This paper highlights the importance of psychological models and cross-cultural research in the area of hearing help-seeking and hearing-aid uptake, and consequently some directions for future research are proposed.

The effect of phased caffeine withdrawal and abstention on tinnitus severity was assessed using a pseudo-randomized, double-blinded, placebo-controlled crossover trial of 30 days duration. Sixty-six volunteers who experienced tinnitus and who usually consumed at least 150 mg/day of caffeine participated. The intervention was a direct replacement of usual caffeinated tea/coffee with double-blinded supplies, under one of two conditions. Condition 1: Maintenance followed by phased withdrawal. Condition 2: Phased withdrawal followed by reintroduction and maintenance. Tinnitus severity was measured by the total score of the Tinnitus Questionnaire on Days 1, 15, and 30. Secondary measures included twice daily self-rated symptoms relevant to tinnitus and caffeine withdrawal. Caffeine had no effect on tinnitus severity, the mean difference between caffeinated and decaffeinated days being -0.04 (95% confidence interval -1.99 to 1.93), p=0.97. Significant acute adverse symptoms of caffeine withdrawal were observed. No evidence was found to justify caffeine abstinence as a therapy to alleviate tinnitus, but acute effects of caffeine withdrawal might add to the burden of tinnitus.

Despite respect being central to good doctor-patient relationships, little research has investigated the effect of respect from doctors on patient outcomes. Group-level influences such as patients' identification with a traditional or consumerist patient role have also received little attention. We investigated these factors in two studies. Participants imagined they had tinnitus and either identified with one of the two patient roles (Study 1, n = 85) or completed a scale measuring their usual role preferences (Study 2, n = 54). They read a hypothetical respectful or disrespectful doctor-patient scenario and completed measures of personal self-esteem, visit outcomes, and the Illness Perception Questionnaire. Study 1 was experimental, while Study 2 was quasi-experimental in design. In both studies, participants playing a patient whose doctor's behaviours were respectful reported greater patient satisfaction, adherence, and likelihood of revisiting the doctor, and in Study 1 also scored lower on (imagined) illness identity and consequences and reported higher self-esteem. In Study 1, participants acting as traditional patients reported lower self-esteem. In Study 2, participants self-categorising as traditional patients reported greater patient satisfaction, adherence, trust and respect for the doctor, but lower self-esteem. Respect and the patient role should be considered when predicting health outcomes.

Data from a pilot study established that, in reference to people with mental handicap and physical disabilities, I1-year-old subjects tended only to use the terms "mentally handicapped," "physically handicapped," and the colloquial term "divvy." The main study asked children to rate a target child ascribed one of these labels (or the label "normal"), and to complete a measure of social distance from that target. In addition, subjects were divided into those with high or low prior contact with people with mental handicap. Subjects did not distinguish among the attributes of the different non-normal labels, but did differentiate between these and normal, indicating they generally simply employ a "normal/abnormal" categorization of others. In line with predictions derived from social identity theory, social stereotypes were unaffected by interpersonal contact. There was no effect of label on measures of anticipated interpersonal social distance. Implications for "mainstreaming" and ways of re-shaping stereotypes are discussed.

This paper extends the self-categorisation model of symptom appraisals to predict that individuals who believe they have a given illness will perceive concurrent symptoms relevant to that illness to be more severe when they categorise themselves as members of a group of people with that illness. These predictions are supported with opportunity samples of individuals reporting, or not reporting a common cold (Study 1, N ¼ 60) and reporting colds or tinnitus (Study 2, N ¼ 64). In both studies, relevant symptoms were rated as more severe when illness group memberships were salient. The methodological, theoretical and clinical implications of these findings and possible therapeutic applications of self-categorisation theory (SCT) to symptom perceptions are discussed.

This paper extends the self-categorisation model of symptom perception to predict that people aged 50 years and over will report higher levels of hearing handicap when they categorise themselves as members of a group of older people. This prediction is supported with an opportunity sample ( N = 50; mean age = 63 years) who completed a questionnaire designed to screen for hearing handicap in "the elderly" ( sic ). Participants also underwent pure-tone audiometry, which confirmed that the observed difference in hearing handicap was not attributable to any difference in hearing threshold level. Hence these findings offer further support for the self-categorisation model of symptom perception. Their theoretical, clinical, and methodological implications together with possible therapeutic applications of self-categorisation theory to auditory rehabilitation of older people are discussed.Cet article étend la théorie de l'auto-catégorisation de la perception d'un symptôme en posant que des individus âgés de 50 ans et plus auront des niveaux plus élevés de handicap auditif quand ils se catégorisent comme membre d'un groupe de personnes âgées. Pour vérifier cette hypothèse, un échantillon ( N = 50, moyenne d'âge 63 ans) a complété un questionnaire présenté sur un écran spécialement conçu pour le handicap auditif des "personnes âgées" ( sic ). Les sujets ont également subi un test d'audiométrie tonale pure, lequel permet de confirmer que les différences observées sur le plan du handicap auditif ne sont pas attribuables à une différence de niveau auditif. Ainsi les résultats offrent un apport supplémentaire à la théorie de l'auto-catégorisation de la perception d'un symptôme. Leurs implications théoriques cliniques et méthodologiques ainsi que de possibles applications thérapeutiques de la théorie de l'autocatégorisation à la réadaptation auditive des personnes âgées sont discutées.

The way in which differences in beliefs provide a basis for understanding apparently irrational patient behaviours is discussed in the context of social identity theory. Implications for doctor-patient communication and the psychological validity of subjective health status and quality of life measures are also noted.

The present study explored illness perceptions of hearing difficulties amongst one hundred participants who reported experiencing hearing difficulties despite normal audiometric thresholds. This experience is referred to as King-Kopetzky syndrome (KKS), obscure auditory dysfunction (OAD), or auditory processing disorder (APD). Logistic regression was used to consider the associations between help-seeking and a range of audiological and illness perception measures. Results indicate that help-seekers present with poorer speech in noise thresholds than non help-seekers, and that coherent illness perceptions and a negative belief in the consequences of hearing difficulties are associated with help-seeking status, regardless of hearing sensitivity.