Paradoxical vocal cord dysfunction (PVCD) has been a highly misunderstood medical disorder that has been discussed in the literature as having varied etiologies. While neurological, as well as other medical explanations have been proposed as possible etiologies, many clinicians and researchers have suggested that PVCD is a psychological disorder. In suggesting a psychological etiology, there have been a wide variety of ideas of the different types of possible psychological classifications it could fall into. The most common psychological diagnosis suggested in the literature has been a conversion disorder, with anxiety and depression also receiving a large amount of support. Stressful and traumatic events have also been implicated as possible contributors. Throughout the literature, there has been a lack of information for how researchers have reached their conclusions and the methods used to make psychological diagnoses. Much of the evidence provided for explaining PVCD as a psychological disorder is the failure of these patients to respond to medical treatments that ordinarily ameliorate physical symptoms. Moreover, there has been an inability to identify an underlying medical cause. No one has studied PVCD from a psychological perspective using psychometrically sound psychological instruments.
The purpose of the present study was to investigate PVCD as a psychological disorder, specifically a conversion disorder. Anxiety and stress were also evaluated as possible contributing factors to this disorder. It was hypothesized that individuals who have received a diagnosis of PVCD would exhibit symptoms requisite of a conversion disorder as defined by the Diagnostic and Statistical Manual for Mental Disorders (DSM-IV; 1994) and measured by the Minnesota Multiphasic Personality Inventory (MMPI-2; 1989). Additionally, it was hypothesized that individuals with this disorder would report higher levels of anxiety than the general population as well as report higher levels of stress than individuals in the general population.
A battery consisting of two different measurement scales and a demographic questionnaire was administered to 47 patients diagnosed with PVCD at a medical outpatient clinic specializing in voice and swallowing disorders located in a large Midwestern city. PVCD was found to exhibit symptoms requisite of a conversion disorder. Further, it was found that patients diagnosed with PVCD do not report higher levels of anxiety, and only females report higher levels of negative stress than individuals in the general population. In addition, significant differences were found among different subgroups of patients on specific scales of the MMPI-2.
Implications of the results address the importance of gaining a better understanding of this disorder as having a psychological etiology. In addition, counseling implications, limitations of the present study, and suggestions for future research are also discussed.