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  • 1.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Edsjö, Lisa
    Uppsala University.
    Kaldo, Viktor
    Karolinska Institutet.
    Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Tinnitus and short-term serial recall in stable versus intermittent masking conditions.2009In: Scandinavian journal of psychology, ISSN 1467-9450, Vol. 50, no 5, p. 517-522Article in journal (Refereed)
    Abstract [en]

    The relation between tinnitus and short-term memory performance in varying background sounds is not well understood. In the present study a sample of 18 persons with tinnitus completed a serial recall test in three conditions, silence, masking and intermittent masking. The performance of a matched control group without tinnitus was also investigated. Based on the literature on the "irrelevant sound effect" we expected that the tinnitus group would perform worse during intermittent masking and that they would score lower overall compared to the control group. Results revealed no statistically significant differences between the groups, nor any group interaction within sound conditions for the serial recall test. Groups did however differ regarding subjective measures of concentration problems, anxiety and depression. Results are discussed in relation to thought suppression and distraction from tinnitus.

  • 2.
    Andersson, Gerhard
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Gustafsson, Tore
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lundén, Charlotte
    Landstinget Dalarna.
    Henriksson, Oskar
    Psykologifabriken AB.
    Fattahi, Kidjan
    Psykologpartners , Linköping.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Carlbring, Per
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Internet-based Acceptance and Commitment Therapy for tinnitus patients2011Conference paper (Other academic)
  • 3.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Veilord, A
    KI KI.
    Svedling, L
    CS / IBL LiU.
    Andersson, F
    CS / IBL LiU.
    Sleman, O
    CS / IBL LiU.
    Westin, Vendela
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning.
    Clason, E
    CS / IBL LiU.
    Sarkohi, Ali
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning.
    Lamminen, M
    Specialistläkarna Specialistläkarna.
    Eriksson, T
    Specialistläkarna Specialistläkarna.
    Carlbring, Per
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Randomized trial of Internet delivered CBT versus group CBT, with the inclusion of a preference arm, stepped care and assessment of sudden gains2007In: The third meeting of the International Society for Research on Internet Interventions,2007, Charlottesville: ISRII , 2007Conference paper (Refereed)
  • 4.
    Andersson, Gerhard
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology.
    Westin , Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Understanding tinnitus distress: Introducing the concepts of moderators and mediators2008In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 47, no S2, p. S106-S111Article in journal (Refereed)
    Abstract [en]

    We focus this theoretical paper on a neglected distinction in tinnitus research between moderators and mediators of tinnitus distress. A moderator variable is one that influences the strength of a relationship between two other variables. In the paper we propose that several variables might act as moderators of tinnitus distress. Degree of hearing loss, arousal, insomnia, characteristics of tinnitus, noise sensitivity, and a range of psychological factors such as personality and perceived control are discussed as potential moderators. We then move on to mediator variables. A mediator variable is one that explains the relationship between the two other variables, and must by definition be caused by a predictor, and then mediate between the predictor and the dependent variable. We propose that stress levels (caused by tinnitus), classical conditioning, selective attention towards tinnitus, and psychological acceptance of tinnitus (versus experiential avoidance) might be mediators of distress. We encourage more research on moderators and mediators of tinnitus distress, as these will help illuminate treatment protocols and how they might work.

  • 5.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Gustafsson, Tore
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Lundén, Charlotte
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Henrikson, Oskar
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Fattahi, Kidjan
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Johnsson, Erik
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Westin Zetterqvist, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Carlbring, Per
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Mäki-Torkko, Elina
    Linköping University, Department of Clinical and Experimental Medicine, Technical Audiology. Linköping University, Faculty of Health Sciences.
    Kaldo, Viktor
    Department of Clinical Neuroscience, Psychiatric Section, Karolinska Institutet, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    A Randomized Controlled Trial of Internet-Delivered Cognitive Behavior Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus2012In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 80, no 4, p. 649-661Article in journal (Refereed)
    Abstract [en]

