Advertisement

Outcome Measures Associated with Perceived Stress

  • Deborah Ann HallEmail author
Chapter

Abstract

We tend to think of situations in life as stressful when they are unpredictable, uncontrollable or overloading. Stress is a very personal experience. Perceived stress is a reflection of how such external stressful events and everyday hassles are ‘filtered’ according to our individual personality traits and coping strategies.

People with tinnitus describe various stress-related complaints, but these symptoms are not just restricted to tinnitus. Poor concentration, sense of loss of control, sleep disturbance and irritability are also shared with people who are experiencing a state of generalised anxiety or depression. Whatever their origin, the goal of any clinical intervention for people with tinnitus should be to reduce these negative symptoms.

This chapter takes a look at the way in which perceived stress associated with tinnitus has been measured. My focus is on clinical trials, but I start from the perspective of questionnaire construction by describing and comparing tinnitus-specific and general stress measures. I then evaluate how these instruments have been applied in a range of contemporary tinnitus trials. The chapter includes tutorials that introduce the reader to fundamental concepts in clinical trial design, understanding the purpose of questionnaires and appreciating the relevance of sample size calculations.

Abbreviations

ACT

Acceptance and commitment therapy

BAI

Beck Anxiety Inventory

BDI

Beck Depression Inventory

CBT

Cognitive behaviour therapy

DSM

Diagnostic and Statistical Manual for Mental Disorders

HADS

Hospital Anxiety and Depression Scale

PROM

Patient-Reported Outcome Measure

PSQ

Perceived Stress Questionnaire

PSS

Perceived Stress Scale

STAI

State-Trait Anxiety Inventory

TRQ

Tinnitus Reaction Questionnaire

TRT

Tinnitus retraining therapy

References

  1. Abbott JA, Kaldo V, Klein B et al (2009) A cluster randomised trial of an internet-based intervention program for tinnitus distress in an industrial setting. Cogn Behav Ther 38(3):162–173CrossRefPubMedGoogle Scholar
  2. American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Association Publishing, ArlingtonCrossRefGoogle Scholar
  3. Andresen EM (2000) Criteria for assessing the tools of disability outcomes research. Arch Phys Med Rehabil 81(12 Suppl 2):S15–S20CrossRefPubMedGoogle Scholar
  4. Arain M, Campbell MJ, Cooper CL et al (2010) What is a pilot or feasibility study? A review of current practice and editorial policy. BMC Med Res Methodol 10(1):67CrossRefPubMedPubMedCentralGoogle Scholar
  5. Åsberg M, Montgomery SA, Perris C et al (1978) A comprehensive psychopathological rating scale. Acta Psychiatrica Scandinavica 57(S271):5–27CrossRefGoogle Scholar
  6. Beck AT, Epstein N, Brown G et al (1988) An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol 56(6):893–897CrossRefPubMedGoogle Scholar
  7. Beck AT, Ward CH, Mendelson M et al (1961) An inventory for measuring depression. Arch Gen Psychiatry 4(6):561–571CrossRefPubMedGoogle Scholar
  8. Churchill R, Moore THM, Furukawa TA et al (2013) ‘Third wave’ cognitive and behavioural therapies versus treatment as usual for depression. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD008705.pub2
  9. ClinicalTrials.gov Identifier: NCT00724152Google Scholar
  10. ClinicalTrials.gov Identifier: NCT00730834Google Scholar
  11. Cohen S, Williamson G (1988) Perceived stress in a probability sample of the United States. In: Spacapam S, Oskamp S (eds) The social psychology of health: Claremont symposium on applied social psychology. Sage, Newbury Park, CAGoogle Scholar
  12. Cohen S, Kamarck T, Mermelstein R (1983) A global measure of perceived stress. J Health Soc Behav 24(4):385–396CrossRefPubMedGoogle Scholar
  13. Davis PB, Paki B, Hanley PJ (2007) Neuromonics tinnitus treatment: third clinical trial. Ear Hear 28(2):242–259CrossRefPubMedGoogle Scholar
  14. Derogatis LR, Lipman RS, Rickels K et al (1974) The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory. Behav Sci 19(1):1–15CrossRefPubMedGoogle Scholar
