Tinnitus and Metacognitive Beliefs—Results of a Cross-Sectional Observational Study

Abstract

Recent research has highlighted the role of metacognitions as a moderator for psychological distress in patients with chronic diseases. The present study investigates the role of metacognitions and worry in the association between tinnitus distress, anxiety, and depression. A cross-sectional study was carried out with a sample of tinnitus-outpatients who completed the Tinnitus-Handicap Inventory, Beck Anxiety Inventory, Beck Depression Inventory, Metacognition Questionnaire-30, Penn-State-Worry-Questionnaire. Associations of metacognitions, worries, tinnitus distress, anxiety and depression were investigated using structural equation models (SEMs). A sample of n = 107 patients was included in the study. In the first SEM, tinnitus distress significantly predicted depression (β = 0.68, p < 0.001) and anxiety (β = 0.47, p < 0.001). In the second model, worries and meta-cognitions were added as moderators. The explained variance substantially increased for depression (46 to 53%) and anxiety (22 to 35%) and the association of tinnitus distress with depression (β = 0.57, p < 0.001) and anxiety was weakened (β = 0.32, p < 0.001). Negative beliefs significantly predicted worries (β = 0.51, p < 0.001) and explained 41% of its variance. A good model fit for the final model was found (comparative fit index (CFI) = 0.98; (Tucker Lewis index) TLI = 0.96; root mean square error of approximation (RMSEA) = 0.067). Anxiety and depression in tinnitus patients might be influenced by worries, which is mainly predicted by negative beliefs about uncontrollability and danger of worries. Thus, psychotherapeutic approaches focused on alterations of metacognitions in patients with tinnitus should be investigated in future studies.3 (List three to ten pertinent keywords specific to the article yet reasonably common within the subject discipline.)

The Comorbidity of Depression and Anxiety Symptoms in Tinnitus Sufferers: A Network Analysis

“…Some interventions could be implemented to alleviate these three symptoms. For example, A2 “Unable to control worry” was identified as the core symptom of the tinnitus sufferers’ network in this study, which is consistent with the findings of Natalini and colleagues’ study [ 65 ]. The authors developed the innovative idea that psychotherapeutic approaches could focus on alterations to the metacognitions of tinnitus sufferers.…”

Cross-sectional and Longitudinal Associations Between Tinnitus and Mental Health in a Population-Based Sample of Middle-aged and Elderly Persons

“…Those negative thoughts and hyperawareness have been suggested to be a mechanism for developing mental health problems . Yet, equally, it could be speculated that mental health problems lead to a negative focus that worsens the experience of tinnitus or that a tendency toward negative thoughts, stress, and hyperawareness may be a shared common cause. Further research is needed to determine the exact pathways.…”

Associations of Earphone Use with Tinnitus and Anxiety/Depression

“…[ 33 ] The plausible mechanisms for contribution of tinnitus on anxiety and depression have been suggested, such as tinnitus-related distress and hyperactivation of limbic and sympathetic nervous system. [ 34 35 36 ] A cognitive-behavioral model of tinnitus was hypothesized that the importance of interpretations of tinnitus by perceived patients which can provoke emotional distress and maintaining the tinnitus-related distress via feedback loops involving cognitive functions, such as selective attention, monitoring, and counterproductive safety behaviors. [ 34 ] For instance, tinnitus distress was correlated with depression and anxiety ( β = 0.68 and 0.47, both P < 0.001).…”

“…[ 34 ] For instance, tinnitus distress was correlated with depression and anxiety ( β = 0.68 and 0.47, both P < 0.001). [ 35 ] To attenuate the potential influence of tinnitus on the association between earphone use and anxiety or depression, the model 2 was adjusted for tinnitus. The results indicated the association of earphone use after adjusted for tinnitus.…”