Details

Autor(en) / Beteiligte

• Drey, Heather A

Titel

Acceptance and Cognitive Defusion Behaviors in a Brief Acceptance-Based Treatment of Chronic Subjective Moderate Tinnitus in Iraq and Afghanistan Combat Veterans

Ort / Verlag

ProQuest Dissertations & Theses

Erscheinungsjahr

2017

Quelle

ProQuest Dissertations & Theses A&I

Beschreibungen/Notizen

• Acceptance and commitment therapeutic (ACT)-based treatment for tinnitus distress has been demonstrated as efficacious in the treatment outcome literature. Yet, little is known about the effectiveness of brief ACT-based treatments for tinnitus distress for veterans of the Iraq and Afghanistan conflicts for whom tinnitus is a top-service connected disability. The present study examined the effectiveness of a four-session ACT-based protocol for male combat veterans with chronic, moderate, subjective tinnitus, post-traumatic stress disorder, and/or mild traumatic brain injury. Seven veterans participated in a 60-minute, four-session ACT-based individual treatment intervention for tinnitus distress. Participants rated their tinnitus distress and ACT skills taught in session for 28 days following treatment. Daily tinnitus distress and ACT skills ratings were examined via regression analyses at the group-aggregate and individual levels of analysis. Pre- post-treatment ratings of mood, quality of life, heart-rate variability, cognitive defusion, tinnitus acceptance, functioning; and tinnitus distress and severity were analyzed using t-tests at the group-aggregate level of analysis. We predicted all participants would have clinically and statistically significant reductions in tinnitus distress related to use of ACT skills taught on the same-day, and ACT skills would predict next-day tinnitus distress ratings. Temporal fluctuations of tinnitus distress were measured with the Daily Global Measure of Tinnitus-Related Distress Scale. ACT skills were measured with the Daily Psychological Flexibility Scale. Pre- post-treatment ratings were measured using the Tinnitus Functional Index, The State-Trait Anxiety Inventory, Believability of Anxious Feelings and Thoughts Questionnaire, The World Health Organization Quality of Life-BREF, Tinnitus Acceptance Questionnaire (TAQ); and J&J Engineering Biofeedback Equipment. We also predicted a significant change from pre- to post-treatment on all measures for each participant. Results supported the idea that ACT skills were associated with same-day but not next-day tinnitus distress ratings. Support was provided for significant pre- to post-treatment changes in mood, cognitive defusion, and heart-rate variability for most participants. However, no improvement in quality of life or tinnitus acceptance was shown. Cognitive defusion, acceptance, and valued action (i.e., psychological flexibility) are identified as key skills in ACT-based treatments for tinnitus distress in this population of veterans.