Goal Attainment Scale in tinnitus (GAS-T): treatment goal priorities by chronic tinnitus patients in a real-world setting

PURPOSE

Standard treatment for tinnitus is cognitive behavioral therapy, although level of evidence of effectiveness is low. There is need for a Goal Attainment Scale to evaluate treatment effects based on patient satisfaction. Preliminary work in a clinical sample has identified six common personal treatment goals. The purpose of this study is to determine whether the preliminary identified goals are confirmed by a heterogeneous sample of people with bothersome tinnitus and to identify any other common personal goals with the intention to construct a closed-end Goal Attainment Scale for tinnitus for use in research of effectiveness of (new) tinnitus treatments.

METHODS

Two consecutive polls were plotted in an online peer support group form a heterogeneous sample. First, members were asked to vote for preliminary identified goals and asked to formulate additional personal goals. Corresponding goals were grouped together. Goals that were acknowledged by at least 10% of respondents were used in the second poll in which respondents could vote for statements that they recognized themselves in.

RESULTS

The first poll (N = 180) resulted in 15 personal treatment goals. Comparison resulted in five common goals, which were confirmed in the second poll (N = 238): to gain control, to improve well-being and sleep, to reduce effects on hearing and to understand tinnitus.

CONCLUSIONS

We expect that if a patient achieves personal goals, he will be likely to reduce healthcare consumption. Based on common personal goals, validity of treatment evaluations is increased. We present a closed-end Goal Attainment Scale in tinnitus.

A cognitive model of tinnitus and hyperacusis; a clinical tool for patient information, appeasement and assessment

Tinnitus and hyperacusis are both aggravating audiological symptoms. Their underlying mechanisms are not fully understood, but the pathophysiology involves a central mechanism rather than a peripheral one. There is no curative treatment. A review of the available research on tinnitus and auditory processing was conducted to connect insights gained from different approaches to the subject; this resulted in the development of a holistic view of both conditions. In this view, the chronic course of the symptoms is pathological and attributed to a stress-related lack of habituation. This article adds to the literature on tinnitus and hyperacusis by presenting a schematic model of the cognitive mechanisms which can be used clinically in patient information sessions which are geared towards provide reassurance and encouraging the development of coping skills. In cooperation with the patient, the model can also help in the identification of underlying pathology. Future aims of study are suggested, elaborating on the role of tinnitus and hyperacusis in normal auditory processing and on the value of insight. Finally, parallels are drawn between tinnitus and positive symptom syndromes in neuropsychiatry and some of its modern visions on their treatment.