Department of Neuroscience, Psychiatry, Uppsala University, Uppsala University Hospital, SE-75185 Uppsala, Sweden; Department of Surgical Sciences, Otolaryngology and Head & Neck Surgery, Uppsala University, Uppsala University Hospital, SE-75185 Uppsala, Sweden.
Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research, Linköping University, SE-58183 Linköping, Sweden; Department of Clinical Neuroscience, Karolinska Institutet, SE-14157 Huddinge, Sweden.
Behav Res Ther. 2014 Mar;54:30-7. doi: 10.1016/j.brat.2014.01.001. Epub 2014 Jan 24.
Hyperacusis, defined as unusual intolerance to ordinary environmental sounds, is a common problem for which there are no controlled trials on psychological treatment. Given the avoidance strategies present in hyperacusis, and similarities with problems such as tinnitus and chronic pain, cognitive behaviour therapy (CBT) is hypothesized to be helpful for patients with hyperacusis. In this randomized controlled study of 60 patients with hyperacusis, CBT was compared with a waiting list control group using the Loudness Discomfort Level test (LDL), the Hyperacusis Questionnaire, the Hospital Anxiety and Depression Scales, the Quality of Life Inventory and an adapted version of the Tampa Scale of Kinesiophobia. There were significant between-group effects in favour of the CBT group on all measures except for the HADS anxiety scale. Between-group effect sizes were moderate to high, with Cohen's d = 0.67 and 0.69 per ear, respectively, for the primary measure LDL, and ranging from d = 0.32 to 1.36 for the secondary measures. The differences between groups ceased to exist when the waiting list group was treated later with CBT, and the treatment results were largely maintained after 12 months. In conclusion, CBT is a promising treatment for hyperacusis, although more research is necessary.
对环境声音异常不耐受的定义为 Hyperacusis，这是一种常见的病症，目前尚无针对其心理治疗的对照试验。鉴于 Hyperacusis 存在回避策略，且与耳鸣和慢性疼痛等问题存在相似性，因此假设认知行为疗法（CBT）对 Hyperacusis 患者有帮助。在这项针对 60 名 Hyperacusis 患者的随机对照研究中，采用 Loudness Discomfort Level 测试（LDL）、Hyperacusis Questionnaire、医院焦虑和抑郁量表、生活质量量表和改编版 Tampa 运动恐惧量表，将 CBT 与等候名单对照组进行了比较。除 HADS 焦虑量表外，CBT 组在所有测量指标上均优于对照组，存在显著的组间效应。主要测量指标 LDL 的组间效应大小为中等至较大，Cohen's d 分别为每耳 0.67 和 0.69，次要测量指标的 d 值范围为 0.32 至 1.36。当等候名单组随后接受 CBT 治疗时，两组间的差异不复存在，并且治疗结果在 12 个月后仍基本保持。总之，CBT 是治疗 Hyperacusis 的一种有前途的方法，但还需要更多的研究。
