| 1. |
- Conrad, Isabell, et al.
(författare)
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The Changeability and Predictive Value of Dysfunctional Cognitions in Cognitive Behavior Therapy for Chronic Tinnitus
- 2015
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Ingår i: International Journal of Behavioral Medicine. - : Springer Verlag (Germany). - 1070-5503 .- 1532-7558. ; 22:2, s. 239-250
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 2. |
- Conrad, Isabell, et al.
(författare)
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The Role of Dysfunctional Cognitions in Patients With Chronic Tinnitus
- 2015
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Ingår i: Ear and Hearing. - : LIPPINCOTT WILLIAMS and WILKINS. - 0196-0202 .- 1538-4667. ; 36:5, s. E279-E289
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 3. |
- Janda, Carolyn, et al.
(författare)
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A Therapeutic Approach to Premenstrual Syndrome (PMS): Modularized Treatment Program
- 2015
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Ingår i: Verhaltenstherapie (Basel). - : KARGER. - 1016-6262 .- 1423-0402. ; 25:4, s. 294-303
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 4. |
- Jasper, Kristine, et al.
(författare)
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Internet-based guided self-help versus group cognitive behavioral therapy for chronic tinnitus : a randomized controlled trial
- 2014
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Ingår i: Psychotherapy and Psychosomatics. - : S. Karger. - 0033-3190 .- 1423-0348. ; 83:4, s. 234-246
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 5. |
- Kaiser, Gudrun, et al.
(författare)
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Methods for coping with premenstrual change: Development and validation of the German Premenstrual Change Coping Inventory
- 2018
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Ingår i: Women & health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0363-0242 .- 1541-0331. ; 58:9, s. 1062-1079
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Tidskriftsartikel (refereegranskat)abstract
- During the premenstrual phase, psychological and physiological changes can occur, which are associated with different levels of disability. When they appear with Premenstrual Dysphoric Disorder (PMDD), different coping strategies may be used by women to deal with premenstrual changes. Currently no German measure exists for assessing premenstrual symptom-related coping strategies. Therefore, we developed the Premenstrual Change Coping Inventory (PMS-Cope). First, the 33-item questionnaire was tested with an exploratory factor analytic approach (EFA) in a sample of 150 women prospectively diagnosed with PMDD or severe Premenstrual Syndrome from August 2013 until March 2016. The EFA resulted in a 12-item scale with a two-factor structure: "seeking positive affect-inducing activities" and "seeking support"; Cronbach`s alpha of 0.73 and 0.71, respectively, demonstrated good reliability for both factors. Confirmatory factor analysis based on a second sample of 89 women conducted from May 2016 until June 2016 confirmed the two-factor structure. Additionally, a potential third factor "healthcare use behavior" was tested with an EFA. For the three-factor solution, satisfactory Cronbachs alpha values (0.70-0.72) were detected. The PMS-Cope was shown to be a valid, reliable, and economic measure. In future research, cross validations and confirmatory factor analyses with the three-factor solution should be conducted.
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| 6. |
- Kleinstaeuber, Maria, et al.
(författare)
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A confirmatory factor analytic validation of the Tinnitus Handicap Inventory
- 2015
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Ingår i: Journal of Psychosomatic Research. - : Elsevier. - 0022-3999 .- 1879-1360. ; 78:3, s. 277-284
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 7. |
- Kleinstaeuber, Maria, et al.
(författare)
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Personality traits predict and moderate the outcome of Internet-based cognitive behavioural therapy for chronic tinnitus
- 2018
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Ingår i: International Journal of Audiology. - : TAYLOR & FRANCIS LTD. - 1499-2027 .- 1708-8186. ; 57:7, s. 538-544
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 8. |
- Kleinstaeuber, Maria, et al.
(författare)
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Psychosocial Profile of Women with Premenstrual Syndrome and Healthy Controls: A Comparative Study
- 2016
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Ingår i: International Journal of Behavioral Medicine. - : SPRINGER. - 1070-5503 .- 1532-7558. ; 23:6, s. 752-763
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 9. |
- Kleinstaeuber, Maria, et al.
(författare)
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The Role of Fear-Avoidance Cognitions and Behaviors in Patients with Chronic Tinnitus
- 2013
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Ingår i: Cognitive Behaviour Therapy. - : Taylor and Francis (Routledge): STM, Behavioural Science and Public Health Titles / Taylor and Francis (Routledge). - 1650-6073 .- 1651-2316. ; 42:2, s. 84-99
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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| 10. |
- Kues, Johanna N., et al.
(författare)
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How to measure the impact of premenstrual symptoms? Development and validation of the German PMS-Impact Questionnaire
- 2016
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Ingår i: Women & health. - : ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD. - 0363-0242 .- 1541-0331. ; 56:7, s. 807-826
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Tidskriftsartikel (refereegranskat)abstract
- 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.
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