‘It's like there are two people in my head’: A phenomenological exploration of anorexia nervosa and its relationship to the self

This study explores the lived experience of anorexia nervosa from the perspective of those who use pro-recovery websites for eating disorders. Fourteen people participated in an online focus group or an e-interview. Data were analysed using interpretative phenomenological analysis. Participants described their disorder as a functional tool for avoiding and coping with negative emotions, changing their identity and obtaining control. A central theme was the experience of an ‘anorexic voice’ with both demonic and friendly qualities. This voice felt like an external entity that criticised individuals and sometimes dominated their sense of self, particularly as anorexia nervosa got worse. Applying dialogical theory suggests a new model of anorexia nervosa, where the anorexic voice is a self-critical position, which disagrees with and attempts to dominate the more rational self. It is suggested that to move on from anorexia nervosa, the individual needs to address his/her anorexic voice and develop a new dominant position that accepts and values his/her sense of self.     

Adding the Voices of Jewish Girls to Developmental Theory

Abstract

Feminist psychologists do not often include Jewish representation when they discuss issues of difference and diversity. Jewish female adolescents have not been included in the current research on teen-age girls and voice. The author finds that Jewish female adolescents do experience themselves as different from the majority culture. This difference is associated with respondents emerging from early adolescence while maintaining relational competence.     

Near-term fetal response to maternal spoken voice

Knowledge about prenatal learning has been largely predicated on the observation that newborns appear to recognize the maternal voice. Few studies have examined the process underlying this phenomenon; that is, whether and how the fetus responds to maternal voice in situ. Fetal heart rate and motor activity were recorded at 36 weeks gestation (n = 69) while pregnant women read aloud from a neutral passage. Compared to a baseline period, fetuses responded with a decrease in motor activity in the 10 s following onset of maternal speech and a trend level decelerative heart rate response, consistent with an orienting response. Subsequent analyses revealed that the fetal response was modified by both maternal and fetal factors. Fetuses of women who were previously awake and talking (n = 40) showed an orienting response to onset of maternal reading aloud, while fetuses of mothers who had previously been resting and silent (n = 29) responded with elevated heart rate and increased movement. The magnitude of the fetal response was further dependent on baseline fetal heart rate variability such that largest response was demonstrated by fetuses with low variability of mothers who were previously resting and silent. Results indicate that fetal responsivity is affected by both maternal and fetal state and have implications for understanding fetal learning of the maternal voice under naturalistic conditions.     

A Qualitative Study of Community–University Partnerships That Support Psychosocial Occupational Therapy

Community partner voices are important to understand because they provide the contexts in which occupational therapy (OT) students research community-identified needs and together, create evidence-based occupation-focused programs while developing clinical reasoning skills in a natural context. The purpose of this study is to understand how community partners experienced partnerships that support community-based research in psychosocial settings. This retrospective study explores the perspectives of community partners that hosted OT students for two-semester service-learning project over 3 years. Findings revealed partners value effective communication with faculty and students, spending time observing, listening, and developing meaningful relationships with clients and staff.     

EDITORS' INTRODUCTION

ABSTRACT

Transsexualism implies that an anatomically normal individual feels that he or she is actually a member of the opposite sex. Treatment usually includes real-life experience along with hormone therapy and sex reassignment surgery. Voice modification surgery may be necessary, as pass ability in general is still in a large extent dependent on the aspects of voice in transsexual people. Often male-to-female patients report being addressed in telephone conversations as their genetic gender, which is experienced as a disability. The purpose of this study was to evaluate the impact of voice on the quality of life in transsexuals.

In order to detect the disability caused by a voice disorder, the validated assessment method the Voice Handicap Inventory (VHI) was used. An additional question about the way patients were addressed in a telephone conversation was added.

As part of a study describing general health in transsexual persons, done at the Ghent University Hospital Belgium, a total of 48 patients were evaluated. In female-to-male transsexuals the median scores were very low, suggesting testosterone treatment led to an acceptable voice alteration. A higher serum LH level was significantly correlated with higher total, functional and emotional VHI scores. In male-to-female transsexuals the scores were significantly higher than those of the female-to-male transsexuals, but still there was no indication of a real disability/handicap. The extra telephone question was scored higher suggesting male-to-female transsexuals did experience a disability caused by their voice. From this study it is concluded that the VHI values did not demonstrate a handicapping effect.     

