Coocorrência de ansiedade e disfonia: estudo coorte das características vocais em pessoas com alta e baixa ansiedade

Abstract

Purpose: To evaluate the vocal aspects and anxiety behaviors in individuals with high and low anxiety over time. Methods: This is a research with a longitudinal design. Seventeen volunteers participated in the study, classified in two groups, according to the trait of anxiety, in a group with low anxiety (LAG) with 03 participants and a group with high anxiety (HAG) with 14 volunteers. The data collection was carried out based on three aspects: psychic linked to anxiety, based on the Trait and State Anxiety Inventory (STAI); physiological measures involving electrical conductance of the skin (ECS), extremity temperature (ET), electromyography (EMG) of the supra and infrahyoid muscles, heart rate (HR) and blood oxygen saturation (SPO²); and the vocal aspects that were collected through self-assessment using the Voice Symptoms Scale (VoiSS), collection of the sustained vowel / ε / speech sample and counting from one to ten, for acoustic analysis and perceptual auditory evaluation of the voice. The acoustics involved extraction of the measures of fundamental frequency (f0), signal-to-noise ratio (SNR), shimmer, jitter, Glottal-to-Noise-Excitation (GNE) and cepstral peak proeminence smoothed (CPPS). The speech samples were analyzed by two specialists and the reliability was verified using the Kappa test (K). The following perceptual parameters were investigated: general degree, roughness, breathiness, instability and strain. The data were analyzed using descriptive and inferential statistics, using the non-parametric variance analysis model (ANOVA) for longitudinal data and the Weight of Evidence (WoE), using the R and ANOVA Bayesian software, using the JASP software. Significance was set at 5%. Results: There was a significant increase in levels of trait and state anxiety over time in HAG. The sustained vowel of infrahyoid EMG was higher for HAG and the suprahyoid EMG of speech linked to LAG. The total and limited VoiSS scores increased over time for HAG. The acoustic averages CPPS and GNE worsen with time for HAG. There was no statistical difference in the comparison of auditory-perceptual analysis between groups over time. The variables that most influenced anxiety were the physiological measures of EMG and HR, all domains of the VoiSS, personal risk factors such as talking a lot, loud and fast, perceptual parameters of vocal quality, general degree and instability, prosodic parameter of speech rate and GNE acoustic measurement. Conclusion: Individuals with high anxiety, after one year, present worsening of the perception of trace anxiety levels, increased vocal symptoms, worsening of CPPS and GNE acoustic measures.