| 1. |
- Dauman, Nicolas, et al.
(författare)
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Exploring Tinnitus-Induced Disablement by Persistent Frustration in Aging Individuals : A Grounded Theory Study
- 2017
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Ingår i: Frontiers in Aging Neuroscience. - : Frontiers Media SA. - 1663-4365. ; 9, s. 1-18
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Tidskriftsartikel (refereegranskat)abstract
- Background: Qualitative research can help to improve the management of patients, meet their expectations and assist physicians in alleviating their suffering. The perception of moment-to-moment variability in tinnitus annoyance is an emerging field of exploration. This study sought to enlighten variability in tinnitus-induced disablement using a qualitative approach. Methods: Twelve participants (six females, six males, aged 51-79) were recruited via the French Tinnitus Association Journal for participation in recorded semi-structured interviews. Each participant had three interviews lasting 1 h, the sessions being separated one from the other by 2 weeks. Following recommendations of Charmaz (2014), the second and third interviews were aimed at gathering rich data, by enhancing the participants’ reflexivity in the circumstances of distress caused by tinnitus. After transcription, the data (n = 36 interviews) were analyzed using the approach to Grounded Theory proposed by Strauss and Corbin (1998). Results: Tinnitus as persistent frustration emerged as being the core category uniting all the other categories of the study. Hence, the core category accounted for the broader scope in participants’ experience of chronic tinnitus. It is suggested that tinnitus-induced disablement varied according to the degree of frustration felt by the participants in not being able to achieve their goals. The implications of this were analyzed using the following categories: “Losing body ownership,” “ Lacking perspectives,” and “Persevering through difficulties.” Based on these findings, we draw a substantive theory of tinnitus tolerance that promotes an active, disciplined and individualized approach to tinnitus-induced disablement. The model distinguishes pathways from sustained suffering to reduced annoyance (i.e., emerging tolerance). It accounts for difficulties that the participants experienced with a perceived unchanged annoyance over time. Furthermore, this model identifies a set of new attitudes toward oneself and others that tinnitus tolerance would entail. Conclusion: The subjective experience of frustration enlightens tinnitus-induced disablement, offering new perspectives for long-term self-management. Modulation of frustration, rather than moderation of tinnitus interference, is suggested as a new approach to the clinical management of tinnitus-related distress.
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| 2. |
- Dauman, Nicolas, et al.
(författare)
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Intra-individual variability in tinnitus patients : Current thoughts and perspectives.
- 2015
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Ingår i: HNO (Berlin. Print). - : Springer Science and Business Media LLC. - 0017-6192 .- 1433-0458. ; 63:4, s. 302-306
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Tidskriftsartikel (refereegranskat)abstract
- Most tinnitus studies have attempted to compare groups of individuals, thus revealing inter-individuals differences, i.e., variations between compared subjects. For methodological reasons, inter-individual studies cannot take into account the variability of tinnitus experience, which has been known for decades to be relevant in daily practice with tinnitus patients. The concept of intra-individual variability has been promoted in the research literature, in order to shed light on this aspect of individual perception. In previous studies, unrelated to hearing, the concept of intra-individual variability implied inclusion of the environment (i.e., physical and social interactions) as a factor of individual performance. In tinnitus research, we believe that the concept of variability (within a person) could find a place beside the concept of variation (between groups of subjects). In this paper, four perspectives of tinnitus experiences from the clinical and research fields are described: (1) ENT consultation; (2) short-term group psychotherapy; (3) psychodynamic psychotherapy; and (4) clinical psychological research. Intra-individual variability stresses the importance of defining tinnitus in a dynamic way, contrary to the current definition of tinnitus as the perception of sound(s). In clinical practice, it is useful to embrace the perspective of the perceiverof tinnitus, and to include social and cultural circumstances as well as audiological/physical changes.
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| 3. |
- Dauman, Nicolas, et al.
(författare)
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Habituation models : can tinnitus be compared to anexternal sound?
