Greater degrees of perceived similarity, being female and higher estimated pain were linked to a stronger 'emotional reaction', whereas previous exposure to pain facilitated 'perspective taking'. Pointing out similarities between people and their past experiences, as well as focusing on the imagined discomfort being felt by another person, may modulate empathy for pain.

Neuroimaging studies have revealed partially shared neural substrates for both the actual experience of pain and empathy elicited by the pain of others. We examined whether prior pain exposure increased neural activity in the anterior midcingulate cortex (aMCC) and bilateral anterior insula (AI) as a correlate of empathy for pain. Participants (N=64: 32 women, 32 men) viewed pictures displaying exposure to pressure pain (pain pictures) and pictures without any cue of pain (neutral pictures). Prior to the experiment, half of the participants were exposed to the same pain stimulus as the one seen in the pain pictures (pain exposure condition); the other half had no such experience (touch exposure condition). A balanced sex ratio was kept, to investigate possible sex differences. In the region-of-interest analyses, participants of the pain exposure condition showed decreased activity in the right AI and the aMCC relative to participants of the touch exposure condition. While in men, no differences were found in relation to their exposure condition, women with pain exposure showed decreased activity in the aMCC and additionally, in bilateral AI. Based on the entire sample, whole brain analyses revealed stronger activation in the retrosplenial cortex, dorsomedial prefrontal cortex, and medial prefrontal cortex in the pain exposure condition. In conclusion, prior pain exposure did not increase, but decreased activity in regions regularly associated with empathy for pain. However, pain experience increased activity in regions associated with memory retrieval, perspective taking, and top-down emotion regulation, which might facilitate empathizing with others.

These results suggest that hyperacusis is associated with noise-related avoidance behavior and anxiety. Systematic exposure to sound could play a significant role in the treatment of hyperacusis.

Tinnitus retraining therapy (TRT), as conceived of mainly by PJ Jastreboff, has recently received increasing attention in the media, as well as in seminars and congresses on treatment methods for chronic tinnitus. It is often claimed, though not explicitly in scientific publications, that TRT is currently the most efficacious therapy for tinnitus, obtaining improvement rates exceeding 80%. This assertion is highly significant in light of the most likely increasing prevalence of chronic tinnitus and ensuing urgent demand for effective therapies. Before examining the evidence regarding the effectiveness of TRT, Jastreboff's theoretical idea of tinnitus as a neurophysiological disorder is examined and evaluated. This idea is plausible and is supported by some evidence. The interaction between neuroacoustic and emotional processes emphasized by Jastreboff is, however, neither new nor sufficiently elaborated with respect to the underlying psychological factors. The TRT intervention technique and its main components 'directive counselling' and use of 'noise generators' are found to be theoretically well grounded. The lack of detailed information concerning TRT implementation and the potential consequence that differing interventions may be labelled TRT are criticized. Jastreboff's obvious opposition to psychologists' participation in TRT, despite the increase in efficacy they could affect through utilization of cognitive restructuring techniques and behaviour modification interventions, is also criticized. Finally, studies regarding the efficacy of TRT are reviewed and severe methodological shortcomings (e.g. lack of controlled randomized group studies) in TRT research are noted. Taking the current state of evidence into account, we conclude that there is no convincing empirical support for the assumption that TRT is superior to other treatments, since no comparative studies have been conducted. It is contended that there is more substantial empirical support for the efficacy of cognitive-behavioural interventions in reducing tinnitus annoyance and tinnitus-related suffering. The necessity for methodologically well-designed studies to pinpoint effect sizes of TRT and compare them with other techniques, especially cognitive-behavioural ones, is emphasized.

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Their high predictive values suggest that chronicity and personality disorder rank among the most important characteristics of addiction severity.