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Annals of Behavioral Medicine

, Volume 17, Issue 4, pp 357–366 | Cite as

A Review of psychological treatment approaches for patients suffering from tinnitus

  • Gerhard Andersson
  • Lennart Melin
  • Christina Hägnebo
  • Berit Scott
  • Per Lindberg
Review

Abstract

Disabling tinnitus (ringing or buzzing in the ear) is a condition experienced by at least 1–2% of the population. Since medical and technical treatments are only partly successful, several psychological treatment approaches have been applied in the treatment of tinnitus. This article reviews 38 studies on hypnosis, biofeedback, and cognitive-behavioral approaches together with relaxation techniques. It is concluded that relaxation training together with cognitive-behavioral coping techniques is the method which so far has received the most empirical support. Still, more research is needed on the effects of psychological treatment. Finally, five recommendations are made regarding the treatment of tinnitus patients.

Keywords

Cochlear Implant Relaxation Training Cinnarizine Tinnitus Patient Chronic Tinnitus 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. (1).
    Hazell JWP, Jastreboff PJ: Tinnitus I: Auditory mechanisms: A model for tinnitus and hearing impairment.Journal of Otolaryngology. 1990,79:1–5.Google Scholar
  2. (2).
    Jakes S: Otological symptoms and emotion. A review of the literature.Advances in Behaviour Research and Therapy. 1988,10: 53–103.CrossRefGoogle Scholar
  3. (3).
    Hallam R, Rachman S, Hinchcliffe R: Psychological aspects of tinnitus. In Rachman S (ed),Contributions to Medical Psychology (Vol. 3). Oxford, UK: Pergamon Press, 1984, 31–53.Google Scholar
  4. (4).
    Kirsch CA, Blanchard EB, Parnes SM: A review of behavioral techniques in the treatment of subjective tinnitus.Annals of Behavioral Medicine. 1989,11:58–65.CrossRefGoogle Scholar
  5. (5).
    Axelsson A, Ringdahl A: Tinnitus—A study of its prevalence and characteristics.British Journal of Audiology. 1989,23:53–62.PubMedCrossRefGoogle Scholar
  6. (6).
    Davis A: The prevalence of hearing impairment and reported hearing disability among adults in Great Britain.International Journal of Epidemiology. 1989,18: 911–917.PubMedCrossRefGoogle Scholar
  7. (7).
    Parving A, Hein HO, Suadicani B, Ostri B, Gyntelberg F: Epidemiology of hearing disorders.Scandinavian Audiology. 1993,22:101–107.PubMedGoogle Scholar
  8. (8).
    Lindberg P, Lyttkens L, Melin L, Scott B: Tinnitus—Incidence and handicap.Scandinavian Audiology. 1984,13:287–291.PubMedGoogle Scholar
  9. (9).
    Lewis J, Stephens D, Huws D: Suicide in tinnitus.Journal of Au-diological Medicine. 1992,7:30–37.Google Scholar
  10. (10).
    Sood SK, Coles RRA: Hyperacusis and phonophobia in tinnitus patients.British Journal of Audiology. 1988,22:228.Google Scholar
  11. (11).
    Halford JBS, Anderson SD: Anxiety and depression in tinnitus sufferers.Journal of Psychosomatic Research. 1991,35:383–390.PubMedCrossRefGoogle Scholar
  12. (12).
    Eggermont JJ: On the pathophysiology of tinnitus: A review and a peripheral model.Hearing Research. 1990,48:111–124.PubMedCrossRefGoogle Scholar
  13. (13).
    Jastreboff PJ: Phantom auditory perception (tinnitus): Mechanisms of generation and perception.Neuroscience Research. 1990,8:221–224.PubMedCrossRefGoogle Scholar
