Emotional stress as a risk factor of voice disorders in professional singers

Abstract

Introduction : Opera singers are professionals whose voices are extremely heavily burdened, not only due to repertoire, but also due to the hourly workload of the voice and its unique use resulting from the specificity of the profession. Singers are required to fill very large concert halls with their singing and must deal with immediate feedback from the audience which is associated with a lot of stress. Stage fright, as a type of stress, is a phenomenon that takes place over a period of time and has a triple dimension: pre-concert stage fright during which the musician prepares for a performance, concert stage fright which involves a sense of a lack of control over the performance, and post-concert stage fright, i.e. retrospection of the work and the assessment of whether the quality of the performance met the expectations set by oneself and by others. Although certain personality traits are crucial for coping with stressful situations, they are not taken into account during the recruitment process for vocal studies or applications to work in the opera. Voice disorders may cause problems and have negative economic consequences for professional singers. The aim of this study was to determine the incidence of voice disorders among people working in professional opera theaters as singers with regard to their temperament and personality traits, and the influence of such disorders on the levels of stress in this professional group. Materials and methods : The study involved 225 singers, employed in 6 randomly chosen opera theaters in Poland: the Grand Theater of the National Opera in Warsaw, the Grand Theater in Poznan, Opera Nova in Bydgoszcz, the Grand Theater in Łodź, Wroclaw, and the Castle Opera in Szczecin. The research instruments were: the Voice Handicap Index (VHI), the Neuroticism Ekstraversion Openness–Five Factor Inventory (NEO-FFI), the Formal Characteristics of Behavior–Temperament Inventory (FCB-TI), and the author’s questionnaire. Results : Voice disorders were found in 57.3% of respondents (n = 129; p ≤ 0.001). Significant relationships were observed between voice disorders and noise in the workplace (60.4%; p = 0.023). As well as this, the risk of infection in the workplace was an important contributor to voice disorders indicated by 93% of the whole study group and 96.9% of participants with voice disorders (n = 129; p = 0.008). Singers with voice disorders suffered from chronic sinusitis [X 2 (1) = 5.407; p < 0.05] and bronchial asthma [X 2 (1) = 4.565; p < 0.05] significantly more often. Respondents with voice disorders were characterized by higher neuroticism i.e., the personality trait which increases susceptibility to stress (n = 129; p = 0.012). Conclusions : 1. It seems reasonable to create interdisciplinary teams monitoring the process of a professional singers’ education. 2. Neuroticism increased the susceptibility of professional singers to stress, and thus predisposed them to voice disorders. 3. An increased risk of infection as well as noise in the workplace are significant external factors contributing to voice disorders in professional singers. 4. Higher emotional reactivity and perseverance may predispose to an increased incidence of voice disorders among singers. As such, there is a need for a psychologist in an interdisciplinary team dealing with these professionals, both during their education and work. 5. The coexistence of somatic diseases, associated with higher neuroticism translates into increased susceptibility to stress, and thus, a higher incidence of voice disorders.