  15. Fackrell K, Hall DA, Barry J et al (2014) Tools for tinnitus measurement: development and validity of questionnaires to assess handicap and treatment effects. In: Signorelli F, Turjman F (eds) Tinnitus: causes, treatment and short & long-term health effects. Nova Science Publishers Inc, New York, pp 13–60Google Scholar
  16. Fliege H, Rose M, Arck P et al (2001) Validierung des “Perceived Stress Questionnaire” (PSQ) an einer deutschen Stichprobe. Diagnostica 47:142–152CrossRefGoogle Scholar
  17. Gomaa MAM, Elmagd MHA, Elbadry MM et al (2014) Depression, anxiety and stress scale in patients with tinnitus and hearing loss. Eur Arch Otorhinolaryngol 271(8):2177–2184CrossRefPubMedGoogle Scholar
  18. Hall DA, Szczepek A, Kennedy V et al (2015) Current reported outcome domains in studies of adults with a focus on the treatment of tinnitus: protocol for a systematic review. BMJ Open 11;5(11):e009091.Google Scholar
  19. Hall DA, Haider H, Szczepek AJ et al (2016) Systematic review of outcome domains and instruments used in clinical trials of tinnitus treatments in adults. Trials 17(1):270. Google Scholar
  20. Hallam RS, Jakes SC, Hinchcliffe R (1988) Cognitive variables in tinnitus annoyance. Br J Clin Psychol 27(3):231–222CrossRefGoogle Scholar
  21. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23(1):52–62CrossRefGoogle Scholar
  22. Hanley PJ, Davis PB, Paki B et al (2008) Treatment of tinnitus with a customized, dynamic acoustic neural stimulus: clinical outcomes in general private practice. Ann Otol Rhinol Laryngol 117(11):791–799CrossRefPubMedGoogle Scholar
  23. Heijneman KM, de Kleine E, van Dijk P (2012) A randomized double-blind crossover study of phase-shift sound therapy for tinnitus. Otolaryngol Head Neck Surg 147(2):308–315CrossRefPubMedGoogle Scholar
  24. Henry JA, Dennis KC, Schechter MA (2005) General review of tinnitus prevalence, mechanisms, effects and management. J Speech Lang Hear Res 48(5):1204–1235CrossRefPubMedGoogle Scholar
  25. Hesser H, Gustafsson T, Lundén C et al (2012) A randomized controlled trial of internet-delivered cognitive behavior therapy and acceptance and commitment therapy in the treatment of tinnitus. J Consult Clin Psychol 80(4):649–661CrossRefPubMedGoogle Scholar
  26. Hunot V, Churchill R, Teixeira V et al (2007) Psychological therapies for generalised anxiety disorder. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD001848.pub4
  27. Hunot V, Moore THM, Caldwell DM et al (2013) ‘Third wave’ cognitive and behavioural therapies versus other psychological therapies for depression. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD008704.pub2
  28. Ireland CE, Wilson PH, Tonkin JP et al (1985) An evaluation of relaxation training in the treatment of tinnitus. Behav Res Ther 23:423–430CrossRefPubMedGoogle Scholar
  29. ISRCTN registry: ISRCTN17631678Google Scholar
  30. ISRCTN registry: ISRCTN38408464Google Scholar
  31. Jakes SC, Hallam RS, Chambers C et al (1985) A factor analytical study of tinnitus complaint behaviour. Audiology 24:195–206CrossRefPubMedGoogle Scholar
  32. Joyce J, Herbison GP (2015) Reiki for depression and anxiety. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD006833.pub2
  33. Kaldo V, Cars S, Rahnert M et al (2007) Use of a self-help book with weekly therapist contact to reduce tinnitus distress: a randomized controlled trial. J Psychosom Res 63(2):195–202CrossRefPubMedGoogle Scholar
  34. Kaldo V, Levin S, Widarsson J et al (2008) Internet versus group cognitive-behavioral treatment of distress associated with tinnitus: a randomized controlled trial. Behav Ther 39(4):348–359CrossRefPubMedGoogle Scholar
  35. Kennedy V, Wilson C, Stephens D (2004) Quality of lie and tinnitus. Audiol Med 2(1):29–40CrossRefGoogle Scholar
  36. Kirshner B, Guyatt G (1985) A methodological framework for assessing health indices. J Chronic Dis 38(1):27–36CrossRefPubMedGoogle Scholar
  37. Kuk FK, Tyler RS, Russell D et al (1990) The psychometric properties of a tinnitus handicap questionnaire. Ear Hearing 11(6):434–445CrossRefPubMedGoogle Scholar
  38. Langguth B, Landgrebe M, Kleinjung T et al (2011) Tinnitus and depression. World J Biol Psychiatry 12(7):489–500CrossRefPubMedGoogle Scholar
  39. Lazarus RS (1966) Psychological stress and the coping process. McGraw-Hill, New YorkGoogle Scholar
