Soly Erlandsson

Psychological and Audiological Correlates of Perceived Tinnitus Severity

Beliefs and attitudes towards tinnitus have been found to play an important role in the process of rehabilitation. The relationship between audiological, psychological and psychosomatic factors (self-assessment of vertigo and headache and the perceived severity of tinnitus) was investigated in a clinical population of 163 subjects. Audiological descriptives comprised pure-tone average (dB HL), etiology of hearing loss, duration of tinnitus and tinnitus localisation. Perceived severity of tinnitus was assessed with a questionnaire focusing on tinnitus impact on aspects of quality of life, concentration and sleep. A 28-item handicap and support questionnaire was used and factor analysed, resulting in three factors: perceived attitudes, social support and disability/handicap. Tinnitus severity was significantly related to perceived attitudes. The influence of social support on tinnitus severity did not seem to be crucial. The results showed that significantly more women than men complained about vertigo. Unilateral tinnitus localisation was also more prevalent in females. The subjects with multiple tinnitus localisations were older and had significantly more sleep disturbance than subjects with tinnitus localized to the ears only. In accordance with previously reported observations, the frequency of headaches was strongly correlated with the severity of tinnitus.

Self-reported tinnitus and noise sensitivity among adolescents in Sweden

The last ten years, the use of gentamicin has increased due to antibiotic resistance among bacterial pathogens. One of the side effects of gentamicin is its toxicity on hearing. Several authors had even pointed out synergistic effects of gentamicin and noise on hearing. It was therefore reasonable to think that the damaging effects of noise could be emphasized by a gentamicin treatment of the subjects. In order to test the applicability of the Leq8h for estimating the hazard of noise on animals treated with a non-ototoxic dose of gentamicin (40 mg/kg for 8 days), two experiments were carried out with guinea pigs. The animals were exposed to octave band noises centred at 8 kHz and treated with gentamicin either simultaneously or sequentially with regard to the noise exposure. Two noise exposures having different acoustic energy, respectively Leq8h = 85 dB and 98.8 dB SPL, were tested. The auditory function of the guinea pigs was tested by recording auditory-evoked potentials. The electrophysiological findings were completed by histological data. The gentamicin treatment tested in the current studies did not cause any auditory permanent threshold shift neither cochlear disruptions, although the treatment could be considered as approximately ten times the therapeutic dose used in human. The auditory deficit induced by the mixed exposures to noise and gentamicin did not worsen the noise effect alone in our experimental conditions. As a result, the European value recommended for noise exposure (Leq8h=85 dB) seems to be robust enough to protect gentamicin-treated workers.

Predictive Factors for the Severity of Tinnitus: Factores predictivos de la severidad del tinnitus

The majority of patients with tinnitus experience a lessening of their symptoms during an 18-month period after their first consultation. The exception to this rule is severe incapacitating tinnitus, the sometimes very troublesome symptoms of which show no sign of diminishing with time. The aim of the present study was to investigate risk factors for incapacitating tinnitus, as measured by absence from work related to tinnitus (AWT) of more than 1 month during an 18-month period after the first visit to the tinnitus clinic. Audiometric data and the scores from the Tinnitus Severity Questionnaire and the Nottingham Health Profile at the first visit to the clinic were correlated to AWT by a logistic regression model. By using this risk model, an individual risk score for AWT could be estimated. Depression and physical immobility were strong predictors of AWT, and hearing loss was moderate. Based on these results, we suggest that the aetiology of tinnitus severity could be described as depression-/anxiety-related, somatic, and auditory tinnitus.

Reported hearing protection use in young adults from Sweden and the USA : Effects of attitude and gender

The present study investigates differences between a Swedish and an American sample of young students regarding attitudes towards noise and the use of hearing protection at concerts. The study population was comprised of 179 participants from Sweden and 203 participants from the United States, who ranged in age from 17 to 21 years. Questionnaires were used to gather information on hearing symptoms and attitudes towards noise (Youth Attitude to Noise Scale). Multivariate analysis of variance revealed that attitudes towards noise differed significantly due to gender and country. Men had slightly more positive attitude towards noise than women, and men from the USA had more positive attitudes than men from Sweden. Least positive were the women from Sweden (except regarding attitudes towards the ability to concentrate in noisy environments). Multivariate logistic regression analysis was used to examine the influence of attitudes towards noise and country on young peoples use of hearing protection at concerts. The results indicated that attitudes and country explained 50% of the variance in use of hearing protection.

Psychological dimensions in patients with disabling tinnitus and craniomandibular disorders

Forty-two patients with severe tinnitus and craniomandibular disorders (CMD) are presented from an audiological and psychological point of view. During a 2-week period, the patients rated their mood and their tinnitus. Based upon mood ratings, patients were grouped into three clusters (high, medium and low mood). The three groups differed in a number of respects, audiological as well as psychological. Patients in the low mood group experienced significantly more intense and severe tinnitus and more daily stress than patients in the high mood group. Ratings of irritation and concentration difficulties seemed to be mood related, and discriminated between patients in the low mood group and patients in the moderate and the high mood groups. Difference in hearing level between the left and the right ear was more pronounced in patients with low mood. There were, however, no significant differences between the groups in the stomatognathic variables. It is concluded that the above mentioned audiological and psychological observations should be considered as potentially important for satisfactory management of individual tinnitus patients. Further studies of the effects of optimally compensated hearing on depressed mood in patients with noise-induced hearing loss (NIHL) and tinnitus are required.

