title: Catastrophizing and fear of tinnitus predict quality of life in patients with chronic tinnitus.
abstract: OBJECTIVE
  It is well established that catastrophic misinterpretations and fear are involved in the suffering and disability of patients with chronic pain. This study investigated whether similar processes explain suffering and disability in patients with chronic tinnitus. We hypothesized that patients who catastrophically (mis)interpret their tinnitus would be more fearful of tinnitus, more vigilant toward their tinnitus, and report less quality of life. Moreover, tinnitus-related fear was expected to act as a mediator in reduced quality of life.
  
  
  METHODS
  Sixty-one tinnitus patients from an outpatient ENT department of the University Hospital of Antwerp (Belgium) completed a number of questionnaires about their tinnitus. Hierarchical regression analyses were performed to test hypothesized associations and to assess mediation by tinnitus-related fear.
  
  
  RESULTS
  Analyses revealed significant associations between catastrophizing and fear and between catastrophizing and increased attention toward the tinnitus. Furthermore, both tinnitus-related catastrophizing and fear were negatively associated with quality of life; moreover, tinnitus-related fear fully mediated the association between catastrophizing about the tinnitus and quality of life.
  
  
  CONCLUSIONS
  The findings confirm earlier suggestions that tinnitus-related concerns and fears are associated with impaired quality of life, which is in line with a cognitive behavioral account of chronic tinnitus. Future research avenues and clinical applications are discussed.
authors.affiliation: Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands. r.cima@maastrichtuniversity.nl
authors.forename: Rilana F F
authors.initials: RF
authors.lastname: Cima
authors.forename: Geert
authors.initials: G
authors.lastname: Crombez
authors.forename: Johan W S
authors.initials: JW
authors.lastname: Vlaeyen
mesh_terms: D000328:Adult; D000368:Aged; D058443:Catastrophization / Q000523:psychology*; D002908:Chronic Disease; D004185:Disability Evaluation; D005239:Fear / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D011237:Predictive Value of Tests; D011788:Quality of Life; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D014012:Tinnitus / Q000523:psychology*