Hostname: page-component-78c5997874-lj6df Total loading time: 0 Render date: 2024-11-04T19:45:40.672Z Has data issue: false hasContentIssue false

Tinnitus rehabilitation: a mindfulness meditation cognitive behavioural therapy approach

Published online by Cambridge University Press:  23 April 2007

M Sadlier*
Affiliation:
Physiotherapy Department, University Hospital of Wales, Cardiff, UK
S D G Stephens
Affiliation:
Department of Neurology, Ophthalmology and Audiological Medicine, School of Medicine, Cardiff University, Cardiff, UK
V Kennedy
Affiliation:
Welsh Hearing Institute, University Hospital of Wales, Cardiff, UK.
*
Address for correspondence: Mike Sadlier, Physiotherapy Department, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK. Fax: 44 (0)2920 742625 E-mail: [email protected]

Abstract

Background:

Chronic tinnitus is a frequent symptom presentation in clinical practice. No drug treatment to date has shown itself to be effective. The aim of the present study was to investigate the effects of cognitive behavioural therapy and meditation in tinnitus sufferers.

Methodology:

Patients were selected from a dedicated tinnitus clinic in the Welsh Hearing Institute. A waiting list control design was used. Twenty-five chronic tinnitus sufferers were consecutively allocated to two groups, one receiving a cognitive behavioural therapy/meditation intervention of four one hour sessions with the other group waiting three months and subsequently treated in the same way, thereby acting as their own control. The main outcome was measured using the Hallam tinnitus questionnaire. A four to six month follow up was conducted.

Results:

These showed significant statistical reductions in tinnitus variables both in the active and also in the control group. Post-therapy, no significant change was found after the waiting list period. The improvement was maintained at the four to six month period.

Conclusion:

The positive findings give support for the use of cognitive behavioural therapy/meditation for chronic tinnitus sufferers.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2007