  14. (14).
    Tonndorf J: The analogy between tinnitus and pain: A suggestion for a physiological basis of chronic tinnitus.Hearing Research. 1987,28:271–275.PubMedCrossRefGoogle Scholar
  15. (15).
    Wilson PH, Henry JL, Nicholas MK: Cognitive methods in the management of chronic pain and tinnitus.Australian Psychologist. 1993,28:172–180.CrossRefGoogle Scholar
  16. (16).
    Tyler RS, Stouffer JL: A review of tinnitus loudness.Hearing Journal. 1989,42:52–57.Google Scholar
  17. (17).
    Axelsson A, Coles R, Erlandsson S, Meikle M, Vernon J: Evaluation of tinnitus treatment: Methodological aspects.Journal of Audiological Medicine. 1993,2:141–150.Google Scholar
  18. (18).
    Murai K, Tyler RS, Harker LA, Stouffer JL: Review of pharmacological treatment of tinnitus.American Journal of Otology. 1992,13:454–464.PubMedGoogle Scholar
  19. (19).
    Marks NJ, Emery P, Onisphorou C: A controlled trial of acupuncture in tinnitus.Journal of Laryngology and Otology. 1984,98:1103–1109.PubMedGoogle Scholar
  20. (20).
    Hazell JWP, Wood SM, Cooper HR, et al: A clinical study of tinnitus maskers.British Journal of Audiology. 1985,79:65–146.CrossRefGoogle Scholar
  21. (21).
    Melin L, Scott B, Lindberg P, Lyttkens L: Hearing aids and tinnitus—An experimental group study.British Journal of Audiology. 1987,27:91–97.CrossRefGoogle Scholar
  22. (22).
    Hazell JWP: Electrical tinnitus suppression. In Cooper H (ed),Cochlear Implants. A Practical Guide. London: Whurr, 1991, 355–369.Google Scholar
  23. (23).
    Dobie RA, Hoberg KE, Rees TS: Electrical tinnitus suppression: A double-blind crossover study.Otolaryngology, Head and Neck Surgery. 1986,95:319–323.Google Scholar
  24. (24).
    Coles R, Bradley P, Donaldson I, Dingle A: A trial of tinnitus therapy with ear-canal magnets.Clinical Otolaryngology. 1991,16:371–372.PubMedCrossRefGoogle Scholar
  25. (25).
    Hazell JWP: Tinnitus II: Surgical management of conditions associated with tinnitus and somatosounds.Journal of Otolaryngology. 1990,19:6–10.PubMedGoogle Scholar
  26. (26).
    Hinchcliffe R, King PF: Medicolegal aspects of tinnitus. 1: Medicolegal position and current state of knowledge.Journal of Audiological Medicine. 1992,7:38–58.Google Scholar
  27. (27).
    Dobie RA, Sullivan MD, Katon WJ, Sakai CS, Russo J: Antidepressant treatment of tinnitus patients.Acta Otolaryngology. 1992,772:242–247.Google Scholar
  28. (28).
    Thomas M, Laurell G, Lundeberg T: Acupuncture for the alleviation of tinnitus.Laryngoscope. 1988,98:664–667.PubMedCrossRefGoogle Scholar
  29. (29).
    Erlandsson S, Ringdahl A, Hutchins T, Carlsson SG: Treatment of tinnitus: A controlled comparison of masking and placebo.British Journal of Audiology. 1987,21:37–44.PubMedCrossRefGoogle Scholar
  30. (30).
    Lyttkens L, Lindberg P, Scott B, Melin L: Treatment of tinnitus by external electrical stimulation.Scandinavian Audiology. 1986,15:157–164.PubMedGoogle Scholar
  31. (31).
    Stephens SDG: The treatment of tinnitus—A historical perspective.Journal of Laryngology and Otology. 1984,98:963–972.PubMedGoogle Scholar
  32. (32).
    Wilson PH, Henry JL: Psychological approaches in the management of tinnitus.Australian Journal of Otolaryngology. 1993,7: 296–302.Google Scholar
  33. (33).