- 2014
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Konferensbidrag (refereegranskat)abstract
- Background:The process of habituation often remains obscure to those patients most disturbed by tinnitus.Since three decades, the Cognitive-Behavioural Therapy (CBT) has promoted a habituation model (Hallam et al. 1984) founded on experimental data regarding the orienting response (OR) (Horvath 1980). Habituation of the OR is the natural extinction of attention to repeated identical stimuli which lose their ability to trigger orientation. Considering epidemiological data, the habituation model (Hallam & McKenna, 2006) hypothesizes that:1. tolerance is “a natural and inevitable process” illustrated by three quarter of people with tinnitus;2. annoyance is “a consequence of a failure to cease attending” to tinnitus, because of psycho-physiological factors that delay a natural process to occur (i.e., extinction of the OR)
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| 4. |
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| 5. |
- Dauman, Nicolas, et al.
(författare)
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Learning from tinnitus patients' narratives : A case study in the psychodynamic approach
- 2012
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 7:19540
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Tidskriftsartikel (refereegranskat)abstract
- Tinnitus is assumed to be the perception of sound that results exclusively from activity within the nervous system without any external stimulation. Approximately 1-2% of the population regard their tinnitus as a serious threat towards their quality of life. The way the patients describe their suffering varies, sometimes also depending on the interest and insight of the clinician to whom they turn to for help. The lack of insightful narratives of someone who is severely annoyed by the presence of a constant tinnitus sound may lead to limited and biased models of tinnitus suffering. In the present case study the participating patient, a woman aged 70, shared her experience of being victimized by tinnitus with the clinician/ researcher during a number of psychotherapeutic sessions. The psychodynamic, narrative approach, made it possible for the client to articulate the unique and specific meaning that she experienced as being part of her suffering. In her words, tinnitus became a tolerable symptom that she managed to work through within psychotherapeutic alliance
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| 6. |
- Dauman, Nicolas, et al.
(författare)
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Liberating parents from guilt : a grounded theory study of parents' internet communities for the recognition of ADHD
- 2019
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Ingår i: International Journal of Qualitative Studies on Health and Well-being. - : Informa UK Limited. - 1748-2623 .- 1748-2631. ; 14:1
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: This study presents a qualitative analysis of information posted on the Internet by two communities of French parents promoting the recognition of ADHD in the context of current health and school practices.METHOD: Grounded Theory (Strauss & Corbin's approach) was applied to the posted messages, with the aim to discover the main concern and common theme through a constant comparison analysis.RESULTS: Liberating parents from feeling responsible for their child's misconduct was found to be the core category. From this perspective, we account for the commitment of the digital communities to formalize the child's conduct as a consequence of a neurodevelopmental disorder. This approach helps to account for the promotion of behavioural expertise and conditioning strategies (e.g., positive reinforcement) for handling the child's so-called disorder as appropriate parental responses. Giving evidence for parenting struggles was the third main concern of the communities, in the face of perceived skepticism from professionals towards ADHD as a medical condition.CONCLUSIONS: By using examples from countries that are found to have a more pro-medical approach to ADHD, the communities aim at improving such medical practices in France. Issues surrounding the claim that ADHD would require a specific style of parenting are also discussed.
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| 7. |
- Dauman, Nicolas, et al.
