Abstract
This paper describes a comprehensive program for behavioral management of complex tinnitus. The clinical characteristics and typical treatment of tinnitus are reviewed. Psychosocial sequelae are discussed in terms of their exacerbation of the symptom and their potential as foci of treatment. The management problems of tinnitus are considered analogous to those of chronic pain. A case illustration is provided with a description of the treatment process. The comprehensive behavioral program discussed in the present paper included biofeedback therapy, pain management training, social skills training, assertion training, in vivo exposure to being alone, cognitive treatment of depression, and marital therapy. Outcomes were monitored multidimensionally. Self-report of tinnitus severity decreased after the 6th treatment day and stabilized at a “mild” rating after the 9th day. Skin temperature readings at baseline increased and stabilized after the 8th day, and the patient was able to reliably increase skin temperature on request. Scores on the Beck Depression Inventory and the Willoughby Personality Schedule, and a self-rating of Fear of Being Alone dropped markedly by the end of treatment. Follow-up data at 3 months indicated maintenance of gains.
Similar content being viewed by others
References
Bandura, A. (1977).Social learning theory. Englewood Cliffs, New Jersey: Prentice-Hall.
Basmajian, J., & Blumenstein, R. (1980).Electrode placement in EMG biofeedback. Baltimore: Williams and Wilkins.
Beck, A. T. (1972).Depression: Causes and treatment. Philidelphia: University of Pennsylvania Press.
Beck, A. T. (1976).Cognitive therapy and the emotional disorders. New York: International Universities Press.
Beck, A. T., Ward, C. H., Mendelson, M., Mock, J., & Erbaugh, J. (1961). An inventory for measuring depression.Archives of General Psychiatry, 4 53–63.
Borton, T., Moore, W., Jr. & Clark, S. (1981). Electromyographic feedback for tinnitus aurium.Journal of Speech and Hearing Disorders, 46 39–45.
Elfner, L., May, J., Moore, J., & Mendelson, J. (1981). Effects of EMG and thermal feedback training on tinnitus: A case study.Biofeedback and Self-Regulation, 6 517–521.
Fordyce, W. E. (1976).Behavioral methods in chronic pain and illness. St. Louis: C. V. Mosby.
Glass, D. & Singer, J. (1972). Behavioral after-effects of unpredictable and uncontrollable aversive events.American Scientist, 60 457–465.
Goldfried, M., & Davison, G. (1976).Clinical behavioral therapy. New York: Holt, Rinehart & Winston.
Griggs, J.Ringing ears (1982). Springfield, Missouri: National Tinnitus Fund.
Grossan, M. (1976). Treatment of subjective tinnitus with biofeedback.Ear. Nose and Throat Journal, 55 314–318.
Hazell, J. (1981). Tinnitus.Practicioner, 225 1577–1585.
House, P. (1978). Treatment of severe tinnirus with biofeedback training.Laryngoscope, 88 406–412.
House, P. (1981). Personality of the tinnitus patient.CIBA Foundation Symposia, 85 193–203.
House, J., Miller, L., & House, P. (1977). Severe tinnitus: Treatment with biofeedback training.Transactions of the American Academy of Ophthalmology and otolaryngology, 84 697–703.
King, N., & Montgomery, R. (1980). Biofeedback-induced control of human peripheral temperature: A critical review of the literature.Psychological Bulletin, 88 738–752.
McCaul, K., & Malott, J. (1984). Distraction and coping with pain.Psychological Bulletin, 95 516–533.
McFadden, D. (1982).Tinnitus: Facts, theories, and treatments. Washington: National Academy Press.
Mykelbust, A. (1960).The psychology of deafness. New York: Grune and Stratton.
Shea, J., Emmett, J., Orchik, D., et al. (1981). The medical treatment of tinnitus.Annals of Otology, Rhinology and Laryngology, 90 597–601.
Sternbach, R. A. (1974).Pain patients: Traits and treatment. New York: Academic Press.
Thompson, S. (1981). Will it hurt less if I can control it? A complex answer to a simple question.Psychological Bulletin, 90 89–101.
Turner, R. M., Ditomasso, R. A., & Murray, M. R. (1981). Psychometric analysis of the Willoughby Personality Schedule.Journal of Behavior Therapy and Experimental Psychiatry, 11 185–194.
Willoughby, R. R. (1932). Some properties of the Thurstone Personality Schedule and a suggested revision.Journal of Social Psychology, 3 401–424.
Wolpe, J., & Lang, P. J. (1964). A fear survey schedule for use in behavior therapy.Behaviour Research and Therapy, 2 27–30.
Wood, K., Webb, W., Jr., Orchik, D., & Shea, J. (1983). Intractable tinnitus: Psychiatric aspects of treatment.Psychosomatics, 24 559–565.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Duckro, P.N., Pollard, C.A., Bray, H.D. et al. Comprehensive behavioral management of complex tinnitus: A case illustration. Biofeedback and Self-Regulation 9, 459–469 (1984). https://doi.org/10.1007/BF01000563
Issue Date:
DOI: https://doi.org/10.1007/BF01000563