Reliability and validity of the Lithuanian Tinnitus Handicap Inventory

Internet-delivered cognitive behavioral therapy for tinnitus compared to Internet-delivered mindfulness for tinnitus: a study protocol of a randomized controlled trial

BACKGROUND

Tinnitus affects around 15% of the population and can be a debilitating condition for a sizeable part of them. However, effective evidence-based treatments are scarce. One recommended treatment for tinnitus is cognitive behavioral therapy which has been found to be effective when delivered online. However, more treatments including mindfulness-based interventions have been studied recently in an attempt to facilitate the availability of effective treatments. There are promising findings showing great effects in reducing tinnitus-induced distress and some evidence about the efficacy of such intervention delivered online. However, there is a lack of evidence on how these two treatments compare against one another. Therefore, the aim of this study will be to compare Internet-delivered cognitive behavioral therapy for tinnitus against an Internet-delivered mindfulness-based tinnitus stress reduction intervention in a three-armed randomized controlled trial with a waiting list control condition.

METHODS

This study will be a randomized controlled trial seeking to recruit Lithuanian-speaking individuals suffering from chronic tinnitus. The self-report measure Tinnitus Handicap Inventory will be used. Self-referred participants will be randomized into one of three study arms: Internet-delivered cognitive behavioral therapy, Internet-delivered mindfulness-based tinnitus stress reduction intervention, or a waiting-list control group. Post-treatment measures will be taken at the end of the 8-week-long intervention (or waiting). Long-term efficacy will be measured 3 and 12 months post-treatment.

DISCUSSION

Internet-delivered interventions offer a range of benefits for delivering evidence-based treatments. This is the first randomized controlled trial to directly compare Internet-delivered CBT and MBTSR for tinnitus in a non-inferiority trial.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05705323. Registered on January 30, 2023.

Psychometric properties of the Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR)

OBJECTIVE

To assess the psychometric properties of a Norwegian translation of the Tinnitus Handicap Inventory (THI-NOR).

DESIGN

A survey was sent by post to patients referred with tinnitus as their main complaint to an audiology department. Patients completed a Norwegian version of the Tinnitus Handicap Inventory (THI-NOR), a Norwegian translation of two revised subscales of the Abbreviated profile of hearing aid benefit (APHAB), the General Health Questionnaire (GHQ-12) as well as questionnaires measuring coping expectancies (TOMCATS) and neuroticism (EPI).

STUDY SAMPLE

Ninety-nine persons with tinnitus.

RESULTS

No associations were found between THI-scores or pure-tone audiometry, gender or age. The proposed subscales of the original THI were not formed by responses from responders. The total scale shows good psychometric properties. Significant correlations were found between distress as measured by the GHQ-12, coping expectancies as measured by TOMCATS and neuroticism as measured by EPI and THI scores.

CONCLUSIONS

THI-NOR has psychometric properties similar to those of the Danish translation (THI-DK), from which it was adapted, and to the original THI. THI-NOR seems to be a valid measure of the impact of tinnitus on a person's everyday life. Findings show that the suggested subscales of the questionnaire should be interpreted with caution.

The role of questioning environment, personality traits, depressive and anxiety symptoms in tinnitus severity perception

Psychological factors have been described as important for tinnitus severity, but attempts to incorporate them in one picture are sparse. This study investigated to what extent traits (personality), states (depressive and anxiety symptoms), sociodemographic factors and questioning environment influence tinnitus severity perception and how they interplay. Data were obtained from 212 subjects in a survey that was undertaken in 2016 at Vilnius University hospital and via internet. Measures included the Tinnitus Handicap Inventory (THI), Visual Analogue Scale (VAS), Hospital Anxiety and Depression Scale (HADS), Big Five Personality Dimensions Scale and sociodemographic questions. A series of stepwise forward and multiple regression analyses were undertaken to discover how factors interconnect. Female gender, age, living in rural area, but not level of education, were found to be associated with THI and HADS. Total HADS score and of both subscales were linked to scores on THI, VAS scales and all personality traits, except agreeableness (and consciousness for anxiety). Anxiety was the most important predictor for tinnitus severity, followed by depressive symptoms. Only neuroticism from personality dimensions was a predictor of THI score, whereas THI scores did not predict scores on neuroticism. All results in scales were higher in the internet group, except agreeableness and neuroticism, while extroversion correlated negatively with THI score only in the hospital group. Tinnitus severity was highly correlated with depressive, anxiety symptoms and neuroticism. Respondents recruited through internet had higher scores on most parameters. Results emphasize the importance of psychological factors in tinnitus management.