Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy for Tinnitus and Hyperacusis Rehabilitation: Outcomes for Patients Treated in Routine Practice

2018 ◽  
Vol 27 (4) ◽  
pp. 547-558 ◽  
Author(s):  
Hashir Aazh ◽  
Brian C. J. Moore

Objective The aim was to assess the effectiveness of cognitive behavioral therapy (CBT) for tinnitus and/or hyperacusis delivered by audiologists working in the National Health Service in the United Kingdom. Design This was a retrospective study, based on questionnaires assessing tinnitus and hyperacusis and insomnia before and after CBT. Study Sample Data were gathered for 68 consecutive patients (average age = 52.5 years) who enrolled for CBT. Results All measures showed significant improvements after CBT. Effect sizes for patients who completed CBT were 1.13 for Tinnitus Handicap Inventory scores; 0.76 for Hyperacusis Questionnaire scores; 0.71, 0.95, and 0.93 for tinnitus loudness, annoyance, and effect on life, respectively, measured using the Visual Analog Scale; and 0.94 for the Insomnia Severity Index score. An analysis including those who dropped out also showed significant improvements for all measures. Conclusion Audiologist-delivered CBT led to significant improvements in self-report measures of tinnitus and hyperacusis handicap and insomnia. The methods described here may be used when designing future randomized controlled trials of efficacy.

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A145-A146
Author(s):  
Hyojin Nam ◽  
Jinyoung Chang ◽  
Rachel Manber ◽  
Mickey Trockel ◽  
Isa Okajima ◽  
...  

Abstract Introduction As dropout from treatment potentially diminishes its therapeutic effect and poses clinical concern, it is important to find out which characteristics of participants are suitable for online-based treatment. Therefore, we aimed to identify factors that predicted a dropout in the e-mail based cognitive behavioral therapy (REFRESH) developed by Stanford University for the purpose of psychological intervention for insomnia. Methods Participants who participated in the REFRESH program consisted of 158 university and graduate students aged 18 to 30 in Hong Kong and Korea who scored higher than 10 on the Insomnia Severity Index (ISI), and the intervention was delivered in 8 weekly sessions sent via weekly e-mails. Among them, 110 were women (70%) and the average age was 22 (±2.71) years old. All participants were asked to answer the following self-reporting questionnaires before and after the intervention: Insomnia Severity Index; ISI, Depression Anxiety Stress Scale 21; DASS-21, Sleep Hygiene Practice Scale; SHPS, Dysfunctional Beliefs and Attitude about Sleep 16; DBAS-16. Descriptive statistics and ROC decision tree analysis were conducted to address our aim. Results Of the 158 participants, 68 completed the program, and 90 participants (57%) dropped out. The best predictor of dropout was DASS score with an optimal cup-point of <34. Of the 107 participants who reported DASS <30, 70(65.4%) dropped out. In contrast, of the 50 participants who reported DASS ≥34, 12(38%) dropped out. The second-level predictor was expectations for sleep score with a cut-point of <18. Among participants with DASS <34 and expectations for sleep score <18, 57(73.1%) dropped out. Of the 29 participants who reported DASS <34 and expectations for sleep score ≥18, 13(44.8%) dropped out. Conclusion Mild levels of depression, anxiety and stress and expectations for sleep appear to be predictive of dropout in an e-mail based intervention. People with mild symptoms may experience less distress and impairment, which may result in lower motivation to receive treatment. This may lead to inability to complete treatment and higher rates of dropout. Support (if any):


2020 ◽  
Vol 4 (1) ◽  
pp. 19
Author(s):  
Bárbara Dinorah Hidalgo Martínez ◽  
Viorkis Pérez Ortiz ◽  
María Caridad Olivera Cardoso ◽  
Lidia López Aristica ◽  
Liset Betancourt Castellanos ◽  
...  

