title: Psychophysiological effects of biofeedback treatment in tinnitus sufferers.
abstract: OBJECTIVE
  Psychophysiological factors in maintaining tinnitus-related distress have been emphasized in current tinnitus models. Hyperreactivity in the autonomous nervous system is supposed to hinder habituation processes and might contribute to maladjustment to tinnitus symptoms in the long run. Accordingly, biofeedback treatment targeting physiological activity ought to reduce tinnitus annoyance and facilitate habituation.
  
  
  METHODS
  One hundred and thirty patients completed a manual-based psychological treatment especially developed for chronic tinnitus sufferers. A subsample consisting of 67 participants were randomly assigned to a waiting list (3 months) and served as a control group. The programme consisted of 15 sessions of cognitive-behavioural therapy combined with a psychophysiological treatment using a biofeedback approach.
  
  
  METHODS
  Different muscle regions of the head and neck and skin conductance level were assessed with biofeedback equipment. Physiological treatment effects were analysed using the pre-post effect sizes in comparison to the wait list group. Correlations for physiological changes and psychological treatment effects were computed.
  
  
  RESULTS
  Moderate to large effect sizes for physiological changes were demonstrated. Physiological and psychological treatment effects were found to be unrelated.
  
  
  CONCLUSIONS
  Our treatment approach, which combined biofeedback therapy with CBT elements, was found to be highly effective in reducing psychophysiological activation. Psychological and physiological variables seem to represent independent response systems.
authors.affiliation: Philipps-University of Marburg, Section Clinical Psychology and Psychotherapy, Germany. heineckk@staff.uni-marburg.de
authors.forename: Kristin
authors.initials: K
authors.lastname: Heinecke
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weise
authors.forename: Winfried
authors.initials: W
authors.lastname: Rief
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001143:Arousal / Q000502:physiology; D001342:Autonomic Nervous System Diseases / Q000503:physiopathology; D001676:Biofeedback, Psychology / Q000379:methods* / Q000502:physiology; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D005260:Female; D006185:Habituation, Psychophysiologic / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D014012:Tinnitus / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D014850:Waiting Lists