This pilot study aims to investigate whether a novel mind–body intervention, Mindfulness Based Tinnitus Stress Reduction (MBTSR), may be a beneficial treatment for chronic tinnitus. Eight tinnitus patients who had previously received Tinnitus Counseling (standard of care) at the University of California, San Francisco (UCSF) Audiology Clinic participated in the MBTSR program. The program included 8 weeks of group instruction on mindfulness practice, a 1-day retreat, supplementary readings, and home-based practice using meditation CDs. Using a pre–post intervention design, mean differences (paired t-tests) were calculated. Benefits were measured by a reduction in clinical symptoms, if present, and a tinnitus symptom perception shift. Tinnitus symptom activity and discomfort as well as psychological outcomes were assessed by self-report questionnaires. Both quantitative and qualitative data were gathered. Results indicate that Effect Sizes, if supported by a larger study, may be clinically significant and demonstrate a substantial decrease for items measuring perceived annoyance and perception of handicap of tinnitus. Change scores on study measures all moved in the hypothesized direction, with the exception of negligible change found for the Acting with Awareness (d = −0.05) factor of mindfulness. This pilot study provides preliminary evidence that an 8-week MBTSR program may be an effective intervention for treating chronic tinnitus and its comorbid symptoms, and may help reduce depression and phobic anxiety while improving social functioning and overall mental health. These promising findings warrant further investigation with a randomized controlled trial.
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Andersson, G., Baguley, D. M., McKenna, L., & McFerran, D. J. (2005). Tinnitus: a multidisciplinary approach. London: Whurr.
Axelsson, A., Coles, R. R. A., Erlandsson, S. E., Meikle, M., & Vernon, J. (1993). Evaluation of tinnitus treatment: methodological aspects. Journal of Audiological Medicine, 2, 141–150.
Baer, R. A., Smith, G. T., Hopkins, T., Krietemeyer, J., & Toney, L. (2006). Using self- report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., et al. (2008). Construct validity of the Five Facet Mindfulness Questionnaire in meditating and nonmeditating samples. Assessment, 15, 329–342.
Baguley, D. M. (2002). Mechanisms of tinnitus. British Medical Bulletin, 63, 195–212.
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, G. (1979). Cognitive therapy of depression. New York: Guilford.
Beddoe, A., & Murphy, S. (2004). Does mindfulness decrease stress and foster empathy among nursing students? The Journal of Nursing Education, 43(7), 305–312.
Brazier, J. E., Harper, R., Jones, N. M. B., O'Cathain, A., Thomas, K. J., Usherwood, T., et al. (1992). Validating the SF-36 health survey: a new measure for primary care. British Medical Journal, 305, 160–164.
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.
Caldwell, K., Harrison, M., Adams, M., Quin, R., & Greeson, J. (2010). Developing mindfulness in college students through movement based classes: effects on mood, self-regulatory self-efficacy, stress, and sleep quality. Journal of American College Health, 58, 433–442.
Carlson, L. E., & Garland, S. N. (2005). Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. International Journal of Behavioral Medicine, 12, 278–285.
Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2004). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress and levels of cortisol, dehydroepiandrosterone sulfate (DHEAS) and melatonin in breast and prostate cancer outpatients. Psychoneuroendocrinology, 29(4), 448–474.
Chiesa, A., & Serretti, A. (2009). Mindfulness based cognitive therapy for psychiatric disorders: a systematic review and meta-analysis. Psychiatry Research, 187, 441–453.
Cohen, J. (1977). Statistical power analysis for the behavioral sciences (2nd ed.). New York: Academic Press.
Davis, C. G., & Morgan, M. S. (2008). Finding meaning, perceiving growth, and acceptance of tinnitus. Rehabilitation Psychology, 53, 128–138.
Department of Veterans Affairs, Veterans Benefits Administration, Annual Benefits Report, FY 2010,5.
Derogatis, L. R. (1983). SCL–90–R: Administration, scoring, and procedures manual II. Baltimore, MD: Clinical Psychometric Research.
Folmer, R. L. (2002). Long-term reductions in tinnitus severity. Biomedical Central Ear, Nose and Throat Disorders, 2, 3.
Goleman, D. (1988). The meditative mind: The varieties of meditative experience. New York: Putnam.
Grossman, P., Tiefenthaler-Gilmer, U., Raysz, A., & Kesper, U. (2007). Mindfulness training as an intervention for fibromyalgia: evidence of postintervention and 3-year follow-up benefits in well-being. Psychotherapy and Psychosomatics, 76(4), 226–233.
Grossman, P., Kappos, L., Mohr, D. C., Gensicke, H., D'Souza, M., Penner, I. K., et al. (2010). MS quality of life, depression and fatigue improve after mindfulness training: a randomized trial. Neurology, 75, 1141–1149.
