Singers are known to be at an increased risk of developing voice disorders and often represent a large percentage of patients who are seen at voice clinics. One of the most common disorders seen in singers is vocal fold nodules that result from chronic trauma to vocal fold tissue, referred to as phonotrauma or phonotraumatic vocal hyperfunction (PVH). While PVH in singers is thought do be due to the simple increase in vocal demands associated with singing, it continues to be unclear why some singers develop PVH though others do not. One factor that has been shown to be more highly associated with hyperfunctional voice disorders is personality, as described in the ?Trait Theory of Voice Disorders.? Testing of this theory has provided empirical evidence that those with PVH score significantly higher on measures of extraversion, neuroticism, and impulsivity than individuals with healthy voices. Unfortunately, there is a paucity of information about whether personality relates to PVH in a similar way to singers. We hypothesize that singers with PVH will score significantly higher on personality measures related to extraversion, neuroticism, and impulsivity than singers without PVH. Additionally, information is also lacking about whether personality traits correlate with daily vocal behaviors. PVH in singers is often assumed to be the sole result of how the voice is used when singing. Our preliminary work using an ambulatory voice monitor and an automated singing classifier has shown a larger number of significant differences between singers with PVH and normal controls during speaking than during singing across a full week of monitoring. We expect that personality measures related to extraversion, neuroticism, and impulsivity will be significantly correlated with ambulatory measures that reflect the amount and type of daily voice use or vocal load, specifically in speech. We hypothesize that these relationships will be stronger in singers with PVH compared to healthy singers. The goal of the proposed project is to determine if certain personality traits are significantly related to the presence of PVH in singers and/or to the daily vocal behaviors that could contribute to the etiology and pathophysiology of phonotrauma in singers. We will administer a multidimensional personality inventory to singers diagnosed with PVH and vocally healthy matched-singers. We will compare each trait scale for singers with PVH and healthy singers using a t- test and then determine which traits are more predictive of patient status using a stepwise binary logistic regression. Each participant will also be monitored for one typical week using an ambulatory voice monitor. Relationships between personality traits scales and voice-related parameters will be conducted using Pearson's r correlations, and linear multiple regression will be used to determine which traits are the most predictive of vocal behavior. The new knowledge produced by this project could be used to aid in improving the prevention, diagnosis and treatment of vocal nodules in singers, particularly with respect to predicting which singers are at a greater risk for developing vocal fold nodules, and in targeting specific daily vocal behaviors during treatment. Laura Toles
Singers are known carry an elevated risk of developing voice disorders, specifically those that are presumed to result from chronic vocal fold tissue trauma such as vocal fold nodules. However, despite the increased voice use requirements of singing, not all singers develop vocal fold nodules. This study aims to identify the influence that personality traits have on ambulatory voice behaviors to differentiate singers with vocal fold nodules from singers with healthy voices. Specifically, we hypothesize that personality measures related to extraversion, neuroticism, and impulsivity will be more strongly correlated with the amount and type of daily voice use or vocal load in speech in singers with vocal fold nodules. We expect that knowledge gained from this project will be useful to improve prevention of vocal fold nodules through prediction of individual risk for singers, and in targeting specific daily vocal behaviors during treatment.
