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Oh SY, Meaklim H, Nicholas CL, Cunnington D, Schenker M, Patrick CJ, Windred D, Phillips LJ. Perfect Enough to Sleep? Perfectionism and Actigraphy-Determined Markers of Insomnia. Behav Sleep Med 2024:1-16. [PMID: 38785108 DOI: 10.1080/15402002.2024.2355476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
OBJECTIVES Perfectionism is an important factor in insomnia development and maintenance. Previous studies exploring the relationship between perfectionism and insomnia have predominantly relied on self-reported sleep measures. Therefore, this study sought to assess whether actigraphy-measured sleep parameters were associated with perfectionism. METHODS Sixty adults (85% females, mean age 30.18 ± 11.01 years) were sampled from the Australian general population. Actigraphy-derived objective sleep measures, subjective sleep diary measures, the Frost Multidimensional Perfectionism Scale (FMPS), Hewitt-Flett Multidimensional Perfectionism Scale (HFMPS) and Depression, Anxiety and Stress Scale 21 (DASS-21) were collected. RESULTS High perfectionism levels were associated with poor sleep, but these relationships differed between objective and subjective measures. Perfectionism via FMPS total score and subscales of Concern over Mistakes, Doubts about Actions, Personal Standards and Self-oriented Perfectionism correlated with subjective sleep onset latency and sleep efficiency with moderate effects (r = .26 to .88). In contrast, perfectionism via HFMPS total score and subscales of Socially Prescribed Perfectionism and Parental Expectations predicted objective sleep onset latency and sleep efficiency. Additionally, stress mediated the relationships between objective sleep efficiency and Concern over Mistakes and Doubts about Actions. CONCLUSIONS Perfectionism demonstrated stronger associations with subjective than objective sleep measures. Higher Parental Expectations and Socially Prescribed Perfectionism may increase one's vulnerability to objectively measured poor sleep. Therefore, perfectionism may be important in preventing and treating insomnia.
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Affiliation(s)
- Susie Y Oh
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
- Turner Institute for Brain and Mental Health, Monash University Healthy Sleep Clinic, Monash University, Clayton, Australia
| | - Hailey Meaklim
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
- Institute for Breathing and Sleep, Austin Health, Victoria, Australia
| | - Christian L Nicholas
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | | | - Maya Schenker
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
| | - Cameron J Patrick
- Statistical Consulting Centre, School of Mathematics and Statistics, The University of Melbourne, Parkville, Australia
| | - Daniel Windred
- Turner Institute for Brain and Mental Health, Monash University Healthy Sleep Clinic, Monash University, Clayton, Australia
| | - Lisa J Phillips
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, Australia
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2
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Akram U, Stevenson JC, Gardani M, Allen S, Johann AF. Personality and insomnia: A systematic review and narrative synthesis. J Sleep Res 2023; 32:e14031. [PMID: 37654128 DOI: 10.1111/jsr.14031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023]
Abstract
The inherent nature of personality serves as a predisposing, and possible maintaining, factor of insomnia. However, methodological differences limit the ability to draw causal conclusions regarding the specific traits involved in the aetiology of the disorder. This systematic review of the relationship between insomnia and personality provides a narrative synthesis of the literature to date. Here, we identified N = 76 studies meeting the inclusion/exclusion criteria. The outcomes reliably evidenced the experience of insomnia to be associated with personality traits that are typically considered to be negative or maladaptive in nature. More specifically, insomnia was related to neuroticism, introversion, perfectionistic doubts and concerns, elevated personal standards, negative affect, social inhibition and avoidance, hysteria, hypochondriasis, psychasthenia, impulsive behaviour, anger, hostility, and psychopathic tendencies, schizotypal and borderline traits, reduced conscientiousness and self-directedness, and negatively perceived perception of the self. Several studies examined the role that personality plays in predicting the treatment efficacy and adherence of CBTi. Moving forward, longitudinal research, methodological consistency, the mediating role of treatment outcomes and adherence, and clinical and population representative samples should be prioritised. Methodological strengths and limitations of the literature are discussed alongside the next steps that should be taken to advance our understanding of the literature.
