Welch David, Dawes Patrick J D
Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, PO Box 913, Dunedin, New Zealand.
Ear Hear. 2008 Oct;29(5):684-92. doi: 10.1097/AUD.0b013e318177d9ac.
Tinnitus has high prevalence and a wide range of etiologies and of impacts on sufferers. Our objective was to develop understanding of the role of personality in the perception of tinnitus in the general population. As a theoretical basis for this, we combined elements of a general model of signal detection with the ideas of ignition (development) and promotion (neural transmission) of tinnitus, and considered plausible roles for personality factors within this conceptual framework.
We interviewed a birth cohort of 970 people aged 32 yr sampled from the general population. On the basis of questioning, we divided them into three groups, those without tinnitus, those with occasional tinnitus (including those with transient tinnitus of very brief duration), and those who experienced tinnitus most of the time. We also established how annoying or distressing the tinnitus was, and assessed personality using the Multidimensional Personality Questionnaire.
Tinnitus was experienced rarely by 38.2% and half the time or more by 6.8% of those studied. Men and women did not differ in the amount of tinnitus reported, but women were more likely to find it annoying. People from lower socioeconomic backgrounds were more likely to report tinnitus. People with tinnitus were more socially withdrawn, reactive to stress, alienated, and less Self-Controlled. People who were more annoyed by tinnitus were more socially withdrawn, and men were more stress reactive and alienated.
Our interpretation of the findings is that personality influences the persistence of tinnitus by influencing the tendency to be aware of it. Consideration of personality factors may improve the ability to tailor tinnitus therapies, and the concept of awareness may benefit treatment outcomes by showing tinnitus sufferers a means of internalizing the locus of control over their symptoms.
耳鸣患病率高,病因广泛,对患者影响较大。我们的目的是深入了解人格在普通人群耳鸣感知中的作用。作为理论基础,我们将信号检测通用模型的要素与耳鸣的引发(发展)和促进(神经传导)的观点相结合,并在此概念框架内考虑人格因素可能发挥的作用。
我们对从普通人群中抽取的970名32岁的出生队列人群进行了访谈。通过询问,我们将他们分为三组:无耳鸣者、偶尔有耳鸣者(包括极短暂的一过性耳鸣者)和大部分时间都有耳鸣者。我们还确定了耳鸣的烦人或痛苦程度,并使用多维人格问卷评估人格。
38.2%的研究对象很少经历耳鸣,6.8%的研究对象半数时间或更长时间经历耳鸣。报告的耳鸣量在男性和女性中无差异,但女性更易觉得耳鸣烦人。社会经济背景较低的人更易报告耳鸣。有耳鸣的人更不爱社交、对压力反应敏感、有疏离感且自控力较差。被耳鸣烦扰程度更高的人更不爱社交,男性对压力反应更敏感且更有疏离感。
我们对研究结果的解读是,人格通过影响对耳鸣的觉察倾向来影响耳鸣的持续存在。考虑人格因素可能会提高耳鸣治疗的针对性,而觉察这一概念可能会通过向耳鸣患者展示一种将症状控制源内在化的方法来改善治疗效果。