Journal of Voice最新文献

{"title":"Relationship Between Group Cohesion Among Singers During Choral Performance and the Quality of Performance.","authors":"Yui Katada, Naomi Yoshida, Ichiro Kita","doi":"10.1016/j.jvoice.2026.02.032","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.032","url":null,"abstract":"<p><strong>Objective: </strong>During a choral performance, the singers attempt to communicate with each other musically and create musical expressions that move audiences emotionally. The musical expression can be influenced by not only the technical aspects of singing but also group cohesion. Increased group cohesion during a performance might enhance the quality of a choral performance. However, whether the qualities of a choral performance, including sensation, vocalization, and expression, are associated with group cohesion among singers during a performance rather than the social relationship within a choir remain unclear. Here, we investigated the relationships between the quality of a choral performance and group cohesion, social closeness, or mind-body awareness using a questionnaire survey.</p><p><strong>Methods: </strong>Thirty-four choral singers from five choirs (three mixed choirs, two female choirs; four to eight singers per choir) sang a song twice with a brief intermission in a normal rehearsal. The performances were then evaluated with recording videos by experts who were professional choral conductors as \"Good\" or \"Poor\".</p><p><strong>Results: </strong>The group cohesion, social closeness, and mind-body awareness scores were higher for \"Good\" than for \"Poor\" performances. In addition, the quality of the choral performances was more closely associated with task-oriented group cohesion than with socio-emotional cohesion.</p><p><strong>Conclusion: </strong>These findings suggest the importance of improving group cohesion among singers during a performance, not only social relationship within a choir to enhance the quality of a choral performance.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Automated Creak Detection in Spanish Speakers with and without AdLD.","authors":"M Eugenia Castro, Fermin M Zubiaur Gomar, Katherine Marks","doi":"10.1016/j.jvoice.2026.01.045","DOIUrl":"10.1016/j.jvoice.2026.01.045","url":null,"abstract":"<p><strong>Objectives: </strong>Adductor laryngeal dystonia (AdLD) is a neurological voice disorder characterized by involuntary spasms of the adductor laryngeal muscles during phonation. An automated creak detector has shown promise in differentiating English speakers with AdLD from controls. However, no study has yet investigated creak in AdLD in Spanish speakers. In fact, there is a paucity of research validating tools to identify laryngeal dystonia (LD) in languages other than English. The purpose of this study was to determine whether creak differentiates Spanish-speaking individuals with and without AdLD.</p><p><strong>Methods: </strong>Twenty speakers with AdLD, twenty speakers without voice disorders (controls), and twenty speakers with glottic insufficiency were recorded in a clinical environment. Each participant read a set of recently developed Spanish stimuli designed for LD screening, containing voiced and voiceless loaded sentences. An open-source creak detector was used to calculate the percentage of creak in each speaker's recording. Mean smoothed cepstral peak prominence (CPPS) per speaker was calculated in Praat.</p><p><strong>Results: </strong>A Pearson's correlation revealed a moderate relationship between creak and CPPS across groups (r = -0.56). An analysis of covariance revealed a statistically significant effect of creak between groups (F(3, 56) = 13.52, P > 0.05, R² = 0.39). Three receiver operating characteristic curve analyses indicated that creak differentiated AdLD and Controls (area under the curve [AUC] = 0.88), as well as AdLD and Glottic Insufficiency with acceptable diagnostic accuracy (AUC = 0.73), but not between control or glottic insufficiency groups.</p><p><strong>Conclusions: </strong>Creak differentiated Spanish speakers with and without AdLD with moderate discrimination. Although creak and CPPS were moderately correlated, when controlling for CPPS, creak was statistically different between speakers with AdLD and speakers with glottic insufficiency, and between speakers with AdLD and controls. Further work is needed to determine the clinical utility of creak in aiding a differential diagnosis of AdLD and muscle tension dysphonia in Spanish-speaking individuals.