Bibliographic record
Abstract
Background: Individuals with a stigmatized medical condition may become reluctant to seek medical help. Among professional singers and actors there can be a stigma associated with voice disorders. However, evidence for this vocal stigma is limited and primarily anecdotal. No quantitative research has explored the impact of vocal stigma that may have on help-seeking behaviour in professional vocal performers. Primary goals of this study were to (a) quantitatively evaluate vocal stigma among professional actors and singers, (b) quantify the association between vocal stigma and help-seeking behaviour, and (c) explore personal factors that may influence vocal stigma.Methods: An online survey questionnaire was created and deployed using LimeSurvey. The questionnaire comprised 64 items, grouped into 8 sections. Sections 1-3 pertained to demographics (6 items), occupation (3 items), and vocal health history (14 items). Sections 4-6 pertained to three constructs for predicting help-seeking: information, motivation, and behavioural skills. Section 7 measured experiences of stigma. These four sections (4-7) each comprised of 10 Likert-type items on 5-point scales. Section 8 was left open-ended for feedback. Performers were recruited via professional organizations, including the National Association of Teachers of Singing and the Alliance of Canadian Cinema, Television and Radio Artists. Gender-matched controls were recruited via Prolific, an online recruiting platform.Results: A total of 200 professional singers and actors and 203 controls participated in the survey (both groups: ages 21-65; female 65%, male 32%, other 3%). Performers reported 14% more stigma than controls (t(401)=8.87, p=0.025). In both groups, stigma correlated negatively with motivation (Performers: r=-0.49; Controls: r=-0.59, p<0.001) and behavioural skills (Performers: r=-0.28; Controls: r=-0.46, p<0.001). Stigma was not significantly associated with information (Performers: r=-0.09, p=0.205; Controls: r=-0.09, p=0.200). The VHI-10 score was positively correlated with vocal stigma (Performers: r=0.46, Controls: r=0.26, p<0.001). In both groups, stigma was negatively associated with age (Performers: r=-0.27, p<0.001; Controls: r=-0.17, p=0.018), recency of a voice disorder (Performers: ρ=0.15, p=0.033; Controls, ρ=0.14, p=0.047), and frequency of voice disorder (Performers: ρ=0.46, p=0.005; Controls: ρ=0.26, p=0.031). In the performer group, singers reported levels of stigma were 15% higher than actors (t(198)=-1.67, p=0.025).Discussion: This study confirms the existence of vocal stigma among professional singers and actors in Canada. Motivation and behavioural skills were negatively associated with stigma, suggesting that those experiencing greater stigma are less likely to seek help for a voice disorder. The negative association between age and stigma may indicate that early-career performers are more vulnerable to the effects of vocal stigma. The positive association between vocal stigma and a history of voice disorder may indicate that vocal stigma is not commonly recognized by individuals without direct experience.Performers’ access to vocal care could be improved by reducing vocal stigma. A common intervention for reducing stigma is education outreach, which could be provided by speech-language pathologists and other vocal health specialists. This could include education about accessing services and clarifying the roles of different health professions. These events could also facilitate conversations about individuals’ struggles and recovery experiences, which have been found effective at combatting stigma in other health areas.By shedding light on vocal stigma, our study could also help performing arts organizations and vocal health specialists collaborate to protect artists in more direct ways, for example by advocating for performers’ medical privacy, supporting injury claims, and promoting preventative practices within the performance industry
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".