    Objective: Our aim in this randomized controlled trial was to investigate the effects on global tinnitus severity of 2 Internet-delivered psychological treatments, acceptance and commitment therapy (ACT) and cognitive behavior therapy (CBT), in guided self-help format. Method: Ninety-nine participants (mean age = 48.5 years; 43% female) who were significantly distressed by tinnitus were recruited from the community. Participants were randomly assigned to CBT (n = 32), ACT (n = 35), or a control condition (monitored Internet discussion forum; n = 32), and they were assessed with standardized self-report measures (Tinnitus Handicap Inventory; Hospital Anxiety and Depression Scale; Quality of Life Inventory; Perceived Stress Scale; Tinnitus Acceptance Questionnaire) at pre-, posttreatment (8 weeks), and 1-year follow-up. Results: Mixed-effects linear regression analysis of all randomized participants showed significant effects on the primary outcome (Tinnitus Handicap Inventory) for CBT and for ACT compared with control at posttreatment (95% CI [-17.03, -2.94], d = 0.70, and 95% CI [-16.29, -2.53], d = 0.68, respectively). Within-group effects were substantial from pretreatment through 1-year-follow-up for both treatments (95% CI [-44.65, -20.45], d = 1.34), with no significant difference between treatments (95% CI [-14.87, 11.21], d = 0.16). Conclusions: Acceptance-based procedures may be a viable alternative to traditional CBT techniques in the management of tinnitus. The Internet can improve access to psychological interventions for tinnitus.

  • 6.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Tinnitus Distress2010Conference paper (Other academic)
  • 7.
    Hesser, Hugo
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress2011In: CLINICAL PSYCHOLOGY REVIEW, ISSN 0272-7358, Vol. 31, no 4, p. 545-553Article, review/survey (Refereed)
    Abstract [en]

    Tinnitus is defined as a sound in the ear(s) and/or head without external origin and is a serious health concern for millions worldwide. The aim of the present study was to determine whether Cognitive Behavior Therapy (CBT) is effective in reducing distress associated with tinnitus. Randomized, controlled trials that assessed the efficacy of CBT for tinnitus-related distress in adults were identified by searching electronic databases (PsychINFO, PubMed, the Cochrane Library), and by manual searches. Fifteen studies (total of 1091 participants) were included in the meta-analysis. CBT compared with a passive and active control at post-assessment yielded statistically significant mean effect sizes for tinnitus-specific measures (Hedgess g = 0.70. and Hedgess g = 0.44, respectively). The average weighted pre-to-follow-up effect size for the CBT group suggested that these effects were maintained over time. Smaller but yet statistically significant effects of CBT were found for mood outcome measures. Characteristics of the studies were unrelated to effect sizes. Methodological rigor, publication bias, and a series of sensitivity analyses did not influence the findings. The results suggest that CBT is an effective treatment of tinnitus distress. However, caution is warranted given that few large-scale, well-controlled trials were identified.

  • 8.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Weise, Cornelia
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Is CBT effective in the treatment of distress associated with tinnitus?: A systematic review and meta-analysis2011Conference paper (Other academic)
  • 9.
    Hesser, Hugo
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Hayes, Steven
    University of Nevada, Reno, NV, USA.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Clients’ in-session acceptance and cognitive defusion behaviors in ACT treatment of tinnitus distress2009Conference paper (Other academic)
  • 10.
    Hesser, Hugo
    et al.
    Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research.
    Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Hayes, Steven C
    University of Nevada.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress.2009In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 47, no 6, p. 523-8Article in journal (Refereed)
    Abstract [en]

    Cognitive-behavioral treatment (CBT) is considered to be an effective treatment of distress associated with tinnitus (perception of internal noises without any outer auditory stimulation), but the processes by which the therapy works remain unclear. Mindfulness and acceptance is receiving increased attention in the treatment literature for chronic medical conditions. However, few studies have examined these and related processes with behavioral or observer measures. In the present study 57 videotapes (a total of 1710min) from 19 clients who participated in a controlled trial of an acceptance-based treatment for tinnitus distress, were coded for frequency and peak level of verbal behaviors expressing either acceptance or cognitive defusion. Frequency of cognitive defusion behaviors and peak level of cognitive defusion as well as peak level of acceptance rated in Session 2, predicted symptom reduction 6 month following treatment. These relationships were not accounted for by the improvement that had occurred prior to the measurement point of the process variables. Moreover, prior symptom changes could not predict process variables rated later in therapy (after most of the improvement in therapy had occurred). Thus, clients' in-session acceptance and cognitive defusion behaviors appear to play an important role in the reduction of negative impact of tinnitus.

