Abstract
BackgroundMeasurement of tinnitus-related distress and treatment responsiveness is key in understanding, conceptualizing and addressing this often-disabling symptom. Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts.ObjectiveTo investigate the convergent validity and responsiveness of the German versions of the Tinnitus Questionnaire [TQ], Tinnitus Handicap Inventory [THI], and Tinnitus Functional Index [TFI] in a large German-speaking sample of patients with chronic tinnitus who completed a psychologically anchored 7-day Intensive Multimodal Treatment Programme.MethodsTwo-hundred-and-ten patients with chronic tinnitus completed all three questionnaires at baseline and post-treatment. Intraclass correlation coefficients determined the convergent validity of each questionnaire’s total and subscale scores. Treatment responsiveness was investigated by [a] comparing treatment-related change in responders vs. non-responders as classified by each questionnaire’s minimal clinically important difference-threshold, and [b] comparing agreement between the questionnaires’ responder classifications.ResultsThe total scores of all three questionnaires showed high agreement before and after therapy (TQ | THI: 0.80 [Pre], 0.83 [Post], TQ | TFI: 0.72 [Pre], 0.78 [Post], THI | TFI: 0.76 [Pre] 0.80 [Post]). All total scores changed significantly with treatment yielding small effect sizes. The TQ and TFI yielded comparable (19.65 and 18.64%) and the THI higher responder rates (38.15%). The TQ | THI and TQ | TFI showed fair, and the THI | TFI moderate agreement of responder classifications. Independent of classification, responders showed significantly higher change rates than non-responders across most scores. Each questionnaire’s total change score distinguished between responders and non-responders as classified by the remaining two questionnaires.ConclusionThe total scores of all three questionnaires show high convergent validity and thus, comparability across clinical and research contexts. By contrast, subscale scores show high inconsistency. Whilst the TFI appears well suited for research purposes, the THI may be better suited to measure psychological aspects of tinnitus-related distress and their changes with accordingly focused treatment approaches.
Highlights
Subjective tinnitus is a multicausally generated symptom that denotes an auditory “phantom” perception without external sound source
The frequency distributions of the total scores of the three tinnitus questionnaires were examined at baseline
The present study followed the analysis outline set by Jacquemin et al (2019) who compared the Dutch versions of the Tinnitus Questionnaire (TQ) and TFI before and after six sessions of High-Definition transcranial Direct Current Stimulation (HD-tDCS)
Summary
Subjective tinnitus is a multicausally generated symptom that denotes an auditory “phantom” perception without external sound source. It is not surprising that psychological treatment approaches have demonstrated effectiveness across both tinnitus-specific and associated psychological domains (Hesser et al, 2011; Cima et al, 2014; Zenner et al, 2017; Landry et al, 2020). Among these treatment approaches, a 7-day Intensive Multimodal Therapy Programme has demonstrated beneficial, if small, long-term effects on tinnitus-related distress, wider emotional distress, and depressive symptoms (Seydel et al, 2010, 2015; Brueggemann et al, 2018a,b). Whilst several self-report measures exist, the heterogeneity of patient populations, available translations, and treatment contexts requires ongoing psychometric replication and validation efforts
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