Personality Traits, Perceived Stress, and Tinnitus-Related Distress in Patients With Chronic Tinnitus: Support for a Vulnerability-Stress Model

Abstract

Background: Despite vulnerability-stress models underlying a variety of distress-related emotional syndromes, few studies have investigated interactions between personality factors and subjectively experienced stressors in accounting for tinnitus-related distress.

Aim: The present study compared personality characteristics between patients with chronic tinnitus and the general population. Within the patient sample, it was further examined whether personality dimensions predicted tinnitus-related distress and, if so, whether differential aspects or levels of perceived stress mediated these effects.

Method: Applying a cross-sectional design, 100 patients with chronic tinnitus completed the Freiburger Persönlichkeitsinventar (FPI-R) measuring personality, the Perceived Stress Questionnaire (PSQ-20) measuring perceived stress and the German version of the Tinnitus Questionnaire (TQ) measuring tinnitus-related distress. FPI-R scores were compared with normed values obtained from a representative German reference population. Mediation analyses were computed specifying FPI-R scores as independent, PSQ20 scores as mediating and the TQ-total score as dependent variables.

Results: Patients with chronic tinnitus significantly differed from the general population across a variety of personality indices. Tinnitus-related distress was mediated by differential interactions between personality factors and perceived stress dimensions.

Conclusion: In conceptualizing tinnitus-related distress, idiosyncratic assessments of vulnerability-stress interactions are crucial for devising effective psychological treatment strategies. Patients' somatic complaints and worries appear to be partly informed by opposing tendencies reflecting emotional excitability vs. aggressive inhibition - suggesting emotion-focused treatment strategies as a promising new direction for alleviating distress.

Keywords: FPI; Tinnitus Questionnaire (TQ); perceived stress; personality; tinnitus; vulnerability-stress.

FIGURE 1

FPI-R values for patients with chronic tinnitus and the general population. Compared to the general population, bold labels indicate significantly higher; italicized labels significantly lower scores for patients with chronic tinnitus.

FIGURE 2

Indirect effects of the mediation analyses. The PSQ20 subscale “joy” was inverted for reasons of consistent presentation (i.e., higher scores indicating higher perceived stress). Arrows indicate significant indirect effects (p < 0.05). All path coefficients are positive. Compared to the general population, bold labels indicate significantly higher; italicized labels significantly lower scores for patients with chronic tinnitus. ^∗Complete mediation (total effect reduced to non-significance upon inclusion of ab); ^† partial mediation (total effect not reduced to non-significance upon inclusion of ab).