  • 11.
    Hesser, Hugo
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, The Swedish Institute for Disability Research. Linköping University, Faculty of Arts and Sciences.
    Acceptance as a Mediator in Internet-delivered Acceptance and Commitment Therapy and Cognitive Behavior Therapy for TinnitusManuscript (preprint) (Other academic)
    Abstract [en]

    Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behavior therapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus.

  • 12.
    Hesser, Hugo
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Stockholm, Sweden .
    Acceptance as a mediator in internet-delivered acceptance and commitment therapy and cognitive behavior therapy for tinnitus2014In: Journal of behavioral medicine, ISSN 0160-7715, E-ISSN 1573-3521, Vol. 37, no 4, p. 756-767Article in journal (Refereed)
    Abstract [en]

    Despite demonstrated efficacy of behavioral and cognitive techniques in treating the impact of tinnitus (constant ringing in the ears), little is known about the mechanisms by which these techniques achieve their effect. The present study examined acceptance of tinnitus as a potential mediator of treatment changes on global tinnitus severity in internet-delivered acceptance and commitment therapy (iACT) and internet-delivered cognitive behavior therapy (iCBT). Data from 67 participants who were distressed by tinnitus and who were randomly assigned to 1 of the 2 treatments were analyzed using a multilevel moderated mediation model. We predicted that acceptance as measured with the two subscales of the tinnitus acceptance questionnaire (i.e., activity engagement and tinnitus suppression) would mediate the outcome in iACT, but not in iCBT. Results provided partial support to the notion that mediation was moderated by treatment: tinnitus suppression mediated changes in tinnitus severity in iACT, but not in iCBT. However, inconsistent with the view that the treatments worked through different processes of change, activity engagement mediated treatment changes across both iACT and iCBT. Acceptance is identified as a key source of therapeutic change in behavioral-based treatments for tinnitus.

  • 13.
    Kemani, M. K.
    et al.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Zetterqvist, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences. Karolinska University Hospital, Sweden.
    Kanstrup, M.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Holmstrom, L.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    Wicksell, R. K.
    Karolinska University Hospital, Sweden; Karolinska Institute, Sweden.
    A validation of the pain interference index in adults with longstanding pain2016In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 60, no 2, p. 250-258Article in journal (Refereed)
    Abstract [en]

    Background: Chronic pain is a major health problem and more knowledge is needed regarding the interference of pain on behaviors in different life domains. Clinically useful and statistically sound pain interference measures are highly important. Studies on youths have shown that the Pain Interference Index (PII) is a reliable and valid instrument that is sensitive to change following behavioral treatment. This measure may also have utility for adults, but no study has so far evaluated the statistical properties of the PII for long-standing pain in adults. Methods: Data were collected from 239 consecutive adults with non-specific chronic pain referred to a tertiary pain clinic. We investigated the factor structure of items using a principal component analysis. Cronbachs alpha was calculated to assess internal consistency. The questionnaires ability to predict levels of, e.g., disability was analyzed by means of regression analyses. Results: Analyses illustrated the adequacy of a one-factor solution with six items. Cronbachs alpha (0.85) suggested a satisfactory internal consistency among items. The PII explained significant amounts of variance in pain disability, physical, and mental health-related quality of life and depression, suggesting concurrent criteria validity. Conclusion: The PII is a brief questionnaire with reliable and valid statistical properties to assess pain interference in adults. Other studies support the reliability and validity of PII for use with youths, and now the PII can be used to analyze the influence of pain on behaviors across age groups. Potentially, the PII can also be used as an outcome measure in clinical trials.