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Affiliation(s)
- Umair Akram
- School of Psychology, University of Lincoln, Lincoln, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | | | - Maria Gardani
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Sarah Allen
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center, University of Freiburg, Freiburg, Germany
- Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
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3
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Rademaker MM, Meijers SM, Smit AL, Stegeman I. Prediction Models for Tinnitus Presence and the Impact of Tinnitus on Daily Life: A Systematic Review. J Clin Med 2023; 12:jcm12020695. [PMID: 36675624 PMCID: PMC9861218 DOI: 10.3390/jcm12020695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/17/2023] Open
Abstract
The presence of tinnitus does not necessarily imply associated suffering. Prediction models on the impact of tinnitus on daily life could aid medical professionals to direct specific medical resources to those (groups of) tinnitus patients with specific levels of impact. Models of tinnitus presence could possibly identify risk factors for tinnitus. We systematically searched the PubMed and EMBASE databases for articles published up to January 2021. We included all studies that reported on multivariable prediction models for tinnitus presence or the impact of tinnitus on daily life. Twenty-one development studies were included, with a total of 31 prediction models. Seventeen studies made a prediction model for the impact of tinnitus on daily life, three studies made a prediction model for tinnitus presence and one study made models for both. The risk of bias was high and reporting was poor in all studies. The most used predictors in the final impact on daily life models were depression- or anxiety-associated questionnaire scores. Demographic predictors were most common in final presence models. No models were internally or externally validated. All published prediction models were poorly reported and had a high risk of bias. This hinders the usability of the current prediction models. Methodological guidance is available for the development and validation of prediction models. Researchers should consider the importance and clinical relevance of the models they develop and should consider validation of existing models before developing new ones.
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Affiliation(s)
- Maaike M. Rademaker
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Sebastiaan M. Meijers
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Adriana L. Smit
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- UMC Utrecht Brain Center, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands
- Correspondence:
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4
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Stricker J, Kröger L, Johann AF, Küskens A, Gieselmann A, Pietrowsky R. Multidimensional perfectionism and poor sleep: A meta-analysis of bivariate associations. Sleep Health 2022; 9:228-235. [PMID: 36400679 DOI: 10.1016/j.sleh.2022.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 11/18/2022]
Abstract
The link between perfectionism and poor sleep has been intensively debated, and previous studies on perfectionism-sleep associations have yielded mixed results. Recent research suggests that the two-dimensional perfectionism model, differentiating perfectionistic concerns (centered around concerns over imperfections) and perfectionistic strivings (centered around excessively high personal standards), may reconcile previously inconclusive findings, as both dimensions might be differentially related to sleep. Thus, to clarify the perfectionism-sleep link, this meta-analysis investigated relations of perfectionistic concerns and strivings with two well-established self-report measures of poor sleep. A systematic literature search yielded 55 effect sizes from 15 studies (N = 10,275) for inclusion in this meta-analysis. Perfectionistic concerns correlated positively with the Insomnia Severity Index (r+ = 0.221, 95% CI [0.102, 0.333], p = .004) and the Pittsburgh Sleep Quality Index (r+ = 0.248, 95% CI [0.172, 0.321], p < .001). Perfectionistic strivings correlated positively, albeit less strongly, with the Insomnia Severity Index (r+ = 0.114, 95% CI [0.039, 0.189], p = .010), but not significantly with the Pittsburgh Sleep Quality Index (r+ = 0.028, 95% CI [-0.026, 0.082], p = .247). These meta-analytic findings indicate that perfectionistic concerns are substantially linked to poor sleep, whereas the relation of perfectionistic strivings with sleep is less evident. Although the identified associations were less robust for perfectionistic strivings than for perfectionistic concerns, previously used labels like "positive" or "adaptive" appear inappropriate for perfectionistic strivings in the context of sleep.
