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  • 1.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Cima, Rilana F F.
    Maastricht University, Netherlands .
    Weise, Cornelia
    Linköping University, Department of Medical and Health Sciences. Linköping University, Faculty of Arts and Sciences. Linköping, Disability Research.
    Autobiographical Memory Specificity in Patients with Tinnitus Versus Patients with Depression and Normal Controls2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 2, p. 116-126Article in journal (Refereed)
    Abstract [en]

    Several studies show that patients with depression and post-traumatic stress disorder respond with fewer specific autobiographical memories in a cued memory task (i.e. the autobiographical memory test; AMT) compared to healthy controls. One previous study found this phenomenon among tinnitus patients as well (Andersson, Ingerholt, andamp; Jansson, 2003). The aim of this study was to replicate the previous study with an additional control group of depressed patients and memory errors as measured with the AMT as an additional outcome. We included 20 normal hearing tinnitus patients, 20 healthy controls and 20 persons diagnosed with clinical depression. The AMT was administered together with self-report measures of depression, anxiety and tinnitus distress. Both the tinnitus and depression groups differed from the healthy control group in that they reported fewer specific autobiographical memories. There were, however, differences between the tinnitus and depression groups in terms of the errors made on the AMT. The depression group had more overgeneral memories than the normal control group, whereas the tinnitus group did not differ from the control group on this memory error. The tinnitus group had more semantic associations and non-memories than the other two groups, suggesting that executive functioning may play a role for the tinnitus group when completing the AMT. Clinical and theoretical implications of the findings are discussed.

  • 2.
    Andersson, Gerhard
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    Ljotsson, Brjann
    Karolinska Institute.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Internet-delivered treatment to promote health2011In: CURRENT OPINION IN PSYCHIATRY, ISSN 0951-7367, Vol. 24, no 2, p. 168-172Article in journal (Refereed)
    Abstract [en]

    Purpose of review The aim of this paper is to provide an updated review of recent controlled trials of Internet interventions for health conditions and how the Internet is used to promote health. Recent findings We identified 18 published trials including studies on diabetes, cancer, pain conditions, obesity, irritable bowel syndrome, stress management, hypertension, metabolic syndrome, cerebral palsy, infertility, HIV infection, and fruit/vegetable consumption. Of the 18 trials, one-third targeted children and adolescents. Two cancer studies investigated the role of peer support in an online environment that failed to result in any major improvements. Overall, several trials did not result in any substantial significant improvements, but there are exceptions, such as treatment of irritable bowel syndrome, headache, and chronic pain. Although a few of the reviewed studies had sufficient sample sizes, the majority were small and underpowered. In particular, this was the case for the studies on children and adolescents. Summary This review suggests that Internet interventions hold some promise as a complement to other treatments such as cognitive behavior therapy. The benefits from participating in online peer support groups are not clear. Although studies on children and adolescents have emerged, there is a lack of studies on older adults with health problems.

  • 3.
    Conrad, Isabell
    et al.
    Johannes Gutenberg University of Mainz, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Jasper, Kristine
    Johannes Gutenberg University of Mainz, Germany.
    Hiller, Wolfgang
    Johannes Gutenberg University of Mainz, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    The Changeability and Predictive Value of Dysfunctional Cognitions in Cognitive Behavior Therapy for Chronic Tinnitus2015In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 22, no 2, p. 239-250Article in journal (Refereed)
    Abstract [en]

    Background Multidimensional tinnitus models describe dysfunctional cognitions as a complicating factor in the process of tinnitus habituation. However, this concept has rarely been investigated in previous research. Purpose The present study investigated the effects of two cognitive-behavioral treatments on dysfunctional tinnitus-related cognitions in patients with chronic tinnitus. Furthermore, dysfunctional cognitions were examined as possible predictors of the therapeutic effect on tinnitus distress. Method A total of 128 patients with chronic tinnitus were randomly assigned to either an Internet-delivered guided self-help treatment (Internet-based cognitive-behavioral therapy, ICBT), a conventional face-to-face group therapy (cognitive-behavioral group therapy, GCBT), or an active control group in the form of a web-based discussion forum (DF). To assess tinnitus-related dysfunctional thoughts, the Tinnitus Cognitions Scale (T-Cog) was used at pre- and post-assessment, as well as at the 6- and 12-month follow-up. Results Multivariate ANOVAs with post hoc tests revealed significant and comparable reductions of dysfunctional tinnitus-related cognitions for both treatments (GCBT and ICBT), which remained stable over a 6- and 12-month period. Negative correlations were found between the catastrophic subscale of the T-Cog and therapy outcome for ICBT, but not for GCBT. This means a higher degree of catastrophic thinking at baseline was associated with lower benefit from ICBT directly after the treatment. Hierarchical regression analysis confirmed catastrophizing as a predictor of poorer therapy outcome regarding emotional tinnitus distress in ICBT. No associations were detected in the follow-up assessments. Conclusion Both forms of CBT are successful in reducing dysfunctional tinnitus-related cognitions. Catastrophizing significantly predicted a less favorable outcome regarding emotional tinnitus distress in ICBT. Clinical implications of these results are described. Dysfunctional cognitions could be targeted more intensively in therapy and in future research on tinnitus.

  • 4.
    Conrad, Isabell
    et al.
    Johannes Gutenberg University of Mainz, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Jasper, Kristine
    Johannes Gutenberg University of Mainz, Germany.
    Hiller, Wolfgang
    Johannes Gutenberg University of Mainz, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    The Role of Dysfunctional Cognitions in Patients With Chronic Tinnitus2015In: Ear and Hearing, ISSN 0196-0202, E-ISSN 1538-4667, Vol. 36, no 5, p. E279-E289Article in journal (Refereed)
    Abstract [en]

    Objectives: The present study investigates the role of dysfunctional cognitions in patients with chronic tinnitus. To explore different dimensions of tinnitus-related thoughts, a 22-item self-report measure, the Tinnitus Cognitions Scale (T-Cog), is presented. Furthermore, dysfunctional cognitions are examined as a possible mediator of the relation between tinnitus distress and depression. Design: The present study analyzes the cross-sectional data of 373 patients with chronic tinnitus. Parallel analysis and principal axis factoring are used to identify the factor structure of the T-Cog. Assumed mediating effects are tested using the asymptotic and resampling procedure. Results: Factor analysis reveals two factors interpreted as tinnitus-related catastrophic thinking and tinnitus-related avoidance cognitions. Internal consistency is sufficient with a Cronbachs of 0.88 for the total scale and 0.74 and 0.87 for the subscales. The authors find high associations between the T-Cog and other measures of tinnitus distress, depression, anxiety, and tinnitus acceptance, indicating convergent validity. With the exception of neuroticism, low correlations with personality factors are found, indicating discriminant validity. Patients with moderate or severe tinnitus distress report significantly higher scores of dysfunctional cognitions than patients with mild tinnitus distress. Tinnitus-related catastrophic thinking and tinnitus-related avoidance cognitions partially mediate the relation between tinnitus distress and depression. Conclusions: Dysfunctional cognitions can play an important role in the degree of tinnitus distress. Catastrophic and avoidant thoughts contribute to the explanation of depression among tinnitus patients. The T-Cog is a reliable and valid questionnaire for the assessment of different dimensions of cognitions. Its use could provide information for identifying tinnitus patients who are particularly suitable for cognitive-behavioral therapy.

  • 5.
    Heinecke, Kristin
    et al.
    Philipps-Universität Marburg, Germany.
    Weise, Cornelia
    Philipps-Universität Marburg, Germany.
    Rief, Winfried
    Philipps-Universität Marburg, Germany.
    Chronischer Tinnitus: Für wen ist eine ambulante Kurzzeitpsychotherapie indiziert?: [Chronic Tinnitus: Which Kind of Patients Benefit from an Outpatient Psychotherapy?]2010In: PPmP. Psychotherapie, Psychosomatik, medizinische Psychologie, ISSN 0937-2032, E-ISSN 1439-1058, Vol. 60, no 7, p. 271-278Article in journal (Refereed)
    Abstract [en]

    Background:Psychotherapy proved to be effective in the treatment of chronic tinnitus sufferers. We investigated, which patient and symptom characteristics predicted the treatment outcome.

