Duckro P N, Pollard C A, Bray H D, Scheiter L
Biofeedback Self Regul. 1984 Dec;9(4):459-69. doi: 10.1007/BF01000563.
This paper describes a comprehensive program for behavioral management of complex tinnitus. The clinical characteristics and typical treatment of tinnitus are reviewed. Psychosocial sequelae are discussed in terms of their exacerbation of the symptom and their potential as foci of treatment. The management problems of tinnitus are considered analogous to those of chronic pain. A case illustration is provided with a description of the treatment process. The comprehensive behavioral program discussed in the present paper included biofeedback therapy, pain management training, social skills training, assertion training, in vivo exposure to being alone, cognitive treatment of depression, and marital therapy. Outcomes were monitored multidimensionally. Self-report of tinnitus severity decreased after the 6th treatment day and stabilized at a "mild" rating after the 9th day. Skin temperature readings at baseline increased and stabilized after the 8th day, and the patient was able to reliably increase skin temperature on request. Scores on the Beck Depression Inventory and the Willoughby Personality Schedule, and a self-rating of Fear of Being Alone dropped markedly by the end of treatment. Follow-up data at 3 months indicated maintenance of gains.
本文描述了一个针对复杂性耳鸣的行为管理综合方案。回顾了耳鸣的临床特征及典型治疗方法。从其对症状的加重作用以及作为治疗重点的可能性方面讨论了心理社会后遗症。耳鸣的管理问题被认为与慢性疼痛的管理问题类似。提供了一个病例说明及治疗过程描述。本文所讨论的综合行为方案包括生物反馈疗法、疼痛管理训练、社交技能训练、自信训练、实际体验独处、抑郁症的认知治疗以及婚姻治疗。从多个维度对结果进行了监测。耳鸣严重程度的自我报告在第6个治疗日之后下降，并在第9天之后稳定在“轻度”等级。基线时的皮肤温度读数在第8天之后上升并稳定下来，并且患者能够根据要求可靠地提高皮肤温度。在治疗结束时，贝克抑郁量表和威洛比人格量表的得分以及对独处恐惧的自我评分显著下降。3个月时的随访数据表明所取得的进展得以维持。