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Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Lasse Kröger
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Anna F Johann
- Department of Psychiatry and Psychotherapy, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany; Institute of Medical Psychology and Medical Sociology, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Anna Küskens
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Annika Gieselmann
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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5
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Stricker J, Kröger L, Küskens A, Gieselmann A, Pietrowsky R. No perfect sleep! A systematic review of the link between multidimensional perfectionism and sleep disturbance. J Sleep Res 2022; 31:e13548. [DOI: 10.1111/jsr.13548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 01/23/2023]
Affiliation(s)
- Johannes Stricker
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Lasse Kröger
- Department of Psychology University of Trier Trier Germany
| | - Anna Küskens
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Annika Gieselmann
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
| | - Reinhard Pietrowsky
- Department of Experimental Psychology Heinrich Heine University Düsseldorf Düsseldorf Germany
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6
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Liu Q, Yang H, Peng W, Liu Z, Wang J, Chu J, Liu J, Li F, Zhong M. Factorial Validity and Factorial Invariance Across Gender of the Frost Multidimensional Perfectionism Scale-Chinese version in Undergraduates. Psychol Rep 2021; 125:2232-2248. [PMID: 34037484 DOI: 10.1177/00332941211018402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study was aimed to examine the factor structure and factorial invariance across gender of the Frost Multidimensional Perfectionism Scale-Chinese version (FMPS-CV). METHODS The FMPS-CV was completed by 2451 undergraduates. Confirmatory factor analyses (CFA) were performed to verify its factorial validity, and Multigroup CFA were performed to examine its factorial invariance across gender. Gender differences were compared on scores of FMPS-CV. The internal consistency and test-retest reliability were also detected. Clinical characteristics were compared between adaptive and maladaptive perfectionists categorized by positive and negative scores of FMPS-CV. RESULTS CFA supported the six-factor structure of FMPS-CV, and Multigroup CFA evidenced its factorial invariance across gender. No significant gender differences were found. The adaptive perfectionists scored significantly lower on clinical variables than maladaptive perfectionists. Moreover, the reliability indicators met the standards. CONCLUSIONS The good psychometrics properties of FMPS-CV supported it could be used to assess perfectionism in Chinese young adults.
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Affiliation(s)
- Qian Liu
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, Normal University, Guangzhou, China
| | - Huihui Yang
- Medical Psychological Center, The 70566Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Wanrong Peng
- Medical Psychological Center, The 70566Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Zhaoxia Liu
- Medical Psychological Center, The 70566Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | - Jingwei Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, Normal University, Guangzhou, China
| | - Jun Chu
- Medical Psychological Center, The 70566Second Xiangya Hospital, Central South University, Changsha, China; Medical Psychological Institute, Central South University, Changsha, China
| | | | | | - Mingtian Zhong
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, School of Psychology, Normal University, Guangzhou, China
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van Munster JJCM, van der Valk WH, Stegeman I, Lieftink AF, Smit AL. The Relationship of Tinnitus Distress With Personality Traits: A Systematic Review. Front Neurol 2020; 11:225. [PMID: 32655464 PMCID: PMC7326028 DOI: 10.3389/fneur.2020.00225] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 03/10/2020] [Indexed: 11/19/2022] Open
Abstract
Objectives: An association between tinnitus distress with anxiety and depression is described in literature. A similar relationship might exist between tinnitus distress and personality traits, especially since associations between personality traits and other chronic diseases are already revealed. In this systematic review, we aim to investigate whether personality is a risk factor for tinnitus distress. Design: We searched PubMed and EMBASE databases from inception up to December 31, 2018 for articles on the association between tinnitus distress and personality. Two researchers screened titles, abstracts, and full texts for eligibility. Directness of evidence and risk of bias were assessed. From the included studies, study characteristics and outcome data of tinnitus distress and personality traits were extracted. Results: A total of 323 unique articles were screened of which 11 cross-sectional studies were eligible for critical appraisal and were used for data extraction. Including study populations were heterogenous, and studies scored high to moderate risk of bias. Nine out of 11 articles showed an association between tinnitus distress and the personality of neuroticism. Conclusions: By limitations in the methodology of included studies, the evidence on specific personality traits as a risk factor for tinnitus distress is inconclusive. Some evidence on a positive association with neuroticism is identified. To draw conclusions about causal relations, these further studies should be of longitudinal design in a cohort setting. These studies should assess tinnitus distress using validated questionnaires with multiple personality dimensions and validated questionnaires to assess personality traits.