    Stouffer JL, Tyler RS, Kileny PR, Dalzell LE: Tinnitus as a function of duration and etiology: Counselling implications.American Journal of Otolaryngology. 1991,72:188–194.Google Scholar
  34. (34).
    Tyler RS, Aran J-M, Dauman R: Recent advances in tinnitus.American Journal of Audiology. 1992,1:36–43.Google Scholar
  35. (35).
    Kihlstrom JF: Hypnosis.Annual Review of Psychology. 1985,36: 385–418.PubMedCrossRefGoogle Scholar
  36. (36).
    Marlowe FI: Effective treatment of tinnitus through hypnotherpy.American Journal of Clinical Hypnosis. 1973,75:162–165.Google Scholar
  37. (37).
    Brattberg G: An alternative method of treating tinnitus: Relaxation-hypnotherapy printarily through the home use of a recorded audio cassette.InternationalJournal of Clinical and Experimental Hypnosis. 1983,31:90–97.CrossRefGoogle Scholar
  38. (38).
    Marks NJ, Karl H, Onisiphorou C: A controlled trial of hypnotherapy in tinnitus.Clinical Otolaryngology. 1985,10:43–46.PubMedCrossRefGoogle Scholar
  39. (39).
    Attias J, Shemsh Z, Shoam C, Shahar A, Sohmer H: Efficacy of self-hypnosis for tinnitus relief.Scandinavian Audiology. 1990,19: 245–249.PubMedGoogle Scholar
  40. (40).
    Attias J, Shemsh Z, Sohmer H, et al: Comparison between self-hypnosis, masking, and attentiveness for alleviation of chronic tinnitus.Audiology. 1993,32:205–212.PubMedCrossRefGoogle Scholar
  41. (41).
    House JW, Miller L, House PR: Severe tinnitus: Treatment with biofeedback training (results in 41 cases).Transactions of the American Academy of Ophthalmology & Otology. 1977,84:697–703.Google Scholar
  42. (42).
    House JW: Treatment of severe tinnitus with biofeedback training.Laryngoscope. 1978,88:406–412.PubMedCrossRefGoogle Scholar
  43. (43).
    Elfner LF, May JG, Moore JD, Mendelson JM: Effects of EMG and thermal feedback training on tinnitus: A case study.Biofeedback and Self-Regulation. 1981,4:517–521.CrossRefGoogle Scholar
  44. (44).
    Duckro PN, Pollard CA, Bray HD, Scheiter L: Comprehensive behavioral management of complex tinnitus: A case illustration.Biofeedback and Self-Regulation. 1984,9:459–469.PubMedCrossRefGoogle Scholar
  45. (45).
    Ince LP, Greene RY, Alba A, Zaretsky HH: Learned self-control of tinnitus through a matching-to-sample feedback technique: A clinical investigation.Journal of Behavioural Medicine. 1984,7: 355–365.CrossRefGoogle Scholar
  46. (46).
    Borton TE, Clark SR: Electromyographic biofeedback for treatment of tinnitus.American Journal of Otology. 1988,9:23–30.PubMedGoogle Scholar
  47. (47).
    Erlandsson S, Carlsson SG, Svensson A: Biofeedback in the treatment of tinnitus: A broadened approach.Göteborg Psychological Reports. 1989,19:1–12.Google Scholar
  48. (48).
    Kirsch CA, Blanchard EB, Parnes SM: A multiple-baseline evaluation of the treatment of subjective tinnitus with relaxation training and biofeedback.Biofeedback and Self-Regulation. 1987,12: 95–312.CrossRefGoogle Scholar
  49. (49).
    Carmen R, Svihovec D: Relaxation—biofeedback in the treatment of tinnitus.American Journal of Otology. 1984,5:376–381.PubMedGoogle Scholar
  50. (50).
    Ince LP, Greene RY, Alba A, Zaretsky HH: A matching-to-sample feedback technique for training self-control of tinnitus.Health Psychology. 1987,6:173–182.PubMedCrossRefGoogle Scholar
  51. (51).
