{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T05:05:01Z","timestamp":1780463101075,"version":"3.54.1"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: The aim of the study was to devise and validate a new questionnaire\u2014Psycho-Vox\u2014for diagnosis of muscle tension dysphonia and develop normative data for Polish-speaking adults. The tool was designed to measure 10 key psychological and social dimensions that have a bearing on functional voice disorders (FVDs), namely perseverance, coping with stress style (task-oriented or avoiding-oriented), mental well-being, resilience, burnout, family and social relationships, and tendency to project a positive self-image, tendency to exaggerate symptoms. Methods: The validation study involved 164 participants (46.3% were patients with muscle tension dysphonia and 53.7% were in good health; 92.7% were women). Their ages ranged from 18 to 76 years (M = 40.2; SD = 13.1). The Psycho-Vox questionnaire comprised 80 items, which participants rated on a 5-point Likert scale. Construct validity was tested using factor analysis with principal component rotation and confirmatory factor analysis. Reliability was determined using Cronbach\u2019s \u03b1, and linguistic comprehension was assessed using the Flesch Reading Ease Score (FRES, Polish version) and the Jasnopis indicator. Sten norms were developed for the entire sample. Results: Factor analysis confirmed the 10-factor structure of the questionnaire, consistent with theoretical assumptions (KMO = 0.734; \u03c72(3160) = 8643.41; p &lt; 0.001), with 89.2% classification agreement. Cronbach\u2019s \u03b1 for individual scales ranged from 0.705 to 0.837, confirming high internal reliability. The results of the FRES and Jasnopis tests indicate that the tool is understandable to adults with secondary or higher education. Significant differences were found between the patient group and the control group in terms of family relationships (p &lt; 0.001), social capital (p = 0.003), mental well-being (p = 0.007), tendency to project a positive self-image (p = 0.004), and tendency to exaggerate symptoms (p = 0.005). A logistic regression model (\u03c72(10) = 62.27; p &lt; 0.001; Hosmer\u2013Lemeshow \u03c72(8) = 5.00; p = 0.757) showed that belonging to the patient group was positively associated with higher scores on the scales of family relationships, mental resilience, mental well-being, tendency to project a positive self-image, and symptom exaggeration, while negatively associated with perseverance and task-oriented coping with stress. The classification accuracy of the model was 73.2%. Sten norms were developed for all diagnostic scales. Conclusions: The Psycho-Vox questionnaire is characterised by good construct validity, high reliability, and practical clinical usefulness. The tool can be used in the differential diagnosis of muscle tension dysphonia and in monitoring the progress of treatment and rehabilitation.<\/jats:p>","DOI":"10.3390\/jcm15114145","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T12:31:56Z","timestamp":1779885116000},"page":"4145","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Psycho-Vox: A Polish Questionnaire for the Differential Diagnosis of Muscle Tension Dysphonia"],"prefix":"10.3390","volume":"15","author":[{"given":"Agata","family":"Szkie\u0142kowska","sequence":"first","affiliation":[{"name":"Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iwona","family":"Pilchowska","sequence":"additional","affiliation":[{"name":"Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3407-2355","authenticated-orcid":false,"given":"Beata","family":"Mia\u015bkiewicz","sequence":"additional","affiliation":[{"name":"Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4551-282X","authenticated-orcid":false,"given":"Paulina","family":"Krasnod\u0119bska","sequence":"additional","affiliation":[{"name":"Audiology and Phoniatrics Clinic, Institute of Physiology and Pathology of Hearing, 02-042 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1001\/jamaoto.2024.2081","article-title":"Voice disorder prevalence and vocal health characteristics in adolescents","volume":"150","author":"Fujiki","year":"2024","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"3712","DOI":"10.1002\/lary.30929","article-title":"Prevalence of voice disorders in the United States: A national population-based study","volume":"134","author":"Huston","year":"2024","journal-title":"Laryngoscope"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1080\/14015439.2022.2085787","article-title":"The interaction between voice disorders and stress for work ability of teachers","volume":"49","author":"Uitti","year":"2024","journal-title":"Logoped. Phoniatr. Vocol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1001\/jamaoto.2020.4956","article-title":"Association between communicative participation and psychosocial factors in patients with voice disorders","volume":"147","author":"Asplund","year":"2021","journal-title":"JAMA Otolaryngol. Head Neck Surg."},{"key":"ref_5","unstructured":"Naqvi, Y., and Gupta, V. (2025). Functional Voice Disorders. StatPearls [Internet], StatPearls Publishing."