    Patients and methods: 95 patients underwent a CBT based treatment including biofeedback elements. Predictors were identified by the use of regression analysis. Outcome was defined as changes in tinnitus annoyance, intensity, duration, the number of responder and the end-state-functioning.

    Results: More than 80% of the participants significantly improved. Positive predictors found in the analysis were an active and non-sceptical treatment expectancy. If patients suffered from depressive disorder, outcome was slightly reduced.

    Conclusion: Most tinnitus patients benefit from outpatient psychotherapy. Positive treatment expectancy should be increased at the beginning of the treatment. Patients who are sceptical should be informed about potential positive treatment results. In the case of affective disorder, additional treatments should be considered.

  • 6.
    Heinecke, Kristin
    et al.
    Philipps-University Marburg, Germany.
    Weise, Cornelia
    Philipps-University Marburg, Germany.
    Rief, Winfried
    Philipps-University Marburg, Germany.
    Psychophysiological effects of biofeedback treatment in tinnitus sufferers2009In: British Journal of Clinical Psychology, ISSN 0144-6657, E-ISSN 2044-8260, Vol. 48, no 3, p. 223-239Article in journal (Refereed)
    Abstract [en]

    Objectives. Psychophysiological factors in maintaining tinnitus-related distress have been emphasized in current tinnitus models. Hyperreactivity in the autonomous nervous system is supposed to hinder habituation processes and might contribute to maladjustment to tinnitus symptoms in the long run. Accordingly, biofeedback treatment targeting physiological activity ought to reduce tinnitus annoyance and facilitate habituation.

    Subjects. One hundred and thirty patients completed a manual-based psychological treatment especially developed for chronic tinnitus sufferers. A subsample consisting of 67 participants were randomly assigned to a waiting list (3 months) and served as a control group. The programme consisted of 15 sessions of cognitive-behavioural therapy combined with a psychophysiological treatment using a biofeedback approach.

    Method. Different muscle regions of the head and neck and skin conductance level were assessed with biofeedback equipment. Physiological treatment effects were analysed using the pre-post effect sizes in comparison to the waitlist group. Correlations for physiological changes and psychological treatment effects were computed.

    Results. Moderate to large effect sizes for physiological changes were demonstrated. Physiological and psychological treatment effects were found to be unrelated.

    Discussion. Our treatment approach, which combined biofeedback therapy with CBT elements, was found to be highly effective in reducing psychophysiological activation. Psychological and physiological variables seem to represent independent response systems.

  • 7.
    Heinecke, Kristin
    et al.
    Philipps-University of Marburg, Germany .
    Weise, Cornelia
    Philipps-University of Marburg, Germany .
    Rief, Winfried
    Philipps-University of Marburg, Germany .
    Stressreaktivität bei Patienten mit chronischem dekompensiertem Tinnitus [Stress reactivity in patients with chronic decompensated tinnitus]2007Conference paper (Other academic)
  • 8.
    Heinecke, Kristin
    et al.
    Philipps-University of Marburg, Germany .
    Weise, Cornelia
    Philipps-University of Marburg, Germany .
    Schwarz, Kristin
    Philipps-University of Marburg, Germany .
    Rief, Winfried
    Philipps-University of Marburg, Germany .
    Physiological and psychological stress reactivity in chronic tinnitus2008In: Journal of behavioral medicine, ISSN 0160-7715, E-ISSN 1573-3521, Vol. 31, no 3, p. 179-188Article in journal (Refereed)
    Abstract [en]

    Several models of tinnitus maintenance emphasize the importance of cognitive, emotional and psychophysiological processes. These factors contribute to distress in patients with decompensated tinnitus symptoms. We investigated whether tinnitus patients show increased physiological levels of arousal, more intense stress reactivity patterns and exaggerated psychological strain compared to healthy controls. Seventy tinnitus patients and 55 healthy controls underwent various stress tests. Muscular reactivity and peripheral arousal as well as strain ratings were assessed. Tinnitus patients reported significantly more strain during stress tests compared to healthy controls. Few physiological reactivity patterns differed significantly between the two groups. The physiological data thus only partly supported a hyperreactivity hypothesis. Strain reports and physiological data were only marginally correlated. Tinnitus patients show maladaptive appraisal processes during stress exposure, yet physiological reactivity is only slightly affected. Treatment programs for patients with decompensated tinnitus symptoms should account for appraisal processes and coping mechanisms in stressful situations.

  • 9.
    Heinrich, Sarah
    et al.
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Rozental, Alexander
    Department of Psychology, Stockholm University, Sweden.
    Carlbring, Per
    Division of Clinical Psychology, Department of Psychology, Stockholm University, Stockholm, Sweden.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
    Cotter, Katherine
    Department of Psychology, Stockholm University, Stockholm, Sweden.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany.
    Treating tinnitus distress via the Internet: A mixed methods approach of what makes patients seek help and stay motivated during Internet-based cognitive behavior therapy2016In: Internet Interventions, ISSN 2214-7829, Vol. 4, no 2, p. 120-130Article in journal (Refereed)
    Abstract [en]

    Background

    Internet-based cognitive behavioral therapy (ICBT) has proven to be an effective treatment in improving patients' ability to cope with tinnitus. However, some patients prefer face-to-face therapy to ICBT, and a few studies have shown considerable dropout rates if the treatment is not guided. This renders it important to identify factors that contribute to the commencement and continuation of ICBT programs.

    Aims

    Because treatment motivation and expectations are important factors in psychological treatment, the aim of our study was to investigate what leads tinnitus patients to seek out ICBT, what helps them to keep up with the treatment, and what (if any) impact these factors have on dropout rates and treatment outcomes.

    Method

    112 tinnitus patients taking part in ICBT for tinnitus responded to symptom-related questionnaires at three points in time (pre-treatment, post-treatment, and one-year-follow-up) and to a questionnaire consisting of open-ended questions about their treatment motivation and expectations before beginning treatment. Data were analyzed using qualitative content analysis, and the results were used to divide the participants into groups. The treatment outcomes of these groups were compared using t-tests, χ2-tests, and both one-factorial and mixed ANOVAs.

    Results

    Four main categories emerged as factors conducive to starting treatment: 1) Targets participants wanted to address, 2) circumstances that led to participation, 3) attitudes towards the treatment, and 4) training features. Participants identified six facilitators for continuing the treatment: success, training, individual attitude, hope, evidence, and support. Naming specific tinnitus-associated problems as targets was associated with greater improvement from pre-treatment to 1-year-follow-up. Describing an active involvement in the treatment was related to increased improvement from post-treatment to follow-up.

    Conclusion

    There are several motivational factors that tinnitus patients consider relevant for beginning and continuing ICBT. Particularly, focusing on specific targets that do not involve the tinnitus itself, and encouraging participants to take an active role in treatment may increase treatment effectiveness. However, further hypothesis-guided research is necessary to confirm our explorative results.

