Ned i bråddjupet : Några kvinnors upplevelser av utbrändhet, coping och förändring

Syftet med studien var att undersöka kvinnors upplevelser av utbrändhet ur ett somatiskt, psy¬kiskt och socialt perspektiv. Vidare var syftet att belysa de copingstrategier som kvinnorna använt sig av för att kunna återgå till arbetet. Ett ytterligare syfte var att belysa hur ovanstående aspekter förändrats enligt kvinnorna efter utbrändheten och vilka copingstrategier de använt sig av för att förhindra ny utbrändhet. Fem kvinnor intervjuades och materialet analyserades med hjälp av teoristyrd och induktiv tematisk analys. Resultatet kopplades sedan till teo¬rin om kognitiv värdering, self-efficacy teorin och teorier om naturens och den fysiska aktivitetens betydelse för välmåendet. Resultatet visade att samtliga kvinnor upplevt somatiska, psykiska och sociala problem vid tiden innan, under och i viss mån efter utbrändheten. Kvinnorna använde sig inledningsvis av problemfokuserad coping (ex. samtalsterapi) i kombination med emotionsfokuserad coping (ex. socialt stöd) för att i slutskedet inbegripa enbart emo¬tionsfokuserad coping (socialt stöd, yoga, naturen) . Vidare var ett resultat att samtliga kvinnor upplevde högre grad av självtro och självmedvetenhet efter tiden som utbrända

Tal som störning vid språklig kommunikation : Betydelsen av inhibitionskontroll och arbetsminneskapacitet