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13048833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Physical Factors Influencing Acoustic Energy Distribution in the Human Voice via One-Dimensional Models.","authors":"Tomáš Vampola, Jaroslav Štorkán","doi":"10.1016/j.jvoice.2026.02.021","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.021","url":null,"abstract":"<p><p>The aim of this study was to create a simplified, analytical one-dimensional (1D) computational model of the human vocal tract (VT) for the vowels [a:], [i:], and [u:]. Compared to other commonly published 1D models, this model used conical elements. In the model, the influence of steady flow and stiffness of boundary tissues is considered. The sensitivity of the transfer function to the dominant physical parameters (mouth area, resistance coefficient, steady flow, and stiffness of boundary tissues) was investigated using the created mathematical models in order to analyze the influence of these parameter combinations on acoustic energy values in the frequency spectrum. This study shows that the steady flow of the acoustic medium and the stiffness of the boundary tissues can significantly affect not only the frequency of the resonance peaks in the frequency spectrum of the VT, but also positively increase the value of total acoustic energy output of the human voice in the 2 to 3.5 kHz frequency range. The analyses show that the vowel [a:] is the more sensitive to the flexibility of the boundary tissues and the steady flow of the acoustic medium than the vowels [i:] and [u:].</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147445772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptual Voice Quality Evaluation Tools: Normophonic, Pathological, and Sung Voices-A Scoping Review.","authors":"Amelia Pettirossi, Lola Terny, Nicolas Audibert, Lise Crevier-Buchman, Véronique Delvaux, Sophie Fagniart, Bernard Harmegnies, Kathy Huet, Myriam Piccaluga, Reina Remman, Virginie Roland, Claire Pillot-Loiseau","doi":"10.1016/j.jvoice.2026.02.030","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.030","url":null,"abstract":"<p><strong>Objective: </strong>The objective of this scoping review is to provide an inventory of tools allowing the perceptual evaluation of voice, whether spoken or sung, and uttered in either a pedagogical or a pathological context. It provides details on these tools in terms of the gender and age of the speakers, the nature of the production context, the corpora collected, the language in which the data collection was conducted, and the most frequently considered attributes of voice.</p><p><strong>Methods: </strong>Four online databases were searched, following Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA) guidelines. The descriptor words \"perceptual\" or \"auditory,\" \"assessment\" or \"evaluation,\" \"voice\" or \"voice quality,\" and \"rating scale\" were principally taken into consideration.</p><p><strong>Results: </strong>Our initial search revealed 891 studies, of which 105 sources met the eligibility criteria for data extraction. This scoping review highlights the existence of 19 tools that have a name, as well as 45 unnamed tools, most of which consist of four or six ordinal degrees. Most of these tools were developed to perceptually evaluate pathological adult voices, half of them in English. The GRBAS(I) and CAPE-V protocols dominate, but this inventory also shows a wide variety of tools, perceived tasks, evaluated attributes, and combinations thereof. All these results confirm the multidimensional aspect of voice quality, with some attributes that are rarely mentioned but deserve to be highlighted.</p><p><strong>Conclusions: </strong>The findings of this review allow researchers, clinicians, and educators to understand the various factors and methods that affect the auditory-perceptual evaluations of voice quality. The results may also guide researchers and educators in developing training programs for less-experienced clinicians and educators to improve their confidence in the auditory-perceptual evaluation of voice. New trends for research in the field are pointed out and discussed.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Resonance of Emotion: How Vocal Resonance Manipulation Shapes Emotional Perception in Singing.","authors":"Ning Xu, Yidan Feng, Xuanda Chen","doi":"10.1016/j.jvoice.2026.02.029","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.029","url":null,"abstract":"<p><strong>Objective: </strong>To investigate how resonance manipulation in Chinese vocal performance causally affects the perceived emotional valence, using an integrated two-phase approach that combines acoustic characterization with perceptual evaluation.</p><p><strong>Methods: </strong>In the Stimulus Selection Phase, 120 native Chinese-speaking participants rated the emotional valence of 300 Chinese music excerpts (children's songs, pop, folk, operas, religious music, and modern folk-pop) on a 7-point Likert scale. Excerpts were temporally degraded to isolate melodic content. Valence scores were binned into 7 levels, and 10 excerpts per level (70 total) were re-recorded by two professional female vocalists in \"full\" and \"thin\" resonance conditions. In the perceptual evaluation phase, 80 additional participants rated the emotional valence of these recorded excerpts (280 trials) using a Latin square design. Acoustic parameters, i.e., H1-H2, mean formant bandwidth (MFB), singing power ratio (SPR), and harmonics-to-noise ratio (HNR), were analyzed, and linear regression models assessed the effects of valence level, resonance condition and their interaction on emotional ratings.