  • 14.
    Weise, Cornelia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Tinnitus distress – Relationships with depression, catastrophizing and help-seeking2010Conference paper (Other academic)
  • 15.
    Weise, Cornelia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Kleinstäuber, Maria
    Johannes Gutenberg University of Mainz, Germany.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Health Sciences.
    Westin, Vendela
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Acceptance of Tinnitus: Validation of the Tinnitus Acceptance Questionnaire2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 2, p. 100-115Article in journal (Refereed)
    Abstract [en]

    The concept of acceptance has recently received growing attention within tinnitus research due to the fact that tinnitus acceptance is one of the major targets of psychotherapeutic treatments. Accordingly, acceptance-based treatments will most likely be increasingly offered to tinnitus patients and assessments of acceptance-related behaviours will thus be needed. The current study investigated the factorial structure of the Tinnitus Acceptance Questionnaire (TAQ) and the role of tinnitus acceptance as mediating link between sound perception (i.e. subjective loudness of tinnitus) and tinnitus distress. In total, 424 patients with chronic tinnitus completed the TAQ and validated measures of tinnitus distress, anxiety, and depression online. Confirmatory factor analysis provided support to a good fit of the data to the hypothesised bifactor model (root-mean-square-error of approximation = .065; Comparative Fit Index = .974; Tucker–Lewis Index = .958; standardised root mean square residual = .032). In addition, mediation analysis, using a non-parametric joint coefficient approach, revealed that tinnitus-specific acceptance partially mediated the relation between subjective tinnitus loudness and tinnitus distress (path ab = 5.96; 95% CI: 4.49, 7.69). In a multiple mediator model, tinnitus acceptance had a significantly stronger indirect effect than anxiety. The results confirm the factorial structure of the TAQ and suggest the importance of a general acceptance factor that contributes important unique variance beyond that of the first-order factors activity engagement and tinnitus suppression. Tinnitus acceptance as measured with the TAQ is proposed to be a key construct in tinnitus research and should be further implemented into treatment concepts to reduce tinnitus distress.

  • 16.
    Weise, Cornelia
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Kleinstäuber, Maria
    University of Mainz, Germany.
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zetterqvist Westin, Vendela
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Educational Sciences.
    Hiller, Wolfgang
    University of Mainz, Germany.
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    The impact of tinnitus acceptance on tinnitus distress  2011Conference paper (Other academic)
  • 17.
    Westin, Vendela
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    C Hayes, Steven
    University of Nevada.
    Andersson , Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact2008In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 46, no 12, p. 1259-1265Article in journal (Refereed)
    Abstract [en]

    Tinnitus is an experience of sound in the absence of an appropriate external source. A symptom that can accompany most central or peripheral dysfunctions of the auditory system, tinnitus can lead to significant distress, depression, anxiety, and decreases in life quality. This paper investigated the construct of psychological acceptance in a population of tinnitus patients. First, a cross-sectional Study (N = 77) was conducted in which a tinnitus specific acceptance questionnaire was developed. Results showed that a Tinnitus Acceptance Questionnaire (TAQ) generated good internal consistency. A factor Solution was derived with two factors: activity engagement and tinnitus supression, Second, a longitudinal study (N = 47) investigated the mediating role of acceptance on the relationship between tinnitus distress at baseline and tinnitus distress, anxiety, life quality, and depression at a 7-month follow-up The results. showed full mediation of activity engagement for depression and life quality at follow-up, partial mediation for tinnitus distress, and no mediation for anxiety. The role of acceptance in the negative impact of tinnitus distress merits further investigation.