Harrop-Griffiths, J., Katon, W., Dobie, R., Sakai, C., & Russo, J. (1987). Chronic tinnitus: association with psychiatric diagnoses. Journal of Psychosomatic Research, 31, 613–622.
Hebert, S., & Lupien, S. J. (2007). The sound of stress: blunted cortisol reactivity to psychosocial stress in tinnitus sufferers. Neuroscience Letters, 411(2), 138–142.
Heller, A. J. (2003). Classification and epidemiology of tinnitus. Otolaryngologic Clinics of North America, 36(2), 239–248.
Herrmann, C. (1997). International experiences with the Hospital Anxiety and Depression Scale — a review of validation data and clinical results. Journal of Psychosomatic Research, 42, 17–41.
Hofmann, S. G., Sawyer, A. T., Witt, A. A., & Oh, D. (2010). The effect of mindfulness based therapy on anxiety and depression: a meta-analytic review. Journal of Consulting and Clinical Psychology, 78, 169–183.
Hojat, M., & Xu, G. (2004). A visitor's guide to effect sizes: statistical significance versus practical (clinical) importance of research findings. Advances in Health Science Education, 9, 241–249.
Holmes, S., & Padgham, N. (2009). Review paper: more than ringing in the wars: a review of tinnitus and its psychosocial impact. Journal of Clinical Nursing, 18(21), 2927–2937.
Kabat-Zinn, J. (1982). An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. General Hospital Psychiatry, 4, 33–47.
Kabat-Zinn, J. (1994). Wherever you go, there you are. New York: Hyperion.
Kabat-Zinn, J. (2005). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain, and illness: Fifteenth (anniversaryth ed.). New York: Bantam Dell.
Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163–190.
Kabat-Zinn, J., Lipworth, L., Burney, R., & Sellers, W. (1987). Four-year follow up of a meditation based program for the self regulation of chronic pain: treatment outcomes and compliance. The Clinical Journal of Pain, 2, 159–17.
Kabat-Zinn, J., Massion, A. O., Kristeller, J., & Peterson, L. G. (1992). Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. The American Journal of Psychiatry, 149, 936–943.
Kabat-Zinn, J., Wheeler, J. E., Light, T., Skillings, Z., Scharf, M. J., Cropley, T. G., et al. (2003). Part II: Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemo-therapy (PUVA). Constructivism in the Human Sciences, 8, 85–106.
Kaplan, K. H., Goldenberg, D. L., & Galvin-Nadeau, M. (1993). The impact of a meditation- based stress reduction program on fibromyalgia. General Hospital Psychiatry, 15(5), 284–289.
Lockwood, A. H., Salvi, R. J., & Burkard, R. F. (2002). Tinnitus. The New England Journal of Medicine, 347, 904–910.
Ludwig, D. S., & Kabat-Zinn, J. (2008). Mindfulness in medicine. Journal of the American Medical Association, 300, 1350–1352. doi:10.1001/jama.300.11.1350.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72, 31–40.
Majumdar, M., Grossman, P., Dietz-Waschkowski, B., Kersig, S., & Walach, H. (2002). Does mindfulness meditation contribute to health? Outcome evaluation of a German sample. Journal of Alternative and Complementary Medicine, 8(6), 719.
Martinez Devesa, P., Perera, R., Theodoulou, M., & Waddell, A. (2010). Cognitive behavioural therapy for tinnitus. Cochrane Database of Systematic Reviews, 9, CD005233.
Mason, O., & Hargreaves, I. (2001). A qualitative study of mindfulness-based cognitive therapy for depression. The British Journal of Medical Psychology, 74(2), 197–212.
Mazurek, B., Stöver, T., Haupt, H., Klapp, B. F., Adli, M., Gross, J., et al. (2010). The significance of stress: its role in the auditory system and the pathogenesis of tinnitus. Hals-, Nasen-, Ohren-Heilkunde, 58, 162–172.
Megwalu, U. C., Finnell, J. E., & Picirillo, J. F. (2006). The effects of melatonin on tinnitus and sleep. Otolaryngology and Head and Neck Surgery, 134(2), 210–213.
Meikle, M. B., Stewart, B. J., Griest, S. E., Martin, W. H., Henry, J. A., Abrams, H. B., et al. (2007). Assessment of tinnitus: measurement of treatment outcomes. Progress in Brain Research, 166, 511–521.
Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.
Møller, A. R. (2000). Similarities between severe tinnitus and chronic pain. Journal of the American Academy of Audiology, 11, 115–124.