</p><p><strong>Results: </strong>Acoustic analyses confirmed significant differences between resonance conditions, with \"full\" resonance showing higher H1-H2, HNR, MFB and SPR, indicating distinct timbral qualities. Perceptual ratings revealed that valence level and resonance condition both significantly predicted emotional ratings (p < 0.001). \"Full\" resonance enhanced positive valence ratings and \"thin\" resonance reduced positive valence ratings across levels, particularly for emotionally ambiguous stimuli.</p><p><strong>Conclusion: </strong>Vocal resonance manipulation is a potent causal factor in shaping emotional perception in singing. The findings bridge the gap between pedagogical concepts and measurable acoustics, showing how the \"full-thin\" resonance continuum serves as a nuanced tool for emotional communication within the Chinese vocal tradition. These results indicate the importance of considering both acoustic implementation and perceptual outcome in understanding timbre-emotion relationships.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436895","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correlation between Obesity and Patient Tolerance to Office-Based Trans-Nasal Laryngeal Procedures.","authors":"Abdul-Latif Hamdan, Lana Ghzayel, Patrick Abou Raji Feghali, Omar Aboul Hosn, Ibana Carapiperis, Lynn Abdel Malak, Nijad Zeineddine, Randa Barazi, Marc Mourad","doi":"10.1016/j.jvoice.2026.01.044","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.01.044","url":null,"abstract":"<p><strong>Objective: </strong>To examine the correlation between obesity and patient tolerance to office-based laryngeal procedures (OBLP) using multiple indices for obesity.</p><p><strong>Study design: </strong>Retrospective chart review METHODOLOGY: The medical records of all patients who underwent OBLP via the trans-nasal approach between February 2025 and September 2025 were reviewed. OBLP were divided into three categories: laryngeal biopsy, laser therapy with or without intralesional steroid injection, and therapeutic injection with pharmaceutical or autologous agents (steroids, botulinum toxin, hyaluronic acid, and platelet-rich plasma). Demographic data included age, gender, history of smoking, reflux disease, allergy, voice diagnosis, body mass index (BMI), neck, and waist circumference. After the procedure, all patients were asked to fill out the IOWA satisfaction with anesthesia scale.</p><p><strong>Results: </strong>Forty-three males and 39 females, mean age 50.56 ± 16.60 years, were included in this study. These were divided into three subgroups: those with a BMI < 25 Kg/m² (n = 27), those with a BMI ranging between 25-29 Kg/m² (n = 33), and those with a BMI ≥ 30 Kg/m² (n = 22). All subgroups were matched by age, gender, history of smoking, and history of reflux. There was a statistically significant difference in the mean IOWA scores between the three subgroups (P = 0.009). Regression analysis accounting for various variables showed a mild significant negative association between neck circumference and IOWA satisfaction score. Subgroup analysis based on type of procedure showed a mild but significant negative association between IOWA score and BMI in those who underwent office-based laser therapy.</p><p><strong>Conclusion: </strong>The results of this investigation showed a statistically significant difference in the mean IOWA score across subgroups of patients belonging to different BMI categories undergoing OBLP via the transnasal approach. There was also a significant, mild negative correlation between BMI and IOWA score in the subgroup who had laser therapy. These results might be useful for patient selection and counseling before OBLP.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147436880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of Resonant Voice Therapy in Individuals With Voice Disorders: Systematic Review and Meta-Analysis.","authors":"Yiyun Gu, Yunyu Wu, Yiyao Wang, Yinjuan Zhu, Zhaoming Huang, Yongli Wang","doi":"10.1016/j.jvoice.2026.02.009","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.009","url":null,"abstract":"<p><strong>Objectives: </strong>To systematically evaluate the efficacy of resonant voice therapy (RVT) in individuals with voice disorders and to quantitatively examine its effects across auditory-perceptual, subjective, and acoustic outcome domains.