  • 18.
    Westin, Vendela
    et al.
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Ostergren, Richard
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Andersson , Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    The effects of acceptance versus thought suppression for dealing with the intrusiveness of tinnitus2008In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 47, p. S112-S118Article in journal (Refereed)
    Abstract [en]

    The purpose of this study was to examine the effect of acceptance versus suppression of disruptions on a mental imagery task in a sample of tinnitus patients. Previous research has indicated that acceptance can be an effective strategy for dealing with unpleasant experiences such as pain and anxiety. The study used a between-group design, including 47 participants who completed a task involving mental imagery in a sound-proof booth. Participants were randomly assigned to three instruction conditions: acceptance, suppression, or a control condition. The results showed a significant difference between the acceptance group and the control group in that participants in the acceptance group were able to focus on the imagery task for a longer time without being interrupted. The study provides preliminary support for the notion that acceptance can be a helpful strategy for tinnitus patients.

  • 19.
    Westin, Vendela
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Schulin, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Stalby, Magnus
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Wisung, Gisela
    Hesser, Hugo
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Zarenoe, Reza
    Linköping University, Department of Clinical and Experimental Medicine. Linköping University, Faculty of Health Sciences.
    Karlsson, M
    Olofsson, U
    Ermedahl-Bydairk, Ulrika
    Andersson, Gerhard
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Randomized Controlled trial of Acceptance and Commitment Therapy for tinnitus distress2008Conference paper (Other academic)
  • 20.
    Zetterqvist Westin, Vendela
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Educational Sciences.
    Schulin, Mikael
    Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Karlsson, Marianne
    Vrinnevisjukhuset, Norrköping.
    Zare Noe, Reza
    Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL. Linköping University, Department of Clinical and Experimental Medicine, Oto-Rhiono-Laryngology and Head & Neck Surgery.
    Olofsson, Ulrike
    Östergötlands Läns Landsting, Sinnescentrum, Department of ENT - Head and Neck Surgery UHL.
    Stalby, Magnus
    Psykologpartners, Linköping.
    Wisung, Gisela
    Psykologpartners, Linköping.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial2011In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, no 11, p. 737-747Article in journal (Refereed)
    Abstract [en]

    The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60min sessions. The TRT treatment consisted of one 150min session, one 30min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen's d=1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen's d=0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.

  • 21.
    Zetterqvist (f.d. Westin), Vendela
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Tinnitus – an acceptance-based approach2011Doctoral thesis, comprehensive summary (Other academic)
    Abstract [en]

    Tinnitus is a highly prevalent health condition creating moderate or severe interference on mood, sleep and daily functioning for a group of those affected. The aims of this thesis were 1) to explore the role of acceptance and psychological flexibility in understanding tinnitus interference both experimentally and with a longitudinal design 2) to evaluate the immediate and long-term outcomes of an acceptance based behaviour therapy (Acceptance and Commitment Therapy; ACT) in the treatment of people with tinnitus and, 3) to investigate the relationship between treatment outcome and processes assumed to be the active ingredients of treatment (acceptance and cognitive defusion).

    Study I (n=47) was an experiment comparing the impact of acceptance to that of thought suppression or a neutral instruction on the ability to maintain attention on an imagery task. Results indicated that participants could benefit from an acceptance strategy when performing the task. Study II (n=47) was a longitudinal trial studying the mediating role of acceptance on the relationship between tinnitus interference at baseline and tinnitus interference, anxiety, life quality, and depression at a seven-month follow-up. Full mediation was found for life quality and depression, and partial mediation for tinnitus interference. Study IV (n=64) was a randomised controlled trial evaluating the immediate and long-term effects of ACT in comparison to those of Tinnitus Retraining Therapy (TRT) and to a wait list control. Results showed that ACT had large immediate effects on tinnitus interference in comparison to wait list, and medium long-term effects in comparison to TRT. Results were also seen on secondary outcome. Self-reported tinnitus acceptance significantly mediated the immediate outcome of ACT. Study III (n=24) was a process study where the video recorded sessions of ACT from study IV were observed and rated with regard to client behaviour. Results showed that in-session acceptance and defusion behaviours rated early in therapy were predictors of sustained positive treatment effects of ACT. These associations continued to be substantial even when controlling for the prior improvement in outcome. This whereas prior symptom change could not predict process variables rated late in therapy. Participants in all trials were chronic tinnitus patients, mainly from different departments of audiology. These findings implicate that 1) acceptance and psychological flexibility may contribute to the understanding of tinnitus interference 2) ACT can reduce tinnitus interference in a group of normal hearing tinnitus patients and 3) acceptance and cognitive defusion are important processes in ACT, related to outcome.

