J Korean Med Sci.  2004 Dec;19(6):864-869. 10.3346/jkms.2004.19.6.864.

Roles of Cognitive Characteristics in Tinnitus Patients

• Lee SY
• Kim JH
• Hong SH
• Lee DS

• KMID: 1778570
• DOI: http://doi.org/10.3346/jkms.2004.19.6.864

Abstract

To investigate the cognitive characteristics that affect the emotional and functional distress caused by tinnitus and to decide and test the model to explain their relations, 167 patients with tinnitus, who visited Samsung Medical Center, Seoul, Korea between March 2001 and May 2002 were recruited. To examine their features related to tinnitus, the following scales were administered; Tinnitus-related basic questionnaire including dysfunctional beliefs, Tinnitus Handicap Inventory, State-Trait Anxiety Inventory, Anxious Thought and Tendencies, Self-Consciousness Scale, and modified 'catastrophic thought' from Coping Strategies Questionnaire. The results showed that the duration of experiencing tinnitus was 4.7 +/-7.1 yr, those who com-plained of hearing one sound were the most common (45.5%), and hearing sounds similarly described to whistling were the most common (22.5%). Also, there were significant correlations among tinnitus features, cognitive characteristics, and distresses from tinnitus. As a result of testing the model, Normed fit index, Incremental fit index, Tucker-Lewis index, and Comparative fit index were over .90, indicating that it is a good model, and Root mean square error of approximation showed a reasonable fit. Also, the direct effects of the trait or severity of tinnitus on distress did not appear to be significant, thus it appeared to be affecting indirectly through the cognitive characteristics. This result shows that cognitive interventions can be important for the psychological adaptations of tinnitus patients.

Keyword

Tinnitus; Cognition; Depression; Anxiety; Psychology

MeSH Terms

Anxiety Disorders/*diagnosis/*epidemiology/psychology
Cognition Disorders/*diagnosis/*epidemiology/psychology
Comorbidity
Depression/diagnosis/epidemiology/psychology
Female
Humans
Korea/epidemiology
Male
Middle Aged
Prevalence
Questionnaires
Risk Assessment/*methods
Risk Factors
Severity of Illness Index
Tinnitus/*diagnosis/*epidemiology/psychology

Figure

• 

  Fig. 1 The model for distresses from tinnitus.

Reference

1. Budd RJ, Pugh R. Tinnitus coping style and its relationship to tinnitus severity and emotional distress. J Psychosom Res. 1996. 41:327–335.

2. Coles RR. Epidemiology of tinnitus: prevalence. J Laryngol Otol. 1984. 9:7–15.

3. Halford JB, Anderson SD. Anxiety and depression in tinnitus sufferers. J Psychosom Res. 1991. 35:383–390.

4. Koo JW, Lee WC, Kim HY, Choi BC, Oh MH, Park YP. Prevalence of tinnitus and hearing thresholds of a non-noise-exposed population with and without tinnitus. Korean J Occup Environ Med. 1999. 11:323–331.

5. Veen ED, Jacobs JB, Bensing JM. Assessment of distress associated with tinnitus. J Laryngol Otol. 1998. 112:258–263.

6. Hiller W, Goebel G. Aran JM, Dauman R, editors. Psychiatric disorders and their degree of severity in patients with severe tinnitus and pain syndromes. Tinnitus 91. 1991. Bordeaux France: Proceedings of the Forth International Tinnitus Seminar;441–444.

7. Katon W, Sullivan MD, Russo J, Dobie R, Sakai C. Depressive symptoms and measures of disability: a prospective study. J Affect Disord. 1993. 27:245–254.

8. Reich GE, Baker LJ. Personality characteristics of tinnitus patients. J Laryngol Otol. 1984. 9:228–232.

9. Rizzardo R, Savastano M, Maron MB, Mangialaio M, Salvadori L. Psychological distress in patients with tinnitus. J Otolaryngol. 1998. 27:21–25.

10. Stephens RD, Hallam RS. The crown-crisp experiential index in patients complaining of tinnitus. Br J Audiol. 1985. 19:151–158.

