Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus
Abstract
:1. Introduction
2. Methods
2.1. Study Design
2.2. Participants
2.3. Intervention
2.4. Data Collection
- Tinnitus severity: Tinnitus Functional Index (TFI; [16]);
- Anxiety symptoms: Generalized Anxiety Disorder-7 (GAD-7; [17]);
- Depressive symptoms: Patient Health Questionnaire-9 (PHQ-9; [18]);
- Sleep disturbance: Insomnia Severity Index (ISI; [19]);
- Health-related quality of life (HRQoL): EQ-5D-5L Visual Analog Scale (VAS; [20]).
2.5. Data Analysis
3. Results
3.1. Study Population
3.2. Change from Pre- (Baseline) to Post-Intervention (8 Weeks)
3.3. TQIQ Minimum Clinical Important Difference (MCID)
4. Discussion
4.1. Change in Tinnitus Sound Qualities Following ICBT Intervention
4.2. Importance of Measuring Tinnitus Sound Qualities
4.3. Study Limitations and Future Directions
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Socio-Demographic Variable | Overall N = 152 | ICBT n = 107 | No Intervention n = 45 | p-Value |
---|---|---|---|---|
Age (years), mean (SD) | 57.3 (11.8) | 56.5 (12.3) | 59.3 (10.3) | 0.179 |
Gender (n) | ||||
Male | 59 (38.8%) | 37 (34.6%) | 22 (48.9%) | 0.098 |
Female | 93 (61.2%) | 70 (65.4%) | 23 (51.1%) | |
Employment status (n) | ||||
Entry level/unskilled work | 2 (1.3%) | 2 (1.9%) | 0 (0.0%) | 0.141 |
Skilled/professional work | 85 (55.9%) | 64 (59.8%) | 21 (46.7%) | |
Retired | 54 (35.5%) | 36 (33.6%) | 18 (40.0%) | |
Not working/unemployed | 11 (7.2%) | 5 (4.7%) | 6 (13.3%) | |
Education (n) | ||||
<High School | 1 (0.7) | 1 (0.9%) | 0 (0.0%) | 0.110 |
High School | 16 (10.5) | 10 (9.3%) | 6 (13.3%) | |
Some college but not degree | 43 (28.3) | 25 (23.4%) | 18 (40.0%) | |
>University degree | 92 (60.5) | 71 (66.4%) | 21 (46.7%) | |
Tinnitus duration (years), mean (SD) | 13.2 (14.9) | 12.8 (15.9) | 14.0 (12.0) | 0.293 |
Frequency of tinnitus awareness, mean (SD) | ||||
Morning | 2.6 (0.7) | 2.6 (0.6) | 2.6 (0.7) | 0.949 |
Afternoon | 2.3 (0.7) | 2.2 (0.7) | 2.5 (0.7) | 0.064 |
Evening | 2.6 (0.6) | 2.6 (0.6) | 2.7 (0.5) | 0.219 |
Night | 2.3 (0.9) | 2.2 (0.9) | 2.4 (0.8) | 0.322 |
Outcome Measures | Overall N = 152 | ICBT n = 107 | No Intervention n = 45 | p-Value | Adjusted p-Value |
---|---|---|---|---|---|
TFI Total | 54.54 (21.69) | 54.74 (22.19) | 54.07 (19.12) | 0.860 | 1.00 |
GAD-7 | 6.97 (5.57) | 7.67 (5.81) | 5.31 (4.57) | 0.009 | 0.009 |
PHQ-9 | 7.44 (5.85) | 8.09 (6.17) | 5.89 (4.74) | 0.019 | 0.019 |