    List of papers
    1. The effects of acceptance versus thought suppression for dealing with the intrusiveness of tinnitus
    Open this publication in new window or tab >>The effects of acceptance versus thought suppression for dealing with the intrusiveness of tinnitus
    2008 (English)In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 47, p. S112-S118Article in journal (Refereed) Published
    Abstract [en]

    The purpose of this study was to examine the effect of acceptance versus suppression of disruptions on a mental imagery task in a sample of tinnitus patients. Previous research has indicated that acceptance can be an effective strategy for dealing with unpleasant experiences such as pain and anxiety. The study used a between-group design, including 47 participants who completed a task involving mental imagery in a sound-proof booth. Participants were randomly assigned to three instruction conditions: acceptance, suppression, or a control condition. The results showed a significant difference between the acceptance group and the control group in that participants in the acceptance group were able to focus on the imagery task for a longer time without being interrupted. The study provides preliminary support for the notion that acceptance can be a helpful strategy for tinnitus patients.

    Keywords
    Tinnitus, Acceptance, Thought suppression
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-16151 (URN)10.1080/14992020802301688 (DOI)
    Available from: 2009-01-08 Created: 2009-01-07 Last updated: 2017-12-14
    2. Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact
    Open this publication in new window or tab >>Is it the sound or your relationship to it? The role of acceptance in predicting tinnitus impact
    2008 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 46, no 12, p. 1259-1265Article in journal (Refereed) Published
    Abstract [en]

    Tinnitus is an experience of sound in the absence of an appropriate external source. A symptom that can accompany most central or peripheral dysfunctions of the auditory system, tinnitus can lead to significant distress, depression, anxiety, and decreases in life quality. This paper investigated the construct of psychological acceptance in a population of tinnitus patients. First, a cross-sectional Study (N = 77) was conducted in which a tinnitus specific acceptance questionnaire was developed. Results showed that a Tinnitus Acceptance Questionnaire (TAQ) generated good internal consistency. A factor Solution was derived with two factors: activity engagement and tinnitus supression, Second, a longitudinal study (N = 47) investigated the mediating role of acceptance on the relationship between tinnitus distress at baseline and tinnitus distress, anxiety, life quality, and depression at a 7-month follow-up The results. showed full mediation of activity engagement for depression and life quality at follow-up, partial mediation for tinnitus distress, and no mediation for anxiety. The role of acceptance in the negative impact of tinnitus distress merits further investigation.

    Keywords
    Tinnitus, Acceptance, Mediation analysis, Tinnitus distress, Defusion, Longitudinal
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-16262 (URN)10.1016/j.brat.2008.08.008 (DOI)
    Available from: 2009-01-12 Created: 2009-01-09 Last updated: 2017-12-14
    3. Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress.
    Open this publication in new window or tab >>Clients' in-session acceptance and cognitive defusion behaviors in acceptance-based treatment of tinnitus distress.
    2009 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 47, no 6, p. 523-8Article in journal (Refereed) Published
    Abstract [en]

    Cognitive-behavioral treatment (CBT) is considered to be an effective treatment of distress associated with tinnitus (perception of internal noises without any outer auditory stimulation), but the processes by which the therapy works remain unclear. Mindfulness and acceptance is receiving increased attention in the treatment literature for chronic medical conditions. However, few studies have examined these and related processes with behavioral or observer measures. In the present study 57 videotapes (a total of 1710min) from 19 clients who participated in a controlled trial of an acceptance-based treatment for tinnitus distress, were coded for frequency and peak level of verbal behaviors expressing either acceptance or cognitive defusion. Frequency of cognitive defusion behaviors and peak level of cognitive defusion as well as peak level of acceptance rated in Session 2, predicted symptom reduction 6 month following treatment. These relationships were not accounted for by the improvement that had occurred prior to the measurement point of the process variables. Moreover, prior symptom changes could not predict process variables rated later in therapy (after most of the improvement in therapy had occurred). Thus, clients' in-session acceptance and cognitive defusion behaviors appear to play an important role in the reduction of negative impact of tinnitus.