Age affects hearing and cognitive abilities. Older people, with and without hearing impairment (HI), exhibit difficulties in hearing speech in noise. Elderly individuals show greater difficulty in segregating target speech from distracting background noise, especially if the noise is competing speech with meaningful contents, so called informational maskers. Working memory capacity (WMC) has proven to be a crucial factor in comprehending speech in noise, especially for people with hearing loss. In auditory scenes where speech is disrupted by competing speech, high WMC has proven to facilitate the ability to segregate target speech and inhibit responses to irrelevant information. People with low WMC are more prone to be disrupted by competing speech and exhibit more difficulties in hearing target speech in complex listening environments. Furthermore, elderly individuals with a HI experience more difficulties in switching attention between wanted and irrelevant stimuli, and they employ more resources and time to attend to the stimuli than do normally - hearing (NH) younger adults. This thesis investigated the importance of inhibitory control and WMC for speech recognition in noise, and perceived listening effort. Four studies were conducted. In the first study, the aim was to develop a test of inhibitory control for verbal content, and to investigate the relation between inhibitory control and WMC, and how these two abilities related to speech recognition in noise, in young normally – hearing (YNH) individuals. In the second study we aimed to investigate the same relationship as in the first study to further strengthen the validity of the inhibitory test developed, as well as the importance of lexical access. It was also an aim to investigate the influence of age and hearing status on lexical access and WMC, and their respective roles for speech recognition in noise in both YNH and elderly HI (EHI) individuals. Study one and two showed that, for YNH, inhibitory control was related to speech recognition in noise, indicating that inhibitory control can help to predict speech recognition in noise performance. The relationship between WMC and speech recognition in noise in YNH shifted in the studies, suggesting that this relationship is multifaceted and varying. Lexical access was of little importance for YNH, although for EHI individuals, both WMC and lexical access was of importance for speech recognition in noise, suggesting that different cognitive abilities were of importance for the YNH and EHI individuals Study three investigated the relationship between inhibitory control, WMC, speech recognition in noise, and perceived listening effort, in YNH and elderly, for their age, NH, individuals (ENH). In study four the same relationships as in study three were investigated, albeit in EHI individuals. Two speech materials with different characteristics, masked with four background noises were used. The results in study three showed that less favourable SNRs were needed for informational maskers than for maskers without semantic content. ENH individuals were more susceptible to informational maskers than YNH individuals. In contrast, in study four, more favourable SNRs were needed for informational maskers. In both studies, results showed that speech recognition in noise performance differed depending on the characteristics of the speech material. The studies showed that high WMC, compared to low WMC, was beneficial for speech recognition in noise, especially for informational maskers, and resulted in lower ratings of perceived effort. Varying results were found in study three and four regarding perceived effort and inhibitory control. In study three good inhibitory control was associated with lower effort rating, while in study four, individuals with a HI and good inhibitory control rated effort as higher. The results suggest that hearing status, age, and cognitive abilities, contribute to the differences in performance between YNH, ENH, and EHI individuals in speech – recognition – in – noise - and cognitive tasks. This thesis has, for the first time, demonstrated that a measure of inhibitory control of verbal content, is related to speech recognition in noise performance in YNH, ENH and EHI individuals. Results presented in this thesis also show that both WMC and inhibitory control are related to an individuals’ perception of how effortful a listening task is. It also adds to the literature that WMC is related to speech recognition in noise performance for ENH and EHI individuals, but that this relationship is not as robust in YNH individuals.Ålder påverkar hörseln och de kognitiva förmågorna. Äldre personer, med och utan hörselnedsättning, uppvisar ofta svårigheter att höra tal i miljöer med bakgrundsljud. De uppvisar större svårigheter att urskilja en måltalare, speciellt om det omgivande ljudet består av annat tal med meningsfullt innehåll, så kallad informationsmaskering. Arbetsminne har visat sig vara en viktig faktor för att förstå tal – i – brus, framför allt för personer med hörselnedsättning. I ljudmiljöer där tal störs av andra talkällor är hög arbetsminneskapacitet av vikt för att understödja förmågan att urskilja måltalaren från de störande talkällorna genom att underlätta inhiberingen av irrelevant information. Individer med lägre arbetsminneskapacitet är mer benägna att störas av andra talkällor, och har svårare att uppfatta måltalaren i komplexa lyssningssituationer. Vidare upplever äldre personer med hörselnedsättning att det är svårare att skifta uppmärksamheten mellan relevant och irrelevant stimuli, och de använder mer resurser och tid till omgivande stimuli än, ex. yngre individer med normal hörsel. I den här avhandlingen undersöktes vikten av inhibitionskontroll och arbetsminne vid taluppfattning i brus och upplevelsen av lyssningsansträngning. Fyra studier genomfördes. Syftet med första studien var att utveckla ett test för verbal inhibitionskontroll, och att undersöka relationen mellan inhibitionskontroll, arbetsminneskapacitet, och deras koppling till taluppfattning i brus hos yngre normalhörande personer. I studie två undersöktes ovanstående relationer för att vidare styrka validiteten för testet av inhibitionskontroll, samt vikten av lexikal åtkomst. Vidare syfte var att undersöka ålderns och hörselns inverkan på lexikal åtkomst och arbetsminneskapacitet, och deras respektive roller för taluppfattning i brus hos både yngre normalhörande och äldre hörselnedsatta personer. Studie ett och två visade att inhibitionskontroll var relaterad till taluppfattning i brus för yngre normalhörande personer, vilket indikerar att inhibitionskontroll kan användas för att underlätta att förutsäga förmågan att uppfatta tal – i – brus. Relationen mellan arbetsminneskapacitet och taluppfattning i brus hos yngre normalhörande var inte solid, vilket tyder på att relationen är mångsidig och skiftande. Lexikal åtkomst var av mindre betydelse för yngre normalhörande personer, ehuru hos äldre hörselskadade personer var både arbetsminneskapacitet och lexikal åtkomst viktigt för taluppfattning i brus. Detta tyder på att olika kognitiva förmågor var betydelsefulla för taluppfattningen i brus för yngre normalhörande och äldre hörselskadade personer. Studie tre undersökte relationen mellan inhibitionskontroll, arbetsminneskapacitet, taluppfattning i brus, och upplevd lyssningsansträngning hos yngre och äldre, för sin ålder, normalhörande personer. Två talmaterial med olika karakteristika användes och maskerades med fyra olika bakgrundsbrus. Resultatet visade att mindre gynnsamma signal – brus - förhållanden uppnåddes när informationsmaskering användes jämfört med brus utan semantiskt innehåll. Äldre normalhörande personer var mer mottagliga för informationsmaskering än yngre normalhörande personer. Hög arbetsminneskapacitet och god inhibitionskontroll var förmånliga för taluppfattning i brus, och resulterade i mindre upplevd lyssningsansträngning, jämfört med personer med lägre arbetsminneskapacitet och sämre inhibitionskontroll. Resultaten talar för att åldersrelaterade tillbakagångar i hörförmåga och, vissa, kognitiva förmågor, bidrar till skillnaderna i prestation mellan yngre och äldre normalhörande personer när det gäller förmågan att uppfatta tal - i - brus. Studie fyra undersökte samma relationer som i studie tre, ehuru hos äldre personer med mild – måttlig sensorineural hörselnedsättning. Resultaten visade att förmågan att uppfatta tal - i - brus varierade beroende på talmaterialets karakteristika, samt vilket bakgrundsbrus som användes. Hög arbetsminneskapacitet och god inhibitionskontroll var fördelaktiga för taluppfattningen, i synnerhet när informationsmaskering användes. Personer med högt arbetsminne upplevde mindre lyssningsansträngning, medan god inhibitionskontroll associerades med högre upplevd lyssningsansträngning. I föreliggande avhandling har det, för första gången, påvisats att verbal inhibitionskontroll relaterar till förmågan att uppfatta tal – i – brus hos yngre och äldre normalhörande, och äldre personer med hörselnedsättning. Resultaten som presenterats i avhandlingen visar att både arbetsminneskapacitet och inhibitionskontroll är associerade med en individs upplevelse av hur ansträngande en lyssningssituation är. Avhandlingen stödjer även tidigare forskning som visar på att arbetsminneskapaciteten är relaterad till förmågan att uppfatta tal – i – brus hos äldre  normalhörande, och äldre hörselskadade personer, men att denna relation inte är lika solid för yngre normalhörande personer

