{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T23:15:34Z","timestamp":1787958934669,"version":"build-2784847793"},"reference-count":75,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T00:00:00Z","timestamp":1718668800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Psychiatry"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Gold-standard approaches for chronic tinnitus involve hearing amplification measures and psychological therapy, where applicable. Whilst schema therapy is accumulating evidence as a transdiagnostically useful treatment framework, its applicability for patients with chronic tinnitus has not yet been examined. The present study (a) explores latent dimensions of psychological distress in a sample of chronic tinnitus patients, and (b) examines whether the schema mode model might explain these dimensions \u2013 thus constituting a potentially helpful conceptualization and treatment framework.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p><jats:italic>N<\/jats:italic> = 696 patients with chronic tinnitus completed the Tinnitus Questionnaire, Tinnitus Handicap Inventory, Hospital Anxiety and Depression Scale, Perceived Stress Questionnaire and ICD-10 Symptom Rating. As criterion, patients further completed the Schema Mode Inventory (SMI-r) \u2013 which assesses psychological constructs linked to negative self-beliefs (\u201cparent modes\u201d), primary emotions resulting from unmet psychological needs (\u201cchild modes\u201d), and secondary emotional or behavioral attempts to reinstate or maintain psychological equilibrium (\u201ccoping modes\u201d). A <jats:italic>varimax<\/jats:italic>-rotated principal axis factor analysis grouped the primary item pool. Factor scale scores were then correlated with the SMI-r.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A three-factor solution explained 37.4% of variance and represented 78% of the included items. Following item content examination, the factors represented (1) General emotional distress, (2) Tinnitus-attributed emotional distress, and (3) Socio-audiological impairment. Factors 1|2 correlated highly (<jats:italic>r<\/jats:italic>\u00a0= 0.70), Factors 2|3 moderately (<jats:italic>r<\/jats:italic> = 0.62). Linked to the schema mode model, Factor 1 correlated highly with the \u201cvulnerable child\u201d (<jats:italic>r<\/jats:italic> = 0.78), and moderately with the \u201cparent\u201d, \u201cangry child\u201d, and \u201cdetached protector\u201d modes (0.53 &amp;lt; <jats:italic>r<\/jats:italic> &amp;lt; 0.65). Factor 2 correlated moderately with the \u201cvulnerable child\u201d (<jats:italic>r<\/jats:italic> = 0.53). Factor 3 was largely uncorrelated with SMI-r scores \u2013 although a low correlation with the \u201cdetached protector\u201d warrants further examination.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>\u201cGeneral\u201d and \u201ctinnitus-attributed\u201d emotional distress correlate highly \u2013 warranting holistic (not symptom-specific) psychological case conceptualization and treatment planning. Viewed from a schema mode perspective, the \u201cvulnerable child\u201d explains substantial variance across both dimensions. Consequently, autobiographically anchored, unmet emotional needs and emotional detachment constitute key treatment targets. Social-audiological impairment should be multimodally conceptualised and treated with hearing aids and psychological support measures, as applicable.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpsyt.2024.1375813","type":"journal-article","created":{"date-parts":[[2024,6,18]],"date-time":"2024-06-18T05:41:02Z","timestamp":1718689262000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["\u201cI feel [so alone] nothing\u201d \u2013 emotional vulnerability and detachment as transdiagnostic key characteristics of patients with chronic tinnitus: a schema mode model approach"],"prefix":"10.3389","volume":"15","author":[{"given":"Benjamin","family":"Boecking","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petra","family":"Brueggemann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Birgit","family":"Mazurek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,6,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/bs.pbr.2020.12.002","article-title":"Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal)","volume":"260","author":"De Ridder","year":"2021","journal-title":"Prog Brain Res"},{"key":"B2","doi-asserted-by":"publisher","first-page":"100250","DOI":"10.1016\/j.lanepe.2021.100250","article-title":"Tinnitus prevalence in Europe: A multi-country cross-sectional population study","volume":"12","author":"Biswas","year":"2022","journal-title":"Lancet Regional Health-Europe"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1007\/s10162-022-00874-y","article-title":"Low evidence for tinnitus risk factors: A systematic review and meta-analysis","volume":"24","author":"Biswas","year":"2023","journal-title":"J Assoc Res Otolaryngol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2017.00206","article-title":"Different teams, same conclusions? 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