The International Tinnitus Journal


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The International Tinnitus Journal

Official Journal of the Neurootological and Equilibriometric Society
Official Journal of the Brazil Federal District Otorhinolaryngologist Society

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ISSN: 0946-5448


A Cognitive Model of Tinnitus and Hyperacusis; A Clinical Tool for Patient Information, Appeasement and Assessment

Author(s): Olav Wagenaar, Marjan Wieringa, Hans Verschuure

Tinnitus and hyperacusis are both aggravating audiological symptoms. Their underlying mechanisms are not fully understood, but the pathophysiology involves a central mechanism rather than a peripheral one. There is no curative treatment. A review of the available research on tinnitus and auditory processing was conducted to connect insights gained from different approaches to the subject; this resulted in the development of a holistic view of both conditions. In this view, the chronic course of the symptoms is pathological and attributed to a stress-related lack of habituation. This article adds to the literature on tinnitus and hyperacusis by presenting a schematic model of the cognitive mechanisms which can be used clinically in patient information sessions which are geared towards provide reassurance and encouraging the development of coping skills. In cooperation with the patient, the model can also help in the identification of underlying pathology. Future aims of study are suggested, elaborating on the role of tinnitus and hyperacusis in normal auditory processing and on the value of insight. Finally, parallels are drawn between tinnitus and positive symptom syndromes in neuropsychiatry and some of its modern visions on their treatment.