WMC, Inhibitory Control, Mask Type, Speech in Noise Recognition, and Listening Effort

Pre-processing and data analysis scripts (R) for the manuscript submitted to Journal of Speech, Language, and Hearing Research (JSLHR-21-00821). Note, the data analysis and data visualisation scripts are just for the 1st revision

The role of cognitive abilities in younger and older normally hearing adults when listening to speech under adverse conditions

Cognitive abilities, such as working memory capacity (WMC), lexical decision making, and cognitive inhibition, can help predict performance on speech-recognition-in-noise tasks. Working memory is assumed to play a major part in every day listening situations, storing and actively working with relevant information, while inhibitory control helps to suppress and separate irrelevant information from interfering with the information processing. With increasing age, comes decreasing cognitive abilities, such as declines in WMC, speed of information processing, and inhibitory control, leading to problems when selectively attending to speech while inhibiting interfering distractors. The aim of the present study was to examine age-related declines in WMC, inhibitory control, and lexical decision making, and their respective roles when listening to speech under adverse listening conditions. Twenty-four young normally-hearing (NH), and 24 elderly ( for their age) NH individuals participated in the study. They completing a cognitive test battery assessing WMC, cognitive inhibition, and lexical decision making, as well as a closed-set (Hagerman sentences) and an open-set (HINT) speech-recognition-in-noise task masked with different maskers. We will present results comparing cognitive abilities in younger normally-hearing individuals with elderly normally-hearing individuals, and how age and cognitive abilities relates to performance on speech-recognition-in-noise tasks.Tal som störning vid språklig kommunikatio

Cognitive inhibition, WMC, and speech-recognition-in-noise

Cognitive abilities are important for a number of human attributes, such as making sense of communication, holding information active in memory, and making decisions. When it is the goal to focus on a single target voice, and resist intrusions from irrelevant information, cognitive inhibition can aid us in our endeavour. Cognitive inhibition is thought to support and co-operate with working memory. Abilities such as cognitive inhibition and working memory are also important for speech processing, even more so when listening to speech under adverse conditions. In order to assess different difficulties that can arise in every day listening situations, it´s of importance to have solid methods for measuring cognitive abilities. In the present study we present a task assessing cognitive inhibition, and how it relates to individual working memory capacity (WMC), and speech-recognition-in-noise. Forty-six young normally-hearing individuals were presented with a cognitive test battery, as well as a speech-in-noise test. Our results suggest that individuals with high WMC, also exhibit good cognitive inhibition. The results also indicate that those who perform well in the cognitive inhibition task need less favourable signal-to-noise-ratios in the speech-recognition task. Our findings indicate that capacity to resist semantic interference can be used to predict performance in speech-recognition tasks when listening under adverse conditions. Tal som störning vid språklig kommunikatio

the Speech recognition under adverse listening conditions in young normally-hearing listeners

