-19-00057] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Purpose The purpose of this document is threefold: (a) review the uses of the terms "vocal fatigue," "vocal effort," "vocal load," and "vocal loading" (as found in the literature) in order to track the occurrence and the related evolution of research; (b) present a "linguistically modeled" definition of the same from the review of literature on the terms; and (c) propose conceptualized definitions of the concepts. Method A comprehensive literature search was conducted using PubMed/MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Scientific Electronic Library Online. Four terms ("vocal fatigue," "vocal effort," "vocal load," and "vocal loading"), as well as possible variants, were included in the search, and their usages were compiled into conceptual definitions. Finally, a focus group of eight experts in the field (current authors) worked together to make conceptual connections and proposed consensus definitions. Results The occurrence and frequency of "vocal load," "vocal loading," "vocal effort," and "vocal fatigue" in the literature are presented, and summary definitions are developed. The results indicate that these terms appear to be often interchanged with blurred distinctions. Therefore, the focus group proposes the use of two new terms, "vocal demand" and "vocal demand response," in place of the terms "vocal load" and "vocal loading." We also propose standardized definitions for all four concepts. Conclusion Through a comprehensive literature search, the terms "vocal fatigue," "vocal effort," "vocal load," and "vocal loading" were explored, new terms were proposed, and standardized definitions were presented. Future work should refine these proposed definitions as research continues to address vocal health concerns.
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Affiliation(s)
- Eric J. Hunter
- Department of Communicative Sciences and Disorders, Michigan State University, East Lansing
| | - Lady Catherine Cantor-Cutiva
- Department of Collective Health, Universidad Nacional de Colombia, Bogotá
- Department of Speech and Language Pathology, Universidad Manuela Beltrán, Bogotá, Colombia
| | - Eva van Leer
- Department of Communication Sciences and Disorders, Georgia State University, Atlanta
| | | | - Chaya Devie Nanjundeswaran
- Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN
| | - Pasquale Bottalico
- Department of Speech and Hearing Science, University of Illinois at Urbana–Champaign
| | - Mary J. Sandage
- Department of Communication Disorders, Auburn University, AL
| | - Susanna Whitling
- Department of Logopedics, Phoniatrics and Audiology, Lund University, Sweden
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Lawrence T, van Mersbergen M. The Relation Between Eating Disorders and Voice Disorders. J Voice 2020; 35:753-764. [PMID: 32037302 DOI: 10.1016/j.jvoice.2020.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 01/11/2020] [Accepted: 01/15/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study is to determine the relation between specific eating disorder diagnoses/purging behaviors and voice disorders. METHOD One hundred-nine participants with eating disorders completed a survey inquiring about eating disorder symptoms, purging behaviors, and voice disorder symptoms. Participants also completed the Eating Disorders Examination Questionnaire, Voice Handicap Index, and the Reflux Symptom Index. RESULTS The prevalence of voice disorders among the group with eating disorders was 21.88%. Of those with both eating disorders and voice disorders, anorexia nervosa appeared to be more prevalent in this group than bulimia nervosa. In addition, purging behaviors of exercise presented with a higher prevalence of voice problems than vomiting. CONCLUSION Individuals with eating disorders seem to be at a higher risk for voice disorders than the general population. Anorexia nervosa and exercise as a purging method were identified as the highest risk factors for voice disorders.
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Affiliation(s)
- Taylor Lawrence
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee.
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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] [What about the content of this article? (0)] [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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Crow KM, van Mersbergen M, Payne AE. Vocal Congruence: The Voice and the Self Measured by Interoceptive Awareness. J Voice 2019; 35:324.e15-324.e28. [PMID: 31558332 DOI: 10.1016/j.jvoice.2019.08.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 08/26/2019] [Accepted: 08/27/2019] [Indexed: 11/18/2022]
Abstract
Voices are, by nature, idiosyncratic representations of individuals because they possess anatomical, physiological, and psychological characteristics that are unique to them, which contribute to vocal output, and thus, establish the voice as a salient marker of their individuality. The areas of experimental psychology and cognitive neuroscience have examined the psychological and neurological constructs that form one's sense of self and have employed measures of interoceptive and exteroceptive abilities to discover the underlying constructs of the sense of self. This study employed measures of interoceptive awareness to assess level of vocal congruence. Forty-one participants analyzed in this study underwent a heartbeat detection task designed to assess the level of interoceptive awareness and were placed into two groups: those high in interoceptive awareness and those low in interoceptive awareness. They completed two tasks, a speaking task, which included structured passages and conversation, and a listening task, where they listened to themselves in the speaking task. Following each task, they completed a Vocal Congruence Scale designed to assess the level of identification they have within themselves related to the sound of their voice. Individuals scoring high in interoceptive awareness scored significantly higher in vocal congruence than those scoring lower in interoceptive awareness. Additionally, when analyzed with other measures of personality, anxiety, mood, and voice handicap, the Vocal Congruence Scale appears to measure a unique aspect of vocal identity with one's self that encompasses interoceptive awareness.