  • 10.
    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.
    Rief, Winfried
    University of Marburg.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Clinical and Social Psychology. Linköping University, Faculty of Arts and Sciences.
    The effect of waiting: A meta-analysis of wait-list control groups in trials for tinnitus distress2011In: JOURNAL OF PSYCHOSOMATIC RESEARCH, ISSN 0022-3999, Vol. 70, no 4, p. 378-384Article, review/survey (Refereed)
    Abstract [en]

    Objective: The response rates and effects of being placed on a wait-list control condition are well documented in psychiatric populations. Despite the usefulness of such estimates and the frequent use of no-treatment controls in clinical trials for tinnitus, the effect of waiting in a tinnitus trial has not been investigated systematically. The aim of the present study was to quantify the overall effect of wait-list control groups on tinnitus distress. Methods: Studies were retrieved via a systematic review of randomised controlled trials of cognitive behaviour therapy for tinnitus distress. Outcomes of psychometrically robust tinnitus-specific measures (Tinnitus Handicap Inventory, Tinnitus Questionnaire, Tinnitus Reaction Questionnaire) from wait-list control groups were quantified using meta-analytic techniques. Percentage of change and standard mean difference effect sizes were calculated using the pre and post wait period. Results: Eleven studies involving 314 wait-list subjects with tinnitus were located. The analysis for a waiting period of 6 to 12 weeks revealed a mean decrease in scores on tinnitus-specific measures of 3% to 8%. Across studies, a statically significant small mean within-group effect size was obtained (Hedges g=.17). The effects were moderated by methodological quality of the trial, sample characteristics (i.e., age, tinnitus duration), time of the wait-list and how diagnosis was established. Conclusion: Subjects in a tinnitus trial improve in tinnitus distress over a short waiting phase. The effects of waiting are highly variable and depend on the characteristics of the sample and of the trial.

  • 11.
    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)
  • 12.
    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.

  • 13.
    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)
  • 14.
    Janda, Carolyn
    et al.
    Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany.
    Kues, Johanna N.
    Division of Clinical Psychology and Psychotherapy, Department of Psychology , Philipps University , Marburg , Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
    Kleinstäuber, Maria
    Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University, Marburg, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps University, Marburg, Germany.
    A symptom diary to assess severe premenstrual syndrome and premenstrual dysphoric disorder2017In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 57, no 7, p. 837-854Article in journal (Refereed)
    Abstract [en]

    The differentiation between premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) has been widely discussed. PMDD is listed as a mental disorder in the DSM-5, whereas PMS is not considered as a mental disorder in any diagnostic manual. Consequently, PMS is operationalized in different ways. Keeping a symptom diary is required to diagnose PMDD but is also recommended for PMS. The aim of our study was, therefore, to operationalize PMS and PMDD within a DSM-5-based symptom diary. We developed a symptom-intensity-score (SI-score) and an interference-score (INT-score) to evaluate the symptom diary. Ninety-eight women (aged 20-45 years) completed a symptom diary over two menstrual cycles, a retrospective screening for premenstrual symptoms, and answered additional impairment questionnaires from August 2013 to August 2015. The scores revealed moderate to good reliability (Cronbachs a = 0.83-0.96). Convergent validity was shown by significant correlations with a retrospective screening, the Pain Disability Index, and the German PMS-Impact Questionnaire. Discriminant validity was indicated by low correlations with the Big Five Inventory-10. These scores may facilitate the evaluation of prospective symptom ratings in research and clinical practice. Future research should focus on continuing to validate the scores (e.g., in an ambulatory setting).

  • 15.
    Janda, Carolyn
    et al.
    University of Marburg, Germany.
    Kues, Johanna N.
    University of Marburg, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    A Therapeutic Approach to Premenstrual Syndrome (PMS): Modularized Treatment Program2015In: Verhaltenstherapie (Basel), ISSN 1016-6262, E-ISSN 1423-0402, Vol. 25, no 4, p. 294-303Article in journal (Refereed)
    Abstract [en]

    Background: The paper presents a modularized treatment approach for women with premenstrual symptoms. Many women of reproductive age suffer from physical and/or mental premenstrual complaints, which can significantly reduce the quality of everyday life. Current studies showed positive effects of cognitive-behavioral therapy and lifestyle interventions. Overall, there is a lack of effective treatment approach. Method: The present approach addresses women with a severe premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD). It consists of a detailed psychoeducation, cognitive interventions regarding PMS-related dysfunctional cognitions, strategies to change dysfunctional behaviors, and targets lifestyle issues such as stress, relaxation, balanced diet, and sports. Results: First results of the efficacy as well as the contentment with the treatment program were reported within a case study. Conclusion: The paper presents newly developed treatment guidelines, which can be integrated both, in research and therapeutic practice. The treatment guidelines should be used in further research to optimize the treatment of premenstrual burden.

  • 16.
    Jasper, Kristine
    et al.
    Johannes Gutenberg University of Mainz, Germany .
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Philipps University Marburg, Germany.
    Conrad, Isabell
    Johannes Gutenberg University of Mainz, Germany .
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institutet, Stockholm, Sweden .
    Hiller, Wolfgang
    Johannes Gutenberg University of Mainz, Germany .
    Kleinstaeuber, Maria
    Philipps University Marburg, Germany.
    Internet-based guided self-help versus group cognitive behavioral therapy for chronic tinnitus: a randomized controlled trial2014In: Psychotherapy and Psychosomatics, ISSN 0033-3190, E-ISSN 1423-0348, Vol. 83, no 4, p. 234-246Article in journal (Refereed)
    Abstract [en]

    BACKGROUND:

    The aim of this randomized controlled trial was to investigate the effects of conventional face-to-face group cognitive behavioral therapy (GCBT) and an Internet-delivered guided self-help treatment (Internet-based CBT, ICBT) on tinnitus distress.

    METHODS:

    A total of 128 adults with at least mild levels of chronic tinnitus distress were randomly assigned to GCBT (n = 43), ICBT (n = 41), or a web-based discussion forum (DF) that served as a control condition (n = 44). Standardized self-report measures [the Tinnitus Handicap Inventory (THI), Mini-Tinnitus Questionnaire (Mini-TQ), Hospital Anxiety and Depression Scale, Insomnia Severity Index and Tinnitus Acceptance Questionnaire] were completed at the pre- and post-assessments and at the 6-month follow-up.

    RESULTS:

    Repeated-measures ANOVAs revealed significant time × group interaction effects on the primary outcomes (THI and Mini-TQ scores) in favor of both CBT interventions compared with the DF at post-assessment (0.56 ≤ g ≤ 0.93; all p ≤ 0.001). There were no significant differences between GCBT and ICBT (all p > 0.05) and the treatment effects remained stable at the 6-month follow-up.

    CONCLUSIONS:

    This study provides evidence that ICBT might be an equally effective alternative to conventional CBT in the management of chronic tinnitus. Despite encouraging results, further research is necessary to determine the actual potential of ICBT as a viable alternative to CBT, and under which circumstances it is effective.

  • 17.
    Jasper, Kristine
    et al.
    Johannes Gutenberg-University Mainz, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Philipps-University Marburg, Germany.
    Conrad, Isabell
    Johannes Gutenberg-University Mainz, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Hiller, Wolfgang
    Johannes Gutenberg-University Mainz, Germany.
    Kleinstäuber, Maria
    Philipps-University Marburg, Germany.
    The working alliance in a randomized controlled trial comparing Internet-based self-help and face-to-face cognitive behavior therapy for chronic tinnitus2014In: Internet Interventions, ISSN 2214-7829, Vol. 1, no 2, p. 49-57Article in journal (Refereed)
    Abstract [en]

    Objective

    This study (ID: NCT01205906) compared the impact of the working alliance between the therapist and the client on treatment outcome in a group and an Internet-based cognitive behavior therapy (GCBT vs. ICBT) for chronic tinnitus.

    Methods

    The Working Alliance Inventory — Short Revised (WAI-SR, scale range: 1–5) was administered to 26 GCBT and 38 ICBT participants after treatment weeks 2, 5, and 9, and the Tinnitus Handicap Inventory (THI) before and after the treatment.

    Results

    High alliance ratings were found in both ICBT (WAI-SR total scores at week 9: M = 3.59, SD = 0.72) and GCBT (WAI-SR total scores at week 9: M = 4.20, SD = 0.49), but significantly higher ratings occurred in GCBT on most WAI-SR scales (ps < .01). Significant time × group interactions for most WAI-SR scales indicated differences in alliance growth patterns between the treatments (ps < .001). Residual gain scores for the therapy outcome measure ‘tinnitus distress’ were significantly correlated with the agreement on treatment tasks between therapist and client in ICBT (r = .40, p = .014) and with the affective therapeutic bond in GCBT (r = .40, p = .043) at mid-treatment (week 5).

