Biofeedback-based behavioral treatment for chronic tinnitus: Results of a randomized controlled trial.

Abstract

Many tinnitus sufferers believe that their tinnitus has an organic basis and thus seek medical rather than psychological treatments. Tinnitus has been found to be associated with negative appraisal, dysfunctional attention shift, and heightened psychophysiological arousal, so cognitive-behavioral interventions and biofeedback are commonly suggested as treatments. This study developed and investigated the efficacy of a biofeedback-based cognitive-behavioral treatment for tinnitus. In total, 130 tinnitus patients were randomly assigned to an intervention or a wait-list control group. Treatment consisted of 12 sessions of a biofeedback-based behavioral intervention over a 3-month period. Patients in the wait-list group participated in the treatment after the intervention group had completed the treatment. Results showed clear improvements regarding tinnitus annoyance, diary ratings of loudness, and feelings of controllability. Furthermore, changes in coping cognitions as well as changes in depressive symptoms were found. Improvements were maintained over a 6-month follow-up period in which medium-to-large effect sizes were observed. The treatment developed and investigated in this study is well accepted and leads to clear and stable improvements. Through demonstration of psychophysiological interrelationships, the treatment enables patients to change their somatic illness perceptions to a more psychosomatic point of view.

Acceptance of Tinnitus: Validation of the Tinnitus Acceptance Questionnaire

“…In our sample, a lower rate of female participants (39.4%) was found. Other tinnitus studies show an approximately equal distribution of gender (e.g., 46.9% females in the meta-analysis by Hesser et al), however, some trials conducted in Germany also report lower rates of female participants, i.e., 33 -38% (Kröner-Herwig, Hebing et al, 1995;Weise, Heinecke et al, 2008;Zachriat & Kröner-Herwig, 2004). In addition, a high level of education was found.…”

“…In particular, cognitive-behavioural treatment (CBT) approaches have been shown to be effective in reducing tinnitus distress (Hesser, Weise, Westin, & Andersson, 2011). These interventions include strategies to change both dysfunctional behaviours and cognitions associated with tinnitus (e.g., Weise, Heinecke, & Rief, 2008;Zachriat & Kröner-Herwig, 2004). Commonly used strategies are for instance attention shift from the tinnitus to enable habituation, exposure to noises and/or to silence to reduce avoidance behaviour, or identification and modification of dysfunctional beliefs to enhance tinnitus acceptance.…”

Tinnitus

“…40 Relax ation therapy does benefi t patients. 42 Formal CBT was shown to reduce tinnitus distress in systematic review and meta-analysis, 43,44 although these studies involved patients suffi ciently distressed as to warrant referral to a psychologist, and therapy was undertaken by expert practitioners, which could limit applicability to a general clinic. 45 A prescriptive treatment protocol for tinnitus called tinnitus retraining therapy (TRT) 46 includes counselling and sound-generator therapy.…”

Internet-Based Guided Self-Help versus Group Cognitive Behavioral Therapy for Chronic Tinnitus: A Randomized Controlled Trial

“…Cognitive behavioral therapy (CBT) is one of the most-researched tinnitus management interventions but is rarely offered in clinical practice [3,4]. The effect of CBT on tinnitus distress has been demonstrated in reviews and meta-analyses [5,6,7]. Furthermore, a recent study by Cima et al [8] revealed that a specialized CBT treatment for tinnitus had a high potential for widespread implementation in routine health care.…”