title: Social and emotional characteristics of adults seeking a cochlear implant and their spouses.
abstract: OBJECTIVE
  Because past research has shown that benefits of cochlear implantation may include a significant decrease in psychological and emotional difficulties, this study examined whether persons seeking cochlear implants in recent years differed psychologically from those referred in the early 1980s. A second objective was to explore mechanisms by which profound deafness could contribute to psychological and emotional difficulties for implant candidates and their spouses.
  
  
  METHODS
  178 cochlear implant candidates referred from 1981 to 1998 at the University of Iowa Hospitals completed a standard battery of psychological tests and questionnaires. The sample was divided into six 3-year cohorts and compared on standardized measures of psychological and emotional adjustment, and in participation in social and non-social activities. Spouses of implant candidates completed a similar assessment.
  
  
  RESULTS
  The sample was characterized by elevations in depression, social introversion, suspiciousness, and social anxiety and loneliness. There were no significant differences among cohorts across time except for an increase in expectations for implant success. Spouses also evidenced elevated levels of psychological distress. Hearing status was associated with significant differences in social activity participation. A paradoxical interaction was found between marital status and deafness.
  
  
  CONCLUSIONS
  There was no evidence that the psychological status of implant candidates is changing across time, suggesting continued psychological benefit for persons receiving cochlear implants. Both candidates and their spouses participated in fewer social activities than normal controls. Findings underscore the complex relation between marital status, deafness, and engagement and participation in positive activities.
authors.affiliation: Department of Psychology, The University of Iowa, Iowa City 52242, USA. john-knutson@uiowa.edu
authors.forename: John F
authors.initials: JF
authors.lastname: Knutson
authors.forename: Abigail
authors.initials: A
authors.lastname: Johnson
authors.forename: Kathleen T
authors.initials: KT
authors.lastname: Murray
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D019929:Cochlear Implantation / Q000523:psychology* / Q000706:statistics & numerical data; D003638:Deafness / Q000523:psychology* / Q000601:surgery; D003863:Depression / Q000209:etiology; D005260:Female; D006312:Hearing Loss, Bilateral / Q000523:psychology* / Q000601:surgery; D006801:Humans; D007439:Introversion, Psychological; D007484:Iowa; D008297:Male; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D012922:Social Change; D012934:Social Isolation / Q000523:psychology*; D018454:Spouses / Q000523:psychology*; D013995:Time; D035502:Trust