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J Am Acad Audiol 2022; 33(04): 206-213
DOI: 10.1055/a-1709-4912
Research Article

Perception of Tinnitus: Direct and Indirect Effects of Resilience, Personality Traits, and Psychiatric Symptoms

Mariana L. Martins 
1   Department of Speech Therapy, Federal University of Paraiba, João Pessoa, Brazil
,
Melyssa K.C. Galdino
2   Department of Psychology, Federal University of Paraiba, João Pessoa, Brazil
,
Bernardino Fernández-Calvo
3   Department of Psychology, University of Córdoba, Córdoba, Spain
4   Maimonides Biomedical Research Institute of Cordoba (IMIBIC), Cordoba, Spain
,
Fátima C.A. Branco-Barreiro
5   Department of Speech Therapy, Federal University of São Paulo, São Paulo, Brazil
,
Thiago P. Fernandes
2   Department of Psychology, Federal University of Paraiba, João Pessoa, Brazil
,
Marine R.D. da Rosa
1   Department of Speech Therapy, Federal University of Paraiba, João Pessoa, Brazil
› Author Affiliations Funding This work was supported by the Coordination for the Improvement of Higher Education Personnel (CAPES). Bernardino Fernández-Calvo was the recipient of a Senior Distinguished Researcher position (Beatriz Galindo Program) in the Department of Psychology at the Universidad de Córdoba (ref. BEAGAL18/00006).
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Abstract

Background Psychiatric conditions are common in individuals with tinnitus. Therefore, the ways individuals cope with such conditions and personality can influence the characteristics of tinnitus.

Purpose The study aims to investigate the direct and indirect effects of resilience, personality traits, and psychiatric symptoms on the tinnitus perception.

Research Design This is a descriptive, cross-sectional, and observational study involving quantitative results.

Study Sample Thirty-seven individuals with chronic tinnitus (for more than 6 months) sought the tinnitus care service (mean age = 44.6 years; SD = 11.7 years).

Data Collection and Analysis The specific anamnesis of tinnitus, adult self-report questionnaire, resilience scale, big five inventory, Tinnitus Handicap Inventory (M = 45.0; SD = 24.1), and visual analog scale (M = 6.4; SD = 2.7) were used. Psychoacoustic measurements (loudness: M = 25.4; SD = 12.8) of tinnitus were performed to characterize the condition in terms of pitch and loudness. The study analyzed the relationship between tinnitus (annoyance, severity, and loudness), psychiatric symptoms, personality, and resilience using multiple mediations.

Results Resilience did not influence tinnitus severity (BCa: -1.12 to 0.51), annoyance (BCa: -0.10 to 0.11), or loudness (BCa: -0.44 to 0.28) when mediated by anxiety and depression. Additionally, there was only a direct effect of resilience for annoyance (t = - 2.14, p = 0.03; BCa: -0.10 to 0.11). There was no direct influence of anxiety and depression on the tinnitus severity (b = 0.53, p > 0.05), annoyance (b = - 0.01, p > 0.05), or loudness (b = 0.11, p > 0.05). However, there was an association of personality traits (neuroticism) with the tinnitus severity (b = 1.16, 95% CI: 0.15–2.17; t = 2.53, p = 0.02) and annoyance (b = 0.12, 95% CI: 0.003–0.24; t = 2.09, p = 0.04).

Conclusion Resilience and psychiatric symptoms did not have a direct or indirect influence on the tinnitus annoyance, severity, or loudness. However with a direct association of resilience and annoyance, and neuroticism trait with the tinnitus annoyance and severity. Our results suggest that patients with chronic tinnitus and high neuroticism should receive personalized treatment.

Keywords

tinnitus - hearing - audiology - psychiatric disorders - anxiety - depression - neuroticism - personality

Data Availability

The clinically collected data used to support the findings of this study are available from the corresponding author upon request.


Presentations and Submissions

This manuscript has not been published or presented elsewhere in part or in entirety, and is not under consideration by another journal.


Disclaimer

Any mention of a product, service, or procedure in the Journal of the American Academy of Audiology does not constitute an endorsement of the product, service, or procedure by the American Academy of Audiology.


