Longitudinal Investigation of Factors Impacting the Development and Rehabilitation of Phonotrauma

项目摘要/摘要 日常生活中的发声行为被认为是声音创伤发生和持续的主要因素 (例如，声带小结、息肉等)，这是最普遍的行为嗓音障碍之一。这个 缺乏对高危人群动态发声行为的前瞻性纵向调查 限制了导致和补偿声音创伤的因素之间的区别，因此 影响最佳风险评估、缓解和治疗决策。最近的研究发现， 有声音创伤的个体具有更高水平的与社会支配性和冲动有关的人格特征 在日常生活中发声时，发声剂量越大，发声强度越大。个人 如果没有目前的发声病理，这些相同的人格特征和发声之间有很强的联系 行为，这表明个性特征和日常生活中说话的声音使用可能是 声带损伤的发生，对预后有一定的影响。这样做的主要目标是 该项目旨在确定个性特征和日常语音使用对儿童精神障碍发展的持久作用 声音创伤，声带运动学的变化，以及改变破坏性发声行为的能力 前瞻性的、纵向的方法。目标1试图确定人格和发声行为因素涉及的 发展中的声音创伤。这将通过使用人格特质问卷进行初步评估来实现， 通过声带的高速视频内窥镜进行动态语音监测和喉部评估 没有症状的歌手，他们是大学声音集中音乐节目的新生。我们将进行这些工作 评估程序每两年进行一次，从歌手大一开始，到 他们大三的时候。目标2将评估哪些活动和声带运动学参数最具预测性 声音创伤的症状。目标3将调查个性对治疗/行为依从性的影响 通过人格评估和动态监测在日常生活中的建议 参与发声治疗。这些研究将是第一次使用动态监测来(1)前瞻性地 观察与语音创伤发展相关的因素；(2)测量人格特质对语音创伤的影响 有能力改变个人的发声行为。它还将是第一个使用高速视频内窥镜的公司 观察声音损伤随时间的发展情况。该项目将支持促进国际和平研究所的长期发展 职业目标，这是实施一项计划，利用心理社会和行为因素来改善 高危人群声损伤的防治。这一职业目标只能实现 在纵向研究方法、高级统计分析和获取和 高速电视内窥镜检查分析。这项研究的结果将建立一个框架，最终在早期改善 确定声音创伤风险，制定风险缓解策略，并告知治疗方法。

PROJECT SUMMARY / ABSTRACT Voice behavior in daily life is assumed to be a primary factor in the development and persistence of phonotrauma (e.g., vocal fold nodules, polyps, etc.), which is one of the most prevalent behavioral voice disorders. The shortage of prospective, longitudinal investigations into the ambulatory voice behaviors in high-risk individuals limits the differentiation between factors that are causative versus compensatory to phonotrauma, and therefore impacts optimal risk-assessment, mitigation, and therapeutic decision-making. Recent work has found that individuals with phonotrauma had higher levels of personality traits related to social dominance and impulsivity and higher speaking vocal doses and increased speaking vocal intensity during voice use in daily life. Individuals without current vocal pathology had strong relationships between those same personality traits and vocal behaviors, suggesting that personality traits and speaking voice use in daily life could be robust factors in the development of phonotrauma and could play a role in the prognosis for recovery. The primary objective of this project is to determine the enduring role that personality traits and daily voice use have on the development of phonotrauma, changes in vocal fold kinematics, and on the ability to change damaging vocal behavior using prospective, longitudinal methods. Aim 1 seeks to identify personality and vocal behavior factors involved in the development of phonotrauma. This will be achieved through initial assessment using a personality trait inventory, ambulatory voice monitoring, and laryngeal assessment via high-speed videoendoscopy of vocally asymptomatic singers who are freshmen in a college voice concentration music program. We will conduct these assessment procedures bi-annually, beginning in the singer’s freshman year and ending at the conclusion of their junior year. Aim 2 will assess which ambulatory and vocal fold kinematic parameters are the most predictive of phonotrauma. Aim 3 will investigate the impact that personality has on compliance with therapeutic/behavioral recommendations in daily life through personality assessment and ambulatory monitoring before and after participation in voice therapy. These studies will be the first to use ambulatory monitoring to (1) prospectively observe factors related to the development of phonotrauma and (2) measure the impact that personality traits have on the ability to change individual vocal behaviors. It will also be the first to use high-speed videoendoscopy to observe development of phonotrauma over time. This project will support advancement of the PI’s long-term career objective, which is to implement a program that uses psychosocial and behavioral factors to improve the prevention and treatment of phonotrauma in high-risk populations. This career objective can only be achieved with adequate training in longitudinal research methods, advanced statistical analyses, and acquisition and analysis of high-speed videoendoscopy. Results from this study will build a framework to ultimately improve early identification of phonotrauma risk, develop risk mitigation strategies, and inform treatment approaches.