Mindfulness Based Tinnitus Reduction (MBTR): A Symptom Perception Shift Program
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Purpose
This study is a randomized, controlled trial of Mindfulness Based Tinnitus Reduction (MBTR) vs. Treatment As Usual (TAU). This study aims to determine patient's benefit from participating in an 8-week MBTR program as measured by a reduction in clinical symptoms, if present, and a tinnitus symptom perception shift. Sixty-four tinnitus patients who have previously received Tinnitus Counseling (TAU) at the UCSF Audiology Clinic under the direction of Robert Sweetow, PhD will be invited to participate in the MBTR study. Subjects will be randomly assigned to the experimental and control groups of 32 each. All subjects will have received Tinnitus Counseling at least 6-months prior to entry into the study. Tinnitus symptom activity and discomfort as well as psychological outcomes will be assessed by self-report questionnaires. The primary outcome measure is the Tinnitus Handicap Inventory (THI) measuring tinnitus symptom severity. The secondary outcome measures include the Tinnitus Visual Analogue Scale (TVAS), the Symptom Checklist-90-Revised (SCL-90-R), Hamilton Anxiety and Depression Scale (HADS), and the Five Factor Mindfulness Questionnaire (FFMQ). In addition to tinnitus symptom severity, secondary outcome measures are used to measure change in mindfulness and other clinical symptoms such as anxiety and depression, if they exist. The experimental group will complete measures at pre-, post-, at 3-months and 12-months follow-up. A 12-month follow-up assessment will be conducted with the experimental group to identify any enduring effects of the treatment. The control group will fill out measures at pre-, post-, and 3-month time periods. The 12-month follow-up will be conducted with the experimental group only and will be the uncontrolled portion of the study.
The purpose of this study is to 1) Design and execute an MBTR program for patients with tinnitus within the UCSF Department of Audiology. 2) Determine patient's benefit from participating in an 8-week MBTR program as measured by a decrease in tinnitus distress, and a reduction in clinical symptoms (i.e., depression, anxiety), if present. 3) Compare the responses on study measures to those of the control group. 4) Collect follow-up data at 6- and 12-months post intervention to assess enduring effects, if any, in the experimental group. 5) Use the data and patient feedback to modify UCSF's Audiology program and guide future programming in regards to the treatment and care of patients with tinnitus.
| Condition | Intervention | Phase |
|---|---|---|
|
Tinnitus Anxiety Depression |
Behavioral: Mindfulness Based Tinnitus Reduction |
Phase 2 |
| Study Type: | Interventional |
| Study Design: | Allocation: Randomized Endpoint Classification: Efficacy Study Intervention Model: Parallel Assignment Masking: Open Label Primary Purpose: Treatment |
| Official Title: | Phase 2 Mindfulness Based Tinnitus Reduction (MBTR) Study: A Symptom Perception Shift Program |
- Tinnitus Handicap Inventory (THI) [ Time Frame: One Year ] [ Designated as safety issue: No ]The THI is a self-report measure that can be used in a busy clinical practice to quantify the impact of tinnitus on daily living. The measure is brief, easy to administer and interpret, broad in scope, and psychometrically robust. Convergent validity was assessed using another measure of perceived tinnitus handicap (Tinnitus Handicap Questionnaire). Construct validity was assessed using the Beck Depression Inventory, Modified Somatic Perception Questionnaire, symptom rating scales (annoyance, sleep disruption, depression, and concentration), and perceived tinnitus pitch and loudness judgments.
- Symptom Checklist-90- Revised [ Time Frame: Two Years ] [ Designated as safety issue: No ]
- Five-Factor Mindfulness Questionnaire (FFMQ) [ Time Frame: One Year ] [ Designated as safety issue: No ]
- Hamilton Anxiety & Depression Scale (HADS) [ Time Frame: One Year ] [ Designated as safety issue: No ]
- Tinnitus Visual Analogue Scale (VAS) [ Time Frame: one-year ] [ Designated as safety issue: No ]Tinnitus Visual Analogue Scale (VAS) is a collection of straight lines 100mm in length anchored at the end with extremes (e.g., no tinnitus distress, extreme tinnitus distress) of the tinnitus sensation, feeling or response. This means of measuring distress has been suggested for use in research (Axelsson, Coles, Erlandsson, Meikle, & Vernon, 1993).
| Estimated Enrollment: | 64 |
| Study Start Date: | January 2011 |
| Estimated Study Completion Date: | January 2015 |
| Estimated Primary Completion Date: | May 2014 (Final data collection date for primary outcome measure) |
| Arms | Assigned Interventions |
|---|---|
| Experimental: Mindfulness Based Tinnitus Reduction |
Behavioral: Mindfulness Based Tinnitus Reduction
The Mindfulness Based Tinnitus Reduction (MBTR) program will be held for two-and-a-half hours one evening per week over 8 consecutive weeks. Participants will also complete a day-long Sunday retreat between the 6th and 7th sessions. Each participant will take part in a 30-minute private interview with the course instructor prior to beginning the program.
Other Name: MBTR
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No Intervention: Tinnitus Counseling Only Control
Control group subjects will have had treatment as usual (TAU) care from the UCSF Audiology Clinic which includes Tinnitus Counseling (TC) at least three-months prior to enty into the study.
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Show Detailed Description Eligibility| Ages Eligible for Study: | 18 Years and older |
| Genders Eligible for Study: | Both |
| Accepts Healthy Volunteers: | No |
Inclusion Criteria:
- Age > 18
- English speaking
- Duration of subjective chronic tinnitus > 6 months
- Moderate to strong tinnitus annoyance (Minimum THI score of > 28 )
Exclusion Criteria:
- Age < 18
- Non-English speaking
- > Moderate Hearing Loss
- Duration of chronic subjective tinnitus < 6 months
- Treatable tinnitus
- Severe depression and/or anxiety
- Recent (within 3-month) history of alcohol or drug abuse or dependence other than tobacco or caffeine
- No recent (within 3 months) start of new tinnitus treatment
- THI score < 28
- No previous psychological treatment for their tinnitus.
- History of traumatic brain injury (TBI) with loss of consciousness (LOC)
- History of psychotic disorders or dementia
- Currently undergoing litigation or legal matters related to auditory disorders
Contacts and Locations| United States, California | |
| UCSF Audiology Clinic | |
| San Francisco, California, United States, 94115 | |
| UCSF | |
| San Francisco, California, United States, 94115 | |
| Study Director: | Jennifer Gans, PsyD | Clinical Psychologist |
More Information
Publications:
| Responsible Party: | University of California, San Francisco |
| ClinicalTrials.gov Identifier: | NCT01229709 History of Changes |
| Other Study ID Numbers: | H8935-35834-01 |
| Study First Received: | October 26, 2010 |
| Last Updated: | May 15, 2013 |
| Health Authority: | United States: Institutional Review Board |
Keywords provided by University of California, San Francisco:
|
Tinnitus Mindfulness MBSR Mindfulness Based Stress Reduction MBTR |
Additional relevant MeSH terms:
|
Anxiety Disorders Depression Depressive Disorder Tinnitus Mental Disorders Behavioral Symptoms Mood Disorders |
Hearing Disorders Ear Diseases Otorhinolaryngologic Diseases Sensation Disorders Neurologic Manifestations Nervous System Diseases Signs and Symptoms |
ClinicalTrials.gov processed this record on June 18, 2013