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1McKenna, L, Hallam, RS, Hinchcliffe, R. The prevalence of psychological disturbance in neurotology outpatients. Clin Otolaryngol 1991;16:452–6CrossRefGoogle ScholarPubMed
2Stephens, SD, Hallam, RS. The Crown-Crisp Experiential Index in patients complaining of tinnitus. Br J Audiol 1985;19:151–8CrossRefGoogle ScholarPubMed
3Stephens, SD, Corcoran, AL. A controlled study of tinnitus masking. Br J Audiol 1985;19:159–67CrossRefGoogle ScholarPubMed
4Coles, RR. Epidemiology of tinnitus: (1) prevalence. J Laryngol Otol Suppl 1984;9:715Google Scholar
5Shailer, MJ, Tyler, RS, Coles, RR. Critical masking bands for sensorineural tinnitus. Scand Audiol 1981;10:157–62CrossRefGoogle ScholarPubMed
6Stephens, SD, Hallam, RS, Jakes, SC. Tinnitus: a management model. Clin Otolaryngol 1986;11:227–38CrossRefGoogle ScholarPubMed
7House, JW, Brackmann, DE. Tinnitus: surgical treatment. Ciba Found Symp 1981;85:204–16Google ScholarPubMed
8Tyler, RS, Baker, LJ. Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 1983;48:150–4CrossRefGoogle ScholarPubMed
9Weisenberg, MI. Pain and pain control. Psychol Bull 1977;84:1008–44CrossRefGoogle ScholarPubMed
10Rozanski, A, Blumenthal, JA, Kaplan, J. Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 1999;99:2192–217CrossRefGoogle ScholarPubMed
11Kiecolt-Glaser, JK, Page, GG, Marucha, PT, MacCallum, RC, Glaser, R. Psychological influences on surgical recovery. Perspectives from psychoneuroimmunology. Am Psychol 1998;53:1209–18CrossRefGoogle ScholarPubMed
12Salovey, P, Rothman, AJ, Detweiler, JB, Steward, WT. Emotional states and physical health. Am Psychol 2000;55:110–21CrossRefGoogle ScholarPubMed
13Baum, A, Posluszny, DM. Health psychology: mapping biobehavioral contributions to health and illness. Annu Rev Psychol 1999;50:137–63CrossRefGoogle ScholarPubMed
14Noakes, TD, St Clair Gibson, A, Lambert, EV. From catastrophe to complexity: a novel model of integrative central neural regulation of effort and fatigue during exercise in humans: summary and conclusions. Br J Sports Med 2005;39:120–4CrossRefGoogle Scholar
15House, JW. Management of the tinnitus patient. Ann Otol Rhinol Laryngol 1981;90 (6 Pt 1):597601CrossRefGoogle ScholarPubMed
16Stephens, SD, Hallam, RS, Jakes, SC. Tinnitus –a treatment model. Acta Otorhinolaryngol Belg 1986;40:471–81Google ScholarPubMed
17Londero, A, Peignard, P, Malinvaud, D, Nicolas-Puel, C, Avan, P, Bonfils, P. Contribution of cognitive and behavioral therapy for patients with tinnitus: implication in anxiety and depression. Ann Otolaryngol Chir Cervicofac 2004;121:334–45CrossRefGoogle ScholarPubMed
18Andersson, G, Melin, L, Hägnebo, C, Scott, B, Lindberg, P. A review of psychological treatment approaches for patients suffering from tinnitus. Annals of Behavioural Medicine 1995;17:357–66CrossRefGoogle ScholarPubMed
19Tonndorf, J. The analogy between tinnitus and pain: a suggestion for a physiological basis of chronic tinnitus. Hear Res 1987;28:271–5CrossRefGoogle Scholar
20Andersson, G. Psychological aspects of tinnitus and the application of cognitive-behavioral therapy. Clin Psychol Rev 2002;22:977–90CrossRefGoogle ScholarPubMed
21Folmer, RL. Long-term reductions in tinnitus severity. BMC Ear Nose Throat Disord 2002;2:3CrossRefGoogle ScholarPubMed
22Kabat-Zinn, J, Lipworth, L, Burney, R. The clinical use of mindfulness meditation for the self-regulation of chronic pain. J Behav Med 1985;8:163–90CrossRefGoogle ScholarPubMed
23Kabat-Zinn, J, Massion, AO, Kristeller, J, Peterson, LG, Fletcher, KE, Pbert, L et al. Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders. Am J Psychiatry 1992;149:936–43Google ScholarPubMed
24Mason, O, Hargreaves, I. A qualitative study of mindfulness-based cognitive therapy for depression. Br J Med Psychol 2001;74(Part 2):197212CrossRefGoogle ScholarPubMed
25Grossman, P, Niemann, L, Schmidt, S, Walach, H. Mindfulness-based stress reduction and health benefits. A meta-analysis. J Psychosom Res 2004;57:3543CrossRefGoogle ScholarPubMed
26Carlson, LE, Speca, M, Patel, KD, Goodey, E. 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 2004;29:448–74CrossRefGoogle ScholarPubMed
27Kabat-Zinn, J. An outpatient program in behavioral medicine for chronic pain patients based on the practice of mindfulness meditation: theoretical considerations and preliminary results. Gen Hosp Psychiatry 1982;4:3347CrossRefGoogle ScholarPubMed
28Møller, AR. Similarities between severe tinnitus and chronic pain. J Am Acad Audiol 2000;11:115–24Google ScholarPubMed
29Andersson, G, Stromgren, T, Strom, L, Lyttkens, L. Randomized controlled trial of internet-based cognitive behavior therapy for distress associated with tinnitus. Psychosom Med 2002;64:810–16Google ScholarPubMed
30Lazar, SW, Bush, G, Gollub, RL, Fricchione, GL, Khalsa, G, Benson, H. Functional brain mapping of the relaxation response and meditation. Neuroreport 2000;11:1581–5CrossRefGoogle ScholarPubMed
31Sadlier, M, Stephens, SD. An approach to the audit of tinnitus management. J Laryngol Otol 1995;109:826–9Google Scholar
32Hallam, RS, Jakes, SC, Hinchcliffe, R. Cognitive variables in tinnitus annoyance. Br J Clin Psychol 1988;27(Pt 3):213–22CrossRefGoogle ScholarPubMed
33Snaith, RP. The Hospital Anxiety And Depression Scale. Health Qual Life Outcomes 2003;1:29CrossRefGoogle ScholarPubMed
34Pavot, W, Diener, E, Colvin, CR, Sandvik, E. Further validation of the Satisfaction with Life Scale: evidence for the cross-method convergence of well-being measures. J Pers Assess 1991;57:149–61CrossRefGoogle ScholarPubMed
35Lindberg, P, Scott, B, Melin, L, Lyttkens, L. Long-term effects of psychological treatment of tinnitus. Scand Audiol 1987;16:167–72CrossRefGoogle ScholarPubMed
36Engel, GL. From biomedical to biopsychosocial. Being scientific in the human domain. Psychosomatics 1997;38:521–8CrossRefGoogle ScholarPubMed
37Holgers, KM, Zoger, S, Svedlund, K. Predictive factors for development of severe tinnitus suffering-further characterisation. Int J Audiol 2005;44:584–92CrossRefGoogle ScholarPubMed
38Falkenberg, E-S, Tungland, O, Skollerud, S. Habituation Therapy of Chronic Distressing Tinnitus: a Presentation of a Treatment programme and an Evaluation Study of its Effects. Audiological Medicine 2003;2:132–7CrossRefGoogle Scholar
39Benson, H. The relaxation response: therapeutic effect. Science 1997;278:1694–5CrossRefGoogle ScholarPubMed
40Shaw, G, Srivastava, ED, Sadlier, M, Swann, P, James, JY, Rhodes, J. Stress management for irritable bowel syndrome: a controlled trial. Digestion 1991;50:3642CrossRefGoogle ScholarPubMed
41Teasdale, JD, Segal, ZV, Williams, JM, Ridgeway, VA, Soulsby, JM, Lau, MA. Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. J Consult Clin Psychol 2000;68:615–23CrossRefGoogle ScholarPubMed
42Thomas, MS, Sadlier, M, Smith, A. The effect of Multi Convergent Therapy on the psychopathology, mood and performance of Chronic Fatigue Syndrome patients: A preliminary study. Counselling and Psychotherapy Research 2006;6:91–9CrossRefGoogle Scholar
43Ma, SH, Teasdale, JD. Mindfulness–based cognitive therapy for depression: replication and exploration of differential relapse prevention effects. J Consult Clin Psychol 2004;72:3140CrossRefGoogle ScholarPubMed
44Heller, AJ. Classification and epidemiology of tinnitus. Otolaryngol Clin North Am 2003;36:239–48CrossRefGoogle ScholarPubMed
45Henry, JA, Schechter, MA, Loovis, CL, Zaugg, TL, Kaelin, C, Montero, M. Clinical management of tinnitus using a “progressive intervention” approach. J Rehabil Res Dev 2005;42(4 Suppl 2):95116CrossRefGoogle ScholarPubMed