(författare)
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The construction of meaning through psychotherapy : a tinnitus case story
- 2014
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Konferensbidrag (refereegranskat)abstract
- Besides considering tinnitus as a complication following a hearing impairment or a sudden noise trauma, it is essential to consider the emotional suffering of the patient as it may be linked to personal experiences in life. Repressed traumatic incidents can manifest itself in the wake of tinnitus onset. ObjectiveIn the case of tinnitus suffering psychotherapy resting on psychodynamic foundations has a very remote place in the literature. Naturally, the narrative of the client is of special quality in the psychodynamic psychotherapy approach. The objective of this study was therefore to illustrate how the narrative of a suffering client can be an inherent part of psychotherapy as well as a source of qualitative data in research on tinnitus (Dauman & Erlandsson, 2012). MethodThe patient was a 70 years old woman with tinnitus (Lucie) who experienced her suffering as life threatening, which at times required psychiatric hospitalization. She participated in 16 psychotherapy sessions taken place over a period of eight months. The interview method building on free associations was judged to be the best way to understand the meaning behind evoked narratives of the patient. ResultsWith the purpose to describe the analytical procedure we applied a narrative structure based on the following four labels: Listening to Lucie - Learning from Lucie’s speech - Narrative breakdown and psychotherapy - Psychodynamic insights on Lucie’s emotional drives. The social dimension of the patient’s suffering was a central theme in her narrative, expressed by others’ reluctance to listen to her despair as well as her own deep sorrow for a broken social bond prior to her psychological brake-down. ConclusionThe construction of meaning is a human act of self-preservation. In this case, it helped the patient to overcome alienation and made her tinnitus bearable.
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| 8. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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Is ADHD a way of conceptualizing long-term emotional stress and social disadvantage?
- 2022
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Ingår i: Frontiers in Public Health. - : Frontiers Media SA. - 2296-2565. ; 10
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Forskningsöversikt (refereegranskat)abstract
- Background: The prevalent, neuropsychiatric, deficit perspective on children and youth diagnosed with ADHD prohibits a multidimensional approach where socio-economic status, family stress and relationships within the families are relevant factors to examine. Assessments of ADHD through the use of rating scales and short-term interventions may lead not only to overdiagnosis but also to a reductionistic approach in the psychiatric field. This literature review aims to address research outside the prevailing discourse on ADHD as an organic brain dysfunction and broaden the perspectives on children's behavioral difficulties. Methods: The articles included in this applied, mixed-method, systematic review includes 26 peer-reviewed articles, both English and French, with a search focus on ADHD in children and youth related to Attachment styles and relationships. Results: In the studies reported, researchers approached correlations between ADHD and attachment in different ways, and in most cases, there was a caution to address causality. The role of parents was found to be both buffering and aggravating for the appearance of ADHD. In the French case studies, the diagnosis was conceptualized as a relational phenomenon where the child's behavior was inseparable from family member's suffering. Discussion: This review article illustrates how children's difficulties in terms of ADHD symptoms can be addressed through a paradigm where emotional and cognitive dysregulation is understood through psychosocial factors rather than as a neurological condition. In our view, to avoid an overly reductionistic and medicalized approach to children's behavioral difficulties, it is time to reiterate the value of the biopsychosocial perspective. Conclusion: Professionals and researchers need to acknowledge that becoming diagnosed with ADHD has a strong connection to economic disadvantage, social status, and familial care. The academic discourse of addressing brain dysfunctions might serve the unintended purpose of masking emotional stress and social disadvantage that manifests across generations. A biopsychosocial approach to ADHD including family, emotional history, and socio-economic issues could imply a lesser focus on medical treatment as a first choice.
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| 9. |
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| 10. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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The Aftermath of Silencing the Trauma : A Narrative Case Study
- 2023
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Ingår i: Narrative and Mental Health. - Oxford : Oxford University Press. - 9780197620571 - 9780197620540 ; , s. 86-103
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Bokkapitel (refereegranskat)abstract
- The association between silence and powerlessness is one reason behind rape victims’ decision to remain silent about the assault. Rape victims, who most often are traumatized, face a wide array of negative experiences as a consequence of the violence. At the heart of this trauma narrative is the case of a female patient, 70 years old, suffering from tinnitus, for which she was offered psychotherapy. During one of the last therapy sessions the patient disclosed that she was raped at the age of 22 by a man she met when searching for a job. This case study explores the complex relationship between sensory fragments (i.e., hallucinations and tinnitus) and the disclosure of a hidden trauma that occurred half a century earlier. It also illustrates how establishing a confidential therapeutic alliance can contribute to a sustained integration of fragmented experiences of the trauma into a personal history.
