An Interdisciplinary Approach to the Management of Vocal Cord Dysfunction in an Elite Female Swimmer: A Case Study

in Case Studies in Sport and Exercise Psychology

Click name to view affiliation

Claire-Marie RobertsUniversity of the West of England

Search for other papers by Claire-Marie Roberts in
Current site
Google Scholar
PubMedClose
*
DOI:
https://doi.org/10.1123/cssep.2017-0011
Keywords:
adolescent; interdisciplinarity; perfectionism; precompetitive anxiety; swimming; vocal cord dysfunction
In Print:
Volume 2: Issue 1
Page Range:
12–20
Restricted access

Acute pulmonary disorders are commonplace within the athletic population, with exercise-induced bronchoconstriction and vocal cord dysfunction (VCD) common diagnoses. VCD is a condition that causes the vocal folds to close during inhalation, causing obstruction at the larynx and thereby a severely-impaired sporting performance. VCD can be brought on by laryngeal irritants, emotional and psychological stress, and asthma. The present case study details the interdisciplinary approach to the treatment of an elite female swimmer with VCD with an intervention program that lasted 9 weeks, instigated by a local general practitioner who chose to engage a sport psychology practitioner due to the sport-specific nature of the psychological stress she experienced. The steps involved in the design of the sport psychology interventions are outlined and the relationship of those interventions to the work of the other specialists is discussed. The 9-week intervention program was aimed at reducing the swimmer’s levels of precompetitive state anxiety and perfectionist tendencies using a combination of goal-setting, imagery, and cognitive restructuring. During the course of 9 weeks, the athlete’s levels of competitive state anxiety and perfectionist tendencies reduced, along with the frequency of VCD occurrence.

Claire-Marie Roberts is with the Department of Health and Social Sciences, Faculty of Health & Applied Sciences, University of the West of England, Bristol, United Kingdom.

Address author correspondence to Claire-Marie Roberts at claire-marie.roberts@uwe.ac.uk.
  • Collapse
  • Expand

Case Studies in Sport and Exercise Psychology

Cover Case Studies in Sport and Exercise Psychology

  • Anbar, R.D., & Hehir, D.A. (2000). Hypnosis as a diagnostic modality for vocal cord dysfunction. Pediatrics, 107(6), e21.1–e21.4.

  • Banez, G.A., & Culbert, T.P. (2005). An integrative approach to vocal cord dysfunction in young athletes. Biofeedback, 33(2), 54–57.

  • British Psychological Society. (2008). Generic professional practice guidelines. Leicester, UK: Author.

  • British Psychological Society. (2011). Qualification in sport and exercise psychology (Stage 2). Leicester, UK: Author.

  • Campainha, S., Ribeiro, C., Guimarăes, M., & Lima, R. (2012). Vocal cord dysfunction: A frequently forgotten entity. Case Reports in Pulmonology, 2012, 1–4. PubMed doi:10.1155/2012/525493

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Christopher, K.L., & Morris, M.J. (2010). Vocal cord dysfunction, paradoxical vocal cord motion or laryngomalacia? Our understanding requires an interdisciplinary approach. Otolaryngologic Clinics of North America, 43(1), 43–66. PubMed doi:10.1016/j.otc.2009.12.002

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Cumming, J., & Williams, S.E. (2012). The role of imagery in performance. In S. Murphy (Ed.), Handbook of sport and performance psychology (pp. 213–232). New York, NY: Oxford University Press.

    • Search Google Scholar
    • Export Citation

  • Deffenbacher, J.L., Zwemer, W.A., Whisman, M.A., Hill, R.A., & Sloan, R.D. (1986). Irrational beliefs and anxiety. Cognitive Therapy and Research, 10, 281–291. doi:10.1007/BF01173466

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Dixon, L.B., Holoshitz, Y., & Nossel, I. (2016). Treatment engagement of individuals experiencing mental illness: Review and update. World Psychiatry, 15, 13–20. PubMed doi:10.1002/wps.20306

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Dozois, D.J., & Beck, A.T. (2011). Cognitive therapy. In J.D. Herbert & E.M. Forman (Eds.), Acceptance and mindfulness in cognitive behavior therapy: Understanding and applying the new therapies (pp. 26–56). Chichester, UK: Wiley.

    • Search Google Scholar
    • Export Citation

  • Drinka, T., & Clark, P.G. (2000). Health care team work: Interdisciplinary practice and teaching. Westport, CT: Auburn House.

  • Earles, J., Kerr, B., & Kellar, M. (2003). Psychophysiologic treatment of vocal cord dysfunction. Annals of Allergy, Asthma, and Immunology, 90, 669–671. PubMed doi:10.1016/S1081-1206(10)61874-1

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Essau, C.A., Leung, P.W.L., Conradt, J., Cheng, H., & Wong, T. (2008). Anxiety symptoms in Chinese and German adolescents: Their relationship with early learning experiences, perfectionism, and learning motivation. Depression and Anxiety, 25, 801–810. PubMed doi:10.1002/da.20334

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Flett, G.L., & Hewitt, P.L. (2005). The perils of perfectionism in sport and exercise. Current Directions in Psychological Science, 14, 14–18. doi:10.1111/j.0963-7214.2005.00326.x

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Flett, G.L., Hewitt, P.L., Blankstein, K.R., & Mosher, S.W. (1991). Perfectionism, self-actualization, and personality adjustment. Journal of Social Behavior & Personality, 6, 147–160.