    Conclusion

    More time was needed to build a strong alliance in ICBT although GCBT yielded generally higher alliance ratings. Moreover, different aspects of the therapeutic alliance might be important for treatment success in ICBT versus GCBT.

  • 18.
    Kleinstaeuber, Maria
    et al.
    University of Marburg, Germany.
    Frank, Ina
    Johannes Gutenberg University of Mainz, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    A confirmatory factor analytic validation of the Tinnitus Handicap Inventory2015In: Journal of Psychosomatic Research, ISSN 0022-3999, E-ISSN 1879-1360, Vol. 78, no 3, p. 277-284Article in journal (Refereed)
    Abstract [en]

    Objective: Because the postulated three-factor structure of the internationally widely used Tinnitus Handicap Inventory (THI) has not been confirmed yet by a confirmatory factor analytic approach this was the central aim of the current study. Methods: From a clinical setting, N = 373 patients with chronic tinnitus completed the THI and further questionnaires assessing tinnitus-related and psychological variables. In order to analyze the psychometric properties of the THI, confirmatory factor analysis (CFA) and correlational analyses were conducted. Results: CFA provided a statistically significant support for a better fit of the data to the hypothesized three-factor structure (RMSEA = .049, WRMR = 1.062, CFI = .965, TLI = .961) than to a general factor model (RMSEA = .062, WRMR = 1.258, CFI = .942, TLI = .937). The calculation of Cronbachs alpha as indicator of internal consistency revealed satisfactory values (.80-.91) with the exception of the catastrophic subscale (.65). High positive correlations of the THI and its subscales with other measures of tinnitus distress, anxiety, and depression, high negative correlations with tinnitus acceptance, moderate positive correlations with anxiety sensitivity, sleeping difficulties, tinnitus loudness, and small correlations with the Big Five personality dimensions confirmed construct validity. Conclusion: Results show that the THI is a highly reliable and valid measure of tinnitus-related handicap. In contrast to results of previous exploratory analyses the current findings speak for a three-factor in contrast to a unifactorial structure. Future research is needed to replicate this result in different tinnitus populations.

  • 19.
    Kleinstaeuber, Maria
    et al.
    Johannes Gutenberg University of Mainz, Germany.
    Jasper, Kristine
    Johannes Gutenberg University of Mainz, Germany.
    Schweda, Isabell
    Johannes Gutenberg University of Mainz, Germany.
    Hiller, Wolfgang
    Johannes Gutenberg 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 Health 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 Health Sciences.
    The Role of Fear-Avoidance Cognitions and Behaviors in Patients with Chronic Tinnitus2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 2, p. 84-99Article in journal (Refereed)
    Abstract [en]

    The current study investigated the role of fear-avoidance—a concept from chronic pain research—in chronic tinnitus. A self-report measure the “Tinnitus Fear-Avoidance Cognitions and Behaviors Scale (T-FAS)” was developed and validated. Furthermore, the role of fear-avoidance behavior as mediator of the relationship between anxiety sensitivity and tinnitus handicap was investigated. From a clinical setting, N = 373 patients with chronic tinnitus completed questionnaires assessing tinnitus handicap (Tinnitus Handicap Inventory), anxiety, depression (Hospital Anxiety and Depression Scale), anxiety sensitivity (Anxiety Sensitivity Index-3), personality factors (Big Five Inventory-10), and fear-avoidance. To analyze the psychometric properties, principal component analysis with parallel component extraction and correlational analyses were used. To examine a possible mediating effect, hierarchical regression analysis was applied. The principal component analysis resulted in a three-factor solution: Fear-avoidance Cognitions, Tinnitus-related Fear-Avoidance Behavior, and Ear-related Fear-Avoidance Behavior. Internal consistency was satisfactory for the total scale and all subscales. High correlations between tinnitus-related handicap scales, depressive and anxiety symptoms, and the T-FAS were found, whereas associations with personality factors were low. Moreover, results indicate a significant partial mediation of fear-avoidance behaviors in the relationship between anxiety sensitivity and the cognitive dimension of tinnitus handicap. Results show that fear-avoidance behavior plays an important role in tinnitus handicap. More attention should be paid to this concept in research and clinical practice of psychotherapy for chronic tinnitus.

  • 20.
    Kleinstaeuber, Maria
    et al.
    Philipps University, Germany.
    Schmelzer, Katarina
    Johannes Gutenberg University of Mainz, Germany.
    Ditzen, Beate
    University of Heidelberg Hospital, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Hiller, Wolfgang
    Johannes Gutenberg University of Mainz, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Psychosocial Profile of Women with Premenstrual Syndrome and Healthy Controls: A Comparative Study2016In: International Journal of Behavioral Medicine, ISSN 1070-5503, E-ISSN 1532-7558, Vol. 23, no 6, p. 752-763Article in journal (Refereed)
    Abstract [en]

    According to modern bio-psychosocial theories of premenstrual syndrome (PMS), the aim of this study is to investigate systematically associations between selected psychosocial factors and premenstrual symptoms in different menstrual cycle phases. Several psychosocial variables were assessed, in a sample of German women with PMS (N = 90) and without premenstrual complaints (N = 48) during the follicular and luteal phase of the menstrual cycle. Presence of PMS was indicated by analysis of contemporary daily ratings of premenstrual symptom severity and impairment for one menstrual cycle. Regarding perceived chronic stress (AE (2) = 0.34), self-efficacy (AE (2) = 0.12), and two dimensions of self-silencing (0.06 aeamp;lt;currencyamp;gt;aEuroeAE (2) aeamp;lt;currencyamp;gt;aEuroe0.11) analyses revealed only a significant effect of group. Regarding body dissatisfaction and somatosensory amplification, a significant effect of group (0.07 aeamp;lt;currencyamp;gt;aEuroeAE (2) aeamp;lt;currencyamp;gt;aEuroe0.16) and additionally a group by menstrual cycle phase interaction (AE (2) = 0.06) was identified. Regarding relationship quality, a significant effect of menstrual cycle phase (AE (2) = 0.08) and a group by menstrual cycle phase interaction (AE (2) = 0.06) was demonstrated. In respect to sexual contentment, acceptance of premenstrual symptoms, and the remaining two dimensions of self-silencing statistical analyses revealed no effects at all. Linear multiple regression analysis revealed that 20 % of the variance in PMS symptom severity was explained by the psychosocial variables investigated. Body dissatisfaction ( = 0.26, p = 0.018) and the divided self-dimension of self-silencing ( = 0.35, p = 0.016) were significant correlates of PMS severity. Results of this study are consistent with previous research and additionally show patterns of associations between specific psychosocial factors and PMS in dependence of menstrual cycle phase that have not been researched before. The role of the psychosocial variables we investigated in regard to the development and maintenance of PMS should be clarified in future research.

  • 21.
    Kleinstaeuber, Maria
    et al.
    Univ Auckland, New Zealand; Philipps Univ, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Univ Auckland, New Zealand.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Karolinska Inst, Sweden.
    Probst, Thomas
    Donau Univ, Austria.
    Personality traits predict and moderate the outcome of Internet-based cognitive behavioural therapy for chronic tinnitus2018In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 57, no 7, p. 538-544Article in journal (Refereed)
    Abstract [en]

    Objective: The aim of this study is to investigate whether the Big Five personality traits predict the outcome of Internet-based cognitive behavioural therapy (ICBT) and whether they moderate the outcome between ICBT and face-to-face group cognitive behavioural therapy (GCBT). Design: This study investigated the Big Five personality traits as predictors and moderators of the outcome (tinnitus handicap) in a trial comparing ICBT and GCBT for chronic tinnitus. Study sample: N= 84 patients with chronic tinnitus were randomised to either ICBT (n = 41) or GCBT (n = 43). Results: A multilevel model for discontinuous change was performed. Higher scores on the "openness" scale of the Big Five Personality inventory (BFI-10) predicted a lower tinnitus handicap (Tinnitus Handicap Inventory, THI) at post-treatment in ICBT (p amp;lt;0.05). Openness moderated the outcome at post-treatment in favour of ICBT (p amp;lt;0.05). Higher scores on the BFI-10 "conscientiousness" scale predicted a more favourable outcome in ICBT at 6-month (p amp;lt;0.05) and 12-month follow-up (pamp;lt; 0.05), but the BFI-10 "conscientiousness" scale was positively associated with the THI at baseline (pamp;lt;0.05). Conclusions: ICBT might be the preferred treatment choice for tinnitus patients being open towards new experiences. Moreover, ICBT requires autonomous work and self-motivation by the patient in order to have an impact.

