From the Journal of Psychotherapy and Psychosomatics press release via AlphaGalileo:
Emotional Exhaustion (EE), the experience of feeling drained of energy due to prolonged stress, has been associated with the onset of a number of medical disorders.
The aim of this investigation, published in one of the last issues of Psychotherapy and Psychosomatics, was to assess possible associations between hearing status (hearing loss and noise exposure) and health (sleep quality, life satisfaction, depression and coping) in relation to tinnitus.
Investigators used uncomfortable loudness levels (ULL) as an objective measure of hyperacusis, which is a reduced sound tolerance and found in about 80% of individuals with tinnitus.
Emotional exhaustion (EE), was included, for the first time, as a predictor for tinnitus. The study is cross-sectional and includes subjective and objective measures of hearing, as well as subjective ratings of EE. The sample of the present study was based on two types of inclusion criteria: (1) degree of EE and (2) living in the greater Stockholm area.
Questionnaires were used to assess the participants’ general demographics, mental health (e.g., depressive symptoms, EE), hearing status (e.g., tinnitus, hearing loss), life satisfaction, sleep quality and coping. Any tinnitus was defined as a ‘yes’ response (sometimes, often or always) to the question ‘Have you recently experienced a sound in one or both ears that was not from an external source (called tinnitus) which lasted for more than five minutes?’
Severity of tinnitus was the mean total score on the Tinnitus Handicap Questionnaire (THQ) comprising 26 questions. EE was assessed with the exhaustion subscale of the Oldenburg Burnout Inventory. Coping was assessed using a modified version of Carver’s brief COPE inventory.
The overall prevalence of any tinnitus was 31% in our 348 participants, of whom 11% reported severe tinnitus. The aim of the present study was to assess possible associations between hearing status and health-related variables, ULL and EE in relation to tinnitus. The most important finding was that EE (both sexes) and coping (only in men) strongly increased the odds of tinnitus prevalence and severity.
The coping finding can have a biological basis, but could also be the result of learned social and behavioral patterns. It is important to highlight the fact that these odds are higher than traditionally related factors such as hearing loss, work-related noise, hypertension and smoking. Hypertension and smoking status were not significantly related to tinnitus prevalence (data not shown), perhaps due to the low prevalence of smokers (10%) and medically defined hypertension (22%) in this study.
Individuals with tinnitus had significantly lower ULL thresholds (i.e. hyperacusis) in the left and right ears compared to those without tinnitus. For the first time, with this study EE is found to be the strongest predictor of tinnitus prevalence and severity in both women and men. The relationship between tinnitus severity and EE was highly significant even when controlling for hearing loss.
In contrast, when controlling for EE, hearing loss was not significantly correlated with tinnitus severity. This has clinical implications since the findings suggest the importance of screening for stress-related disorders in tinnitus patients.