</p><p><strong>Methods: </strong>A systematic literature search was conducted across Web of Science, PubMed, Scopus, Embase, Cochrane Library, and CNKI databases to identify randomized controlled trials (RCTs) and quasi-RCTs investigating RVT in pediatric and adult populations with voice disorders. A meta-analysis was performed for outcomes deemed clinically and statistically comparable, using fixed- or random-effects models. Outcomes that could not be quantitatively synthesized were summarized narratively. Risk-of-bias (RoB) was assessed using the Cochrane RoB tool.</p><p><strong>Results: </strong>Eight eligible studies involving 321 participants were finally included. The meta-analysis showed that RVT significantly improved auditory-perceptual voice quality, as reflected by GRBAS (G) (mean difference [MD] = -0.52, 95% confidence interval [CI] [-0.75, -0.30], P < 0.00001). Significant decreases in subjective outcomes, particularly voice handicap index-30, were observed when RVT was compared with no-direct-voice intervention (MD = -9.64, 95% CI [-14.70, -4.58], P = 0.0002). Among acoustic parameters, RVT was associated with significant extensions in maximum phonation time (MD = 4.36, 95% CI [2.45, 6.28], P < 0.00001) and drops in Jitter (MD = -0.19, 95% CI [-0.26, -0.12], P < 0.00001). However, results for Shimmer (MD = -0.70, 95% CI [-1.85, 0.44], P = 0.23) and fundamental frequency (standardized mean difference = 0.02, 95% CI [-0.43, 0.47], P = 0.93) were inconsistent or nonsignificant.</p><p><strong>Conclusion: </strong>RVT is an effective intervention for improving auditory-perceptual voice quality and patient-reported voice handicap in individuals with voice disorders, with selective benefits on acoustic measures. Although the evidence is limited by clinical and methodological heterogeneity and the small number of high-quality trials, the findings support the applicability of RVT and underscore the need for well-designed studies with standardized outcome measures to strengthen the evidence base.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice-Related Quality of Life in Early Adolescents: A Preliminary Cross-Sectional Study.","authors":"Mankirat Multani, Meera Niranjan Khadilkar, Deviprasad Dosemane, Sudhin Karuppali, Jayashree Kanthila, Suraj Pai","doi":"10.1016/j.jvoice.2026.02.019","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.019","url":null,"abstract":"<p><strong>Purpose: </strong>Adolescent voice changes can affect self-identity, psychosocial well-being, and overall quality of life, sometimes resulting in social withdrawal and communication challenges. While adaptations of the Voice Handicap Index, such as the Pediatric VHI and CVHI-10, exist for younger populations, research on the applicability of the original VHI in adolescents remains limited. The present study evaluates the VHI in individuals aged 11-15 years by providing normative data, exploring age and gender variations, and comparing scores between adolescents with and without self-perceived pubertal voice changes.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among 80 adolescents (11-15 years) recruited from schools in South India. After excluding clinically evident laryngeal pathology, eligible participants completed demographic profiling and VHI. Descriptive statistics and group comparisons were performed.</p><p><strong>Results: </strong>Total VHI scores ranged from 0 to 65 (mean 17.6 ± 17.4), with most participants reporting minimal handicap. A small subgroup of adolescents reporting self-perceived pubertal voice change (n=4) had higher mean scores (35.3 ± 13.7) than their peers (16.7 ± 17.2). Differences by age group and sex were not statistically significant. Across the cohort, functional (6.6 ± 6.6) and physical (6.5 ± 6.1) subscales were more affected than the emotional domain (4.3 ± 5.7).</p><p><strong>Conclusion: </strong>This preliminary study provides self-reported VHI values in early adolescents, indicating generally mild handicap in healthy individuals but higher perceived impact among those with self-perceived pubertal voice change. While based on a small symptomatic subgroup, the findings offer early insights that can guide future multicenter studies and the development of adolescent-appropriate validated tools.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147379344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Singing A Different Tune: A Longitudinal Analysis of Vocal Habits Among Professional and Amateur Performers.","authors":"Michael W Denham, Isaac L Alter, Evan Kennedy, Drew Gehling, Ryan C Branski, Hayley L Born","doi":"10.1016/j.jvoice.2026.01.053","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.01.053","url":null,"abstract":"<p><strong>Objectives/hypothesis: </strong>This study sought to characterize the attitudes of performers regarding factors commonly believed to influence the voice. The primary goal was to describe the vocal health habits of singers to provide a framework for clinical counseling and a potential schema for future investigation. Secondary objectives included examining changes in these attitudes over time and identifying differences between professional and amateur vocalists.