Catastrophizing and Fear of Tinnitus Predict Quality of Life in Patients With Chronic Tinnitus (original) (raw)
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The Role of Fear-Avoidance Cognitions and Behaviors in Patients with Chronic Tinnitus
Cognitive Behaviour Therapy, 2012
The current study investigated the role of fear-avoidance-a concept from chronic pain research-in chronic tinnitus. A self-report measure the "Tinnitus Fear-Avoidance Cognitions and Behaviors Scale (T-FAS)" was developed and validated. Furthermore, the role of fear-avoidance behavior as mediator of the relationship between anxiety sensitivity and tinnitus handicap was investigated. From a clinical setting, N ¼ 373 patients with chronic tinnitus completed questionnaires assessing tinnitus handicap (Tinnitus Handicap Inventory), anxiety, depression (Hospital Anxiety and Depression Scale), anxiety sensitivity (Anxiety Sensitivity Index-3), personality factors (Big Five Inventory-10), and fear-avoidance. To analyze the psychometric properties, principal component analysis with parallel component extraction and correlational analyses were used. To examine a possible mediating effect, hierarchical regression analysis was applied. The principal component analysis resulted in a three-factor solution: Fear-avoidance Cognitions, Tinnitus-related Fear-Avoidance Behavior, and Ear-related Fear-Avoidance Behavior. Internal consistency was satisfactory for the total scale and all subscales. High correlations between tinnitus-related handicap scales, depressive and anxiety symptoms, and the T-FAS were found, whereas associations with personality factors were low. Moreover, results indicate a significant partial mediation of fearavoidance behaviors in the relationship between anxiety sensitivity and the cognitive dimension of tinnitus handicap. Results show that fear-avoidance behavior plays an important role in tinnitus handicap. More attention should be paid to this concept in research and clinical practice of psychotherapy for chronic tinnitus.
Journal of Experimental Psychopathology
The current study is the first substantial investigation to determine whether tinnitus perception mediates the relationship between physiological and psychological problems (PP). Simple random sampling, with a cross-sectional design, was used to collect data from 100 adult patients (males = 60; females = 40) diagnosed with chronic tinnitus. Subjects were approached through various public and private hospitals, at their respective Audiology and Ear, Nose, and Throat departments in Rawalpindi and Lahore, Pakistan. Participants underwent complete physiological and psychological tinnitus evaluations, such as tinnitus matching and audiometry, as well as assessments using standardized tinnitus instruments. The mediation analyses revealed an indirect relationship with hearing loss (HL) and PP (e.g., anxiety, stress, depression, mood swings) in tinnitus patients. These findings suggest that physiological problems such as tinnitus and HL might contribute to the development of psychological s...
2013
Objective: Persistent tinnitus affects 10 to 15% of adults. Little is understood about why only a small percentage of patients become severely affected. Catastrophic thinking has been suggested as one potentially relevant factor that might infl uence a patient ' s coping behavior, and thus tinnitus habituation. The current study investigates the concept of tinnitus catastrophizing and its relation with distress and medical utilization in recent onset tinnitus. Design: Participants were administered a survey assessing catastrophizing, tinnitus distress, medical utilization, coping, and mood disturbance. Regression analyses investigated the nature of tinnitus catastrophizing and its contributions to distress and health care utilization. Study sample: 278 subjects with tinnitus for less than six months were recruited from Ear-Nose-Throat units, through the internet, and newspaper articles. Results: Controlling for background variables, high subjective tinnitus loudness, low behavioral coping, and depressive symptoms were signifi cantly associated with tinnitus catastrophizing. Furthermore, greater tinnitus catastrophizing was related to higher distress and more frequent medical visits. Conclusions: Tinnitus catastrophizing appears to be pivotal already at an early stage of tinnitus experience. Addressing catastrophizing by specifi c prevention and intervention programs might reduce the development of distress and medical utilization in the long term. Longitudinal studies are required to clarify cause-effect relations.
Quality of Life Research, 2012
Purpose To determine the prevalence and severity of psychological comorbidity in patients with chronic tinnitus in comparison with other chronic illnesses, namely chronic pain, chronic asthma and atopic dermatitis. Methods Psychological diagnoses were done according to ICD-10 Chapter V(F). Subjective impairment was evaluated using 5 psychometric questionnaires: tinnitus questionnaire, Berlin mood questionnaire, sense of coherence (SOC-L9) and perceived stress questionnaire. Sleep disturbance was measured by the subdomain 'exhaustion' of the Giessen physical complaints inventory. Results Somatoform or affective disorders were most frequent in all disease groups. Patients with chronic tinnitus had a stronger SOC and better subjective mood, stronger commitment, and less anger and anxious depression than the patients with chronic pain, chronic asthma or atopic dermatitis. However, in patients with higher tinnitus annoyance, psychological comorbidity was similar to that found in patients with other chronic diseases. Conclusions Besides collecting medical and social history, special psychometric instruments should be used for the diagnosis of tinnitus patients. Based on relative high frequency of psychological comorbidity, we recommend interdisciplinary cooperation between otorhinolaryngologists and other specialists (psychosomatic medicine, psychology or psychiatry) during the treatment of tinnitus patients, especially when high degree of tinnitus annoyance is involved.