11. Tyler RS, Baker LJ. Difficulties experienced by tinnitus sufferers. J Speech Hear Disord. 1983. 48:150–154.

12. Lindberg P, Scott B, Melin L, Lyttkens L. Long-term effect of psychological treatment of tinnitus. Scand Audiol. 1987. 16:167–172.

13. Lindberg P, Scott B, Melin L, Lyttkens L. Behavioural therapy in the clinical management of tinnitus. Br J Audiol. 1988. 22:265–272.

14. Meikle MB, Vernon J, Johnson RM. The perceived severity of tinnitus; some observations concerning a large population of tinnitus clinic patients. Otolaryngol Head Neck Surg. 1984. 92:689–696.

15. Sullivan MD, Katon W, Dobie R, Sakai C, Russo J, Harrop-Griffiths J. Disabling tinnitus: association with affective disorder. Gen Hosp Psychiatry. 1988. 10:285–291.

16. Sweetow RW. Cognitive behavioral modification in tinnitus management. Hear Instr. 1984. 35:14–19.

17. Sweetow RW. Cognitive aspects of tinnitus patient management. Ear Hear. 1986. 7:390–396.

18. Andersson G, Lyttkens L. A meta-analytic review of psychological treatments for tinnitus. Br J Audiol. 1999. 33:201–210.

19. Newman CW, Jacobson GP, Spitzer JP. Development of the Tinnitus Handicap Inventory. Arch Otolaryngol Head Neck Surg. 1996. 122:143–148.

20. Kim JH, Lee SY, Kim CH, Lim SL, Shin JN, Chung WH, Yu BH, Hong SH. Reliability and validity of a Korean adaptation of the Tinnitus Handicap Inventory. Korean J Otholaryngol. 2002. 45:328–334.

21. Spielberger CD, Gorsuch RL, Lushene RE. Manual for the state-trait anxiety inventory. 1970. Pal. Alto, CA: Consulting Psychologist Press.

22. Kim JT. Relationship between trait anxiety and sociality. 1978. Korea University;Masters Thesis.

23. Uhlenhuth EH, McCarty T, Paine S, Warner T. The revised Anxious Thoughts and Tendencies (AT&T) scale: a general measure of anxiety-prone cognitive style. J Affect Disord. 1999. 52:51–58.

24. Lim SL, Kim JH. Evaluation of catastrophizing and clinical application: a standardization study of Korean Anxious Thoughts and Tendencies Scale. Korean J Clin Psychol. 2002. 21:189–206.

25. Fenigstein A, Scheier MF, Buss AH. Public and private self-consciousness: assessment and theory. J Consult Clin Psychol. 1975. 43:522–527.

26. Kim EJ, Oh KJ. Cognitive and behavioral factors associated with persistence of depressive symptoms: 3 months' follow-up study. Korean J Clin Psychol. 1994. 13:1–19.

27. Hong S. The criteria for selecting appropriate fit indices in structural equation modeling and their rat ionales. Korean J Clin Psychol. 2000. 19:151–177.

28. Bentler PM, Bonett DG. Significance tests and goodness of fit in the analysis of covariance structure. Psychol Bull. 1980. 88:588–606.

29. Browne MH, Cudeck R. Bollen KA, Long JS, editors. Alternative ways of assessing model fit. Testing structural equation models. 1993. Newbury Park: California Sage;136–162.

30. Lee SY, Lim SL, Hong SH, Lee DS, Kim JH. Dysfunctional beliefs of tinnitus patients who suffer from depression. Korean J Clin Psychol. 2003. 22:709–723.

31. Scott B, Lindberg P, Melin L, Lyttkens L. Predictors of tinnitus discomfort, adaptation and subjective loudness. Br J Audiol. 1990. 24:51–62.

32. Andersson G. The role of psychology in managing tinnitus: a cognitive behavioral approach. Semin Hear. 2001. 22:65–76.

33. Jeong SH, Kang SH, Lee ZN, Kang BJ, Rim HD. Review of psychiatric approaches to tinnitus. J Korean Soc Biol ther Psychiatry. 1997. 3:250–257.

34. Andersson G, Stromgren T, Strom L, Lyttkens L. Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus. Psychosom Med. 2002. 64:810–816.