  • 22.
    Kleinstäuber, Maria
    et al.
    University of Mainz, Germany.
    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.
    Tausch, Kristine
    University of Mainz, Germany.
    Schweda, Isabell
    University of Mainz, Germany.
    Hiller, Wolfgang
    University of Mainz, Germany.
    The role of fear avoidance in tinnitus patients2011Conference paper (Refereed)
  • 23.
    Kues, Johanna N.
    et al.
    University of Marburg, Germany.
    Janda, Carolyn
    University of Marburg, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    How to measure the impact of premenstrual symptoms? Development and validation of the German PMS-Impact Questionnaire2016In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 56, no 7, p. 807-826Article in journal (Refereed)
    Abstract [en]

    With 75% of women of reproductive age affected, premenstrual symptoms are very common, ranging from emotional and cognitive to physical symptoms. Premenstrual Syndrome and Premenstrual Dysphoric Disorder can lead to substantial functional interference and psychological distress comparable to that of dysthymic disorders. The assessment of this impact is required as a part of the diagnostic procedure in the DSM-5. In the absence of a specific measure, the authors developed the PMS-Impact Questionnaire. A sample of 101 women reporting severe premenstrual complaints was assessed with the twenty-two items in the questionnaire during their premenstrual phase in an ongoing intervention study at the Philipps-University Marburg from August 2013 until January 2015. An exploratory factor analysis revealed a two-factor solution (labeled Psychological Impact and Functional Impact) with 18 items. A Cronbachs alpha of 0.90 for Psychological Impact and of 0.90 for Functional Impact indicated good reliability. Convergent construct validity was demonstrated by moderate to high correlations with the Pain Disability Index. Low correlations with the Big Five Inventory-10 indicated good divergent validity. The PMS-Impact Questionnaire was found to be a valid, reliable, and an economic measure to assess the impact of premenstrual symptoms. In future research, cross validations and confirmatory factor analyses should be conducted.

  • 24.
    Kues, Johanna N.
    et al.
    University of Marburg, Germany.
    Janda, Carolyn
    University of Marburg, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research.
    Internet-based cognitive behavioural self-help for premenstrual syndrome: study protocol for a randomised controlled trial2014In: Trials, ISSN 1745-6215, E-ISSN 1745-6215, Vol. 15, no 472Article in journal (Refereed)
    Abstract [en]

    Background: With a prevalence of 3 to 8% among women of reproductive age, severe premenstrual symptoms are very common. Symptoms range from emotional and cognitive to physical changes. Severe symptoms (that is, premenstrual syndrome) can have a strong impact on everyday functioning and quality of life. Impairment can be as serious as that of dysthymic disorders. Many affected women receive either no treatment at all or are unsatisfied with their treatment. Although there is some evidence for the reduction of distress through cognitive behavioural therapy, there are only a small number of randomised controlled trials carefully investigating the efficacy of this psychotherapeutic approach. Thus, this study aims to evaluate the efficacy of a cognitive behavioural self-help treatment for women suffering from premenstrual syndrome. Methods/design: The study is conducted as a randomised controlled trial. The complex diagnostic assessment includes the completion of a symptom diary over two consecutive cycles and a telephone interview. Eligible women are randomly assigned to either a treatment or a wait-list control group. The intervention is based on cognitive behavioural therapy principles and is provided via the internet. It consists of 14 different modules on which participants work over 8 consecutive weeks. In addition to written information, participants receive email feedback from a clinical psychologist on a weekly basis. Participants assigned to the wait-list receive the treatment after the end of the waiting period (8 weeks). The primary outcome measure is the Premenstrual Syndrome Impairment Measure. Secondary outcomes include the Premenstrual Syndrome Coping Measure, the Short-Form Social Support Questionnaire, the Questionnaire for the Assessment of Relationship Quality, and the Perceived Stress Scale. Data is collected during the premenstrual (luteal) phase at pre-treatment, post-treatment, and 6-month follow-up. Discussion: So far, there is no study investigating internet-based cognitive behavioural therapy for premenstrual syndrome. The programme approaches the problem of high prevalence in combination with severe impairment and insufficient treatment options.

  • 25.
    Kues, Johanna N
    et al.
    Kues Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
    Janda, Carolyn
    Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
    Krzikalla, Clara
    Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Psychiatry Section, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Division of Clinical Psychology and Psychotherapy, Department of Psychology, Philipps-University of Marburg, Marburg, Germany.
    The effect of manipulated information about premenstrual changes on the report of positive and negative premenstrual changes.2018In: Women & health, ISSN 0363-0242, E-ISSN 1541-0331, Vol. 58, no 1, p. 16-37Article in journal (Refereed)
    Abstract [en]

    Although women predominantly report negative premenstrual changes, a substantial portion of women also reports positive changes. Little is known about factors related to report of positive and negative premenstrual changes. The aim of this experimental study at the Philipps-University of Marburg from January and February 2015 was to investigate the effect of manipulated information about premenstrual changes on the retrospective report of premenstrual changes. A total of 241 healthy women were randomly assigned either to an experimental group (EG) reading: (1) text focusing on negative and positive premenstrual changes (EG1 (+/-)); (2) text focusing on negative changes (EG2 (-)); or (3) control group (CG) text. At least one positive premenstrual change was reported by the majority of the participating women. The results of the MANOVA and discriminant analysis showed that, after having read the text, EG2 (-) reported more negative and fewer positive premenstrual changes in a retrospective screening compared to EG1 (+/-) and CG. No significant difference was observed between EG1 (+/-) and CG. The results show the negative influence of information focusing on negative premenstrual changes on the retrospective report of both negative and positive premenstrual changes.

  • 26.
    Nyenhuis, Nele
    et al.
    University of Gottingen.
    Zastrutzki, Sarah
    Hannover Medical School.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Jaeger, Burkard
    Hannover Medical School.
    Kroener-Herwig, Birgit
    University of Gottingen.
    Evaluation of a self-help program in acute tinnitus2010In: INTERNATIONAL JOURNAL OF BEHAVIORAL MEDICINE, Springer Science Business Media , 2010, Vol. 17, p. 224-225Conference paper (Refereed)
    Abstract [en]

    n/a

  • 27.
    Nyenhuis, Nele
    et al.
    University of Göttingen, Germany.
    Zastrutzki, Sarah
    Hannover Medical School, Germany.
    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.
    Jäger, Burkard
    Hannover Medical School, Germany.
    Kröner-Herwig, Birgit
    University of Göttingen, Germany.
    An Internet-based unguided self-help training for acute tinnitus: Acceptance and adherence2012Conference paper (Other academic)
  • 28.
    Nyenhuis, Nele
    et al.
    University of Göttingen, Germany.
    Zastrutzki, Sarah
    Hannover Medical School, Germany.
    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.
    Jäger, Burkard
    Hannover Medical School, Germany.
    Kröner-Herwig, Birgit
    University of Göttingen, Germany.
    The efficacy of minimal contact interventions for acute tinnitus: a randomised controlled trial2013In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 42, no 2, p. 127-138Article in journal (Refereed)
    Abstract [en]

