title: A confirmatory factor analytic validation of the Tinnitus Handicap Inventory.
abstract: OBJECTIVE
  Because the postulated three-factor structure of the internationally widely used Tinnitus Handicap Inventory (THI) has not been confirmed yet by a confirmatory factor analytic approach this was the central aim of the current study.
  
  
  METHODS
  From a clinical setting, N=373 patients with chronic tinnitus completed the THI and further questionnaires assessing tinnitus-related and psychological variables. In order to analyze the psychometric properties of the THI, confirmatory factor analysis (CFA) and correlational analyses were conducted.
  
  
  RESULTS
  CFA provided a statistically significant support for a better fit of the data to the hypothesized three-factor structure (RMSEA=.049, WRMR=1.062, CFI=.965, TLI=.961) than to a general factor model (RMSEA=.062, WRMR=1.258, CFI=.942, TLI=.937). The calculation of Cronbach's alpha as indicator of internal consistency revealed satisfactory values (.80-.91) with the exception of the catastrophic subscale (.65). High positive correlations of the THI and its subscales with other measures of tinnitus distress, anxiety, and depression, high negative correlations with tinnitus acceptance, moderate positive correlations with anxiety sensitivity, sleeping difficulties, tinnitus loudness, and small correlations with the Big Five personality dimensions confirmed construct validity.
  
  
  CONCLUSIONS
  Results show that the THI is a highly reliable and valid measure of tinnitus-related handicap. In contrast to results of previous exploratory analyses the current findings speak for a three-factor in contrast to a unifactorial structure. Future research is needed to replicate this result in different tinnitus populations.
authors.affiliation: Philipps-University Marburg, Department of Clinical Psychology and Psychotherapy, Germany. Electronic address: maria.kleinstaeuber@staff.uni-marburg.de.
authors.forename: Maria
authors.initials: M
authors.lastname: Kleinstäuber
authors.affiliation: Johannes Gutenberg-University Mainz, Department of Clinical Psychology and Psychotherapy, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Frank
authors.affiliation: Philipps-University Marburg, Department of Clinical Psychology and Psychotherapy, Germany; Linköping University, Department of Behavioural Sciences and Learning, Swedish Institute for Disability Research and Linnaeus Centre HEAD, Linköping, Sweden.
authors.forename: Cornelia
authors.initials: C
authors.lastname: Weise
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000209:etiology*; D003863:Depression / Q000209:etiology*; D005163:Factor Analysis, Statistical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010551:Personality; D010555:Personality Inventory; D011594:Psychometrics; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards*; D014012:Tinnitus / Q000523:psychology*
keywords: Confirmatory factor analysis; Self-report measure; Tinnitus; Tinnitus Handicap Inventory; Tinnitus distress; Validation