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1186\/s12955-024-02312-4","article-title":"The use of patient-reported outcome measures to improve patient-related outcomes\u2014A systematic review","volume":"22","author":"Bonsel","year":"2024","journal-title":"Health Qual. Life Outcomes"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1007\/s11845-024-03816-0","article-title":"Relationship between voice impairment and stress coping styles in professionally active teachers","volume":"194","author":"Nawrocka","year":"2025","journal-title":"Ir. J. Med. Sci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1798","DOI":"10.1002\/ohn.946","article-title":"Relationship between voice problems and depression among American adults","volume":"171","author":"Lee","year":"2024","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"361","DOI":"10.13075\/mp.5893.01595","article-title":"Voice disorders among teachers from the perspective of affective temperament and occupational burnout syndrome","volume":"76","author":"Nawrocka","year":"2025","journal-title":"Med. Pr. Work. Health Saf."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"581.e7","DOI":"10.1016\/j.jvoice.2018.01.022","article-title":"Voice Disorder and Burnout Syndrome in Teachers","volume":"33","author":"Giannini","year":"2019","journal-title":"J. Voice"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3299","DOI":"10.1007\/s11136-024-03772-3","article-title":"Truth and dare: Patients dare to tell the truth when using PROMs in clinical practice","volume":"33","author":"Haverman","year":"2024","journal-title":"Qual. Life Res."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1059","DOI":"10.1111\/1460-6984.12417","article-title":"Relationship between perceived social support and patient-reported communication outcomes across communication disorders: A systematic review","volume":"53","author":"Eadie","year":"2018","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_13","unstructured":"Pisarek, W. (2007). Wst\u0119p do Nauki o Komunikowaniu, PWN Scientific Publishers."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2929","DOI":"10.1007\/s11136-024-03761-6","article-title":"COSMIN guideline for systematic reviews of patient-reported outcome measures version 2.0","volume":"33","author":"Mokkink","year":"2024","journal-title":"Qual. Life Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s40271-024-00710-w","article-title":"Evaluating comprehensibility of 157 patient-reported outcome measures (PROMs) in the nationwide Dutch outcome-based healthcare program: More attention for comprehensibility of PROMs is needed","volume":"18","author":"Tuinenburg","year":"2024","journal-title":"Patient"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e70050","DOI":"10.1111\/1460-6984.70050","article-title":"Communication patient reported outcome measures for adults with communication disorders: A systematic review of content validity","volume":"60","author":"Hilari","year":"2025","journal-title":"Int. J. Lang. Commun. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"544.e1","DOI":"10.1016\/j.jvoice.2021.09.032","article-title":"A Systematic Review of Voice-Related Patient-Reported Outcome Measures for Use with Adults","volume":"38","author":"Slavych","year":"2021","journal-title":"J. Voice"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1097\/MOO.0b013e328346494d","article-title":"Reconsidering the role of psychosocial factors in functional dysphonia","volume":"19","author":"Deary","year":"2011","journal-title":"Curr. Opin. Otolaryngol. Head Neck Surg."},{"key":"ref_19","first-page":"651","article-title":"Updated recommendations on evidence needed to support measurement comparability among modes of data collection for PROMs: An ISPOR good practices report","volume":"26","author":"Reasner","year":"2023","journal-title":"Value Health"},{"key":"ref_20","unstructured":"Gruszczy\u0144ski, W., Ogonowska, A., and Satkiewicz, A. (2005). Jasnopis\u2014Narz\u0119dzie do Analizy Zrozumia\u0142o\u015bci Tekst\u00f3w w J\u0119zyku Polskim, SWPS."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e3641","DOI":"10.1002\/brb3.3641","article-title":"Comparing five-factor personality traits and psychological distress between dysphonic patients and individuals with vocally healthy voices","volume":"14","author":"Aghajanzadeh","year":"2024","journal-title":"Brain Behav."},{"key":"ref_22","first-page":"386","article-title":"Clinical Psychology and Voice Disorders: A Meta-Analytic Review of Studies Assessing Psychological Characteristics Across Individuals With and Without Voice Disorders","volume":"40","author":"Hiles","year":"2023","journal-title":"J. Voice"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4145\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T04:18:45Z","timestamp":1780460325000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4145"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":22,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15114145"],"URL":"https:\/\/doi.org\/10.3390\/jcm15114145","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]}}}