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This cross-sectional study investigated the mediating role of the emotional state \u201cstress level\u201d and of the two components of the emotional state \u201carousal\u201d and \u201cvalence\u201d with N\u2009=\u2009658 users of the \u201cTrackYourTinnitus\u201d 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.<\/jats:p>","DOI":"10.1038\/srep20382","type":"journal-article","created":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T10:28:35Z","timestamp":1454927315000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":112,"title":["Emotional states as mediators between tinnitus loudness and tinnitus distress in daily life: Results from the \u201cTrackYourTinnitus\u201d application"],"prefix":"10.1038","volume":"6","author":[{"given":"Thomas","family":"Probst","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00fcdiger","family":"Pryss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berthold","family":"Langguth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winfried","family":"Schlee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2016,2,8]]},"reference":[{"key":"BFsrep20382_CR1","doi-asserted-by":"crossref","unstructured":"M\u00f8ller, A. 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