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      Two birds with one stone.–Addressing depressive symptoms, emotional tension and worry improves tinnitus-related distress and affective pain perceptions in patients with chronic tinnitus

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          Abstract

          Background

          Psychological factors link the co-occurrence of tinnitus-related distress and pain perceptions in patients with chronic tinnitus.

          Objective

          This study examines, if treatment-related changes in these factors ameliorate both tinnitus-related distress and pain perceptions in a sample of patients with chronic tinnitus.

          Methods

          N = 1238 patients with chronic tinnitus provided pre- and post-treatment ratings of tinnitus-related distress and affective or sensory pain perceptions alongside measures of depressive symptoms and perceived stress. Treatment comprised an intensive tinnitus-specific multimodal treatment program. Using serial indirect-effects analyses, we examined association patterns between baseline values and change rates of those variables that were found to respond to treatment.

          Results

          Small effect sizes emerged for changes in tinnitus-related distress, affective (but not sensory) pain perceptions, depressive symptoms, emotional tension and worry. At pre- or post-treatment respectively, baseline values and change rates intercorrelated. Across timepoints, (1) baseline tinnitus-related distress and affective pain perceptions were positively associated with improvements in tinnitus-related distress, affective pain perceptions and depressive symptoms. (2) Baseline depressive symptoms or emotional tension mediated positive associations between baseline tinnitus-related distress and improvement in affective pain perceptions. (3) Change in depressive symptoms mediated the effect of baseline tinnitus-related distress on change in affective pain perceptions–partly through associated change in emotional tension or worry. Mood-independent aspects of emotional tension were negatively associated with improvement in affective pain perceptions.

          Conclusions

          Depressive symptoms, emotional tension and worry emerge as key predictors of treatment response and transdiagnostic treatment targets for alleviating tinnitus-related distress and functionally associated affective pain perceptions.

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          Most cited references106

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          The CES-D Scale: A Self-Report Depression Scale for Research in the General Population

          L Radloff (1977)
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            Calculating and reporting effect sizes to facilitate cumulative science: a practical primer for t-tests and ANOVAs

            Effect sizes are the most important outcome of empirical studies. Most articles on effect sizes highlight their importance to communicate the practical significance of results. For scientists themselves, effect sizes are most useful because they facilitate cumulative science. Effect sizes can be used to determine the sample size for follow-up studies, or examining effects across studies. This article aims to provide a practical primer on how to calculate and report effect sizes for t-tests and ANOVA's such that effect sizes can be used in a-priori power analyses and meta-analyses. Whereas many articles about effect sizes focus on between-subjects designs and address within-subjects designs only briefly, I provide a detailed overview of the similarities and differences between within- and between-subjects designs. I suggest that some research questions in experimental psychology examine inherently intra-individual effects, which makes effect sizes that incorporate the correlation between measures the best summary of the results. Finally, a supplementary spreadsheet is provided to make it as easy as possible for researchers to incorporate effect size calculations into their workflow.
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              Evaluating Effect Size in Psychological Research: Sense and Nonsense

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                Author and article information

                Contributors
                Role: ConceptualizationRole: Data curationRole: Formal analysisRole: MethodologyRole: VisualizationRole: Writing – original draftRole: Writing – review & editing
                Role: Data curationRole: Supervision
                Role: Data curation
                Role: Funding acquisitionRole: ResourcesRole: Supervision
                Role: Editor
                Journal
                PLoS One
                PLoS One
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                11 March 2021
                2021
                : 16
                : 3
                : e0246747
                Affiliations
                [1 ] Charité–Universitaetsmedizin Berlin—Tinnitus Center, Berlin, Germany
                [2 ] Division of Psychosomatic Medicine, Medical Department, Charité–Universitaetsmedizin Berlin, Berlin, Germany
                Universiteit Antwerpen, BELGIUM
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                https://orcid.org/0000-0002-8140-3332
                Article
                PONE-D-20-25017
                10.1371/journal.pone.0246747
                7951911
                33705407
                63b82481-69d5-48de-bf62-e8201f6e0b78
                © 2021 Boecking et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 10 August 2020
                : 26 January 2021
                Page count
                Figures: 6, Tables: 2, Pages: 18
                Funding
                Funded by: German Research Foundation (DFG)
                Funded by: Open Access Publication Fund of Charité – Universitätsmedizin Berlin
                We acknowledge support from the German Research Foundation (DFG) and the Open Access Publication Fund of Charité – Universitätsmedizin Berlin. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Medicine and Health Sciences
                Clinical Medicine
                Signs and Symptoms
                Pain
                Medicine and Health Sciences
                Mental Health and Psychiatry
                Mood Disorders
                Depression
                Biology and Life Sciences
                Psychology
                Psychological Attitudes
                Social Sciences
                Psychology
                Psychological Attitudes
                Biology and Life Sciences
                Psychology
                Emotions
                Social Sciences
                Psychology
                Emotions
                Biology and Life Sciences
                Neuroscience
                Cognitive Science
                Cognitive Psychology
                Clinical Psychology
                Biology and Life Sciences
                Psychology
                Cognitive Psychology
                Clinical Psychology
                Social Sciences
                Psychology
                Cognitive Psychology
                Clinical Psychology
                Medicine and Health Sciences
                Pain Management
                Pain Psychology
                Biology and Life Sciences
                Psychology
                Pain Psychology
                Social Sciences
                Psychology
                Pain Psychology
                Biology and Life Sciences
                Psychology
                Emotions
                Anxiety
                Social Sciences
                Psychology
                Emotions
                Anxiety
                Medicine and Health Sciences
                Otorhinolaryngology
                Otology
                Hearing Disorders
                Tinnitus
                Medicine and Health Sciences
                Neurology
                Tinnitus
                Custom metadata
                As per Charité Universitaetsmedizin Berlin’s ethics committee, unfortunately, we cannot make the data public without restrictions because we did not obtain patients' consent to do so at the time. Nevertheless, interested researchers can contact the directorate of the Tinnitus Center Charité Universitaetsmedizin Berlin with data access requests ( birgit.mazurek@ 123456charite.de ).

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                Uncategorized

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