The incidence of anxiety in patients with chronic subjective tinnitus
Биомедицинска истраживања
Introduction. Tinnitus is a perception of a sound in the ears in the absence of acoustic stimulation whose pathophysiological mechanisms have not been evaluated yet. Approximately, 1-2% of people report distress which can negatively affect their daily performance. Our study aimed to assess the incidence of anxiety in patients with tinnitus. Methods. The study was designed as a cross-sectional study. The participants were divided into two groups: a group of 73 patients with tinnitus (with two subgroups in relation to the duration of tinnitus-less than one year and more than one year) and a control group of 43 patients without tinnitus. We examined the presence of anxiety in all patients using the Burns Anxiety Inventory (BAI). The quality of life of all patients was estimated by Tinnitus Handicap Inventory (THI). Results. In the group of patients with tinnitus, 56.2% of them had mild and 24.7% moderate hearing loss, while 27.7% of respondents from control group had mild and 8.5% mode...
The impact of co-morbid factors on the psychological outcome of tinnitus patients
European Archives of Oto-Rhino-Laryngology, 2012
The study was carried out to determine the impact of some co-morbid otological symptoms and demographic factors on the emotional distress and cognitive functioning in patients with tinnitus. One hundred consecutive patients, complaining of constant idiopathic tinnitus, were enrolled into the study. Four tests were administered: Beck Depression Inventory, Hospital Anxiety Depression Scale (HADS, A-anxiety, D-depression), Mini-Mental State Examination (MMSE) and Trail Making Test (TMT). A multivariate stepwise linear regression analysis was performed to estimate the relationship between the results of each of the tests and following co-morbid factors: age, sex, tinnitus duration, tinnitus laterality, hearing status (normal hearing, unilateral hearing loss and bilateral hearing loss) and vertigo/dizziness. It was found that the scores of MMSE and TMT were negatively correlated with age and with hearing status and the scores of HADS-A were slightly correlated with sex. In regression analysis, in HADS-A, sex and to a lesser extent tinnitus duration, in MMSE and TMT age and to a lesser extent tinnitus laterality were the variables that were comprised in the final model. Demographic factors had contributed more than overlapping otological symptoms to the psychological outcome in tinnitus patients.
A psychometric study of complaints in chronic tinnitus
Journal of Psychosomatic Research, 1992
Dimensions of psychological complaints due to chronic and disabling tinnitus were investigated by means of the Tinnitus Questionnaire (TQ), administered to a sample of 138 tinnitus sufferers who had been admitted to a psychosomatic hospital. Factor analysis revealed that tinnitus-related patterns of emotional and cognitive distress, intrusiveness, auditory perceptual difficulties, sleep disturbances, and somatic complaints can be differentiated. Cognitive distortions and inappropriate attitudes towards the tinnitus and it's personal consequences were found to be highly intercorrelated forming a subgroup within a broader and more general distress factor. The stability of the factor solution obtained was examined by systematically varying the number of factors to be extracted. Based on the results of this method, scales are proposed for the questionnaire which can be used in clinical and scientific work to specifically assess major areas of tinnitus-related distress and their degree of severity. Implications for a further evaluation of the instrument are discussed.
Evaluation of a model of distress related to tinnitus
International Journal of Audiology, 2009
This study tested a theoretical model of tinnitus-related distress and of general distress that involved acceptance of tinnitus symptoms and emotional intelligence as factors that may protect against such distress. One hundred and sixty-two tinnitus sufferers from throughout Australia completed measures of acceptance of tinnitus symptoms, emotional intelligence, tinnitus-related distress, and general distress. As hypothesized, greater acceptance of tinnitus symptoms was associated with less tinnitusrelated distress. Emotional intelligence was not associated with tinnitus distress. Greater acceptance and less tinnitus distress were both associated with less general distress, and the association between acceptance and general distress was mediated by tinnitus-related distress. The findings, which provide partial support for the tested model, may have implications for efforts to assist distressed tinnitus sufferers.
Relationship between Subjective Tinnitus Perception and Psychiatric Discomfort
The International Tinnitus Journal, 2016
Introduction: tinnitus patients have higher risk of developing anxiety-depressive disorders and decreased quality of life. The reasons why selected patients are able to cope with chronic tinnitus, whereas it represents a disabling symptom for others remain under discussion. Objectives: the objective of the study was to determine the tinnitus-related degree of distress along with the prevalence of anxiety-depression disorders in a sample of eighty patients referring for chronic tinnitus at the Department of Otolaryngology of Catholic University of Rome from March to September 2015. Materials and Methods: we administered to all patients the Italian versions of Tinnitus Handicap Inventory (THI) and Hospital Anxiety and Depression Scale (HADS). Furthermore we investigated the correlation among patient's discomfort, severity of hearing loss and age. Results: average THI score was 40.85, meaning moderate degree of discomfort; 57.5% of the patients showed HADS scores consistent with high risk of psychiatric comorbidities. A significant linear correlation between THI and HADS scores was demonstrated. Conclusion: we suggest that patients with severe tinnitus-related distress are routinely invited to accomplish psychometric questionnaires, to assess the possibility of a neuropsychiatric evaluation and/or specific pharmacological planning. At this purpose we recommend the administration of HADS, as a reliable and quick instrument.
Tinnitus severity and its association with cognitive and somatic anxiety: a critical study
European Archives of Oto-Rhino-Laryngology, 2012
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