Supplementary Material



Publication History

Received: 03 January 2021

Accepted: 26 November 2021

Accepted Manuscript online:
30 November 2021

Article published online:
18 November 2022

© 2022. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Shulman A, Goldstein B. Subjective idiopathic tinnitus and palliative care: a plan for diagnosis and treatment. Otolaryngol Clin North Am 2009; 42 (01) 15-37 , vii
    CrossrefPubMedGoogle Scholar
  • 2 Eggermont JJ. On the pathophysiology of tinnitus; a review and a peripheral model. Hear Res 1990; 48 (1-2): 111-123
    CrossrefPubMedGoogle Scholar
  • 3 Sanchez TG. Quem disse que zumbido não tem cura?. São Paulo: Máxima editora; 2006
    Google Scholar
  • 4 Pinto PC, Marcelos CM, Mezzasalma MA, Osterne FJ, de Melo Tavares de Lima MA, Nardi AE. Tinnitus and its association with psychiatric disorders: systematic review. J Laryngol Otol 2014; 128 (08) 660-664
    CrossrefPubMedGoogle Scholar
  • 5 Karaaslan Ö, Kantekin Y, Hacımusalar Y, Dağıstan H. Anxiety sensitivities, anxiety and depression levels, and personality traits of patients with chronic subjective tinnitus: a case-control study. Int J Psychiatry Clin Pract 2020; 24 (03) 264-269
    CrossrefPubMedGoogle Scholar
  • 6 Strumila R, Lengvenytė A, Vainutienė V, Lesinskas E. The role of questioning environment, personality traits, depressive and anxiety symptoms in tinnitus severity perception. Psychiatr Q 2017; 88 (04) 865-877
    CrossrefPubMedGoogle Scholar
  • 7 Figueiredo RR. Azevedo AAd. 2012. Zumbido, (1 ed). Thieme Revinter, pp.1-316
    Google Scholar
  • 8 Kleinstäuber M, Weise C. Psychosocial variables that predict chronic and disabling tinnitus: a systematic review. Curr Top Behav Neurosci 2021; 51: 361-380
    CrossrefPubMedGoogle Scholar
  • 9 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
    CrossrefPubMedGoogle Scholar
  • 10 Wallhäusser-Franke E, Delb W, Balkenhol T, Hiller W, Hörmann K. Tinnitus-related distress and the personality characteristic resilience. Neural Plast 2014; 2014: 370307
    CrossrefPubMedGoogle Scholar
  • 11 Welch D, Dawes PJ. Personality and perception of tinnitus. Ear Hear 2008; 29 (05) 684-692
    CrossrefPubMedGoogle Scholar
  • 12 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
    CrossrefPubMedGoogle Scholar
  • 13 Campbell-Sills L, Cohan SL, Stein MB. Relationship of resilience to personality, coping, and psychiatric symptoms in young adults. Behav Res Ther 2006; 44 (04) 585-599
    CrossrefPubMedGoogle Scholar
  • 14 Wagnild G. A review of the Resilience Scale. J Nurs Meas 2009; 17 (02) 105-113
    CrossrefPubMedGoogle Scholar
  • 15 Wagnild GM, Young HM. Development and psychometric evaluation of the Resilience Scale. J Nurs Meas 1993; 1 (02) 165-178
    PubMedGoogle Scholar
  • 16 Wallhäusser-Franke E, Repik I, Delb W, Glauner A, Hörmann K. Long-term development of acute tinnitus. Laryngorhinootologie 2015; 94 (11) 759-769
    PubMedGoogle Scholar
  • 17 Qi M, Zeng X-l, Zhang S-q. et al. Effect of positive psychological quality on emotional distress in patients with chronic tinnitus. Journal of Sun Yat-sen University. Med Sci 2018; 39 (05) 748-758
    Google Scholar
  • 18 Wang X, Qi M, Zeng X. et al. Social Support and tinnitus distress: the importance of developing positive psychological qualities in patients with chronic tinnitus. Audiol Neurotol 2021; 26 (04) 246-256
    CrossrefPubMedGoogle Scholar
  • 19 Farhadi M, Mahmoudian S, Saddadi F. et al. Functional brain abnormalities localized in 55 chronic tinnitus patients: fusion of SPECT coincidence imaging and MRI. J Cereb Blood Flow Metab 2010; 30 (04) 864-870
    CrossrefPubMedGoogle Scholar
  • 20 Achenbach TM, Rescorla LA. Manual for the ASEBA Adult Forms & Profiles. 2001. Burlington, VT: University of Vermont, Research Center for Children, Youth, & Families;