  40. Lee E-H (2012) Review of the psychometric evidence of the perceived stress scale. Asian Nurs Res 6(4):121–127CrossRefGoogle Scholar
  41. Levenstein S, Prantera C, Varvo V et al (1993) Development of the perceived stress questionnaire: a new tool for psychosomatic research. J Psychosom Res 37(1):19–32CrossRefPubMedGoogle Scholar
  42. Lovibond PF, Lovibond SH (1995) Manual for depression, anxiety and stress scales. Psychology Foundation, SydneyGoogle Scholar
  43. Malouff JM, Noble W, Schutte NS et al (2010) The effectiveness of bibliotherapy in alleviating tinnitus-related distress. J Psychosom Res 68(3):245–251CrossRefPubMedGoogle Scholar
  44. Mayo-Wilson E, Montgomery P (2013) Media-delivered cognitive behavioural therapy and behavioural therapy (self-help) for anxiety disorders in adults. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD005330.pub4
  45. McNeill C, Távora-Vieira D, Alnafjan F (2012) Tinnitus pitch, masking, and the effectiveness of hearing aids for tinnitus therapy. Int J Audiol 51(12):914–919CrossRefPubMedGoogle Scholar
  46. Newman CW, Jacobson GP, Spitzer JB (1996) Development of the tinnitus handicap inventory. Arch Otolaryngol Head Neck Surg 122:143–148CrossRefPubMedGoogle Scholar
  47. Olze H, Szczepek AJ, Haupt H et al (2012) The impact of cochlear implantation on tinnitus, stress and quality of life in postlingually deafened patients. Audiol Neurootol 17(1):2–11CrossRefPubMedGoogle Scholar
  48. Ori R, Amos T, Bergman H et al (2015) Augmentation of cognitive and behavioural therapies (CBT) with d-cycloserine for anxiety and related disorders. Cochrane Database Syst Rev. doi: 10.1002/14651858.CD007803.pub2
  49. Pinto PCL, Marcelos CM, Mezzasalma MA et al (2014) Tinnitus and its association with psychiatric disorders: systematic review. J Laryngol Otol 128(8):660–664CrossRefPubMedGoogle Scholar
  50. Reiss S, Peterson RA, Gursky DM, McNally RJ (1986) Anxiety sensitivity, anxiety frequency and the prediction of fearfulness. Behav Res Ther 24(1):1–8CrossRefPubMedGoogle Scholar
  51. Robinson SK, McQuaid JR, Viire ES et al (2003) Relationship of tinnitus questionnaires to depressive symptoms, quality of well-being and internal focus. Int Tinnitus J 9(2):97–103PubMedGoogle Scholar
  52. Robinson SK, Viirre ES, Bailey KA et al (2008) A randomized controlled trial of cognitive-behavior therapy for tinnitus. Int Tinnitus J 14(5):119–126PubMedGoogle Scholar
  53. Seydel C, Haupt H, Szczepek AJ et al (2010) Long-term improvement in tinnitus after modified tinnitus retraining therapy enhanced by a variety of psychological approaches. Audiol Neurootol 15(2):69–80CrossRefPubMedGoogle Scholar
  54. Spielberger CD, Gorsuch RL, Lushene RE (1970) STAI manual. Consulting Psychologists Press, Palo Alto, CAGoogle Scholar
  55. Távora-Vieira D, Eikelboom RH, Miller S (2011) Neuromonics tinnitus treatment for patients with significant level of hearing loss: an adaptation of the protocol. Int J Audiol 50(12):881–886CrossRefPubMedGoogle Scholar
  56. Tyler RS, Baker LJ (1983) Difficulties experienced by tinnitus sufferers. J Speech Hear Disord 48(2):150–154CrossRefPubMedGoogle Scholar
  57. Watts E, Fackrell K, Smith S et al (2016) Why is tinnitus a problem? A qualitative analysis of problems reported by tinnitus patients. 10th International Tinnitus Research Initiative Conference, Nottingham, UK. http://www.tinnitusresearch.org/images/files/meetings/files2016/TRI2016_Abstract_Book.pdf. Accessed 26 May 2017
  58. Williams HC, Burden-Teh E, Nunn AJ (2015) What is a pragmatic clinical trial? J Invest Dermatol 135. doi: 10.1038/jid.2015.134
  59. Wilson PH, Henry J, Bowen M et al (1991) Tinnitus reaction questionnaire: psychometric properties of a measure of distress associated with tinnitus. J Speech Lang Hear Res 34(1):197–201CrossRefGoogle Scholar
  60. Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67(6):361–370Google Scholar

Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.National Institute for Health Research Nottingham Biomedical Research CentreNottinghamUK
  2. 2.Otology and Hearing Group, Division of Clinical NeuroscienceSchool of Medicine, University of NottinghamNottinghamUK

Personalised recommendations