Hearing, use of hearing protection, and attitudes towards noise among young American adults

The purpose of the present study was to investigate possible associations between college students’ attitudes, risk-taking behaviour related to noisy activities, and hearing problems such as threshold shifts or self-experienced hearing symptoms. The sample included 258 students aged between 17 and 21 enrolled at the University of Pennsylvania, USA. A questionnaire measuring attitudes towards noise, use of hearing protection, and self-reported hearing symptoms was distributed among the students. After completing the questionnaire a hearing screening, including pure-tone audiometry and tympanometry, was conducted. The result revealed that 26% had thresholds poorer than the screening level of 20 dBHL. Attitudes were significantly related to self-experienced hearing symptoms, but not to threshold shifts. Attitudes and noise sensitivity was, significantly related to use of hearing protection. Hearing protection use was found in activities such as using firearms, mowing lawns, and when using noisy tools but was less reported for concerts and discotheques. It can be concluded that the young adults in this study expose themselves to hearing risks, since the use of hearing protection is in general very low.

Coping strategies used by middle-aged males with noise-induced hearing loss, with and without tinnitus

Abstract The aim of this study was to examine the relationship between general coping strategies and specific communication strategies, adopted by males with noise-induced hearing loss (NIHL) in order to deal with stressful events and demanding auditory situations. The sample included 72 males with NIHL; 22 without tinnitus, 26 with mild tinnitus, and 24 with severe tinnitus. The following variables were measured: “active coping” “escape coping” and “passive acceptance” (general coping strategies), and “maladaptive behaviours”, “verbal strategies” and “nonverbal strategies” (specific communication strategies). The results showed that males without tinnitus or with mild tinnitus combined “active coping” and “passive acceptance”, whereas males with severe tinnitus supplemented these strategies with “escape coping”. The relationship between general coping and specific communication strategies was weak, although giving a significant correlation between “escape coping” and “maladaptive behaviours”. The results...

A stomatognathic analysis of patients with disabling tinnitus and craniomandibular disorders (CMD)

Forty-two patients with disabling tinnitus and reported symptoms of craniomandibular disorders (CMD) were investigated by means of questionnaire, semistructured interview, stomatognathic examination and 2-week diary with thrice-daily ratings of tinnitus and mood. The findings have been analysed in order to identify symptoms of CMD related to tinnitus, and it was concluded that awareness of diurnal bruxism and feeling of jaw tenderness/fatigue may be related to fluctuating tinnitus, vertigo and hyperacusis.

Benefits from group psychotherapy in the treatment of severe refractory tinnitus

The aim of this study was to investigate the effectiveness of group psychotherapy, founded on a psychodynamic, interpersonal approach and influenced by techniques used in cognitive behavioural therapy, in alleviating severe refractory tinnitus as well as psychiatric symptoms. Consecutive tinnitus patients without socially disabling hearing loss were recruited if they fulfilled risk criteria for developing severe refractory tinnitus based on a screening procedure with established validity. Thirty-seven patients participated in the group psychotherapy and were compared to patients (n =38) not receiving group therapy, who were primarily recruited to participate in a placebo-controlled study of the effects of a selective serotonin reuptake inhibitor. Changes in the severity of tinnitus, anxiety and depression were the main outcomes. Assessments were performed at entry, after 12 weeks treatment, and for the psychotherapy group only, at follow-up three months after the intervention period. Between-group comparisons of change scores over 12 weeks showed no difference between treatment groups. Comparisons within the groups revealed no benefits at the end of the intervention period, but at follow-up a significant improvement in anxiety (p<0.01) was recorded for the psychotherapy group. The findings suggest that short-term group psychotherapy in severe refractory tinnitus is beneficial in terms of anxiety reduction. Group psychotherapy may also contribute to a raised awareness of the existence of a close association between emotional/physical arousal and tinnitus suffering.

Risks and music - Patterns among young women and men in Sweden

Music and high levels of sound have not traditionally been associated with risk-taking behaviors. Loud music may intensify and bring more power and meaning to the musical experience, but it can at the same time be harmful to hearing. The present study aims to increase the knowledge about young womens and mens risk judgement and behaviour by investigating patterns in adolescent risk activities among 310 adolescents aged 15-20 (143 women; 167 men). The Australian instrument ARQ was used with additional questions on hearing risks and a factor analysis was conducted. The main results showed that the factor structure in the judgement and behavior scale for Swedish adolescents was rather different from the factor structure in the Australian sample. Also, the factor structure was not similar to the Australian sample split on gender. The results are discussed from a gender- and existential perspective on risk taking, and it is emphasized that research on risk behavior needs to reconceptualize stereotypical ideas about gender and the existential period in adolescence.