  La fibromialgia es una enfermedad con fuerte impacto psicológico, de evolución crónica que provoca dolor, rigidez e hipersensibilidad en músculos, tendones y articulaciones por más de tres meses de evolución. Generalmente está asociada a alteraciones cognitivas, disminución del sueño, astenia, ansiedad y depresión a diferentes grados. Aunque la etiología no se conoce con exactitud, el diagnóstico es clínico por exclusión. En este estudio se determinó la eficacia de la terapia cognitivo-conductual (TCC) en pacientes con fibromialgia en el Hospital Básico Miguel H. Alcívar de Bahía de Caráquez, Ecuador. El estudio fue descriptivo y prospectivo en 30 pacientes diagnosticados de fibromialgia, en el periodo de mayo a septiembre de 2017. La mayoría de los pacientes fueron mujeres entre 30 y 40 años de edad, cuyo síntoma principal fue el dolor generalizado, con espectro ansioso-depresivo. Se utilizó el test de ansiedad y depresión hospitalaria para diagnosticar la presencia de ansiedad y depresión antes y después de la terapia. Los pacientes con fibromialgia fueron tratados con hipnosis, con un enfoque cognitivo conductual, en el 70,1 % los síntomas desaparecieron o mejoraron durante los meses en los que mantuvieron el tratamiento, lo cual demuestra la efectividad del tratamiento con TCC en pacientes con fibromialgia.   Palabras clave: Fibromialgia, depresión, ansiedad, terapia cognitivo-conductual, hipnosis.   Abstract Fibromyalgia is a disease with a strong psychological impact, of chronic evolution that causes pain, stiffness and hypersensitivity in muscles, tendons and joints, for more than three months of evolution. It is generally associated with cognitive alterations, decreased sleep, asthenia, anxiety and depression to different degrees. Although the etiology is not exactly known, the diagnosis is clinical by exclusion. In this study, the efficacy of cognitive-behavioral therapy (CBT) was determined in patients with fibromyalgia at the Basic Hospital Miguel H. Alcívar de Bahía de Caráquez, Ecuador. The study was descriptive and prospective in 30 patients diagnosed with fibromyalgia, in the period from May to September 2017. Most of the patients were women between 30 and 40 years of age, whose main symptom was generalized pain, with an anxious spectrum- depressant. The hospital anxiety and depression test was used to diagnose the presence of anxiety and depression before and after therapy. Fibromyalgia patients were treated with hypnosis, with a cognitive behavioral approach, in 70.1% the symptoms disappeared or improved during the months in which they maintained the treatment, which demonstrates the effectiveness of CBT treatment in patients with fibromyalgia.   Keywords: Fibromyalgia, depression, anxiety, cognitive-behavioral therapy, hypnosis.


Author(s):  
Nawel Abdesslem ◽  
Sabeur Hamrouni ◽  
Roy Jesse Shephard ◽  
Mohamed Souhaiel Chelly

Objective: This study made a preliminary exploration of the efficacy of physically-based cognitive-behavioral therapy and deep relaxation for children with attention-deficit hyperactivity disorder (ADHD). Methods: ADHD behavior and cognitive functions were assessed by test D2 and Conner’s scale before and after a one-year physically-based training program. The reliability of test scores was assessed by repeat testing of a control group (CG) of 10 students who did not have ADHD. Children (10 per group) with ADHD were assigned to physically-based cognitive-behavioral therapy and deep relaxation (E1) or physically-based cognitive-behavioral alone (E2). Results: After 52 weeks of treatment, an intra-group comparison showed that E1 and E2 had improved their scores on the test D2, whereas CG showed no significant change. In addition, most participants with ADHD showed a remarkable improvement in their attentional behavior, with group E1 responding better to treatment than group E2. Conclusions: Physically-based cognitive behavioral therapy appears to improve function and social competence in children with ADHD, and should be recommended as an alternative or supplement to pharmaceutical treatment.


2016 ◽  
Vol 53 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Murad Atmaca ◽  
Hanefi Yildirim ◽  
Seda Yilmaz ◽  
Neslihan Caglar ◽  
Osman Mermi ◽  
...  

Background The effect of a variety of treatment modalities including psychopharmacological and cognitive behavioral therapy on the brain volumes and neurochemicals have not been investigated enough in the patients with obsessive-compulsive disorder. Therefore, in the present study, we aimed to investigate the effect of cognitive behavioral therapy on the volumes of the orbito-frontal cortex and thalamus regions which seem to be abnormal in the patients with obsessive-compulsive disorder. We hypothesized that there would be change in the volumes of the orbito-frontal cortex and thalamus. Methods Twelve patients with obsessive-compulsive disorder and same number of healthy controls were included into the study. At the beginning of the study, the volumes of the orbito-frontal cortex and thalamus were compared by using magnetic resonance imaging. In addition, volumes of these regions were measured before and after the cognitive behavioral therapy treatment in the patient group. Results The patients with obsessive-compulsive disorder had greater left and right thalamus volumes and smaller left and right orbito-frontal cortex volumes compared to those of healthy control subjects at the beginning of the study. When we compared baseline volumes of the patients with posttreatment ones, we detected that thalamus volumes significantly decreased throughout the period for both sides and that the orbito-frontal cortex volumes significantly increased throughout the period for only left side. Conclusions In summary, we found that cognitive behavioral therapy might volumetrically affect the key brain regions involved in the neuroanatomy of obsessive-compulsive disorder. However, future studies with larger sample are required.


2012 ◽  
Vol 26 (4) ◽  
pp. 390-404 ◽  
Author(s):  
Anne D. Simons ◽  
C. Nathan Marti ◽  
Paul Rohde ◽  
Cara C. Lewis ◽  
John Curry ◽  
...  

Objective: Examine the degree to which homework completion is associated with various indices of clinical improvement in adolescents with depression treated with cognitive behavioral therapy (CBT) either as a monotherapy and in combination with antidepressant medication. Method: This study used data from the Treatment of Adolescents with Depression Study (TADS), which compared the efficacy of CBT, fluoxetine (FLX), the combination of CBT and FLX (COMB), and a pill placebo (PBO; TADS Team, 2003, 2004, 2005). Current analyses included only TADS participants in the CBT (n = 111) or COMB (n = 107) conditions. Analyses focused on the relations between partial and full homework completion and a dichotomized measure of clinical response, evaluator and self-report ratings of depressive symptoms, hopelessness, and suicidality. Results: Homework completion significantly predicted clinical improvement, decrease in self-reported hopelessness, suicidality, and depression—but not in evaluator-rated depressive symptoms—in adolescents treated with CBT only. These relationships were almost completely absent in the COMB condition. The only significant COMB finding was that partially completed homework was related to decrease in hopelessness over time. Conclusions: These findings suggest that the ability of therapists and clients to collaboratively develop and complete between-session assignments is associated with response to CBT, self-report of severity of depressive symptoms, hopelessness, and suicidality and may be integral to optimizing the effects of CBT when delivered as a monotherapy.