In the present study we aimed to investigate individual differences in cognitive inhibition, WMC, and how they relate to performance on a speech-recognition-in-noise task. Sixteen young normally-hearing individuals were presented with a cognitive test battery, as well as a sentence corpus masked by 5 different maskers, targeting 80% speech-recognition. One masker was a slightly modulated (10%) speech-shaped noise (SSN), 2 maskers were constructed by modulating the SSN with the envelopes from a single female talker, and the international speech test signal (ISTS). We also masked the target sentences with the ISTS, and a single female talker reading a passage in a Swedish newspaper. Our results showed that cognitive inhibition is significantly related to performance when maskers with meaningful, semantic information is used. The results further indicate that young normally-hearing individuals can take advantage of temporal and spectral dips to fill in missing information. Our findings suggest that choice of speech material is of importance for the outcome in speech-recognition-in-noise tasks. We further propose that tasks of cognitive inhibition can be used to predict performance in a speech-recognition task.Tal som störning vid språklig kommunikatio

Informational masking and listening effort in speech recognition innoise : the role of working memory capacity and inhibitory control in older adults with and without hearing impairmen

Purpose: The study aimed to assess the relationship between 1) speech-recognition-in-noise, mask type, working memory capacity (WMC), inhibitory control, and 2) self-rated listening effort, speech material, and mask type, in older adults with and without hearing-impairment. It was of special interest to assess the relationship between WMC, inhibitory control, and speech-recognition-in-noise when informational maskers masked target speech. Method: A mixed design was used. A group (N= 24) of older (mean age = 69.7 years) HI individuals, and a group of age-normal hearing adults (mean age = 59.3 years, SD = 6.5) participated in the study. The participants were presented with auditory tests in a sound attenuated room and the cognitive tests in a quiet office. The participants were asked to rate listening effort after being presented with energetic and informational background maskers in two different speech materials used in this study (i.e., Hearing in Noise Test and the Hagerman Test). Linear-Mixed Effects models were set up to assess the effect of the two different speech materials, energetic and informational maskers, hearing ability, WMC, inhibitory control, and self-rated listening effort. Results: Results showed that WMC and inhibitory control was of importance for speech-recognition-in-noise, even when controlling for PTA4 (pure tone average 4) hearing thresholds and age, when the maskers were informational. Concerning listening effort, on the other hand,  the results suggest that hearing ability, but not cognitive abilities, is important for self-rated listening effort in speech-recognition-in-noise. Conclusion: Speech-in-noise recognition is more dependent on WMC for older adults in informational maskers than in energetic maskers. Hearing ability is a stronger predictor than cognition for self-rated listening effort

Is Having Hearing Loss Fundamentally Different? : Multigroup Structural Equation Modeling of the Effect of Cognitive Functioning on Speech Identificatio

