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Audiologist-Supported Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States: A Pilot Trial
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In: ETSU Faculty Works (2021)
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Dismantling Internet-Based Cognitive Behavioral Therapy for Tinnitus. The Contribution of Applied Relaxation: A Randomized Controlled Trial
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In: ETSU Faculty Works (2021)
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Abstract:
Background: Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if heterogeneous tinnitus subgroups respond differently to ICBT. Aims: This dismantling study aimed to explore the contribution of applied relaxation within ICBT for reducing tinnitus distress and comorbidities associated with tinnitus. A secondary aim was to assess whether outcomes varied for three tinnitus subgroups, namely those with significant tinnitus severity, those with low tinnitus severity, and those with significant depression. Methods: A parallel randomized controlled trial design (n = 126) was used to compare audiologist-guided applied relaxation with the full ICBT intervention. Recruitment was online and via the intervention platform. Assessments were completed at four-time points including a 2-month follow-up period. The primary outcome was tinnitus severity as measured by the Tinnitus Functional Index. Secondary outcomes were included for anxiety, depression, insomnia, negative tinnitus cognitions, health-related quality of life, hearing disability, and hyperacusis. Treatment engagement variables including the number of logins, number of modules opened, and the number of messages sent. Both an intention-to-treat analysis and completer's only analysis were undertaken. Results: Engagement was low which compromised results as the full intervention was undertaken by few participants. Both the ICBT and applied relaxation resulted in large reduction of tinnitus severity (within-group effect sizes d = 0.87 and 0.68, respectively for completers only analysis), which were maintained, or further improved at follow-up. These reductions in tinnitus distress were greater for the ICBT group, with a small effect size differences (between-group d = 0.15 in favor of ICBT for completers only analysis). Tinnitus distress decreased the most at post-intervention for those with significant depression at baseline. Both ICBT and applied relaxation contributed to significant reductions on most secondary outcome measures, with no group differences, except for a greater reduction of hyperacusis in the ICBT group. Conclusion: Due to poor compliance partly attributed to the COVID-19 pandemic results were compromised. Further studies employing strategies to improve compliance and engagement are required. The intervention's effectiveness increased with initial level of tinnitus distress; those with the highest scores at intake experienced the most substantial changes on the outcome measures. This may suggest tailoring of interventions according to tinnitus severity. Larger samples are needed to confirm this.
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Keyword:
applied relaxation; Audiology and Speech-Language Pathology; cognitive behavioral therapy; digital therapeutics; internet intervention; telehealth; tinnitus
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URL: https://dc.etsu.edu/cgi/viewcontent.cgi?article=10799&context=etsu-works
https://dc.etsu.edu/etsu-works/9533
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Use of Open-Ended Questionnaires to Examine the Effects of Tinnitus and Its Relation to Patient-Reported Outcome Measures
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In: ETSU Faculty Works (2021)
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Tinnitus and auditory cortex; Using adapted functional near- infrared- spectroscopy to expand brain imaging in humans
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Auditory and vestibular symptoms after COVID-19 infection: a preliminary Brazilian report
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In: Revista CEFAC, Vol 23, Iss 6 (2021) (2021)
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| 6 |
Tinnitus Does Not Interfere with Auditory and Speech Perception.
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In: The Journal of neuroscience : the official journal of the Society for Neuroscience, vol 40, iss 31 (2020)
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Features, Functionality, and Acceptability of Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States
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In: ETSU Faculty Works (2020)
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What’s That Ringing in Your Ears?
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In: ETSU Faculty Works (2020)
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| 9 |
Internet-based Cognitive Behavioral Therapy (ICBT) for Tinnitus in the U.S
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In: ETSU Faculty Works (2020)
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| 10 |
Translation and Adaptation of Three English Tinnitus Patient-Reported Outcome Measures to Spanish
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In: ETSU Faculty Works (2020)
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| 11 |
The Case for Employing Elements of Tauma Counseling for Patients with Tinnitus
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In: ETSU Faculty Works (2020)
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| 12 |
The use of the Dangerous Decibels® program for refrigeration company workers and their children: an intergenerational pilot study
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In: Revista CEFAC, Vol 22, Iss 1 (2020) (2020)
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| 13 |
Development of an educational tool on tinnitus in a website format
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In: Revista CEFAC, Vol 22, Iss 6 (2020) (2020)
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| 14 |
Improving Accessibility of an Internet-Intervention for Tinnitus
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In: ETSU Faculty Works (2019)
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Readability Following Cultural and Linguistic Adaptations of an Internet-Based Intervention for Tinnitus for Use in the United States
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In: ETSU Faculty Works (2019)
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Aging and Central Auditory Disinhibition: Is It a Reflection of Homeostatic Downregulation or Metabolic Vulnerability?
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In: Brain Sciences ; Volume 9 ; Issue 12 (2019)
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A Cross-Sectional Questionnaire Study of Tinnitus Awareness and Impact in a Population of Adult Cochlear Implant Users.
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| 20 |
Recording of tinnitus psychoacoustic measurements: an integrative literature review
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In: Revista CEFAC, Vol 21, Iss 5 (2019) (2019)
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