“…Cortisol is released during stress and previous studies suggest that stress is a risk factor in developing vocal symptoms or dysphonia (Baker, 2008;Dietrich, Verdolini Abbott, GartnerSchmitdt & Rosen, 2008;Dietrich & Verdolini Abbott, 2012;Chen, Chiang, Chung, Hsiao & Hsiao, 2010;Gassull, Casanova, Botey, Amador, 2010;Lyberg Åhlander, 2011;Lyberg Åhlander, Pelegrín García, Whitling, Rydell & Löfqvist, 2014;Rantala, Hakala, Holmqvist & Sala, 2012). About 23-25% of individuals seeking care for voice disorders or with common vocal pathologies show stress scores deviating upwards from normal scores Misono et al, 2014).…”