title: Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the "TrackYourTinnitus" application.
abstract: The psychological process how tinnitus loudness leads to tinnitus distress remains unclear. This cross-sectional study investigated the mediating role of the emotional state "stress level" and of the two components of the emotional state "arousal" and "valence" with N = 658 users of the "TrackYourTinnitus" smartphone application. Stress mediated the relationship between tinnitus loudness and tinnitus distress in a simple mediation model and even in a multiple mediation model when arousal and valence were held constant. Arousal mediated the loudness-distress relationship when holding valence constant, but not anymore when controlling for valence as well as for stress. Valence functioned as a mediator when controlling for arousal and even when holding arousal and stress constant. The direct effect of tinnitus loudness on tinnitus distress remained significant in all models. This study demonstrates that emotional states affect the process how tinnitus loudness leads to tinnitus distress. We thereby could show that the mediating influence of emotional valence is at least equally strong as the influence of stress. Implications of the findings for future research, assessment, and clinical management of tinnitus are discussed.
authors: Department of Psychology, University of Regensburg, Germany.|Department of Psychology and Psychotherapy, University of Witten/Herdecke, Germany.
authors: Thomas
authors: T
authors: Probst
authors: Institute of Databases and Information System, Ulm University, Germany.
authors: Rüdiger
authors: R
authors: Pryss
authors: Department of Psychiatry and Psychotherapy, University of Regensburg, Germany.
authors: Berthold
authors: B
authors: Langguth
authors: Department of Psychiatry and Psychotherapy, University of Regensburg, Germany.
authors: Winfried
authors: W
authors: Schlee
mesh_terms: D000328:Adult; D001143:Arousal / Q000502:physiology; D001307:Auditory Perception / Q000502:physiology; D003430:Cross-Sectional Studies; D004644:Emotions / Q000502:physiology*; D005260:Female; D006801:Humans; D008144:Loudness Perception / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D063731:Mobile Applications; D014012:Tinnitus / Q000523:psychology*