ISI | 11.31 (6.34) | 11.85 (6.42) | 10.02 (6.02) | 0.105 | 0.105 |
EQ-5D-5L VAS | 75.80 (15.74) | 75.55 (15.91) | 76.40 (15.49) | 0.763 | 0.763 |
TQIQ Total | 52.29 (17.33) | 53.12 (16.89) | 50.31 (18.37) | 0.363 | 1.00 |
TQIQ Loudness | 7.20 (2.20) | 7.15 (2.18) | 7.33 (2.27) | 0.639 | 1.00 |
TQIQ Pitch | 6.95 (2.65) | 6.90 (2.67) | 7.09 (2.64) | 0.685 | 1.00 |
TQIQ Complexity | 1.78 (2.40) | 1.80 (2.43) | 1.73 (2.34) | 0.869 | 1.00 |
TQIQ Frequency | 7.13 (2.39) | 7.04 (2.67) | 7.33 (2.67) | 0.517 | 1.00 |
TQIQ Coexisting | 5.39 (2.59) | 5.67 (2.61) | 4.73 (2.43) | 0.041 | 0.451 |
TQIQ Distractibility | 4.09 (2.80) | 4.06 (2.75) | 4.16 (2.94) | 0.842 | 1.00 |
TQIQ Maskability | 4.66 (2.80) | 4.64 (2.74) | 4.71 (2.97) | 0.880 | 1.00 |
TQIQ Mood | 3.98 (3.13) | 4.38 (3.05) | 3.02 (3.12) | 0.014 | 0.154 |
TQIQ Loud sounds | 5.41 (3.38) | 5.50 (3.34) | 5.18 (3.49) | 0.588 | 1.00 |
TQIQ Sensitivity | 5.70 (2.88) | 5.98 (2.71) | 5.02 (3.17) | 0.060 | 0.660 |
TQIQ Internal qualities * | 5.90 (2.08) | 5.91 (2.06) | 5.89 (2.14) | 0.967 | 1.00 |
TQIQ External qualities ** | 5.03 (2.42) | 5.29 (2.34) | 4.41 (2.53) | 0.040 | 0.080 |
TQIQ Mild (score 0–37) | 26.08 (7.52) | 25.53 (6.60) | 26.82 (8.91) | 0.676 | 1.00 |
TQIQ Significant (score 38–51) | 44.90 (3.60) | 44.92 (3.52) | 44.85 (3.95) | 0.953 | 1.00 |
TQIQ Severe (score ≥ 52) | 65.84 (10.64) | 65.79 (10.76) | 66.00 (10.58) | 0.938 | 1.00 |
Outcome Measures | ICBT Mean ∆ (95% CI) | No Intervention Mean ∆ (95% CI) | Difference Between Groups | ||
---|---|---|---|---|---|
Mean ∆ (95% CI) | ES | p-Value | |||
TFI Total | 26.03 (21.83,30.23) | 15.79 (10.06,21.53) | 10.24 (−17.99,−2.49) | 0.50 | 0.010 |
GAD-7 | 3.59 (2.63,4.55) | 0.97 (−0.27,2.21) | 2.62 (0.86,4.38) | 0.55 | 0.002 |
PHQ-9 | 4.04 (2.92,5.16) | 1.56 (0.15,2.96) | 2.48 (0.45,4.52) | 0.47 | 0.007 |
ISI | 4.91 (93.82,6.00) | 2.28 (0.95,3.61) | 2.63 (0.65,4.61) | 0.51 | 0.003 |
EQ-5D-5L VAS | −4.26 (−6.84,−1.67) | −0.75 (−3.58,2.08) | −3.51 (−8.13,1.12) | −0.29 | 0.136 |
TQIQ Total | 14.82 (11.83,17.82) | 1.04 (−2.31,4.40) | 13.78 (8.70,18.86) | 0.95 | <0.001 |
TQIQ Loudness | 2.05 (1.60,2.49) | 0.66 (0.11,1.23) | 1.38 (0.61,2.15) | 0.63 | <0.001 |
TQIQ Pitch | 2.53 (2.04,3.00) | 0.93 (0.43,1.44) | 1.59 (0.79,2.39) | 0.69 | <0.001 |
TQIQ Complexity | 0.49 (0.22,0.77) | −0.14 (−0.67,0.40) | 0.63 (0.09,1.17) | 0.41 | 0.024 |
TQIQ Frequency | 2.10 (1.62,2.56) | 0.20 (−0.28,0.68) | 1.89 (1.11,2.68) | 0.85 | <0.001 |