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Affiliation(s)
- Karen M Crow
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
| | - Miriam van Mersbergen
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee.
| | - Alexis E Payne
- School of Communication Sciences and Disorders, The University of Memphis, Memphis, Tennessee
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Abstract
Objectives: The purpose of the present study was to examine the nature of the relationship between perceptions of vocal and mental (cognitive) effort during reading and speaking tasks.Methods: One hundred and four young, healthy adult participants were randomized into one of three groups. Each group performed a writing task meant to elicit low mental effort, high mental effort, or high mental effort followed by a period of relaxation. Participants then engaged in reading and speaking tasks, meant to elicit high (suppression of a prepotent desire to speak louder) or low (no suppression of a prepotent desire to speak louder) mental effort, and completed ratings of mental effort and vocal effort via adapted versions of the Borg CR10.Results: Findings indicate that ratings of perceived mental and vocal effort are related to one another, evidenced by strong correlations, and additional analyses reveal that mental effort might drive this relationship.Conclusions: Perceptions of vocal effort appear to mirror ratings of mental effort during tasks for which vocal activity is relatively stable but cognitive demands fluctuate. The possibility that perceptions of mental effort might influence perceptions of vocal effort should be considered when creating reliable and valid measures of vocal effort as well as when interpreting currently adapted measures of vocal effort in the clinical context.
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Affiliation(s)
- Miriam van Mersbergen
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN, USA
| | - Lisa A Vinney
- Department of Communication Sciences and Disorders, Illinois State University, Normal, IL, USA
| | - Alexis E Payne
- School of Communication Sciences and Disorders, University of Memphis, Memphis, TN, USA
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Nanjundeswaran C, van Mersbergen M, Morgan K. Restructuring the Vocal Fatigue Index Using Mokken Scaling: Insights Into the Complex Nature of Vocal Fatigue. J Voice 2019; 33:110-114. [DOI: 10.1016/j.jvoice.2017.09.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 09/11/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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van Leer E, van Mersbergen M. Using the Borg CR10 Physical Exertion Scale to Measure Patient-perceived Vocal Effort Pre and Post Treatment. J Voice 2016; 31:389.e19-389.e25. [PMID: 27887811 DOI: 10.1016/j.jvoice.2016.09.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2016] [Revised: 08/17/2016] [Accepted: 09/21/2016] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Reduction of vocal effort is a therapeutic goal in resonant voice therapy and in the treatment of a variety of voice disorders. The Borg CR10 is a perceived effort scale that is widely accepted across a wide variety of disciplines. The purpose of the present study was to examine (1) the utility of an anchored, adapted Borg CR10 in observing treatment-related vocal effort reduction and (2) the convergent validity of the Borg CR10 in its relation to Voice Handicap Index (VHI) item 14. STUDY DESIGN This is a pretest-posttest experimental design. METHODS A total of 36 individuals with phonotraumatic hyperfunctional voice disorders completed item 14 of the VHI and the Borg CR10 at the start and completion of four sessions of resonant voice therapy treatment. RESULTS Scores from the Borg CR10 significantly differentiated pre- from post-therapy perceived effort levels. Convergent validity was demonstrated through significant associations with scores from item 14 of the VHI. CONCLUSION The anchored Borg CR10 is an easy to use clinical tool to capture treatment-related vocal effort reduction. Whereas VHI item 14 indicates how frequently increased perceived effort is experienced, the Borg CR10 captures the severity of perceived effort used. Thus, the two measures complement each other.
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Affiliation(s)
- Eva van Leer
- Department of Education Psychology, Special Education and Communication Disorders, Georgia State University, Atlanta, Georgia.
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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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Doherty ML, van Mersbergen M. Personal and Professional Characteristics of Music Educators: One Size Does Not Fit All. J Voice 2016; 31:128.e7-128.e13. [PMID: 26804786 DOI: 10.1016/j.jvoice.2015.12.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Accepted: 12/13/2015] [Indexed: 11/18/2022]
Abstract
OBJECTIVES/HYPOTHESIS The prevalence of voice disorders among various educator groups is well known, and voice disorders among music educators are higher than the general classroom educators. Music educators vary with respect to behavioral and personality factors, personal characteristics, type of music taught, job-specific environment, and governmental professional expectations. This study aims to identify risk factors for voice disorders in a heterogeneous population of music educators. STUDY DESIGN An online survey was conducted with 213 respondents. METHODS Survey questions addressed demographics, level of education, years of music teaching experience, specialty training, primary teaching assignments and instrument, vocal health behaviors, and diagnoses of voice disorders. Summary statistics and group comparisons are reported. RESULTS Those whose primary instrument was voice reported a greater frequency of voice disorders. Female and older music educators also had a higher prevalence of voice disorders. CONCLUSIONS Music educators are a heterogeneous group of individuals who require more careful consideration in the prevention and treatment of occupational voice problems.
