title: Acceptance of Tinnitus As an Independent Correlate of Tinnitus Severity.
abstract: OBJECTIVE
  Tinnitus is the experience of sounds without an identified external source, and for some the experience is associated with significant severity (i.e., perceived negative affect, activity limitation, and participation restriction due to tinnitus). Acceptance of tinnitus has recently been proposed to play an important role in explaining heterogeneity in tinnitus severity. The purpose of the present study was to extend previous investigations of acceptance in relation to tinnitus by examining the unique contribution of acceptance in accounting for tinnitus severity, beyond anxiety and depression symptoms.
  
  
  METHODS
  In a cross-sectional study, 362 participants with tinnitus attending an ENT clinic in Sweden completed a standard set of psychometrically examined measures of acceptance of tinnitus, tinnitus severity, and anxiety and depression symptoms. Participants also completed a background form on which they provided information about the experience of tinnitus (loudness, localization, sound characteristics), other auditory-related problems (hearing problems and sound sensitivity), and personal characteristics.
  
  
  RESULTS
  Correlational analyses showed that acceptance was strongly and inversely related to tinnitus severity and anxiety and depression symptoms. Multivariate regression analysis, in which relevant patient characteristics were controlled, revealed that acceptance accounted for unique variance beyond anxiety and depression symptoms. Acceptance accounted for more of the variance than anxiety and depression symptoms combined. In addition, mediation analysis revealed that acceptance of tinnitus mediated the direct association between self-rated loudness and tinnitus severity, even after anxiety and depression symptoms were taken into account.
  
  
  CONCLUSIONS
  Findings add to the growing body of work, supporting the unique and important role of acceptance in tinnitus severity. The utility of the concept is discussed in relation to the development of new psychological models and interventions for tinnitus severity.
authors: 1Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden; and 2Department of Clinical Neuroscience, Psychiatry Section, Karolinska Institutet, Stockholm, Sweden.
authors: Hugo
authors: H
authors: Hesser
authors: Ellinor
authors: E
authors: Bånkestad
authors: Gerhard
authors: G
authors: Andersson
mesh_terms: D000368:Aged; D001007:Anxiety / Q000523:psychology*; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D015999:Multivariate Analysis; D012044:Regression Analysis; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013548:Sweden; D014012:Tinnitus / Q000503:physiopathology / Q000523:psychology*