Results of the test of specific knowledge pre vs. post treatment in the two groups (n = 197).

***<p> = p<.001.</p

Third party disability for significant others of individuals with tinnitus: A cross-sectional survey design

Abstract: There is more awareness of third party disability,defined as the disability and functioning of a significant other (SO) due toa health condition of their family members. The effects of third party disability on SOs of individuals with tinnitus has received little attention. To address this knowledge gap, this study investigated third party disability in significant others (SOs) of individuals with tinnitus. A cross-sectional survey design including 194 pairs of individuals from the USA, with tinnitus and their significant others. The SO sample completed the Consequences of Tinnitus on Significant Others Questionnaire (CTSOQ). Individuals with tinnitus completed standardized self-reported outcome measures for tinnitus severity, anxiety, depression, insomnia, hearing related quality of life, tinnitus cognitions, hearing disability and hyperacusis. The CTSOQ showed that 34 (18%) of SOs had mild impact, 59 (30%) had significant impact, and 101 (52%) had severe impact. The clinical variables of tinnitus severity, anxiety and hyperacusis in individuals with tinnitus were the best predictors of the impact of tinnitus on SOs. These results show that SOs of individuals with tinnitus may experience third party disability. The effect of the individual’s tinnitus on SOs may be greater when the individual with tinnitus has higher levels of tinnitus severity, anxiety, and hyperacusis

Descriptive characteristics.

<p>Descriptive characteristics.</p

Immediate results with time x group interaction and estimated means and standard error at pre and post (n = 204) in accordance with the Intention-to-treat principle.

<p>In addition, to facilitate the understanding the observed standard deviation was added (n = 204 and 195 at pre and post respectively).</p><p>Note: ** = p<.01; *** = p<.001.</p

CONSORT flow chart.

<p>CONSORT flow chart.</p

Long-term efficacy of audiologist-guided Internet-based cognitive behaviour therapy for tinnitus in the United States: A repeated-measures design

Objectives This study investigated the long-term outcomes 1-year after undertaking an Internet-based cognitive behavioural therapy (ICBT) for tinnitus distress in a US population. Secondary aims were to identify the effects on additional difficulties associate with tinnitus and any unwanted events related to ICBT for tinnitus. Methods A repeated-measures design with 4 time points was used. Participants previously undertaking two randomized ICBT efficacy trials for tinnitus in the US were invited to participate. Of the 200 invited, 132 (66 %) completed the 1-year follow-up questionnaire. The primary outcome was a change in tinnitus distress from baseline at one year post-intervention, as assessed by the Tinnitus Functional Index. Secondary assessment measures were included for anxiety, depression, insomnia, hearing disability, hyperacusis, tinnitus cognitions and health-related quality of life. Results Undertaking ICBT for tinnitus led to significant improvements 1-year post-intervention for tinnitus severity, with a large effect size (d = 1.06; CI: 0.80 to 1.32). Medium effects were found for anxiety (d = 0.54; CI: 0.29 to 0.79), depression (d = 0.46; CI: 0.21 to 0.70), insomnia (d = 0.47; CI: 0.22 to 0.72), and tinnitus cognitions (d = 0.43, CI: 0.18 to 0.68). Small effect sizes were found for hearing disability, hyperacusis and health-related quality of life. Adverse events related to the intervention were only reported by 1 participant. Conclusions The benefits of audiologist-guided ICBT for tinnitus and tinnitus-related difficulties were maintained 1-year post-intervention with very few adverse events reported. Ways of disseminate evidence-based easily accessible interventions to the general population with bothersome tinnitus should be sought

Time of effortful persistence as function of experimental manipulations (instruction and induction).

<p>Participants were required to ignore emotional task-irrelevant sound while performing a mentally challenging task (mental arithmetic). Induction manipulation (attention control vs. mindfulness induction) followed the suppression manipulation (suppression vs. no instructions) in the experiment; thus, these are the delayed effects of suppression. Error bar denotes standard error of mean. *  =  <i>p</i><.05; <i>ns</i>  =  non-significant at specified alpha level (.05).</p

Stages-of-change clusters according to cluster analysis.

<p><b>(</b>Error bars indicate standard deviation).</p

Application of the Behavior Change Wheel within the context of internet-based cognitive behavioral therapy for tinnitus management

Purpose: Although experiencing tinnitus can lead to many difficulties, these can be reduced by using techniques derived from cognitive behavioral therapy. Internet-based cognitive behavioral therapy (ICBT) has been developed to provide an accessible intervention. The aim of this study was to describe how ICBT can facilitate tinnitus management by identifying the active ingredients of the intervention from the perspective of health behavior change. Method: The ICBT intervention was evaluated using the Behavior Change Wheel in eight steps across the following three stages: (1) understanding the behavior, (2) identifying intervention options, and (3) identifying content and implementation options. Results: Target behaviors identified to reduce tinnitus distress, as well as additional problems associated with tinnitus, included goal setting, an increased understanding of tinnitus, encouraging deep breathing and progressive muscle relaxation, identifying and restructuring unhelpful thoughts, engaging in positive imagery, and reducing avoidance behaviors. ICBT provided the required components for individuals to be physically and psychologically capable of adapting to tinnitus, providing social and environmental opportunities to manage hearing loss through practice and training, and facilitated automatic and reflective motivation. Conclusion: Understanding ICBT in the context of the Behavior Change Wheel has helped identify how its effectiveness can be improved and can be used for future tinnitus intervention planning.</p

Years since hearing disability, self-reported hearing disability, self-reported anxiety and depression, self-reported hearing disability acceptance, readiness to change composite and committed action composite according to stage with highest scores (Note: Precontemplation was not in the analysis as n = 0 in this stage).

<p>Years since hearing disability, self-reported hearing disability, self-reported anxiety and depression, self-reported hearing disability acceptance, readiness to change composite and committed action composite according to stage with highest scores (Note: Precontemplation was not in the analysis as n = 0 in this stage).</p