Voice disorders are common and can cause significant functional, occupational, and social impairment. Voice-related handicap is highest in patients with low perceived control, which is the extent to which one can control events or one's reactions to events. Greater perceived control is associated with better overall well- being and disease-specific outcomes in other medical disorders. Interventions that increase perceived control exist and can be delivered online to maximize access, but have not been tested in patients with voice disorders. The proposed research aims will clarify the relationships between perceived control and voice outcomes using innovative technology-based approaches, facilitating strategic adaptation of an existing perceived control intervention for evaluation by patients with a common voice disorder, muscle tension dysphonia.
The research aims are to (1) characterize changes and covariation in perceived control and voice handicap using repeated real-time measures, (2) measure associations between perceived control and laboratory measures of voice using a cross-sectional approach, and (3) develop and test a perceived control intervention designed to increase perceived control and improve voice outcomes using a randomized controlled trial design.
These aims will be complemented by career development goals to (1) acquire expertise at interface between modern psychology and voice research, (2) develop expertise in multidimensional voice assessment, and (3) acquire experience with advanced intervention development and randomized study design. To accomplish these career development goals, the investigator will take formal coursework, attend intensive workshops/learning institutes, participate in local and national meetings, and perform hands-on design and analysis with the guidance of a multidisciplinary mentor and consultant team, in the context of a highly supportive institutional environment. Completion of these aims and training goals will help position the PI to establish the use of innovative technology-based assessment and intervention in voice research, and will contribute new information about how psychological factors influence voice outcomes.
These aims will also pave the way toward a new addition to the treatment armamentarium for voice disorders, which currently includes voice therapy, medications, and surgery, but no systematic approach to addressing contributory psychological factors. The overall goal of the investigator is to contribute to integrated care that leads to the best possible voice and quality of care outcomes for patients with voice disorders.

Public Health Relevance

Voice problems are common and can significantly reduce quality of life. Psychological factors appear to impact voice outcomes, but how they do so is not well understood. The goal of this study is to use innovative technology-based approaches to characterize how a psychological factor called perceived control influences voice outcomes, to create an intervention that improves perceived control, and test whether that intervention leads to better voice outcomes. This study has the potential to lead to a new treatment option in voice care.

National Institute of Health (NIH)
National Institute on Deafness and Other Communication Disorders (NIDCD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Communication Disorders Review Committee (CDRC)
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Rivera-Rentas, Alberto L
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University of Minnesota Twin Cities
Schools of Medicine
United States
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Misono, Stephanie; Haut, Caroline; Meredith, Liza et al. (2018) Dysphonia, Perceived Control, and Psychosocial Distress: A Qualitative Study. J Voice :
Cohen, Seth M; Lee, Hui-Jie; Roy, Nelson et al. (2018) Pharmacologic management of voice disorders by general medicine providers and otolaryngologists. Laryngoscope 128:682-689
Nguyen-Feng, Viann N; Frazier, Patricia A; Stockness, Ali et al. (2018) Web-Based Perceived Present Control Intervention for Voice Disorders: A Pilot Study. J Voice :
Misono, Stephanie; Yueh, Bevan; Stockness, Ali N et al. (2017) Minimal Important Difference in Voice Handicap Index-10. JAMA Otolaryngol Head Neck Surg 143:1098-1103