    Google Scholar
  • 21 Newman CW, Jacobson GP, Spitzer JB. Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg 1996; 122 (02) 143-148
    Google Scholar
  • 22 Paula Erika Alves F, Cunha F, Onishi ET, Branco-Barreiro FC, Ganança FF. Tinnitus Handicap Inventory: cross-cultural adaptation to Brazilian Portuguese. Pro Fono 2005; 17 (03) 303-310
    CrossrefPubMedGoogle Scholar
  • 23 McCombe A, Baguley D, Coles R, McKenna L, McKinney C, Windle-Taylor P. British Association of Otolaryngologists, Head and Neck Surgeons. Guidelines for the grading of tinnitus severity: the results of a working group commissioned by the British Association of Otolaryngologists, Head and Neck Surgeons, 1999. Clin Otolaryngol Allied Sci 2001; 26 (05) 388-393
    CrossrefPubMedGoogle Scholar
  • 24 Kleinstäuber M, Frank I, Weise C. A confirmatory factor analytic validation of the Tinnitus Handicap Inventory. J Psychosom Res 2015; 78 (03) 277-284
    CrossrefPubMedGoogle Scholar
  • 25 Adamchic I, Langguth B, Hauptmann C, Tass PA. Psychometric evaluation of visual analog scale for the assessment of chronic tinnitus. Am J Audiol 2012; 21 (02) 215-225
    CrossrefPubMedGoogle Scholar
  • 26 Figueiredo RR, Azevedo AAd, Oliveira PdM. Análise da correlação entre a escala visual-análoga e o Tinnitus Handicap Inventory na avaliação de pacientes com zumbido. Rev Bras Otorrinolaringol 2009; 75: 76-79
    CrossrefGoogle Scholar
  • 27 Branco-Barreiro FCA. Avaliação Audiológica Básica e Psicoacústica do Zumbido. In: Samelli AG Zumbido: Avaliação, diagnóstico e reabilitação: Abordagens atuais. 1st ed.. São Paulo, Brazil: Lovise; 2004: 55-58
    Google Scholar
  • 28 Henry JA. Audiological assessment. In: Snow JB. ed. Tinnitus: Theory and Management; 2004
    Google Scholar
  • 29 Pesce RP, Assis SG, Avanci JQ, Santos NC, Malaquias JV, Carvalhaes R. Cross-cultural adaptation, reliability and validity of the resilience scale. Cad Saude Publica 2005; 21 (02) 436-448
    CrossrefPubMedGoogle Scholar
  • 30 Rocha MM. Silvares EFdM. Versão Brasileira, não publicada do Adult Self-Report for ages 18–59. In: Rescorla A. ed. Questionnaire Adult Self-Report for ages 18–59. 2010
    Google Scholar
  • 31 Kipper LdC. Estudo das características de personalidade e fatores de vulnerabilidade em pacientes adultos com transtorno do pânico e de suas relações com a resposta ao tratamento e com o curso da doença Faculdade de Medicina . Universidade Federal do Rio Grande do Sul; 2007. . Accessed March 21, 2021 at: https://lume.ufrgs.br/handle/10183/12633
    Google Scholar
  • 32 John OP, Srivastava S. The Big Five Trait taxonomy: History, Measurement, and Theoretical perspectives. Handbook of Personality: Theory and Research, 2nd ed. New York, NY: Guilford Press; 1999
    Google Scholar
  • 33 Ribeiro AAT, Soeiro C. A influência da personalidade na detecção da mentira,. Instituto Superior de Ciências da saúde Egas Moniz; 2013
    Google Scholar
  • 34 Hayes AF. Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York, NY: Guilford Press; 2013. . xvii, 507-xvii, 507
    Google Scholar
  • 35 Hoekstra CE, Wesdorp FM, van Zanten GA. Socio-demographic, health, and tinnitus related variables affecting tinnitus severity. Ear Hear 2014; 35 (05) 544-554
    CrossrefPubMedGoogle Scholar
  • 36 Wallhäusser-Franke E, Brade J, Balkenhol T, D'Amelio R, Seegmüller A, Delb W. Tinnitus: distinguishing between subjectively perceived loudness and tinnitus-related distress. PLoS One 2012; 7 (04) e34583
    CrossrefPubMedGoogle Scholar
  • 37 Simões J, Schlee W, Schecklmann M, Langguth B, Farahmand D, Neff P. Big five personality traits are associated with tinnitus improvement over time. Sci Rep 2019; 9 (01) 18234
    CrossrefPubMedGoogle Scholar
  • 38 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
    CrossrefPubMedGoogle Scholar