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Affiliation(s)
- Mary Lynn Doherty
- School of Music, Northern Illinois University, 1425 Lincoln Avenue, DeKalb, Illinois 60115.
| | - Miriam van Mersbergen
- School of Allied Health and Communicative Disorders, Northern Illinois University, 1425 Lincoln Avenue, DeKalb, Illinois 60115
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Johns-Fiedler H, van Mersbergen M. The Prevalence of Voice Disorders in 911 Emergency Telecommunicators. J Voice 2015; 29:389.e1-10. [DOI: 10.1016/j.jvoice.2014.08.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
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Abstract
PURPOSE Previous research has proposed that persons with functional dysphonia (FD) present with temperamental traits that predispose them to their voice disorder. We investigated this theory in a controlled experiment and compared them with social anxiety (SA) and healthy control (HC) groups. METHOD Twelve participants with FD, 19 participants with SA, and 23 HC participants were studied before, during, and after mental imagery of positive, neutral, and aversive scripts in a within-subject reversal paradigm with multiple experimental conditions using psychometric, self-report, and psychophysiological measures. RESULTS In psychometric tests, those with FD demonstrated increased fear in social situations but not increased avoidance. On measures of mood, all groups responded with predicted increases in pleasant mood for positive scripts and unpleasant mood for aversive scripts; on vocal effort ratings, those with FD reported greater effort for all scripts following imagery. Under experimentally controlled conditions, the SA and HC groups demonstrated predicted activation of EMG measures of mood, whereas the FD group demonstrated overall reduced activation of EMG measures. CONCLUSION Results may suggest that those with FD respond to emotional stimuli with reduced behavioral expression, compared with SA and HC groups, consistent with the temperamental trait of behavioral constraint.
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Affiliation(s)
- Miriam van Mersbergen
- Department of Otolaryngology, University of Wisconsin-Madison, Clinical Science Center G225, 600 Highland Avenue, Madison, WI 53719, USA.
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Abstract
Voice disorders, specifically vocal fatigue, are more commonly reported by women than by men. Previously, 4 women with normal untrained voices read loudly for 2 hours in an attempt to fatigue the voice. Vocal function deteriorated, as indicated by increases in phonation threshold pressure (PTP) and self-perceived phonatory effort. The increase in PTP was delayed or attenuated to some degree in 3 of the women when they drank ample amounts of water before the experiment. The current study examined the same vocal-loading task and water-drinking condition in 4 vocally normal men. PTP increased after the loud-reading task. Although 2 of the men appeared to benefit from increased systemic hydration (PTP increased more when they were underhydrated than well-hydrated), the other 2 men's data changed in the opposite direction. Phonatory effort correlated well with PTP; this varied across subject and pitch. Laryngeal endoscopy revealed an anterior glottal gap in two men after the loud-reading task. Amplitude of vocal fold vibration was judged to be reduced after the loud-reading task in three subjects when underhydrated and one subject when well hydrated. The high between-subject variability prohibits a conclusion that drinking water is beneficial to vocal function in men, but all subjects studied to date demonstrated detrimental vocal effects of prolonged loud talking.
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Affiliation(s)
- Nancy Pearl Solomon
- Department of Communication Disorders, University of Minnesota, Minneapolis, USA.
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Verdolini K, Min Y, Titze IR, Lemke J, Brown K, van Mersbergen M, Jiang J, Fisher K. Biological mechanisms underlying voice changes due to dehydration. J Speech Lang Hear Res 2002; 45:268-281. [PMID: 12003510 DOI: 10.1044/1092-4388(2002/021)] [Citation(s) in RCA: 84] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Four vocally untrained healthy adults, 2 men and 2 women, completed the study. A double-blind placebo-controlled approach was used to administer three treatments to each participant on separate days. Drugs treatments involved a single 60-mg dose of a diuretic, Lasix (LA), on one day, and a single 50-mg dose of an oral antihistamine, diphenhydramine hydrochloride (DH), on another day. A third day involved the administration of a placebo, sugar pills (SP). Critical posttreatment measures were weight (kg), which estimated systemic dehydration, saliva viscosity (centipoise), which estimated secretion dehydration, and phonation threshold pressure (PTP, in cm H2O), at high pitches, which indicated pulmonary drive for phonation. The central experimental question was: Does systemic dehydration, or secretory dehydration, or both, mediate increases in PTP that are known to occur following dehydration treatments? The results showed that LA induced systemic dehydration, as shown by a decrease in total body mass of about 1%. Weight losses were seen during a 1- to 4-hour block following drug administration and persisted for at least 8 hours thereafter. PTPs also increased in that condition, about 23% relative to baseline, but only several hours after whole-body dehydration was initially seen (5-12 hours after drug administration). In contrast, no evidence was seen that DH accomplished either secretory dehydration or PTP shifts. The results indicate that systemic dehydration can mediate PTP increases. The influence of secretory dehydration on PTP is unclear.
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Affiliation(s)
- Katherine Verdolini
- School of Health and Rehabilitation Sciences, University of Pittsburgh, PA 15260, USA.
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