When Tinnitus Loudness and Annoyance Are Discrepant: Audiological Characteristics and Psychological Profile

Abstract

This study evaluates sociodemographic and clinical characteristics of patients reporting discrepant levels of tinnitus loudness and annoyance. 4958 subjects recruited from a national tinnitus association completed a comprehensive screening questionnaire including Klockhoff and Lindblom’s loudness grading system and the psychometric Mini-TQ (Tinnitus Questionnaire). There was a moderate correlation of 0.45 between loudness and annoyance. Of the subjects reporting very loud tinnitus, about one third had only mild or moderate annoyance scores. They were not different from those with high annoyance regarding age, gender and tinnitus duration, but annoyance was increased when subjects had additional hearing loss (OR = 1.71), vertigo/dizziness (OR = 1.94) or hyperacusis (OR = 4.96). Another significant predictor was history of neurological disease (OR = 3.16). Subjects reported low annoyance despite high loudness more often if not feeling low/depressed and not considering themselves as victims of their noises. A specific psychological profile was found to characterize annoyed tinnitus sufferers. Permanent awareness of the noises, decreased ability to ignore them and concentration difficulties were reported frequently even when overall annoyance scores were comparatively low. It is concluded that the coexistence of tinnitus with hearing loss, vertigo/dizziness and hyperacusis as complicating otological conditions seems to be of clinical relevance for the prediction of high annoyance levels. Tinnitus loudness and annoyance are not necessarily congruent and should be assessed separately.

A confirmatory factor analytic validation of the Tinnitus Handicap Inventory

“…This is a replication of previous findings (e.g., [16]). Finally, as postulated, between the Big Five personality traits extraversion, agreeableness, openness, and conscientiousness only small correlations or even zero-correlations were identified.…”

“…For this purpose, scales that only assess the subjective loudness or intensity of the tinnitus are not sufficient, in particular because tinnitus loudness itself is rather moderately or lowly correlated with the experienced distress [16][17][18][19]. Instead measures that directly assess different dimensions of the impairment and distress associated with tinnitus are necessary.…”

The influence of psychological factors on tinnitus severity

“…Obviously, further factors, which are not reflected by the SCL-90-R, are relevant for tinnitus severity. Among them may be tinnitus loudness, coping behavior, comorbidities such as hearing loss, vertigo, dizziness and hyperacusis, tinnitus duration, age at tinnitus onset and etiology of tinnitus onset, which all have been proposed as factors that have an influence on the quality of life of tinnitus patients [17,[42][43][44][45][46][47].…”

A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial

“…Some lead a fully functioning life; however, tinnitus becomes a distressing and incapacitating symptom that seriously interferes with many aspects of daily life in 3–6% of the general population (Ahmad & Seidman, 2004; Davis & Rafaie, 2000). The severity of the distress experienced from the tinnitus is determined not by the acoustic characteristics, such as pitch and loudness of tinnitus (Andersson, 2003; Henry & Meikle, 2000; Hiller & Goebel, 2007), but by the cognitive, emotional and behavioural reactions to it (Andersson, 2002; Andersson & Westin, 2008; Cima, Crombez, & Vlaeyen, 2011; McKenna, Handscomb, Hoare, & Hall, 2014). Many tinnitus patients suffer from insomnia (Cronlein et al, 2016), concentration difficulties (Hallam, McKenna, & Shurlock, 2004; Rossiter, Stevens, & Walker, 2006) or headaches (Langguth et al, 2015).…”