    Acute tinnitus can lead to substantial distress and eventually result in long-lasting impairment. The aim of this study was to compare the efficacy of a cognitive-behavioural intervention (delivered as Internet self-management, bibliotherapy or group training) to the information-only control condition. Applicants suffered from subjective tinnitus for up to six months, were between 18 and 75 years old and received no other tinnitus-related psychological treatment. A total of 304 participants were randomly assigned to one of the four study arms. Tinnitus distress, depressive symptoms, psychosomatic discomfort and treatment satisfaction were assessed. At the post-assessment tinnitus distress was significantly lower in the Internet and the group training conditions compared to the control condition. Inter-group effect sizes were moderate to large. At follow-up, all active training conditions showed significantly reduced tinnitus distress compared to the control condition (intention-to-treat analysis). An additional completer analysis showed a significant reduction in tinnitus distress only for the group condition. All effect sizes were moderate. There were no differences regarding psychosomatic discomfort, but depressive symptoms were reduced in the group condition at the post-assessment (intention-to-treat analysis). Treatment satisfaction was significantly higher in the training conditions. The dropout rate was 39%. The present study shows that distress can be reduced as early as the acute stadium and that minimal-contact interventions are a promising way to do this. In particular, the Internet and group conditions led to a large, immediate decrease in distress, and the participants were highly satisfied with the training.

  • 29.
    Probst, Thomas
    et al.
    Danube Univ Krems, Austria.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Philipps Univ, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Inst, Sweden.
    Kleinstaeuber, Maria
    Philipps Univ, Germany; Univ Auckland, New Zealand.
    Differences in baseline and process variables between non-responders and responders in Internet-based cognitive behavior therapy for chronic tinnitus2019In: Cognitive Behaviour Therapy, ISSN 1650-6073, E-ISSN 1651-2316, Vol. 48, no 1, p. 52-64Article in journal (Refereed)
    Abstract [en]

    Although Internet-based cognitive behavior therapy (iCBT) is an effective treatment for chronic tinnitus, several patients do not improve. In the current study, baseline and process variables were compared between non-responders and responders. Data from patients participating in two randomized controlled trials on iCBT for chronic tinnitus were re-analyzed. Based on the literature, a pre-post difference on the Tinnitus Handicap Inventory (THI) of less than seven points improvement was used to operationalize non-response. Associations between non-response and baseline variables (age, gender, and questionnaire scores), patient progress (THI), the process of the therapeutic alliance (Working Alliance Inventory-Short Revised; WAI-SR), as well as other process variables (number of logins, amount of messages sent from therapists to patients) were investigated. The results showed that non-responders had a less favorable change on the THI than responders already at mid-treatment (pamp;lt;.05). The alliance (WAI-SR) during iCBT was not associated with non-response. Non-responders showed more severe sleep disturbances, logged in less in the iCBT platform, and received fewer messages from the therapists than responders, but these differences were mostly not significant anymore when correcting for multiple testing. To conclude, no symptom change in the first half of iCBT for chronic tinnitus patients is a risk factor of not benefiting from iCBT.

  • 30.
    Rheker, Julia
    et al.
    Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institute, Stockholm, Sweden.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Germany.
    The role of “on demand” therapist guidance vs. no support in the treatment of tinnitus via the internet: A randomized controlled trial2015In: Internet Interventions, ISSN 2214-7829, Vol. 2, no 2, p. 189-199Article in journal (Refereed)
    Abstract [en]

    Objective

    Internet-based cognitive behavioral self-help treatments (iCBT) have been shown to successfully reduce the distress associated with tinnitus. Despite this success, little is known about the mechanisms that make iCBT for tinnitus sufferers work. Availability of minimal therapeutic support is assumed to positively influence treatment outcome in iCBT, but the lower limit of required support is not known. In face-to-face therapy, patients' positive outcome expectations have demonstrated an advantageous effect on outcome. The first aim of our study was thus to investigate the role of ‘on demand’ therapeutic guidance vs. no therapeutic support on treatment outcome in an iCBT for tinnitus sufferers. Our second aim was to investigate whether positive outcome expectations can predict treatment outcome.

    Methods

    A total of 112 tinnitus patients were randomly assigned to one of two groups (support-on-demand or non-support). Both groups received an established iCBT treatment for tinnitus. While participants in the support group (n = 56) could ask a therapist for additional support, those in the other (n = 56) received no therapeutic guidance. Tinnitus distress was assessed pre- and post-treatment via the Tinnitus Handicap Inventory (THI) and the Mini-Tinnitus Questionnaire (Mini-TQ). Pre-treatment outcome expectations were assessed using the Patient Questionnaire on Therapy Expectation and Evaluation (PATHEV).

    Results

    We observed significantly less tinnitus distress in the THI (support: t(55) = 7.51, p ≤ .001; non-support: t(55) = 7.68, p ≤ .001) and Mini-TQ (support: t(55) = 8.24, p ≤ .001; non-support: t(55) = 8.46, p ≤ .001) in both groups from pre- to post-treatment, but no significant differences between the groups or interactions. The PATHEV subscale “Hope of Improvement” significantly predicted treatment outcome as measured by the THI (β = 0.28, p = .027).

    Conclusions

    The iCBT self-help program is a good treatment option for tinnitus sufferers whether or not support-on-demand is provided. Furthermore, our results show the importance of outcome expectations to the efficacy of iCBT in tinnitus patients. Future research should focus on discovering further predictors of treatment outcome.

  • 31.
    Schmelzer, Katarina
    et al.
    Johannes Gutenberg University of Mainz, Germany.
    Ditzen, Beate
    University of Zurich, Switzerland.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Hiller, Wolfgang
    Johannes Gutenberg University of Mainz, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Clinical Profiles of Premenstrual Experiences Among Women Having Premenstrual Syndrome (PMS): Affective Changes Predominate and Relate to Social and Occupational Functioning2015In: Health Care for Women International, ISSN 0739-9332, E-ISSN 1096-4665, Vol. 36, no 10, p. 1104-1123Article in journal (Refereed)
    Abstract [en]

    Our objective for this study was to examine symptom severity among women suffering from premenstrual syndrome as well as associations between symptom severity and impairment. In a one-cycle prospective study, various premenstrual symptoms of 91 women were assessed. Tension and irritability were the most severe symptoms. Headache, irritability, self-deprecating thoughts, and depressed mood were the symptoms that were subjectively rated as the most burdensome. Significant correlations were found between the mean premenstrual severity and functional impairment. The severity of premenstrual affective symptoms was related to social impairment. The severity of psychological symptoms was correlated with occupational impairment. These findings confirm the prominent role of premenstrual affective symptoms and support classification guidelines focusing on both affective and physical changes.

  • 32.
    Weise, Cornelia
    Linköping University, Department of Behavioural Sciences and Learning. Linköping University, Faculty of Arts and Sciences.
    Tinnitus2011In: PSYCHOTHERAPEUT, ISSN 0935-6185, Vol. 56, no 1, p. 61-76Article in journal (Refereed)
    Abstract [en]

    Tinnitus is defined as the perception of sound in the absence of an acoustic stimulus. With a prevalence of about 10-15% among adults tinnitus is a common symptom. If tinnitus persists for a longer time and if the patient does not adapt to it, a range of associated problems can be found. The most common problems are sleep disturbance, emotional disturbance and concentration problems. Given the distress caused by tinnitus the risk of patients falling into a vicious circle of increased attention to tinnitus, dysfunctional appraisal processes, negative emotions and avoidance behaviour increases. This in turn, can severely affect tinnitus distress and quality of life in the long run. Different treatment approaches for tinnitus have been developed and cognitive-behavioural forms of treatment in particular were found to be effective in reducing tinnitus distress. The present paper provides an overview of the symptom tinnitus, etiological models, diagnostic approaches and different forms of treatment.