    • Search Google Scholar
    • Export Citation

  • Flett, G.L., Hewitt, P.L., Boucher, D., Davidson, L., & Munro, Y. (1997). The Child-Adolescent Perfectionism Scale: Development, validation, and association with adjustment. (Unpublished manuscript). Department of Psychology, University of Columbia, Canada.

    • Search Google Scholar
    • Export Citation

  • Frost, R.O., & Henderson, K.J. (1991). Perfectionism and reactions to athletic competition. Journal of Sport & Exercise Psychology, 13, 323–335. doi:10.1123/jsep.13.4.323

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Frost, R.O., Marten, P., Lahart, C., & Rosenblate, R. (1990). The dimensions of perfectionism. Cognitive Therapy and Research, 14, 449–468.

  • Gardner, F.L., & Moore, Z.E. (2005). Using a case formulation approach in sport psychology consulting. The Sport Psychologist, 19, 430–445. doi:10.1123/tsp.19.4.430

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Gardner, F.L., & Moore, Z.E. (2006). Clinical sport psychology. Champaign, IL: Human Kinetics.

  • Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford, UK: Further Education Unit.

  • Gilman, R., & Ashby, J.S. (2006). Perfectionism. In G.G. Bear & K.M. Minke (Eds.), Children’s needs III: Development, prevention, and intervention (pp. 303–312). Bethesda, MD: National Association of School Psychologists.

    • Search Google Scholar
    • Export Citation

  • Griffith, R. (2016). What is Gillick competence? Human Vaccines and Immunotherapeutics, 12, 244–247. PubMed doi:10.1080/21645515.2015.1091548

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hall, C., Mack, D.E., & Paivio, A. (1998). Imagery use by athletes: Development of the sport imagery questionnaire. International Journal of Sport Psychology, 29(1), 73–89.

    • Search Google Scholar
    • Export Citation

  • Hanks, C.D., Parsons, J., Benninger, C., Kaeding, C., Best, T.M., Phillips, G., & Mastronarde, J.G. (2012). Etiology of dyspnea in elite and recreational athletes. The Physician and Sports Medicine, 40(2), 28–33. doi:10.3810/psm.2012.05.1962

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Holmes, P.S., & Collins, D.J. (2001). The PETTLEP approach to motor imagery: A functional equivalence model for sport psychologists. Journal of Applied Sport Psychology, 13, 60–83. doi:10.1080/10413200109339004

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Hughes, J.N., & Baker, D.B. (1990). The clinical child interview. New York, NY: Guildford Press.

  • Jackson, M.K., Burns, K.K., & Richter, M.S. (2014). Confidentiality and treatment decisions of minor clients: A health professional’s dilemma & policy maker’s challenge. SpringerPlus, 3(1), 320. doi:10.1186/2193-1801-3-320

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Juster, H.R., Heimberg, R.G., Frost, R.O., Holt, C.S., Mattia, J.I., & Faccenda, K. (1996). Social phobia and perfectionism. Personality and Individual Differences, 21, 403–410. doi:10.1016/0191-8869(96)00075-X

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Kearns, H., Forbes, A., & Gardiner, M. (2007). A cognitive behavioural coaching intervention for the treatment of perfectionism and self-handicapping in a nonclinical population. Behaviour Change, 24, 157–172. doi:10.1375/bech.24.3.157

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Keegan, R.J. (2016). Being a sport psychologist. London, UK: Palgrave.

  • McCarthy, P.J., Jones, M.V., Harwood, C.G., & Davenport, L. (2010). Using goal setting to enhance positive affect among junior multievent athletes. Journal of Clinical Sport Psychology, 4, 53–68. doi:10.1123/jcsp.4.1.53

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Mellalieu, S.D., Neil, R., Hanton, S., & Fletcher, D. (2009). Competition stress in sport performers: Stressors experienced in the competition environment. Journal of Sports Sciences, 27, 729–744. PubMed doi:10.1080/02640410902889834

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Neil, R., Mellalieu, S.D., & Hanton, S. (2006). Psychological skills usage and the competitive anxiety response as a function of skill level in rugby union. Journal of Sports Science & Medicine, 5, 415–423. PubMed

    • Search Google Scholar
    • Export Citation

  • Nock, M.K., & Prinstein, M.J. (2005). Clinical features and behavioral functions of adolescent self-mutilation. Journal of Abnormal Psychology, 114, 140–146. PubMed doi:10.1037/0021-843X.114.1.140

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Orlick, T. (2007). In pursuit of excellence (4th ed.). Champaign, IL: Human Kinetics.

