Department of Audiology, Pento Speech and Hearing Centers, Apeldoorn, the Netherlands.
Department of Child Health, The Netherlands Organization for Applied Scientific Research (TNO), Leiden, the Netherlands.
Am J Audiol. 2024 Sep 3;33(3):613-623. doi: 10.1044/2024_AJA-23-00210. Epub 2024 May 20.
The aim of this study was to investigate the short- and long-term effects of a new cognitive sound exposure therapy (CSET) in patients with hyperacusis.
A new therapy was developed to reduce hyperacusis using sound exposure combined with breathing and relaxation strategies from both acceptance and commitment therapy and cognitive behavioral therapy. Patients who were referred to the Speech and Hearing Centers located in Hengelo and Zwolle in the Netherlands and aged ≥ 18 years with hyperacusis as main complaint and no or mild hearing loss were included in this study. Patients were seen for CSET between June 2020 and August 2022. The sessions took place biweekly. Sessions ended when exposure reached a level with a maximum of 70-80 dB SPL. Short-term effects between the start and the end of therapy were based on tolerable level of sound exposure (dB SPL), subjective-level hinderance of hyperacusis, and sensitivity to sound using the Hyperacusis Questionnaire (HQ). The long-term effect was based on HQ 6 months after the end of therapy. Linear mixed-effects and regression models were applied to study outcomes over time.
In total, 30 patients, 15 men and 15 women, aged between 24 and 76 years were included in this study. The mean number of sessions during therapy was 6 and ranged between 4 and 8. Results showed an increase of exposure level (mean change was +23.7 dB with an of 7.9, < .001), a decrease in sensitivity to daily sounds (mean [] change was -1.6 [2.1], < .001), and a decrease in HQ (mean [] change was -9.8 [4.9], < .001), between the start and the end of therapy. There was no significant change in HQ after the end of therapy and 6 months later; mean () change was 0.2 (4.3), = .81.
The evaluation of CSET indicated a decrease in short- and long-term sensitivity to sound in patients with hyperacusis. Additionally, CSET has shown a positive impact, not only for the sounds used in the therapy sessions but also in transferring benefits to everyday sounds. The results of combining psychoeducation, sound exposure, and counseling are promising and warrant further evaluation.
本研究旨在探讨一种新的认知声音暴露疗法（CSET）对听力敏度患者的短期和长期疗效。
开发了一种新的治疗方法，通过将声音暴露与来自接受与承诺疗法和认知行为疗法的呼吸和放松策略相结合，来减轻听力敏度。该研究纳入了荷兰亨格洛和兹沃勒的言语和听力中心转诊的、年龄≥18 岁、主诉听力敏度且无或轻度听力损失的患者。这些患者在 2020 年 6 月至 2022 年 8 月间接受 CSET 治疗。该治疗每两周进行一次。当暴露水平达到 70-80dB SPL 最大值时，治疗结束。短期疗效基于可耐受的声音暴露水平（dB SPL）、听力敏度的主观障碍程度以及使用听力敏度问卷（HQ）评估的对声音的敏感性。长期疗效则基于治疗结束后 6 个月的 HQ 评分。采用线性混合效应和回归模型来研究随时间变化的结果。
共有 30 名患者，15 名男性，15 名女性，年龄 24-76 岁，纳入本研究。治疗期间，平均治疗次数为 6 次，范围为 4-8 次。结果显示，暴露水平升高（平均变化为+23.7dB，标准误为 7.9，<0.001），对日常声音的敏感性降低（平均 []变化为-1.6[2.1]，<0.001），HQ 降低（平均 []变化为-9.8[4.9]，<0.001），这些都是在治疗开始到结束时观察到的变化。治疗结束后和 6 个月时，HQ 没有显著变化，平均（）变化为 0.2（4.3），=0.81。
CSET 的评估结果表明，听力敏度患者的短期和长期声音敏感性均有所下降。此外，CSET 不仅对治疗过程中使用的声音产生积极影响，而且对日常声音也有转移获益的效果。这种结合心理教育、声音暴露和咨询的方法具有良好的应用前景，值得进一步研究。
