Moayedfar Saeideh, Khoddami Seyyedeh Maryam, Aghdak Pejman, Ansari Noureddin Nakhostin, Dabirmoghaddam Payman
Saeideh Moayedfar, Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.
Seyyedeh Maryam Khoddami, Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Enghelab Avenue, Pitch-e-shemiran, Tehran 11489, Iran.
J Voice. 2025 Sep 12. doi: 10.1016/j.jvoice.2025.07.041.
Limited research has examined anxiety in muscle tension dysphonia (MTD). This study aimed to compare anxiety levels between primary MTD patients and healthy speakers. Additionally, it explored self-perceived voice characteristics and their relationship with anxiety in both groups.
A total of 223 participants were recruited, including 120 primary MTD patients and 103 healthy speakers. Anxiety levels and severity were assessed using the Beck Anxiety Inventory (BAI). Self-perceived voice assessments, including voice self-assessment, vocal effort, vocal tract discomfort (VTD), vocal fatigue index (VFI), and voice-related pain scale (VRPS), were conducted to compare self-voice perceptions between the two groups. Additionally, correlations between anxiety and self-perceived voice measures were analyzed.
The mean BAI score was significantly higher in patients than in healthy speakers, with a weak effect size (P = 0.0001, η² = 0.122). While most participants in both groups had mild anxiety, anxiety severity was significantly associated with MTD status (P = 0.0001). Significant differences were found between the two groups in voice self-assessment (P = 0.0001) and in vocal effort, VTD, VFI, and VRPS scores (P < 0.05). The Bonferroni correction (α = 0.007) indicated significant positive correlations for the VTD frequency (r = 0.34, P = 0.001) and the VTD severity (r = 0.34, P = 0.001) in the healthy speakers. Comparison with patients showed that three measures (all positive) were significant in the patient group. Comparison using Fisher's z tests revealed no statistically significant differences between two groups for any individual measure (all > 0.05).
Given the higher anxiety levels in primary MTD patients compared with healthy individuals, a psychogenic or multidisciplinary approach can be integrated into their assessment and voice therapy. The findings should be interpreted with consideration of the absence of additional tools for anxiety assessment and the presence of disordered control groups.
关于肌肉紧张性发音障碍（MTD）患者焦虑情况的研究有限。本研究旨在比较原发性MTD患者与健康发声者的焦虑水平。此外，还探究了两组人群自我感知的嗓音特征及其与焦虑的关系。
共招募了223名参与者，包括120名原发性MTD患者和103名健康发声者。使用贝克焦虑量表（BAI）评估焦虑水平和严重程度。进行自我感知嗓音评估，包括嗓音自我评估、发声努力程度、声道不适（VTD）、嗓音疲劳指数（VFI）和嗓音相关疼痛量表（VRPS），以比较两组之间的自我嗓音感知。此外，分析了焦虑与自我感知嗓音指标之间的相关性。
患者的平均BAI得分显著高于健康发声者，效应量较小（P = 0.0001，η² = 0.122）。虽然两组中的大多数参与者都有轻度焦虑，但焦虑严重程度与MTD状态显著相关（P = 0.0001）。两组在嗓音自我评估（P = 0.0001）以及发声努力程度、VTD、VFI和VRPS得分方面存在显著差异（P < 0.05）。Bonferroni校正（α = 0.007）表明，健康发声者中VTD频率（r = 0.34，P = 0.001）和VTD严重程度（r = 0.34，P = 0.001）存在显著正相关。与患者组比较发现，患者组中有三项指标（均为正值）具有显著性。使用Fisher z检验进行比较显示，两组在任何个体指标上均无统计学显著差异（均> 0.05）。
鉴于原发性MTD患者的焦虑水平高于健康个体，可将心理或多学科方法纳入其评估和嗓音治疗中。本研究结果应结合焦虑评估工具的缺乏以及无序对照组的存在进行解读。
