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J Am Acad Audiol 2024; 35(03/04): 081-092
DOI: 10.1055/a-2255-7643
Research Article

Confirmatory Factor Analysis of the Hyperacusis Impact Questionnaire, Sound Sensitivity Symptoms Questionnaire, and Screening for Anxiety and Depression in Tinnitus, Including Preliminary Analyses of the Parent Versions for Use with Children

Hashir Aazh 
1   Department of Audiology, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
2   Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, R&D Department, Guildford, United Kingdom
,
Chloe Hayes
3   Cambridge Hearing Group, Department of Psychology, Cambridge, United Kingdom
,
Mercede Erfanian
2   Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, R&D Department, Guildford, United Kingdom
4   Institute for Environmental Design and Engineering, The Bartlett, University College London, London, United Kingdom
,
Brian C.J. Moore 
2   Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis, R&D Department, Guildford, United Kingdom
3   Cambridge Hearing Group, Department of Psychology, Cambridge, United Kingdom
,
Silia Vitoratou 
5   Department of Biostatistics and Health Informatics, Psychometric and Measurement Lab, Institute of Psychiatry, Psychology and Neurosciences, King's College London, London, United Kingdom
› Author Affiliations Funding S.V. and C.H. were funded or partially funded by the National Institute for Health and Care Research (NIHR), Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust, and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, or the Department of Health and Social Care. HA and ME were supported by an R&D fund from Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd.
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Abstract

Background We previously reported the results of exploratory factor analysis (EFA) of the Hyperacusis Impact Questionnaire (HIQ), the Sound Sensitivity Symptoms Questionnaire (SSSD), and the Screening for Anxiety and Depression in Tinnitus (SAD-T). Confirmatory factor analysis (CFA) is necessary to confirm the latent constructs determined using EFA. CFA should use different samples but with similar characteristics to those used for EFA.

Purpose The aim was to use CFA to confirm latent constructs derived using EFA of the HIQ, SSSQ, and SAD-T. We further evaluated the psychometric properties of parent versions of these questionnaires (indicated by -P), which are intended for use with children.

Research Design This was a retrospective cross-sectional study.

Study Sample Data for 323 consecutive adults and 49 children who attended a Tinnitus and Hyperacusis Therapy Clinic in the United Kingdom within a 6-month period were included.

Data Collection and Analysis Data were collected retrospectively from the records of patients held at the Audiology Department. CFA with the weighted least-squares mean and variance-adjusted estimator was applied to assess the previously proposed factor structures of the HIQ, SSSQ, and SAD-T. The internal consistency of the scales was assessed via Cronbach's α (α). The items of the HIQ, SSSQ, and SAD-T were tested for measurement invariance regarding age and gender using the multiple indicator multiple cause (MIMIC) model.

Results All questionnaires showed good to excellent internal consistency, with α = 0.93 for the HIQ, 0.87 for the SSSQ, and 0.91 for the SAD-T. The parent versions showed acceptable to good internal consistency, with α = 0.88 for the HIQ-P, 0.71 for the SSSQ-P, and 0.86 for the SAD-T-P. CFA showed that the HIQ, SSSQ, and SAD-T were all one-factor questionnaires and the factors generally were similar to those obtained for the EFA. The MIMIC model showed that all three questionnaires can be considered as measurement invariant, with scores similar across genders and ages.

Conclusion The HIQ, SSSQ, and SAD-T are internally consistent one-factor questionnaires that can be used in clinical and research settings to assess the impact of hyperacusis, the severity of sound sensitivity symptoms, and to screen for anxiety and depression symptoms. Future studies should further explore the psychometric properties of the parent versions of the HIQ, SSSQ, and SAD-T.

Keywords

EFA - CFA - hyperacusis - tinnitus - misophonia

Ethical Approval

The study was registered and approved as a clinical audit by the Quality Governance Department at the Royal Surrey NHS Foundation Trust (RSFT). Patient consent was waived, as this was a retrospective analysis of the available clinical data. Analysis of the data was approved by the Southwest-Cornwall and Plymouth Research Ethics Committee and the Research and Development department at the RSFT (Project ID: 182924).


Supplementary Material



Publication History

Received: 11 April 2023

Accepted: 24 January 2024

Accepted Manuscript online:
29 January 2024

Article published online:
29 November 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

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