Clinical Psychology and Voice Disorders: A Meta-Analytic Review of Studies Assessing Psychological Characteristics Across Individuals With and Without Voice Disorders

Luke Aldridge-Waddon; Chloe Hiles; Victoria Spence; Matthew Hotton

doi:10.1016/j.jvoice.2023.09.012

Clinical Psychology and Voice Disorders: A Meta-Analytic Review of Studies Assessing Psychological Characteristics Across Individuals With and Without Voice Disorders

J Voice. 2023 Oct 6:S0892-1997(23)00287-4. doi: 10.1016/j.jvoice.2023.09.012. Online ahead of print.

Authors

Luke Aldridge-Waddon¹, Chloe Hiles², Victoria Spence³, Matthew Hotton⁴

Affiliations

¹ Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK. Electronic address: luke.aldridge-waddon@hmc.ox.ac.uk.
² Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK.
³ VoiceFit Specialist Speech Therapy Services, VoiceFit Specialist Speech Therapy Services, UK.
⁴ Oxford Institute for Clinical Psychology Training and Research, Oxford Health NHS Foundation Trust, UK; Psychological Medicine, Oxford University Hospitals NHS Foundation Trust, UK.

PMID: 37806904
DOI: 10.1016/j.jvoice.2023.09.012

Abstract

Objectives: Clinical voice disorders are heterogenous conditions capturing problems with voice production and control. Psychological conceptualizations of voice disorders posit that mood, anxiety, and personality characteristics contribute to the development and maintenance of voice symptoms. This review brings together research comparing these psychological characteristics across groups with and without voice disorders, with the aim of profiling group differences.

Methods: A systematic search of PubMed, CINAHL, Ovid (PsycInfo, MEDLINE, Embase), and Web of Science databases was conducted, with studies required to assess psychological characteristics between samples with and without voice disorders. Relative study quality and risk of bias were formally evaluated, synthesizing results via meta-analysis (estimating standardized mean difference; SMD) and narrative synthesis.

Results: Thirty-nine studies (N = 4740) were reviewed. Marked psychological differences were observed between case-control groups, including significantly higher self-reported features of depression (SMD = 0.50), state anxiety (SMD = 0.58), trait anxiety (SMD = 0.52), health anxiety (SMD = 0.57), and neuroticism (SMD = 0.47) in voice disorder groups. However, less consistent patterns of difference were observed between voice disorder types, including minimal quantitative differences between functional and organic diagnoses.

Conclusions: Findings underline and formulate the psychological features associated with experiencing a voice disorder, indicating individuals with voice disorders present with considerable psychological needs that may benefit from clinical psychology input.

Keywords: Clinical psychology; Dysphonia; Formulation; Meta-analysis; Psychosocial.

Publication types

Review