Conrad Isabell, Kleinstäuber Maria, Jasper Kristine, Hiller Wolfgang, Andersson Gerhard, Weise Cornelia
1Department of Clinical Psychology, Johannes Gutenberg-University of Mainz, Mainz, Germany; 2Department of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University Marburg, Marburg, Germany; 3Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden; and 4Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research and Linnaeus Centre HEAD, Linköping University, Linköping, Sweden.
Ear Hear. 2015 Sep-Oct;36(5):e279-89. doi: 10.1097/AUD.0000000000000168.
The present study investigates the role of dysfunctional cognitions in patients with chronic tinnitus. To explore different dimensions of tinnitus-related thoughts, a 22-item self-report measure, the "Tinnitus Cognitions Scale" (T-Cog), is presented. Furthermore, dysfunctional cognitions are examined as a possible mediator of the relation between tinnitus distress and depression.
The present study analyzes the cross-sectional data of 373 patients with chronic tinnitus. Parallel analysis and principal axis factoring are used to identify the factor structure of the T-Cog. Assumed mediating effects are tested using the asymptotic and resampling procedure.
Factor analysis reveals two factors interpreted as "tinnitus-related catastrophic thinking" and "tinnitus-related avoidance cognitions." Internal consistency is sufficient with a Cronbach's α of 0.88 for the total scale and 0.74 and 0.87 for the subscales. The authors find high associations between the T-Cog and other measures of tinnitus distress, depression, anxiety, and tinnitus acceptance, indicating convergent validity. With the exception of neuroticism, low correlations with personality factors are found, indicating discriminant validity. Patients with moderate or severe tinnitus distress report significantly higher scores of dysfunctional cognitions than patients with mild tinnitus distress. Tinnitus-related catastrophic thinking and tinnitus-related avoidance cognitions partially mediate the relation between tinnitus distress and depression.
Dysfunctional cognitions can play an important role in the degree of tinnitus distress. Catastrophic and avoidant thoughts contribute to the explanation of depression among tinnitus patients. The T-Cog is a reliable and valid questionnaire for the assessment of different dimensions of cognitions. Its use could provide information for identifying tinnitus patients who are particularly suitable for cognitive-behavioral therapy.
本研究调查功能失调性认知在慢性耳鸣患者中的作用。为了探索与耳鸣相关想法的不同维度，我们提出了一种包含22个条目的自陈量表——“耳鸣认知量表”（T-Cog）。此外，还将功能失调性认知作为耳鸣痛苦与抑郁之间关系的一个可能中介因素进行检验。
本研究分析了373例慢性耳鸣患者的横断面数据。采用平行分析和主轴因子分析法来确定T-Cog的因子结构。使用渐近和重抽样程序检验假设的中介效应。
因子分析揭示了两个因子，分别被解释为“与耳鸣相关的灾难性思维”和“与耳鸣相关的回避认知”。总量表的Cronbach's α为0.88，分量表的Cronbach's α分别为0.74和0.87，内部一致性良好。作者发现T-Cog与耳鸣痛苦、抑郁、焦虑和耳鸣接纳的其他测量指标之间高度相关，表明具有收敛效度。除了神经质外，与人格因素的相关性较低，表明具有区分效度。中度或重度耳鸣痛苦的患者功能失调性认知得分显著高于轻度耳鸣痛苦的患者。与耳鸣相关的灾难性思维和与耳鸣相关的回避认知部分介导了耳鸣痛苦与抑郁之间的关系。
功能失调性认知在耳鸣痛苦程度中可能起重要作用。灾难性和回避性思维有助于解释耳鸣患者的抑郁情况。T-Cog是评估认知不同维度的可靠有效问卷。使用它可为识别特别适合认知行为疗法的耳鸣患者提供信息。
