Open Access Open Access  Restricted Access Subscription or Fee Access

Effects of long- and short-term experiences on stress during identification works of dead bodies: Rapid stress level measurement using voice

Masakazu Higuchi, PhD, Isao Yamamoto, PhD, Yasuhiro Omiya, PhD, Mitsuteru Nakamura, PhD, Shuji Shinohara, PhD, Takeshi Takano, BE, Kimiko Nakagawa, PhD, Hiroshi Ohira, PhD, Yoshihiro Yamada, PhD, Shinichi Tokuno, MD, DMCC, PhD


Objective: The mental health issues of personnel dealing with the deceased at times of disasters is a problem and techniques are needed that allow for real-time, easy-to-use stress checks. We have studied techniques for measuring mental state using voice analysis which has the benefit of being non-invasive, easy-to-use, and can be performed in real-time. For this study, we used voice measurement to determine the stress experienced during body identification training workshops for dentists. We studied whether or not stress levels were affected by having previous experience with body identification either in actual disaster settings or during training.

Design: Since participants training using actual dead bodies in particular are expected to suffer higher stress exposure, we also assessed their mental state pre- and post-training using actual dead bodies.

Results: The results confirmed marked differences in the mental state between before and after training in participants without any actual experience, between participants who engaged in training using manikins before actual dead bodies and participants who did not.

Conclusions: These results suggest that, in body identification training, the level of stress when coming into contact with dead bodies varies depending on participants’ experience and the training sequence. Moreover, it is believed that voice-based stress assessment can be conducted in the limited time during training sessions and that it can be usefully implemented in actual disaster response settings.


disaster medicine, body identification, stress evaluation, voice biomarker

Full Text:



Shigemura J, Someda H, Tokuno S, et al.: Disaster victim identification: psychological distress and posttraumatic stress in dentists after the 2011 Fukushima disaster. Psychiatry. 2018; 81(1): 85-92.

Ursano RJ, McCarroll JE: The nature of a traumatic stressor: handling dead bodies. J Nerv Mental Dis. 1990; 178(6): 396-398.

Katayama K, Itoga H, Someda H: Lessons learned from dental activities in the Great East Japan Earthquake disaster relief mission (First Report): Disaster victim identification activities conducted by Japan Self-Defense Forces Dental Officers. Natl Def Med J. 2012; 59(12): 131-139 [in Japanese].

McCarroll JE, Fullerton CS, Ursano RJ, et al.: Posttraumatic stress symptoms following forensic dental identification: Mt. Carmel, Waco, Texas. Am J Psychiatry. 1996; 153(6): 778-782.

Yamamoto I, Ohira H, Yamado Y, et al.: Identification training program using a cadaver-like dental mannequin. Jpn J Disaster Med. 2016; 21(2): 173-178 [in Japanese].

Goldberg DP: Manual of the General Health Questionnaire, Windsor, England, UK: NFER Publishing, 1978.

Beck AT, Ward CH, Mendelson M, et al.: An inventory for measuring depression. Arch Gen Psychiatry. 1961; 4(6): 561-571.

Delgado-Rodriguez M, Llorca J: Bias. J Epidemiol Commun Health. 2004; 58(8): 635-641.

Izawa S, Sugaya N, Shirotsuki K, et al.: Salivary dehydroepiandrosterone secretion in response to acute psychosocial stress and its correlations with biological and psychological changes. Biol Psychol. 2008; 79(3): 294-298.

Suzuki G, Tokuno S, Nibuya M, et al.: Decreased plasma brain-derived neurotrophic factor and vascular endothelial growth factor concentrations during military training. PloS One. 2014; 9(2): e89455.

Tokuno S, Mitsuyoshi S, Suzuki G, et al.: Stress evaluation by voice: A novel stress evaluation technology. Proceedings of the 9th International Conference on Early Psychosis. Tokyo, Japan, November 17-19, 2014.

Omiya Y, Shinohara S, Higuchi M, et al.: Stress evaluation using voice in dental identification work of dead body. Abstracts of Neuroscience 2017. Washington, DC, November 11-15, 2017.

Higuchi M, Yamamoto I, Omiya Y, et al.: Measurement of stress level to prevent post-traumatic stress disorder developed by identifying dead bodies. Econophys, Sociophys Other Multidiscip Sci J. 2017; 7(1): 13-18.

Hagh-Shenas H, Goodarzi MA, Dehbozorgi G, et al.: Psychological consequences of the Bam earthquake on professional and nonprofessional helpers. J Trauma Stress. 2005; 18(5): 477-483.

Bryant RA, Harvey AG: Posttraumatic stress reactions in volunteer firefighters. J Traumatic Stress. 1996; 9(1): 51-62.

Omiya Y, Hagiwara N, Shinohara S, et al.: Development of mind monitoring system using call voice. Abstracts of Neuroscience 2016. San Diego, November 12-16, 2016.

Mitsuyoshi S, Tanaka Y, Ren F, et al.: Emotion voice analysis system connected to the human brain. Proceedings of the 12th International Conference on Natural Language Processing and Knowledge Engineering. Beijing, China, December 7-10, 2007, pp. 479–484.

Tokuno S: Pathophysiological voice analysis for diagnosis and monitoring of depression. In Kim YK (ed.): Understanding Depression. Singapore: Springer, 2018, pp. 83-95.

Higuchi M, Nakamura M, Shinohara S, et al.: Effectiveness of a voice-based mental health evaluation system for mobile devices: prospective study. JMIR Form Res. 2020; 4(7): e16455.

R Foundation for Statistical Computing: R: A language and environment for statistical computing: Available at Accessed July 1, 2019.

Tukey JW: Comparing individual means in the analysis of variance. Biometrics. 1949; 5(2): 99-114.

Herman JP, Cullinan WE: Neurocircuitry of stress: Central control of the hypothalamo-pituitary-adrenocortical axis. Trends Neurosci. 1977; 20(2): 78-84.



  • There are currently no refbacks.