    Walsh WM, Gerley PP: Thermal biofeedback and the treatment of tinnitus.Laryngoscope. 1985,95:987–989.PubMedCrossRefGoogle Scholar
  52. (52).
    Landis L, Landis E: Is biofeedback effective for chronic tinnitus? An intensive study with seven subjects.American Journal of Otolaryngology. 1992,13:349–356.PubMedCrossRefGoogle Scholar
  53. (53).
    Erlandsson S, Rubenstein B, Carlsson SG: Tinnitus: Evaluation of biofeedback and stomatognathic treatment.British Journal of Audiology. 1991,25:151–161.PubMedCrossRefGoogle Scholar
  54. (54).
    White TP, Hoffman SR, Gale EN: Psychophysiological therapy for tinnitus.Ear and Hearing. 1986,7:397–399.PubMedCrossRefGoogle Scholar
  55. (55).
    Haralambous G, Wilson PH, Platt-Hepworth S, et al: EMG biofeedback in the treatment of tinnitus: An experimental evaluation.Behaviour Research and Therapy. 1987,25:49–55.PubMedCrossRefGoogle Scholar
  56. (56).
    Podoshin L, Ben-David Y, Fradis M, Gerstel R, Felner H: Idiopathic subjective tinnitus treated by biofeedback, acupuncture, and drug therapy.Ear, Nose and Throat Journal. 1991,70:284–289.Google Scholar
  57. (57).
    Sirimanna T, Stephens D: Coping with tinnitus.Practitioner. 1992,256:821–826.Google Scholar
  58. (58).
    Coles RRA: A survey of tinnitus management in national health service hospitals.Clinical Otolaryngology. 1992,17:313–316.PubMedCrossRefGoogle Scholar
  59. (59).
    MacLeod-Morgan C, Court J, Roberts R: Cognitive restructuring: A technique for the relief of chronic tinnitus.Australian Journal of Clinical and Experimental Hypnosis. 1982,70:27–33.Google Scholar
  60. (60).
    Chiodo J, Walley PB, Jenkins JO: A modified progressive relaxation training program in the rehabilitation of a hearing-impaired client.International Journal of Behavioral Geriatrics. 1983,2:43–46.Google Scholar
  61. (61).
    Malesta VJ, Sutker PB, Adams HE: Experimental assessment of tinnitus aurium.Journal of Behavioral Assessment. 1980,2:309–317.CrossRefGoogle Scholar
  62. (62).
    Hallam RS, Jakes SC: Tinnitus: Differential effects of therapy in a single case.Behaviour Research and Therapy. 1985,23:691–694.PubMedCrossRefGoogle Scholar
  63. (63).
    Lindberg P, Lyttkens L, Melin L, Scott B: The use of a coping technique in the treatment of tinnitus.Scandinavian Journal of Behaviour Therapy. 1984,75:117–121.Google Scholar
  64. (64).
    Lindberg P: Effects of self-control training on tinnitus in a deaf patient—A case study.Scandinavian Journal of Behaviour Therapy. 1988,17:223–229.Google Scholar
  65. (65).
    Jakes SC, Hallam RS, Rachman S, Hinchcliffe R: The effects of reassurance, relaxation training, and distraction on chronic tinnitus sufferers.Behaviour Research and Therapy. 1986,24:497–507.PubMedCrossRefGoogle Scholar
  66. (66).
    Lindberg P, Scott B, Melin L, Lyttkens L: Behavioural therapy in the clinical management of tinnitus.British Journal of Audiology. 1988,22:265–272.PubMedCrossRefGoogle Scholar
  67. (67).
    Goebel G, Hiller W, Fruhauf K, Fichter MM: Effects of inpatient multimodal behavioral treatment on complex chronic tinnitus. In Aran J-M, Dauman R (eds),Tinnitus 91. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications, 1992, 465–470.Google Scholar
  68. (68).
    Scott B, Lindberg P, Melin L, Lyttkens L: Psychological treatment of tinnitus. An experimental group study.Scandinavian Audiology. 1985,74:223–230.Google Scholar