Author(s):  
Nasrin Jaberghaderi ◽  
Mansour Rezaei ◽  
Mitra Kolivand ◽  
Azita Shokoohi

Objective: This study was conducted to examine and compare the effectiveness of cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR) in child victims of domestic violence (child physical abuse and/or witnessing parents’ conflicts). Method: A total of 139 girls and boys, aged 8-12 years, were randomly assigned into CBT (n = 40), EMDR (n = 40), or control groups (n=59). All children received up to 12 individual treatment sessions over 4–12 weeks. Blind assessment was done before and 2 weeks after the treatment and on a variety of teacher-parent-rated and self-report measures of posttraumatic symptomatology, depression, anxiety, and behavior problems. Results: CBT and EMDR were effective in ameliorating psychological sequelae of victims of domestic violence on the measured variables (p =.001). Comparison of the treatment and control groups suggested moderate to high practical significance in treatment groups vs controls. Conclusion: Both CBT and EMDR can help children to greatly recover from the outcomes of domestic violence in comparison with control group. Moreover, structured trauma treatments are strongly recommended and can be used for children


2020 ◽  
Vol 29 (3) ◽  
pp. 476-490
Author(s):  
Vinaya Manchaiah ◽  
George Vlaescu ◽  
Srinivas Varadaraj ◽  
Elizabeth Parks Aronson ◽  
Marc A. Fagelson ◽  
...  

Objective Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. Internet-based cognitive behavioral therapy (ICBT) demonstrates potential as a means of delivering this support but is not currently available in the United States. This article discusses the adaptation of an ICBT intervention, originally used in Sweden, Germany, and the United Kingdom, for delivery in the United States. The aim of this study was to (a) modify the web platform's features to suit a U.S. population, (b) adapt its functionality to comply with regulatory aspects, and (c) evaluate the credibility and acceptability of the ICBT intervention from the perspective of health care professionals and patients with bothersome tinnitus. Materials/Method Initially, the iTerapi ePlatform developed in Sweden was adopted for use in the United States. Functional adaptations followed to ensure that the platform's functional and security features complied with both institutional and governmental regulations and that it was suitable for a U.S. population. Following these adaptations, credibility and acceptance of the materials were evaluated by both health care professionals ( n = 11) and patients with bothersome tinnitus ( n = 8). Results Software safety and compliance regulatory assessments were met. Health care professionals and patients reported favorable acceptance and satisfaction ratings regarding the content, suitability, presentation, usability, and exercises provided in the ICBT platform. Modifications to the features and functionality of the platform were made according to user feedback. Conclusions Ensuring that the ePlatform employed the appropriate features and functionalities for the intended population was essential to developing the Internet-based interventions. The favorable user evaluations indicated that the intervention materials were appropriate for the tinnitus population in the United States.


2020 ◽  
Author(s):  
Daniel Walter ◽  
Jana Buschsieweke ◽  
Lydia Dachs ◽  
Hildegard Goletz ◽  
Anja Goertz-Dorten ◽  
...  

Abstract BackgroundDepressive disorders are common in adolescence and are associated with a wide range of negative long-term outcomes. Highly controlled randomized controlled trials (RCT) provide considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) as a treatment for depression, but the effectiveness of CBT under routine care conditions remains unproven.MethodsIn the present observational study, the changes achieved through routine CBT in adolescents with depressive disorders treated in a university outpatient clinic were analyzed, and compared to a historical control group of adolescents with depressive disorders who had received treatment as usual. At the start and end of treatment (pre- and post-assessment), parent and self-ratings of the German versions of the Youth Self-Report (YSR), the Child Behavior Checklist (CBCL) and rating scales for depressive symptoms (FBB-DES, SBB-DES) were assessed. A total of 331 adolescents aged 11–18 years with complete data were assessed for the main analysis.ResultsThe analysis yielded small to large pre-post effect sizes (Cohen’s d) for the total sample (d = 0.33 to d = 0.82) and large effect sizes for adolescents who were rated in the clinical range on each (sub)scale at the start of treatment (d = 0.85 to d = 1.30). When comparing patients in the clinical range with historical controls, medium to large net effect sizes (d = 0.53 to d = 2.09) emerged for the total scores in self- and parent rating. However, a substantial proportion of the sample remained in the clinical range at the end of treatment.ConclusionsThese findings suggest that CBT is effective for adolescents with depressive disorders when administered under routine care conditions, but the results must be interpreted with caution due to the lack of a direct control condition.Trial registrationDRKS, DRKS00021518. Registered 27 April 2020 - Retrospectively registered, http://drks.de


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