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| 11. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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The experience of tinnitus and its Interaction with unique life histories
- 2014
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Konferensbidrag (refereegranskat)abstract
- Objectives Alleviating tinnitus is a challenging project for professionals within audiology and related fields. Meeting a suffering patient can be challenging as it demands a special interest for the patient as a complex living system. One perspective that risks being placed in the background, is the experience of the patient – the inside perspective.Focus of the present study was to describe tinnitus through the eyes of the sufferer reflecting two aspects: Why is tinnitus accompanied by a psychological suffering? Can the personal life history contribute in making the relationship between tinnitus and the experienced suffering more comprehensible? Methods The unique meaning structure of patients’ reflections on their life with tinnitus was explored by the use of the narrative psychological approach. Participants were women and men in the age between 40-60 years and for whom tinnitus was experienced as a major problem. Individual, tape-recorded, deep interviews (3 – 4 for each patient) took place over a period of 3 to 4 months. The ethical committee in the West region of Sweden approved the study. Results In resemblance with how people suffering from a severe illness construct their stories (Gergen & Gergen, 1983) the analysis of the study samples’ narratives emanated from three plot dimensions: stability, progression and regression. Patients who in their passed had been faced with several serious challenges seemed to have a particularly pessimistic undertone. This may reflect how the construction of life stories interacts with previous experiences and interpretations. Tinnitus may thus pose a particularly great challenge for individuals who have experienced accumulative trauma in their past. ConclusionBy allowing different voices to be heard increased understanding can be gained about how tinnitus interacts with unique life histories.
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| 12. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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The Experience of Tinnitus and Its Interaction With Unique Life Histories : Life Events, Trauma and Inner Resources Narrated by Patients With Tinnitus
- 2020
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Ingår i: Frontiers in Psychiatry. - : Frontiers Media SA. - 1664-0640. ; 11
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Tidskriftsartikel (refereegranskat)abstract
- Background: The challenges facing people with chronic tinnitus include finding relief and rebuilding quality of life. However, previous traumatic episodes may influence adjustment and prolong suffering. Recovery implies reducing aggravating reactions and improving social roles, relationships and interests. Self-narratives about living with tinnitus have not yet received the attention they deserve in the research literature. Thus, the main goal of the present study was to illustrate how tinnitus suffering interacts with the participants’ unique life histories. Method: Four women and one man (ages 52–58) took part in the study after consulting a special hearing clinic for annoying tinnitus. Criteria for inclusion were that tinnitus was regarded as a problem with negative consequences for quality of life. The participants should be willing to share how the experience of tinnitus suffering interacts with their previous life story. Narrative methodology was employed in order to achieve the goals of the study. We used unstructured interviews with free conversation, which allowed for rich narratives with full contextual meaning. Results: The findings, based on the narrative analysis, revealed that three out of five participants presented a regressive form of narrative indicating ongoing struggles beyond tinnitus itself, which they were unable to bring to closure. For them, valued goals were continuously thwarted by frustrating circumstances in their lives, either past events or current unresolved issues. Progressive and stable narratives, as identified in the other two participants, demonstrated values that rely on others’ attitude and understanding toward their suffering, in sharp contrast to the regressive narratives. We suggest that a central issue in tinnitus rehabilitation should be to help suffering patients to overcome unresolved conflicts and thereby extend their ability for a fuller commitment in life. Conclusion: Considering enduring tinnitus as a chronic condition, whose course is likely to vary depending on the patient’s general health status, an alteration of progressive and stable narratives is likely to occur during the lifespan. A progressive narrative shows similarities to the core construct of the salutogenesis model of health promotion (1). In conclusion, a narrative approach in tinnitus rehabilitation can be health promoting by offering the patient the opportunity to engage in storytelling, which in turn can increase comprehensibility and a sense of coherence. © Copyright © 2020 Erlandsson, Lundin and Dauman.