  • 33.
    Weise, Cornelia
    Philipps-University Marburg, Germany.
    Tinnitus2009In: Wie wirksam ist Biofeedback?: eine therapeutische Methode / [ed] A. Martin & W. Rief, Bern: Huber , 2009, 1, p. 288-Chapter in book (Other academic)
    Abstract [de]

    Durch die systematische Rückmeldung von physiologischen Signalen können Menschen lernen, diese in eine gewünschte Richtung zu verändern. So eröffnen sich faszinierende Behandlungsmöglichkeiten bei psychischen und körperlichen Krankheiten. «Wie wirksam ist Biofeedback?» stellt solche Behandlungsansätze dar und greift dabei Themen auf wie chronische Schmerzzustände, Migräne, Hypertonie, Tinnitus, Epilepsie, Lähmungen - aber auch den Einsatz von Biofeedback als Ergänzung in der Psychotherapie von psychischen Erkrankungen wie Posttraumatischen Belastungsstörungen, Panikstörungen, Schlafstörungen, Depressionen oder Abhängigkeitserkrankungen.Das Buch gibt im Besonderen eine Orientierungshilfe, bei welchem Störungsbild welcher Biofeedback-Ansatz wissenschaftlich überprüft ist. Zusätzliche Rahmeninformationen (z.B. Weiterbildungsrichtlinien, Qualitätssichernde Maßnahmen) werden ebenfalls aufgegriffen.

  • 34.
    Weise, Cornelia
    et al.
    Philipps-Universität Marburg, Germany .
    Heinecke, Kristin
    Philipps-Universität Marburg, Germany .
    Rief, Winfried
    Philipps-Universität Marburg, Germany .
    Biofeedback bei chronischem Tinnitus – Behandlungsleitfaden und vorläufige Ergebnisse zu Wirksamkeit und Akzeptanz: [Biofeedback for chronic tinnitus - Treatment guidelines and preliminary results regarding their efficacy and acceptance]2007In: Verhaltenstherapie (Basel), ISSN 1016-6262, E-ISSN 1423-0402, Vol. 17, no 4, p. 220-230Article in journal (Refereed)
    Abstract [en]

    Introduction: Many tinnitus sufferers receive their illness as somatic and thus search for somatic treatments. Therefore, complementing well established cognitive-behavioural strategies by biofeedback techniques may be a promising approach, because it may increase patients' readiness for psychotherapy. The aim of our randomised controlled trial was to develop a psychophysiological approach and to assess its acceptance in patients with chronic tinnitus. In the cognitive-behavioural part of the approach patients were informed about the influence of stress and cognitions on the way they perceived their tinnitus and learned different coping strategies. Additionally, feedback of bodily parameters demonstrated psychophysiological relationships. As tinnitus patients are assumed to suffer from increased muscle tension in head and shoulders, biofeedback was also used to train them to release these muscles. Patients and Methods: 65 patients with chronic tinnitus were randomly assigned to either an intervention or a waiting list group. Treatment outcome was assessed by scales on treatment satisfaction, a tinnitus questionnaire and a tinnitus diary. Results: The treatment was very well accepted and no adverse effects were reported. Furthermore, strong improvements in tinnitus distress, annoyance and perceived control of tinnitus could be found. These results are supported by moderate to high effect sizes. Conclusion: This treatment approach is very well accepted and effective in reducing tinnitus distress. Through demonstrating psychophysiological relationships the biofeedback-based intervention helps patients change their somatic illness perceptions and enhances readiness for psychotherapy.

  • 35.
    Weise, Cornelia
    et al.
    Philipps-Universität Marburg, Germany.
    Heinecke, Kristin
    Philipps-Universität Marburg, Germany.
    Rief, Winfried
    Philipps-Universität Marburg, Germany.
    Biofeedback-based behavioral treatment for chronic tinnitus: Results of a randomized controlled trial2008In: Journal of Consulting and Clinical Psychology, ISSN 0022-006X, E-ISSN 1939-2117, Vol. 76, no 6, p. 1046-1057Article in journal (Refereed)
    Abstract [en]

    Many tinnitus sufferers believe that their tinnitus has an organic basis and thus seek medical rather than psychological treatments. Tinnitus has been found to be associated with negative appraisal, dysfunctional attention shift, and heightened psychophysiological arousal, so cognitive-behavioral interventions and biofeedback are commonly suggested as treatments. This study developed and investigated the efficacy of a biofeedback-based cognitive-behavioral treatment for tinnitus. In total, 130 tinnitus patients were randomly assigned to an intervention or a wait-list control group. Treatment consisted of 12 sessions of a biofeedback-based behavioral intervention over a 3-month period. Patients in the wait-list group participated in the treatment after the intervention group had completed the treatment. Results showed clear improvements regarding tinnitus annoyance, diary ratings of loudness, and feelings of controllability. Furthermore, changes in coping cognitions as well as changes in depressive symptoms were found. Improvements were maintained over a 6-month follow-up period in which medium-to-large effect sizes were observed. The treatment developed and investigated in this study is well accepted and leads to clear and stable improvements. Through demonstration of psychophysiological interrelationships, the treatment enables patients to change their somatic illness perceptions to a more psychosomatic point of view. © 2008 American Psychological Association.

  • 36.
    Weise, Cornelia
    et al.
    Philipps-Universität Marburg, Germany.
    Heinecke, Kristin
    Philipps-Universität Marburg, Germany.
    Rief, Winfried
    Philipps-Universität Marburg, Germany.
    Biofeedbackgestützte kognitiv-behaviorale Intervention bei chronischem Tinnitus: Entwicklung und Evaluation eines Behandlungs-leitfadens: [Biofeedback-based behavioural treatment of chronic tinnitus: Development and evaluation of a treatment approach]2007Conference paper (Other academic)
  • 37.
    Weise, Cornelia
    et al.
    Philipps-Universität Marburg, Germany.
    Heinecke, Kristin
    Philipps-Universität Marburg, Germany.
    Rief, Winfried
    Philipps-Universität Marburg, Germany.
    Stability of physiological variables in chronic tinnitus sufferers2008In: Applied Psychophysiology and Biofeedback, ISSN 1090-0586, E-ISSN 1573-3270, Vol. 33, no 3, p. 149-159Article in journal (Refereed)
    Abstract [en]

    The etiological tinnitus models propose that suffering can be caused and aggravated by heightened physiological arousal. Therefore psychophysiological treatments are applied. Stability of the measured parameters is essential for the use of biofeedback as well as to permit the attribution of changes to the administered treatment. The aim of our study was to investigate the 3-month reproducibility of psychophysiological parameters in 60 tinnitus patients. Using a repeated-measures design, the activity of these parameters was assessed twice during various stress and relaxation trials. The results showed that the measurements of frontalis, masseter and trapezius muscles were stable, while for the sternocleidomastoid, the skin conductance level (SCL) and the skin temperature retest-stability could not be evidenced. For all parameters, test-retest stability was weak for the relative scores. In conclusion, our study has important implications for applied psychophysiology research: (1) the measurement of EMG assessed in a clinical sample is stable over a 3-month interval; (2) in contrast, the measurements of SCL and skin temperature as well as all relative scores are less stable; and (3) the stability of EMG-parameters in our sample gives first hints that physiological changes can be attributed to an administered biofeedback treatment but further research is required. © 2008 Springer Science+Business Media, LLC.

  • 38.
    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.
    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.
    Autobiographical memory specificity in tinnitus patients2011In: Abstract book: First International Conference on Cognitive Hearing Science for Communication / [ed] J. Rönnberg., B. Lyxell., M. Rudner, 2011, p. 130-Conference paper (Other academic)
    Abstract [en]

    Selective information processing bias has been studied in a few investigations. In a study from 2003, tinnitus patients were found to generate fewer specific autobiographical memories on the autobiographical memory test when compared with a control group.

     Aim of the current study was to replicate this study with a standardized measure of autobiographical memory and also with a control group with depression. We included 30 tinnitus patients and compared the results with a normal hearing ontrol group (N=20) and a depressed control group (n=20) with diagnosed major depression.