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Affiliation(s)
- Juliëtte J C M van Munster
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden University, Leiden, Netherlands.,Department of Neurosurgery, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Wouter H van der Valk
- Department of Otorhinolaryngology and Head & Neck Surgery, Leiden University Medical Center, Leiden University, Leiden, Netherlands
| | - Inge Stegeman
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
| | - Arno F Lieftink
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands
| | - Adriana L Smit
- Department of Otorhinolaryngology and Head & Neck Surgery, University Medical Center Utrecht, Utrecht, Netherlands.,Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands
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8
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Evaluation of a Cognitive Behavioral Model of Tinnitus Distress: A Cross-Sectional Study Using Structural Equation Modeling. Ear Hear 2020; 41:1028-1039. [DOI: 10.1097/aud.0000000000000826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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9
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Biehl R, Boecking B, Brueggemann P, Grosse R, Mazurek B. Personality Traits, Perceived Stress, and Tinnitus-Related Distress in Patients With Chronic Tinnitus: Support for a Vulnerability-Stress Model. Front Psychol 2020; 10:3093. [PMID: 32116880 PMCID: PMC7025561 DOI: 10.3389/fpsyg.2019.03093] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/31/2019] [Indexed: 01/20/2023] Open
Abstract
Background Despite vulnerability-stress models underlying a variety of distress-related emotional syndromes, few studies have investigated interactions between personality factors and subjectively experienced stressors in accounting for tinnitus-related distress. Aim The present study compared personality characteristics between patients with chronic tinnitus and the general population. Within the patient sample, it was further examined whether personality dimensions predicted tinnitus-related distress and, if so, whether differential aspects or levels of perceived stress mediated these effects. Method Applying a cross-sectional design, 100 patients with chronic tinnitus completed the Freiburger Persönlichkeitsinventar (FPI-R) measuring personality, the Perceived Stress Questionnaire (PSQ-20) measuring perceived stress and the German version of the Tinnitus Questionnaire (TQ) measuring tinnitus-related distress. FPI-R scores were compared with normed values obtained from a representative German reference population. Mediation analyses were computed specifying FPI-R scores as independent, PSQ20 scores as mediating and the TQ-total score as dependent variables. Results Patients with chronic tinnitus significantly differed from the general population across a variety of personality indices. Tinnitus-related distress was mediated by differential interactions between personality factors and perceived stress dimensions. Conclusion In conceptualizing tinnitus-related distress, idiosyncratic assessments of vulnerability-stress interactions are crucial for devising effective psychological treatment strategies. Patients' somatic complaints and worries appear to be partly informed by opposing tendencies reflecting emotional excitability vs. aggressive inhibition - suggesting emotion-focused treatment strategies as a promising new direction for alleviating distress.
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Affiliation(s)
- Raphael Biehl
- Tinnitus Center, Charité - Universitätsmedizin-Berlin, Berlin, Germany
| | - Benjamin Boecking
- Tinnitus Center, Charité - Universitätsmedizin-Berlin, Berlin, Germany
| | - Petra Brueggemann
- Tinnitus Center, Charité - Universitätsmedizin-Berlin, Berlin, Germany
| | - Romina Grosse
- Tinnitus Center, Charité - Universitätsmedizin-Berlin, Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Charité - Universitätsmedizin-Berlin, Berlin, Germany
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10
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Durai M, Searchfield G. Anxiety and depression, personality traits relevant to tinnitus: A scoping review. Int J Audiol 2016; 55:605-15. [DOI: 10.1080/14992027.2016.1198966] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Mithila Durai
- School of Population Health - Audiology, University of Auckland, New Zealand
| | - Grant Searchfield
- School of Population Health - Audiology, University of Auckland, New Zealand
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11
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Brüggemann P, Szczepek AJ, Rose M, McKenna L, Olze H, Mazurek B. Impact of Multiple Factors on the Degree of Tinnitus Distress. Front Hum Neurosci 2016; 10:341. [PMID: 27445776 PMCID: PMC4925660 DOI: 10.3389/fnhum.2016.00341] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 06/20/2016] [Indexed: 11/22/2022] Open
Abstract