择偶与人类嗓音

本文对择偶与人类嗓音之间的关系进行了深入分析。首先, 人类具有普遍的异性嗓音偏好：男性偏爱高音调的女性嗓音, 女性偏爱低音调的男性嗓音, 这种普遍偏好受到一系列跟自身婚配价值有关的因素的调节。其次, 人类的嗓音偏好跟嗓音背后的进化意义密切关联：女性化嗓音是女性生育力的线索, 而男性化嗓音是男性好基因和好资源的线索。而且, 富有吸引力的男性嗓音和女性嗓音能够预测个体的性行为和繁殖成功。再次, 富有有吸引力的人类嗓音影响个体的社会认知, 对亲密关系的维系也会带来消极影响。最后, 我们探讨了未来研究的若干方向：研究基频之外的其他嗓音参数, 探讨嗓音偏好的性选择机制、特殊群体的嗓音偏好, 以及嗓音偏好与其他认知过程的关系。     

Expanding the evidence: Developments and innovations in clinical practice,training and competency within voice and communication therapy for trans and gender diverse people

Background: Speech and language therapists (SLTs) deliver voice and communication therapy for trans and gender diverse people to facilitate authentic vocal and communicative expression. Davies, Papp, and Antoni (2015) have provided a comprehensive review of the literature, with recommendations for good clinical care. Several areas highlighted as gaps in the research were identified by the current authors as ones in which evidence is expanding.

Aims: To demonstrate 1) an expansion of the evidence base in particular innovations in voice group therapy for trans women and trans men; 2) the importance of delivering voice and communication therapy as part of a complete approach to trans and gender diverse health care; and (3) developments in training and competency in the UK.

Method: Data were drawn from three small-scale projects, two surveys, and one audit.

Measurements: Data from survey and audits and pre- and post-group acoustic measures of and client self-perceptual measures, including the Transsexual Voice Questionnaire (TVQ^MtF); a client-generated set of questions for trans men; and the migration of vocal identity map, adapted from Narrative Therapy practices.

Results: Positive outcomes for both pitch measures and client perception were recorded. Audit and survey data provided evidence of developments in training and competency in the UK.

Conclusion: Evidence supports group therapy as a successful approach for trans individuals across a number of parameters of voice and self-perception. Voice group protocols for both trans men and trans women should take account of the social context within which to explore relational presence and authentic voice. SLTs within gender identity clinics provide voice and communication as part of a broader pathway of care, alongside sharing professional knowledge and skills. Current UK developments are documented as indicators of positive responses to the growth in the number of SLTs seeking to develop specialist skills within this field.     

Distinctiveness helps when matching static faces and voices

Three experiments are reported which examined the capacity to match a voice with a static image of a face. When using a simultaneous same/different matching task, performance was significantly better than chance (Experiments 1 and 2). However, it did not appear to depend either on sex of speaker, sex of listener, stimulus distinctiveness, or self-reported strategies (Experiment 2). Concerns over floor effects as well as a significant response bias prompted a change of task, and when performance was examined through matching a voice to a face lineup, a more interesting pattern emerged. Again, performance was significantly better than chance, but in addition, it was demonstrably affected by the distinctiveness of the speaker’s voice. These results are considered in the context of theoretical discussions regarding face–voice integration, and in the context of more applied considerations regarding multimodal benefits in witness scenarios.     

Characteristics of inner reading voices

This study examined the phenomenological characteristics of inner speech during silent reading (inner reading voices or IRVs), a type of inner speech that may be particularly amenable to empirical study. A survey was conducted in the general population to assess IRV frequency, location, number, identity, and controllability, and auditory qualities of IRVs. Of 570 survey respondents, 80.7% reported sometimes or always hearing an inner voice during silent reading, and the remaining 19.3% reported always understanding words being read without hearing an inner voice. Results indicated that IRVs are a routine experience for many, with 34.2% of respondents with IRVs hearing an IRV every time something was read, and 45% reporting an IRV often. Most respondents reported IRVs with specific auditory qualities such as gender, accent, pitch, loudness, and emotional tone. IRVs were reported in participants' own voices, as well as in the voices of other people. Some respondents reported being unable to control any aspect of their IRVs, while others could control one or several aspects. These results indicate that there is considerable individual variation in inner speech during silent reading.     

Effects of adults’ contingent responding on infants’ behavior in ambiguous situations

We examined the effect of adults’ contingency in responding to infants’ behavior in an ambiguous situation in two experiments. In Experiment 1, forty-four 12-month-old infants were exposed to an ambiguous toy. An unfamiliar adult responded either contingently or non-contingently to the infant’s bids and then presented the toy and provided positive information. During toy presentation, infants in the non-contingent condition looked less at the experimenter than infants in the contingent condition. In a concluding free-play situation infants in the non-contingent condition played less and tended to touch the toy less. In Experiment 2 (forty-four 12-month-old infants), the parent either responded promptly or with a delay each time the infant made contact initiatives and then presented an ambiguous toy and delivered the positive information. The infants in the non-contingent condition tended to look less at the parent during toy presentation and also tended to play less with the toy during the concluding free-play situation. The findings show that adults’ contingency in responding influences infants’ behavior in ambiguous situations.