Objectives: Previous research suggests that there is a robust relationship between cognitive functioning and speech-in-noise performance for older adults with age-related hearing loss. For normal-hearing adults, on the other hand, the research is not entirely clear. Therefore, the current study aimed to examine the relationship between cognitive functioning, aging, and speech-in-noise, in a group of older normal-hearing persons and older persons with hearing loss who wear hearing aids. Design: We analyzed data from 199 older normal-hearing individuals (mean age = 61.2) and 200 older individuals with hearing loss (mean age = 60.9) using multigroup structural equation modeling. Four cognitively related tasks were used to create a cognitive functioning construct: the reading span task, a visuospatial working memory task, the semantic word-pairs task, and Raven’s progressive matrices. Speech-in-noise, on the other hand, was measured using Hagerman sentences. The Hagerman sentences were presented via an experimental hearing aid to both normal hearing and hearing-impaired groups. Furthermore, the sentences were presented with one of the two background noise conditions: the Hagerman original speech-shaped noise or four-talker babble. Each noise condition was also presented with three different hearing processing settings: linear processing, fast compression, and noise reduction. Results: Cognitive functioning was significantly related to speech-in-noise identification. Moreover, aging had a significant effect on both speech-in-noise and cognitive functioning. With regression weights constrained to be equal for the two groups, the final model had the best fit to the data. Importantly, the results showed that the relationship between cognitive functioning and speech-in-noise was not different for the two groups. Furthermore, the same pattern was evident for aging: the effects of aging on cognitive functioning and aging on speech-in-noise were not different between groups. Conclusion: Our findings revealed similar cognitive functioning and aging effects on speech-in-noise performance in older normal-hearing and aided hearing-impaired listeners. In conclusion, the findings support the Ease of Language Understanding model as cognitive processes play a critical role in speech-in-noise independent from the hearing status of elderly individuals.Funding: The research was supported by three grants: the Linnaeus Centre HEAD excellence center grant (349-2007-8654) from the Swedish Research Council, a program grant from FORTE (2012-1693), awarded to JRas PI, and a grant from the Swedish Research Council, awarded to Dr. Fridberger (VR-2017-06092)</p

Relationships between behavioural and self-report measures in speech recognition in noise

Objective Using data from the n200-study, we aimed to investigate the relationship between behavioural (the Swedish HINT and Hagerman speech-in-noise tests) and self-report (Speech, Spatial and Qualities of Hearing Questionnaire (SSQ)) measures of listening under adverse conditions. Design The Swedish HINT was masked with a speech-shaped noise (SSN), the Hagerman was masked with a SSN and a four-talker babble, and the subscales from the SSQ were used as a self-report measure. The HINT and Hagerman were administered through an experimental hearing aid. Study sample This study included 191 hearing aid users with hearing loss (mean PTA4 = 37.6, SD = 10.8) and 195 normally hearing adults (mean PTA4 = 10.0, SD = 6.0).ResultsThe present study found correlations between behavioural measures of speech-in-noise and self-report scores of the SSQ in normally hearing individuals, but not in hearing aid users. Conclusion The present study may help identify relationships between clinically used behavioural measures, and a self-report measure of speech recognition. The results from the present study suggest that use of a self-report measure as a complement to behavioural speech in noise tests might help to further our understanding of how self-report, and behavioural results can be generalised to everyday functioning.Funding: FORTE, Vetenskapsradet</p

The contribution of age, working memory capacity and inhibitory control on speech-recognition-in-noise in young, and older adult listeners

Purpose The study aimed to investigate the relationship between speech recognition in noise, age, hearing ability, self-rated listening effort, inhibitory control (measured with the Swedish Hayling task), and working memory capacity (WMC; measured with the Reading Span test). Two different speech materials were used: the Hagerman test with low semantic context and Hearing in Noise Test sentences with high semantic context, masked with either energetic or informational maskers. Method A mixed design was used. Twenty-four young normally hearing (Mage = 25.6 years) and 24 older, for their age, normally hearing individuals (Mage = 60.6 years) participated in the study. Speech recognition in noise in both speech materials and self-rated effort in all four background maskers were correlated with inhibitory control and WMC. A linear mixed-effects model was set up to assess differences between the two different speech materials, the four different maskers used in the study, and if age and hearing ability affected performance in the speech materials or the various background noises. Results Results showed that high WMC was related to lower scores of self-rated listening effort for informational maskers, as well as better performance in speech recognition in noise when informational maskers were used. The linear mixed-effects model revealed differences in performance between the low-context and the high-context speech materials, and the various maskers used. Lastly, inhibitory control had some impact on performance in the low-context speech material when masked with an informational masker. Conclusion Different background noises, especially informational maskers, affect speech recognition and self-rated listening effort differently depending on age, hearing ability, and individual variation in WMC and inhibitory control