</p><p><strong>Study design: </strong>Prospective, longitudinal analysis.</p><p><strong>Methods: </strong>A longitudinal assessment was performed across ten years at two time points (2013 and 2023) to investigate potential changes in attitudes and practices over time. Participants were recruited by word of mouth and social media.</p><p><strong>Results: </strong>One hundred nine participants completed the 2013 survey, approximately half of whom were professional vocalists (52.3% professionals vs 47.7% amateurs), defined by those who either considered themselves a professional performer or had at some point obtained their primary source of income from singing or performing. The 2023 cohort included 155 participants who completed the survey, 61.3% of whom were classified as professional vocalists, with the remaining 38.7% classified as amateurs. In both the 2013 and 2023 cohorts, professional vocalists were more likely than amateurs to report factors that affected their voice. Using 2013 survey results, five vocal habits showed statistically significant differences in how amateurs and professionals judged their effects: warming up for 20-60 minutes prior to singing, decongestants, holding breath, cough drops (menthol), and one glass of wine. Using 2023 survey results, eight vocal habits showed statistically significant differences in how amateurs and professionals judged their effects: belting, cough drops (menthol), decongestants, holding breath, menthol spray, spicy foods, steroids, and Throat Coat.</p><p><strong>Conclusion: </strong>This study provides a rich characterization of factors vocalists report as influencing vocal health to varying degrees. Singers' beliefs about vocal health practices at times diverged from available scientific evidence.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Social Determinants of Health, Mental Effort, and Frustration for Voice Therapy.","authors":"Geneva V Mayne, Han Xu, Sandeep Shelly, Amanda I Gillespie","doi":"10.1016/j.jvoice.2026.02.018","DOIUrl":"https://doi.org/10.1016/j.jvoice.2026.02.018","url":null,"abstract":"<p><strong>Objective: </strong>Early life adversity and related social determinants of health (SDOHs) are risk factors for trauma, learning and regulation difficulties, and poor adult health outcomes, such as functional voice disorders (FVDs). It is unknown if learning new voice techniques is confounded by a history of adverse experiences. The purpose of this study was to investigate the relationship between SDOHs and cognitive effort in voice therapy.</p><p><strong>Methods: </strong>Patients referred for voice therapy at the Emory Voice Center in Atlanta, GA were recruited to participate in a non-experimental prospective study using an event-based ecological momentary assessment (EMA) methodology. At therapy initiation, patients completed the Trauma Symptoms of Discrimination Scale (TSDS), the Adverse Childhood Experiences (ACEs) questionnaire, and the Voice Handicap Index-10 (VHI-10). To assess mental effort and frustration for voice therapy, the NASA Task Load Index (NASA-TLX) was administered following each therapy session. Statistical tests were applied to examine differences in ratings among races and voice disorder diagnosis. Pairwise comparisons and generalized estimating equations were used to determine correlations between different outcome measures.</p><p><strong>Results: </strong>Twenty-seven participants (89% female, 60% white) completed the study. No significant differences in baseline perceptions of voice handicap, mental effort, frustration, trauma symptoms, or early adversity were observed among different groups. Elevated and clinically significant TSDS scores (M=46.18, SD=23.82) were observed among patients with FVDs. Statistically significant and positive correlations were observed between TSDS and mental effort and frustration scores (r=0.51, adjusted p=0.0296). Participants' mental-effort scores decreased significantly after therapy visits when considering the effects of confounders, but frustration scores did not.</p><p><strong>Discussion: </strong>Results indicate that patients reporting more trauma symptoms were also more likely to report greater cognitive effort and frustration during voice therapy than those reporting fewer trauma symptoms. While mental effort decreased from session to session during therapy, frustration did not. Findings underscore the need for the universal practice of trauma-informed care that includes equipping patients with resources that encourage positive emotions and resilience for the purpose of sustaining mental effort throughout the course of voice therapy.</p>","PeriodicalId":49954,"journal":{"name":"Journal of Voice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147370150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}