Department of Psychiatry, University of Michigan, Ann Arbor.
Addiction Center, University of Michigan, Ann Arbor.
Am J Audiol. 2023 Sep 6;32(3):593-603. doi: 10.1044/2023_AJA-23-00020. Epub 2023 Aug 11.
Cognitive behavioral therapy (CBT) is a gold standard yet underutilized treatment for tinnitus, and tinnitus is especially highly prevalent among veterans. The aims of this study were twofold: to determine (a) if CBT for tinnitus is underutilized because participants find it less acceptable than other behavioral treatments for tinnitus and (b) if veterans and nonveterans rate behavioral treatments for tinnitus differently.
This cross-sectional study was conducted online with a sample of 277 adults in the United States who self-reported at least some level of bothersome tinnitus in the past week. The sample for this study consisted of 129 veterans and 148 nonveterans. Participants read descriptions of CBT, tinnitus retraining therapy (TRT), and mindfulness-based stress reduction (MBSR). For each treatment, presented to them in random order, they provided credibility, expectancy, and acceptability ratings.
Among 277 participants, 147 (53.07%) reporting gender were women, 216 (77.98%) reporting race/ethnicity were White, and 129 (46.57%) were veterans of any branch of the U.S. Armed Forces. Veteran ratings of credibility, expectancy, and acceptability were significantly lower than nonveteran ratings across treatments. There were differences in credibility, expectancy, and acceptability ratings across treatments, and post hoc testing revealed that TRT was consistently rated higher than CBT or MBSR.
Despite strong research support, CBT was rated as less acceptable than a different, less widely empirically supported treatment. Veterans' ratings of acceptability were lower than those of nonveterans across all treatments.
认知行为疗法(CBT)是治疗耳鸣的金标准,但未得到充分利用,而耳鸣在退伍军人中尤为高发。本研究旨在确定以下两点:(a)CBT 治疗耳鸣是否因患者认为其不如其他耳鸣行为治疗方法可接受而未被广泛应用;(b)退伍军人和非退伍军人对耳鸣行为治疗方法的评价是否存在差异。
该横断面研究通过在线调查方式进行,在美国共招募了 277 名过去一周内至少有过一次耳鸣烦恼经历的成年人作为研究对象。该研究的样本包括 129 名退伍军人和 148 名非退伍军人。参与者阅读了 CBT、耳鸣再训练疗法(TRT)和基于正念的减压疗法(MBSR)的描述。他们对每种治疗方法的可信度、预期和可接受性进行了评价,这些治疗方法以随机顺序呈现给他们。
在 277 名参与者中,有 147 名(53.07%)报告了性别,其中女性占 147 人(53.07%);216 名(77.98%)报告了种族/民族,其中白人占 216 人(77.98%);129 名(46.57%)为美国武装部队的退伍军人。退伍军人对可信度、预期和可接受性的评价明显低于非退伍军人对所有治疗方法的评价。不同治疗方法的可信度、预期和可接受性评价存在差异,事后检验显示,TRT 的评分始终高于 CBT 或 MBSR。
尽管有强有力的研究支持,但 CBT 的可接受性仍低于另一种实证支持较少的治疗方法。退伍军人对所有治疗方法的可接受性评价均低于非退伍军人。