TQIQ Coexisting | 1.69 (1.25,2.14) | 0.38 (−0.17,0.93) | 1.31 (0.55,2.08) | 0.60 | <0.001 |
TQIQ Distractibility | 0.96 (0.52,1.40) | −0.76 (−1.36,−0.15) | 1.72 (0.94,2.50) | 0.77 | <0.001 |
TQIQ Maskability | 1.22 (0.78,1.67) | −0.64 (−1.29,0.00) | 1.87 (1.07,2.67) | 0.82 | <0.001 |
TQIQ Mood | 1.04 (0.46,1.61) | −0.56 (−1.34,0.23) | 1.59 (0.58,2.61) | 0.55 | 0.002 |
TQIQ Loud sounds | 1.49 (0.94,2.03) | 0.73 (−0.10,1.56) | 0.75 (−0.24,1.75) | 0.27 | 0.136 |
TQIQ Sensitivity | 1.26 (0.75,1.77) | 0.22 (−0.55,1.00) | 1.04 (0.12,1.96) | 0.40 | 0.028 |
TQIQ Internal qualities * | 1.76 (1.41,2.11) | 0.13 (−0.22,0.48) | 1.63 (1.14,2.12) | 0.98 | <0.001 |
TQIQ External qualities ** | 1.26 (0.86,1.67) | 0.13 (−0.44,0.71) | 1.13 (0.41,1.85) | 0.55 | 0.002 |
TQIQ Mild (score 0–37) | 8.67 (1.75,15.58) | 2.27 (−5.16,9.71) | 6.39 (−3.37,16.15) | 0.54 | 0.189 |
TQIQ Significant (score 38–51) | 15.00 (10.37,19.63) | −1.92 (−9.52,5.67) | 16.92 (8.20,25.64) | 1.26 | <0.001 |
TQIQ Severe (score ≥52) | 16.36 (11.72,21.00) | 2.24 (−2.55,7.03) | 14.12 (7.60,20.64) | 0.89 | <0.001 |
TQIQ MCID Category | ICBT | No Intervention | ||||
---|---|---|---|---|---|---|
N | Mean Diff. (SD) | 95% CI | N | Mean Diff. (SD) | 95% CI | |
Overall difference score < 19 | 66 (61.7%) | 4.94 (9.08) | 2.71, 7.17 | 41 (91%) | −0.95 (9.55) | −3.97, 2.06 |
Overall difference score ≥ 19 | 41 (38.3%) | 30.73 (9.67) | 27.68, 33.78 | 4 (9%) | 21.50 (1.73) | 18.74, 24.26 |
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Manchaiah, V.; Andersson, G.; Beukes, E.W.; Fagelson, M.A.; Swanepoel, D.W.; Maidment, D. Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus. Clin. Pract. 2025, 15, 69. https://doi.org/10.3390/clinpract15040069
Manchaiah V, Andersson G, Beukes EW, Fagelson MA, Swanepoel DW, Maidment D. Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus. Clinics and Practice. 2025; 15(4):69. https://doi.org/10.3390/clinpract15040069
Chicago/Turabian StyleManchaiah, Vinaya, Gerhard Andersson, Eldré W. Beukes, Marc A. Fagelson, De Wet Swanepoel, and David Maidment. 2025. "Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus" Clinics and Practice 15, no. 4: 69. https://doi.org/10.3390/clinpract15040069
APA StyleManchaiah, V., Andersson, G., Beukes, E. W., Fagelson, M. A., Swanepoel, D. W., & Maidment, D. (2025). Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus. Clinics and Practice, 15(4), 69. https://doi.org/10.3390/clinpract15040069