    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-18989 (URN)10.1016/j.brat.2009.02.002 (DOI)19268281 (PubMedID)
    Available from: 2009-06-07 Created: 2009-06-07 Last updated: 2018-12-12Bibliographically approved
    4. Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial
    Open this publication in new window or tab >>Acceptance and Commitment Therapy versus Tinnitus Retraining Therapy in the treatment of tinnitus: A randomised controlled trial
    Show others...
    2011 (English)In: Behaviour Research and Therapy, ISSN 0005-7967, E-ISSN 1873-622X, Vol. 49, no 11, p. 737-747Article in journal (Refereed) Published
    Abstract [en]

    The study compared the effects of Acceptance and Commitment Therapy (ACT) with Tinnitus Retraining Therapy (TRT) on tinnitus impact in a randomised controlled trial. Sixty-four normal hearing subjects with tinnitus were randomised to one of the active treatments or a wait-list control (WLC). The ACT treatment consisted of 10 weekly 60min sessions. The TRT treatment consisted of one 150min session, one 30min follow-up and continued daily use of wearable sound generators for a recommended period of at least 8h/day for 18 months. Assessments were made at baseline, 10 weeks, 6 months and 18 months. At 10 weeks, results showed a superior effect of ACT in comparison with the WLC regarding tinnitus impact (Cohen's d=1.04), problems with sleep and anxiety. The results were mediated by tinnitus acceptance. A comparison between the active treatments, including all assessment points, revealed significant differences in favour of ACT regarding tinnitus impact (Cohen's d=0.75) and problems with sleep. At 6 months, reliable improvement on the main outcome measure was found for 54.5% in the ACT condition and 20% in the TRT condition. The results suggest that ACT can reduce tinnitus distress and impact in a group of normal hearing tinnitus patients.

    Place, publisher, year, edition, pages
    Elsevier, 2011
    Keywords
    Acceptance and commitment therapy; Stress; Social workers; Burnout; Randomized controlled trial; Stress management
    National Category
    Medical and Health Sciences
    Identifiers
    urn:nbn:se:liu:diva-71844 (URN)10.1016/j.brat.2011.08.001 (DOI)000296941700003 ()21864830 (PubMedID)
    Available from: 2011-11-07 Created: 2011-11-07 Last updated: 2018-12-12
  • 22.
    Zetterqvist, Vendela
    et al.
    Linköping University, The Swedish Institute for Disability Research. Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Educational Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Kaldo, Viktor
    Karolinska Institutet, Stockholm.
    Leva med tinnitus2013 (ed. 1)Book (Other (popular science, discussion, etc.))
    Abstract [sv]

    Har du ett klingande, ringande, tjutande, brusande, surrande, visslande ljud i huvudet eller öronen som påverkar ditt dagliga liv? Ett stort antal personer i Sverige upplever att tinnitus inverkar på deras mående, sömn, koncentrationsförmåga och livskvalitet.Ljudet kan uppfattas störande i ett flertal situationer och ljudmiljöer såsom i tystnad, vid restaurangbesök eller vid samtal. Vissa upplever inte längre samma glädje i aktiviteter som de tidigare uppskattade. Andra känner en oro och frågar sig om deras tinnitus kommer att bli värre, eller om den är tecken på något allvarligt fel.Leva med tinnitus är en självhjälpsbok som bygger på material som arbetats fram och prövats med goda resultat under flera år av forskning och som tillvaratar den senaste utvecklingen inom tinnitusbehandling. Metoderna i boken är hämtade från kognitiv beteendeterapi (KBT) och acceptance and commitment therapy (ACT). Läsaren får arbeta med olika beprövade tekniker och tillägnar sig nya förhållningssätt. Syftet är att tinnitus inte längre ska behöva ta lika stor plats i den enskildes liv.

1 - 22 of 22
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