Morone, N. E., Lynch, C. S., Greco, C. M., Tindle, H. A., & Weiner, D. K. (2008). "I felt like a new person." the effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries. The Journal of Pain, 9(9), 841–848.
Newman, C. W., Jacobson, G. P., & Spitzer, J. B. (1996). Development of the tinnitus handicap inventory. Archives of Otolaryngology – Head & Neck Surgery, 122, 143–148.
Philippot, P., Nef, F., Clauw, L., de Romrée, M., & Segal, Z. (2011). A randomized controlled trial of mindfulness based cognitive therapy for treating tinnitus. Clinical Psychology & Psychotherapy. doi:10.1002/cpp.756.
Randolph, P. D., Caldera, Y. M., Tacone, A. M., & Greak, M. L. (1999). The long-term combined effects of medical treatment and a mindfulness-based behavioral program for the multidisciplinary management of chronic pain in west Texas. Pain Digest, 9, 103–112.
Rosenzweig, S., Reibel, D. K., Greeson, J. M., Brainard, G. C., & Hojat, M. (2003). Mindfulness-based stress reduction lowers psychological distress in medical students. Teaching and Learning in Medicine, 15, 88–92.
Sadlier, M., Stephens, S., & Kennedy, V. (2008). Tinnitus rehabilitation: a mindfulness meditation cognitive behavioural therapy approach. The Journal of Laryngology and Otology, 122(1), 31–37.
Sanchez, L., & Stephens, D. (1997). A tinnitus problem questionnaire in a clinic population. Ear and Hearing, 18, 210–217.
Shapiro, S. L., Schwartz, G. E., & Bonner, G. (1998). Effects of mindfulness-based stress reduction on medical and premedical students. Journal of Behavioral Medicine, 21(6), 581–599.
Shargorodsky, J., Curhan, G., & Wildon, R. (2010). Prevalence and characteristics of tinnitus among US adults. The American Journal of Medicine, 123(8), 711–718.
Smith, B. W., Ortiz, J. A., Steffen, L. E., Tooley, E. M., Wiggins, K. T., Yeater, E. A., et al. (2011). Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters. Journal of Consulting and Clinical Psychology, 79, 613–617.
Speca, M., Carlson, L. E., Mackenzie, M. J., & Angen, M. (2006). Mindfulness-based stress reduction (MBSR) as an intervention for cancer patients. In R. A. Baer (Ed.), Mindfulness-based treatment approaches: Clinician's guide to evidence base and applications (pp. 239–261). CA, Elsevier Academic Press: San Diego.
Surawy, C., Roberts, J., & Silver, A. (2005). The effect of mindfulness training on mood and measures of fatigue, activity, and quality of life in patients with chronic fatigue syndrome on a hospital waiting list: a series of exploratory studies. Behavioural and Cognitive Psychotherapy, 33, 103–109.
Sweetow, R. (1986). Cognitive aspects of tinnitus patient management. Ear and Hearing, 7, 390–396.
Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Journal of Consulting and Clinical Psychology, 68(4), 615–623.
Teasdale, J. D., Moore, R. G., Hayhurst, H., Pope, M., Williams, S., & Segal, Z. V. (2002). Metacognitive awareness and prevention of relapse in depression: empirical evidence. Journal of Consulting and Clinical Psychology, 70(2), 275–287.
Tonndorf, J. (1987). The analogy between tinnitus and pain: A suggestion for a physiological basis of chronic tinnitus. Hear Research, 28, 271–275.
Tyler, R. S., & Baker L. J. (1983). Difficulties experienced by tinnitus sufferers. Journal of Speech and Hearing Disorders, 48, 150–154.
Weiss, M., Nordlie, J. W., & Siegel, E. P. (2005). Mindfulness-based stress reduction as an adjunct to outpatient psychotherapy. Psychotherapy and Psychosomatics, 74(2), 108–112.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67, 361–370.
Zoger, S., Svedlund, J., & Holgers, K. M. (2001). Psychiatric disorders in tinnitus patients without severe hearing impairment: 24 month follow-up of patients at an audiological clinic. Audiology, 40, 133–140.
Special thanks to Doug Tilden who has generously funded this research. I would also like to thank Bob Stahl for his MBSR teacher training and supervision and Margaret Chesney, PhD, Rick Hecht, MD, and Lawrence Lustig, MD for their support throughout. Thank you to all study participants for their enthusiasm and openness to exploring new ways to heal.
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Gans, J.J., O’Sullivan, P. & Bircheff, V. Mindfulness Based Tinnitus Stress Reduction Pilot Study. Mindfulness 5, 322–333 (2014). https://doi.org/10.1007/s12671-012-0184-4
- Mindfulness based tinnitus stress reduction
- Mindfulness based stress reduction