  • Perkner, J., Fennelly, K., Balkissoon, R., Bartelson, B., Ruttenber, A., & Wood, R. (1998). Irritant-associated vocal cord dysfunction. Journal of Occupational and Environmental Medicine, 40, 136–143. doi:10.1097/00043764-199802000-00009

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Polman, R., Rowcliffe, N., Borkoles, E., & Levy, A. (2007). Precompetitive state anxiety, objective and subjective performance, and causal attributions in competitive swimmers. Pediatric Exercise Science, 19, 39–50. PubMed doi:10.1123/pes.19.1.39

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Pope, J., & Koenig, S. (2005). Pulmonary disorders in the training room. Clinics in Sports Medicine, 22, 161–180. doi:10.1016/j.csm.2005.05.003

    • Search Google Scholar
    • Export Citation

  • Portenga, S.T., Aoyagi, M.W., Balague, G., Cohen, A., & Harmison, B. (2011). Defining the practice of sport and performance psychology. Retrieved from http://www.apadivisions.org/division-47/about/resources/defining.pdf

    • Search Google Scholar
    • Export Citation

  • Powell, D., Karanfilov, B., Beechler, K., Treole, K., Trudeau, M., & Forrest, A. (2000). Paradoxical vocal cord dysfunction in juveniles. Archives of Otolaryngology-Head and Neck Surgery, 126, 29–34. PubMed doi:10.1001/archotol.126.1.29

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Rhodes, R.K. (2008). Diagnosing vocal cord dysfunction in young athletes. The Journal of the American Academy of Nurse Practitioners, 20, 608–613. PubMed doi:10.1111/j.1745-7599.2008.00363.x

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Roberts, C.-M. (2015, July). Enhancing adolescent sports performance through parental educational interventions. Paper presented at the 14th European Congress of Psychology, Milan, Italy.

    • Search Google Scholar
    • Export Citation

  • Rumbold, J.L., Fletcher, D., & Daniels, K. (2012). A systematic review of stress management interventions with sport performers. Sport, Exercise, and Performance Psychology, 1, 173–193. doi 10.1037/a0026628

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Rundell, K., & Spiering, B. (2003). Inspiratory stridor in elite athletes. Chest, 123, 468–474. PubMed doi:10.1378/chest.123.2.468

  • Sapieja, K.M., Dunn, J.G.H., & Holt, N.L. (2011). Perfectionism and perceptions of parenting styles in male youth soccer. Journal of Sport & Exercise Psychology, 33, 20–39. PubMed doi:10.1123/jsep.33.1.20

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Shafran, R., Cooper, Z., & Fairburn, C.G. (2002). Clinical perfectionism: A cognitive-behavioural analysis. Behaviour Research and Therapy, 40, 773–791. PubMed doi:10.1016/S0005-7967(01)00059-6

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Smith, R.E., Smoll, F.L., Cumming, S.P., & Grossbard, J.R. (2006). Measurement of multidimensional sport performance trait anxiety in children and adults: The sport anxiety scale-2. Journal of Sport & Exercise Psychology, 28, 479–501. doi:10.1123/jsep.28.4.479

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Stadulis, R.E., MacCracken, M.J., Eidson, T.A., & Severance, C. (2009). A children’s form of the competitive state anxiety inventory: The CSAI-2C. Measurement in Physical Education and Exercise Science, 6, 147–165. doi:10.1207/S15327841MPEE0603_1

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Stoebera, J., Otto, K., Pescheck, E., & Becker, C. (2007). Perfectionism and competitive anxiety in athletes: Differentiating striving for perfection and negative reactions to imperfection. Personality and Individual Differences, 42, 959–969. doi:10.1016/j.paid.2006.09.006

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Stornelli, D., Flett, G., & Hewitt, P. (2009). Perfectionism, achievement, and affect in children: A comparison of students from gifted, arts, and regular programs. Canadian Journal of School Psychology, 24, 267–283. doi:10.1177/0829573509342392

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Taylor, J., & Schneider, B. (1992). The sport-clinical intake protocol: A comprehensive interviewing instrument for applied sport psychology. Professional Psychology: Research and Practice, 23, 318–325. doi 10.1037/0735-7028.23.4.318

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Williams, S.E., Cooley, S.J., Newell, E., Weibull, F., & Cumming, J. (2013). Seeing the difference: Developing effective imagery scripts for athletes. Journal of Sport Psychology in Action, 4, 109–121. doi:10.1080/21520704.2013.781560

    • Crossref
    • Search Google Scholar
    • Export Citation

  • Wilson, J., & Wilson, E. (2006). Practical management: Vocal cord dysfunction in athletes. Clinics in Sports Medicine, 16, 357–360. doi:10.1097/00042752-200607000-00014

    • Crossref
    • Search Google Scholar
    • Export Citation
All Time Past Year Past 30 Days
Abstract Views 2020 1404 8
Full Text Views 38 9 2
PDF Downloads 41 14 4