  69. (69).
    Lindberg P, Scott B, Melin L, Lyttkens L: Long-term effects of psychological treatment of tinnitus.Scandinavian Audiology. 1987,76:167–172.Google Scholar
  70. (70).
    Ireland CE, Wilson PH, Tonkin JP, Platt-Hepworth S: An evaluation of relaxation training in the treatment of tinnitus.Behaviour Research and Therapy. 1985,23:423–430.PubMedCrossRefGoogle Scholar
  71. (71).
    Lindberg P, Scott B, Melin L, Lyttkens L: The psychological treatment of tinnitus: An experimental evaluation.Behaviour Research and Therapy. 1989,27:593–603.PubMedCrossRefGoogle Scholar
  72. (72).
    Loumidis KS, Hallam RS, Cadge B: The effect of written reassuring information on outpatients complaining of tinnitus.British Journal of Audiology. 1991,25:105–109.PubMedCrossRefGoogle Scholar
  73. (73).
    Jakes SC, Hallam RS, McKenna L, Hinchcliffe R: Group therapy for medical patients: An application to tinnitus.Cognitive Therapy and Research. 1992,16:67–82.CrossRefGoogle Scholar
  74. (74).
    Henry JL, Wilson PH: Psychological management of tinnitus. An evaluation of cognitive interventions. In Aran J-M, Dauman R (eds),Tinnitus 91. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications, 1992, 477–480.Google Scholar
  75. (75).
    Davies S, McKenna L, Hallam RS: Relaxation and cognitive therapy: A controlled trial in chronic tinnitus.Psychology & Health. 1995,10:129–144.CrossRefGoogle Scholar
  76. (76).
    Bernstein DA, Borkovec TD:Progressive Relaxation Training: A Manual for the Helping Professions. Champaign, IL: Research Press, 1973.Google Scholar
  77. (77).
    Wilson PH, Bowen W, Farag P: Cognitive and relaxation techniques in the management of tinnitus. In Aran J-M, Dauman R (eds),Tinnitus 91. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications, 1992, 489–491.Google Scholar
  78. (78).
    Rubenstein B, Österberg T, Rosenhall U: Longitudinal fluctuations in tinnitus as reported by an elderly population.Journal of Au-diological Medicine. 1992,7:149–155.Google Scholar
  79. (79).
    Scott B, Lindberg P, Melin L, Lyttkens L: tPredictors of tinnitus discomfort, adaption, and subjective loudness.British Journal of Audiology. 1990,24:51–62.PubMedCrossRefGoogle Scholar
  80. (80).
    Sweetow RW, Levy MC: Tinnitus severity scaling for diagnostic/ therapeutic usage.Hearing Instruments. 1990,47:20–21, 46.Google Scholar
  81. (81).
    Erlandsson SI: Assessment of tinnitus. In Aran J-M, Dauman R (eds),Tinnitus 91. Proceedings of the Fourth International Tinnitus Seminar. Amsterdam: Kugler Publications, 1992, 545–549.Google Scholar
  82. (82).
    Hallam RS, Jakes SC, Hinchcliffe R: Cognitive variables in tinnitus annoyance.British Journal of Clinical Psychology. 1988,27:213–222.PubMedGoogle Scholar
  83. (83).
    Andersson G, Melin L: Functional analysis of hearing handicap.Scandinavian Journal of Behaviour Therapy. 1993,22:147–157.Google Scholar

Copyright information

© The Society of Behavioral Medicine 1995

Authors and Affiliations

  • Gerhard Andersson
    • 1
  • Lennart Melin
    • 1
  • Christina Hägnebo
    • 1
  • Berit Scott
    • 1
  • Per Lindberg
    • 1
  1. 1.Department of Clinical PsychologyUppsala UniversityUppsala

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