    Results showed a significant main effect of group for the number of specific positive memories, with the tinnitus group performing worse than the control group. However, the tinnitus group did not differ from the depressed group, even after controlling for age differences. Similar effects were observed for the negative specific memories, with the tinnitus and depressed group reporting fewer specific memories. We conclude that tinnitus patients with significant tinnitus distress perform on par with depressed persons on a test of autobiographical memory functioning.

  • 39.
    Weise, Cornelia
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences.
    Hesser, Hugo
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Nyenhuis, Nele
    University of Gottingen, Germany .
    Zastrutzki, Sarah
    Hannover Medical Sch, Germany .
    Kroener-Herwig, Birgit
    University of Gottingen, Germany .
    Jaeger, Burkard
    Hannover Medical Sch, Germany .
    The role of catastrophizing in recent onset tinnitus: Its nature and association with tinnitus distress and medical utilization2013In: International Journal of Audiology, ISSN 1499-2027, E-ISSN 1708-8186, Vol. 52, no 3, p. 177-188Article in journal (Refereed)
    Abstract [en]

    Objective: Persistent tinnitus affects 10 to 15% of adults. Little is understood about why only a small percentage of patients become severely affected. Catastrophic thinking has been suggested as one potentially relevant factor that might influence a patients coping behavior, and thus tinnitus habituation. The current study investigates the concept of tinnitus catastrophizing and its relation with distress and medical utilization in recent onset tinnitus. Design: Participants were administered a survey assessing catastrophizing, tinnitus distress, medical utilization, coping, and mood disturbance. Regression analyses investigated the nature of tinnitus catastrophizing and its contributions to distress and health care utilization. Study sample: 278 subjects with tinnitus for less than six months were recruited from Ear-Nose-Throat units, through the internet, and newspaper articles. Results: Controlling for background variables, high subjective tinnitus loudness, low behavioral coping, and depressive symptoms were significantly associated with tinnitus catastrophizing. Furthermore, greater tinnitus catastrophizing was related to higher distress and more frequent medical visits. Conclusions: Tinnitus catastrophizing appears to be pivotal already at an early stage of tinnitus experience. Addressing catastrophizing by specific prevention and intervention programs might reduce the development of distress and medical utilization in the long term. Longitudinal studies are required to clarify cause-effect relations.

  • 40.
    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.
    Kleinstaeuber, Maria
    University of Mainz, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Internet-based cognitive-behavioural treatment of chronic tinnitus2012Conference paper (Other academic)
    Abstract [en]

    Objectives: Tinnitus is a considerable problem for about 2-4% of the adult population. Cognitive behavioural treatments (CBT) have been shown to be effective in reducing tinnitus distress, however, the availability of individual counselling is limited. Therefore Internet-based CBT-approaches (iCBT) have been developed and showed promising results. The aim of our study was to investigate the efficacy of an iCBT to reduce tinnitus distress. Methods: 124 patients with distressing chronic tinnitus were randomly assigned to either an Internet-based CBT (n 0 62) or an online discussion group (n 0 62), both lasting for 10 weeks. The iCBT group works on a self-help program including different tools to improve tinnitus coping. Patients receive individual weekly e-mail feedback. In the online discussion group, patients discuss different topics related to tinnitus, however not to tinnitus coping. Primary and secondary out- come were assessed pre and post treatment and 6 months after the end of the treatment. Results: Significant interactions (time x group) in favour of the iCBT were found. Medium to large between-group effect sizes (Hedges' g) support these findings. After the end of the treatment, patients of the iCBT group reported significantly reduced tinnitus distress (F(1,117)043.28, p<.001; g0.88), increased tinnitus acceptance (F(1,117) 0 37.83, p < .001; g 0 .80) and fewer depres- sive symptoms (F(1,117) 0 22.92, p < .001; g 0 .43). Results of patients participating in the online discussion group were also improved, however significantly less articulated than in the iCBT group. Follow-up results indicated the stability of the improve- ments over 6 months. Conclusion: The guided iCBT was highly accepted and led to significant and long-term stable improvements in tinnitus dis- tress and associated variables. The efficacy of the iCBT was superior to the efficacy of the discussion group. Due to the use of an Internet-based approach, the treatment was available for patients situated all over the country. Thus, implementing Internet-based treatments might partially compensate for the lack of face-to-face treatments to reduce tinnitus distress. Further research is needed to investigate which factors influ- ence the efficacy of Internet-based treatments. Keywords: e-health, CBT, chronic disease, treatment

  • 41.
    Weise, Cornelia
    et al.
    Linköping University, Department of Behavioural Sciences and Learning, Disability Research. Linköping University, Faculty of Arts and Sciences. Linköping University, The Swedish Institute for Disability Research. University of Marburg, Germany.
    Kleinstaeuber, Maria
    University of Marburg, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences. Karolinska Institute, Sweden.
    Internet-Delivered Cognitive-Behavior Therapy for Tinnitus: A Randomized Controlled Trial2016In: Psychosomatic Medicine, ISSN 0033-3174, E-ISSN 1534-7796, Vol. 78, no 4, p. 501-510Article in journal (Refereed)
    Abstract [en]

    Objectives Tinnitus has a substantially negative impact on quality of life in up to 5% of the general population. Internet-based cognitive-behavioral treatment (iCBT) has been shown to be effective in a few trials. The aim of our study was to investigate iCBT for tinnitus by using a randomized controlled trial. Methods Patients with severe tinnitus-related distress were randomly assigned to therapist-guided iCBT (n = 62) or to a moderated online discussion forum (n = 62). Standardized self-report measures for tinnitus-related distress (Tinnitus Handicap Inventory, Mini-Tinnitus Questionnaire) and associated symptoms (tinnitus acceptance, anxiety, depression, and insomnia) were assessed at pretreatment and posttreatment, 6-month-, and 1-year follow-up. Clinical significance was assessed with the Reliable Change Index. Results Multivariate analyses of variance revealed significant main effects for time, group, and interaction in favor of the iCBT group. With regard to tinnitus-related distress, the significant univariate interaction effects (time by group) were supported by large effect sizes (Tinnitus Handicap Inventory: g = 0.83, 95% confidence interval = 0.47-1.20; Mini-Tinnitus Questionnaire: g = 1.08, 95% confidence interval = 0.71-1.64). For the secondary outcomes, significant interactions with small to medium effect sizes were found. Within-group effects for the iCBT, from pretreatment to follow-up, were substantial in regard to tinnitus-related distress (1.38 d 1.81) and small to large for secondary outcomes (0.39 d 1.04). Conclusions Using a randomized controlled trial design, we replicated prior findings regarding positive effects of Internet-delivered CBT on tinnitus-related distress and associated symptoms. Implementing iCBT for tinnitus into regular health care will be an important next step to increase access to treatment for patients with tinnitus. Trial Registration: ClinicalTrials.gov, Identifier: NCT01205919.

  • 42.
    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.

  • 43.
    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)
  • 44.
    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.
    Hiller, Wolfgang
    University of Mainz, Germany.
    Andersson, Gerhard
    Linköping University, Department of Behavioural Sciences and Learning, Psychology. Linköping University, Faculty of Arts and Sciences.
    Internetbasierte kognitiv-behaviorale Behandlung des chronischen Tinnitus – Ergebnisse einer randomisierten- kontrollierten Studie: [Internet-based cognitive behavioural treatment of chronic tinnitus - results of a randomized controlled trial]2011Conference paper (Other academic)
  • 45.
    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.
    Kroymann, Reiner
    Klinik für Psychotherapie und Verhaltensmedizin, Dresden, Germany.
    Zittlau, Horst
    Goebel, Gerhard
    Schön Klinik Roseneck, Prien, Germany.
    Chronischer Tinnitus [Chronic tinnitus]2011In: Biofeedback: Grundlagen, Indikationen, Kommunikation, Vorgehen ; mit 48 Tabellen, Stuttgart: Schattauer , 2011Chapter in book (Other academic)
1 - 45 of 45
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