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| 13. |
- Erlandsson, Soly, 1942-, et al.
(författare)
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The state and art of tinnitus research from a critical discourse perspective
- 2014
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Konferensbidrag (refereegranskat)abstract
- Objectives Tinnitus is a condition that almost entirely belongs to the field of audiological medicine, predominately regarded as a disorder of the ear. The purpose of this study was to explore the state of the art concerning the scientific discourse on tinnitus. Our main interest was to find the answers to: Who are involved in the research; i.e. within a disciplinary context? What approaches have been most influential? How much influence does one specific perspective have on the discourse compared to another perspective?Methods A selection of articles with tinnitus as the main objective, published in international journals between 1930-2013, were analyzed according to Critical discourse analysis and influenced by concepts deriving from (Laclau and Mouffe, 1985). Collected articles were representative, disciplinarily seen.ResultsDiscourse analysis showed to be an appropriate method for studying the discourses on tinnitus within a time period of more then 80 years. The most influential discourse on the definition of tinnitus states that tinnitus is the perception of a sound (s) in the absence of an external sound source. It is clear that this definition has been adopted regardless of disciplinary field. Philosophical and existential aspects of tinnitus suffering are not prevalent in the discourses on tinnitus, a somewhat understandable result, as the influence of medical science is exceptional. ConclusionGenerally seen, the dominance of one discourse in a field of research can lead to an inhibition of other valuable discourses from the periphery (the field of discursivity). The most productive scientific strategy would be to allow several discourses to exist side by side. A significant point to stress, since no epidemiological data so far have demonstrated that the populations of tinnitus patients in any way are homogeneous.
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| 14. |
- Pienkowski, Martin, et al.
(författare)
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A review of hyperacusis and future directions : part II. Measurement, mechanisms, and treatment.
- 2014
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 23:4, s. 420-436
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. In this detailed review of the field, we consolidate present knowledge in the hope of facilitating future research.METHOD: We review and reference the literature on hyperacusis and related areas. This is the 2nd of a 2-part review.RESULTS: Hyperacusis encompasses a wide range of reactions to sounds, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including brain-imaging studies. Researchers are only beginning to understand the many mechanisms at play, and valid animal models are still evolving. There are many counseling and sound-therapy approaches that some patients find helpful, but well-controlled studies are needed to measure their long-term efficacy and to test new approaches.CONCLUSIONS: Hyperacusis can make life difficult in this increasingly noisy world, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.
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| 15. |
- Tyler, Richard S, et al.
(författare)
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A review of hyperacusis and future directions : part I. Definitions and manifestations.
- 2014
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Ingår i: American Journal of Audiology. - : American Speech-Language-Hearing Association. - 1059-0889 .- 1558-9137. ; 23:4, s. 402-19
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Forskningsöversikt (refereegranskat)abstract
- PURPOSE: Hyperacusis can be extremely debilitating, and at present, there is no cure. We provide an overview of the field, and possible related areas, in the hope of facilitating future research.METHOD: We review and reference literature on hyperacusis and related areas. We have divided the review into 2 articles. In Part I, we discuss definitions, epidemiology, different etiologies and subgroups, and how hyperacusis affects people. In Part II, we review measurements, models, mechanisms, and treatments, and we finish with some suggestions for further research.RESULTS: Hyperacusis encompasses a wide range of reactions to sound, which can be grouped into the categories of excessive loudness, annoyance, fear, and pain. Many different causes have been proposed, and it will be important to appreciate and quantify different subgroups. Reasonable approaches to assessing the different forms of hyperacusis are emerging, including psychoacoustical measures, questionnaires, and brain imaging.CONCLUSIONS: Hyperacusis can make life difficult for many, forcing sufferers to dramatically alter their work and social habits. We believe this is an opportune time to explore approaches to better understand and treat hyperacusis.
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