Self-reported and behavioral sound avoidance in tinnitus and hyperacusis subjects, and association with anxiety ratings

Abstract

Objective: The purpose of the study was to analyse the role of sound avoidance and anxiety in tinnitus subjects with hyperacusis, defined as hypersensitivity to low to moderate intensity sounds. Design: A group of tinnitus subjects with hyperacusis was compared to tinnitus subjects without hyperacusis, and healthy controls. For assessing noise avoidance, a questionnaire was developed (noise avoidance questionnaire, NAQ) and the duration of self-exposure to a pure tone was assessed as a behavioral index. Different self-rating instruments concerning tinnitus (STI, TF-12), hyperacusis (GÜF), and anxiety (BAI, STAI-T) were used, as well as a psychoacoustic indicator of hyperacusis (ULL). Study sample: Fifty-six tinnitus subjects with/without hyperacusis and 30 controls without tinnitus and hyperacusis participated in the experiment. Results: The findings indicate that subjects with hyperacusis reported significantly more noise-related avoidance in daily life and show significantly shorter exposure to a pure tone than non-hyperacusic subjects, while discomfort was at the same level for each individual. Self-reported avoidance behavior correlated significantly with distress attributed to hyperacusis (r =0.81), and with anxiety ratings. Conclusions: These results suggest that hyperacusis is associated with noise-related avoidance behavior and anxiety. Systematic exposure to sound could play a significant role in the treatment of hyperacusis.

Key Words::

• Hyperacusis
• tinnitus
• avoidance
• noise avoidance questionnaire
• hypersensitivity to sound
• anxiety

Acknowledgements

We thank Dr. Antonia Barke for her help in translating the noise avoidance questionnaire. The study design was presented at the 28th Symposium der Fachgruppe Klinische Psychologie und Psychotherapie der Deutschen Gesellschaft für Psychologie, from 13 to 15 May 2010 in Mainz, Germany. An abstract of this contribution was published in Zeitschrift für Klinische Psychologie und Psychotherapie (abstract volume). The results were presented at the 7th Workshopkongress der Fachgruppe Klinische Psychologie und Psychotherapie der Deutschen Gesellschaft für Psychologie, from 2 to 4 June 2011 in Berlin, Germany.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.