Objective: The primary cause of subjective tinnitus is a dysfunction of the auditory system; however, the degree of distress tinnitus causes depends largely on the psychological status of the patient. Our goal was to attempt to associate the grade of tinnitus-related distress with the psychological distress, physical, or psychological discomfort patients experienced, as well as potentially relevant social parameters, through a simultaneous analysis of these factors. Methods: We determined the level of tinnitus-related distress in 531 tinnitus patients using the German version of the tinnitus questionnaire (TQ). In addition, we used the Perceived Stress Questionnaire (PSQ); General Depression Scale Allgemeine Depression Skala (ADS), Berlin Mood Questionnaire (BSF); somatic symptoms inventory (BI), and SF-8 health survey as well as general information collected through a medical history. Results: The TQ score significantly correlated with a score obtained using PSQ, ADS, BSF, BI, and SF-8 alongside psychosocial factors such as age, gender, and marital status. The level of hearing loss and the auditory properties of the specific tinnitus combined with perceived stress and the degree of depressive mood and somatic discomfort of a patient were identified as medium-strong predictors of chronic tinnitus. Social factors such as gender, age, or marital status also had an impact on the degree of tinnitus distress. The results that were obtained were implemented in a specific cortical distress network model. Conclusions: Using a large representative sample of patients with chronic tinnitus permitted a simultaneous statistical measurement of psychometric and audiological parameters in predicting tinnitus distress. We demonstrate that single factors can be distinguished in a manner that explains their causative association and influence on the induction of tinnitus-related distress.
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Affiliation(s)
| | | | - Matthias Rose
- Department of Internal Medicine and Psychosomatics, Universitätsmedizin Berlin Berlin, Germany
| | - Laurence McKenna
- Royal National Throat Nose and Ear Hospital, University College Hospitals London, UK
| | - Heidi Olze
- Department of Otorhinolaryngology, Universitätsmedizin Berlin Berlin, Germany
| | - Birgit Mazurek
- Tinnitus Center, Universitätsmedizin Berlin Berlin, Germany
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12
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McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. Front Neurol 2014; 5:196. [PMID: 25339938 PMCID: PMC4186305 DOI: 10.3389/fneur.2014.00196] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2014] [Accepted: 09/17/2014] [Indexed: 11/13/2022] Open
Abstract
The importance of psychological factors in tinnitus distress has been formally recognized for almost three decades. The psychological understanding of why tinnitus can be a distressing condition posits that it becomes problematic when it acquires an emotive significance through cognitive processes. Principle therapeutic efforts are directed at reducing or removing the cognitive (and behavioral) obstacles to habituation. Here, the evidence relevant to a new psychological model of tinnitus is critically reviewed. The model posits that patients' interpretations of tinnitus and the changes in behavior that result are given a central role in creating and maintaining distress. The importance of selective attention and the possibility that this leads to distorted perception of tinnitus is highlighted. From this body of evidence, we propose a coherent cognitive-behavioral model of tinnitus distress that is more in keeping with contemporary psychological theories of clinical problems (particularly that of insomnia) and which postulates a number of behavioral processes that are seen as cognitively mediated. This new model provides testable hypotheses to guide future research to unravel the complex mechanisms underpinning tinnitus distress. It is also well suited to define individual symptomatology and to provide a framework for the delivery of cognitive-behavioral therapy.
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Affiliation(s)
- Laurence McKenna
- Royal National Throat Nose and Ear Hospital, University College Hospitals , London , UK
| | - Lucy Handscomb
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research (NIHR), University of Nottingham , Nottingham , UK ; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK ; UCL Ear Institute, University College London , London , UK
| | - Derek J Hoare
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research (NIHR), University of Nottingham , Nottingham , UK ; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK
| | - Deborah A Hall
- Nottingham Hearing Biomedical Research Unit, National Institute for Health Research (NIHR), University of Nottingham , Nottingham , UK ; Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham , Nottingham , UK
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13
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Andersson G, Edvinsson E. Mixed feelings about living with tinnitus: A qualitative study. ACTA ACUST UNITED AC 2009. [DOI: 10.1080/16513860801899355] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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14
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Andersson G, Westin V. Understanding tinnitus distress: Introducing the concepts of moderators and mediators. Int J Audiol 2009; 47 Suppl 2:S106-11. [DOI: 10.1080/14992020802301670] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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