Assessing the Impact of Sound Sensitivity in Tinnitus

Abstract

Tinnitus and hyperacusis are related auditory disorders that frequently interact. However, little is known about the subjective impact of tinnitus that is exacerbated by sound exposure. Tinnitus is the perception of sound in the absence of auditory stimuli and is frequently associated with auditory system damage. Hyperacusis involves heightened sensitivity or intolerance to sound that can manifest as pain or physical discomfort and is not limited to specific sound qualities other than loudness level. Although tinnitus exacerbated by sound exposure poses increased challenges with treatment prognosis as well as mental health and quality of life factors, there are no objective measurements for assessing areas of impact unique to this specific tinnitus subtype. In the present study, a 20-item Sound-Sensitive Tinnitus Index (SSTI) was created and administered in an online survey. Results were analyzed with data from 277 participants in 32 countries. Analysis showed excellent internal consistency reliability (Cronbach’s alpha = .89), and convergent validity was demonstrated through statistically significant correlations with established measures of tinnitus, depression, anxiety, quality of life, and hyperacusis. Rotated factor analyses revealed four dimensions to the SSTI. Qualitative analysis of open-ended responses also provided insights into respondents’ subjective experience, and the operational definition of sound-sensitive tinnitus was proposed. High levels of mental health and quality of life impact reported by participants underscore the need to differentiate this subtype and to better understand clinical implications in providing care to this underserved population.