Voice therapy is the standard-of-care for many of the nearly 140 million people in the United States who have voice disorders. The University of Pittsburgh Voice Center offers specialized care and treatment for patients experiencing hoarseness, laryngitis, and other conditions. Our team of physicians, physician assistant, and voice specialized speech pathologists at the Voice Center are engaged in research on all scientific levels to address common concerns that patients experience when dealing with voice dysfunction.
Most recently, using data collected from patients seen at our Voice Center in 2020, we were able to measure the levels of experienced depression, anxiety, and perceived stress in patients with voice disorders from before and during the COVID pandemic. Surprisingly, no significant increase was observed, contradicting previous findings that, in general, people are experiencing higher levels of depression, anxiety, and perceived stress due to the pandemic. This lack of significant change may be due to previous evidence suggesting that people with voice disorders often report higher levels of depression, anxiety, and stress compared to healthy controls at baseline.
Additionally, we found that, consistent with prior literature, individuals with muscle tension dysphonia (MTD) score higher on a measure of perceived stress. Stress and stress-reactivity are implicated in the pathogenesis and maintenance of functional voice disorders (like MTD) in both the Trait Theory of Voice Disorders, as well as the Psychobiological Framework of Voice and Stress.
However, even more exciting was the novel discovery that patients with MTD not only had higher scores on a scale measuring perceived stress, but also that these patients significantly reported more stress manifestation symptoms in their body. Said differently, some people experience headaches or stomach problems when they're stressed. People with MTD were more likely to report a higher number of ways that stress impacts their body compared to structural or neurological voice disorders. This novel finding lays the foundation for more rigorous investigation between stress-manifestation in the body and how this phenomenon relates to functional voice disorders, like MTD.
Next, we are currently working together to build a repository of clinically-relevant data on all of our patients. This repository will provide a space for future researchers to query clinical data with ease and answer pressing research questions. Our ultimate goal is to create a tool that is flexible and adaptable over time to serve as a centralized database that can be customized for future research studies.
Other recent research was developing Conversation Training Therapy (CTT). Based on published patient reports on dissatisfaction with traditional therapy, CTT was developed by Jackie Gartner-Schmidt, PhD and Amanda Gillespie, PhD. It was honed with recommendations from expert clinical voice-specialized speech-language pathologists, and successfully piloted in a small case series of patients with voice problems. A NIH R03 grant allowed us to publish the Efficacy of Conversation Training Therapy and it is now a sought-after therapy program. We showed that patients got significantly better just two voice therapy sessions!
Other areas of research are:
- Quantifying Meta-Therapy. The name, meta-therapy, has been coined to describe the clinical dialogues and conceptual frameworks via which voice therapy is discussed.
- The Voice Patient Experience: The relationship between vocal handicap, congruency, perceived control, and mood.
- Voice Disorder Specific Voice Lab Measures vs. One-size Fits All
- Applying the Rehabilitation Treatment Specification System (RTSS) to Voice Therapy in conjunction with our colleagues at Harvard and multiple centers across the nation.
For more information, visit the Voice Center.