{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:35:11Z","timestamp":1791473711277,"version":"4.3.4"},"reference-count":26,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute on Deafness and Communication Disorders (NIDCD) of the National Institute of Health (NIH)","award":["R21DC017214"],"award-info":[{"award-number":["R21DC017214"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinics and Practice"],"abstract":"<jats:p>Background: To examine the changes in perceived tinnitus sound qualities following internet-based cognitive behavioral therapy (ICBT) for tinnitus. Method: This study was embedded within several clinical trials evaluating the efficacy of ICBT and used a quasi-experimental design (N = 152). Participants completed a series of online questionnaires, including measures of tinnitus sound qualities (Tinnitus Qualities and Impact Questionnaire; TQIQ), tinnitus severity (Tinnitus Functional Index; TFI), anxiety (Generalized Anxiety Disorder-7; GAD-7), depression (Patient Health Questionnaire-9; PHQ-9), insomnia (Insomnia Severity Index; ISI), and health-related quality of life (EQ-5D-5L Visual Analog Scale; VAS). Data were analyzed using a range of parametric and non-parametric statistics, and Cohen\u2019s d effect sizes were reported. Results: There were no significant differences between the intervention and control groups in sociodemographic and clinical variables at baseline except for anxiety and depression symptoms, which were higher in the intervention group. A statistically significant reduction in tinnitus severity, anxiety, depression, and insomnia was noted post-intervention, with small-to-moderate effect sizes. Statistically significant improvements were also noted for the TQIQ (overall and all subscales) following ICBT compared to the no-intervention group (p \u2264 0.028), all with small-to-large effect sizes, except for the loud sounds subscale and for participants with a TQIQ &lt; 38 at baseline, or \u201cmild\u201d perceived qualities of tinnitus (p \u2265 0.136). A significantly greater proportion of participants in the intervention group had minimum clinically important differences (38%) on the TQIQ compared to the no-intervention group (9%). Conclusions: ICBT can lead to changes in the perceived qualities of tinnitus sound in addition to reducing tinnitus severity and other aspects, such as anxiety, depression, and insomnia. While these findings are preliminary, they highlight that tinnitus distress and perception may be related. However, the study has several limitations including a lack of audiological variables and objective measures. For this reason, the study results must be viewed with caution and must be treated as preliminary.<\/jats:p>","DOI":"10.3390\/clinpract15040069","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T06:45:51Z","timestamp":1743144351000},"page":"69","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Changes in Perceived Tinnitus Sound Qualities Following Internet-Based Cognitive Behavioral Therapy for Tinnitus"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1254-8407","authenticated-orcid":false,"given":"Vinaya","family":"Manchaiah","sequence":"first","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA"},{"name":"UCHealth Hearing and Balance, University of Colorado Hospital, Aurora, CO 80045, USA"},{"name":"Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA"},{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa"},{"name":"Department of Speech and Hearing, School of Allied Health Sciences, Manipal University, Manipal 576104, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4753-6745","authenticated-orcid":false,"given":"Gerhard","family":"Andersson","sequence":"additional","affiliation":[{"name":"Department of Behavioral Sciences and Learning, Department of Biomedical and Clinical Sciences, Link\u00f6ping University, 58225 Link\u00f6ping, Sweden"},{"name":"Department of Clinical Neuroscience, Karolinska Institute, 17176 Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9434-9160","authenticated-orcid":false,"given":"Eldr\u00e9 W.","family":"Beukes","sequence":"additional","affiliation":[{"name":"Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA"},{"name":"Vision and Hearing Sciences Research Group, School of Psychology and Sports Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2189-4843","authenticated-orcid":false,"given":"Marc A.","family":"Fagelson","sequence":"additional","affiliation":[{"name":"Department of Audiology and Speech-Language Pathology, East Tennessee State University, Johnson City, TN 37614, USA"},{"name":"Audiologic Rehabilitation Laboratory, Auditory Vestibular Research Enhancement Award Program, Veterans Affairs Medical Center, Mountain Home, TN 37684, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8313-1636","authenticated-orcid":false,"given":"De Wet","family":"Swanepoel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine, Aurora, CO 80045, USA"},{"name":"Virtual Hearing Lab, Collaborative Initiative Between University of Colorado School of Medicine and University of Pretoria, Aurora, CO 80045, USA"},{"name":"Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria 0028, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8416-519X","authenticated-orcid":false,"given":"David","family":"Maidment","sequence":"additional","affiliation":[{"name":"School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough LE11 3TU, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1600","DOI":"10.1016\/S0140-6736(13)60142-7","article-title":"Tinnitus","volume":"382","author":"Baguley","year":"2013","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Cederroth, C.R., Gallus, S., Hall, D.A., Kleinjung, T., Langguth, B., Maruotti, A., Meyer, M., Norena, A., Probst, T., and Pryss, R. (2019). Editorial: Towards an Understanding of Tinnitus Heterogeneity. Front. Aging Neurosci., 11.","DOI":"10.3389\/fnagi.2019.00053"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Yang, D., Zhang, D., Zhang, X., and Li, X. (2024). Tinnitus-associated cognitive and psychological impairments: A comprehensive review meta-analysis. Front. Neurosci., 18.","DOI":"10.3389\/fnins.2024.1275560"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Moln\u00e1r, A., Mavrogeni, P., Tam\u00e1s, L., and Maihoub, S. (2022). Correlation Between Tinnitus Handicap and Depression and Anxiety Scores. Ear Nose Throat J., 1455613221139211.","DOI":"10.1177\/01455613221139211"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Mavrogeni, P., Moln\u00e1r, A., Moln\u00e1r, V., Tam\u00e1s, L., and Maihoub, S. (2024). Correlation Between the Pitch and Loudness of Tinnitus, Hearing Levels, and Tinnitus Handicap Inventory Scores in Patients with Chronic Subjective Tinnitus. J. Clin. Med., 13.","DOI":"10.3390\/jcm13237261"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1016\/j.jpsychores.2012.05.002","article-title":"Methodological aspects of clinical trials in tinnitus: A proposal for an international standard","volume":"73","author":"Landgrebe","year":"2012","journal-title":"J. Psychosom. Res."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1044\/2018_AJA-TTR17-18-0038","article-title":"Clinical Protocol to Promote Standardization of Basic Tinnitus Services by Audiologists","volume":"28","author":"Henry","year":"2019","journal-title":"Am. J. Audiol."},{"key":"ref_8","unstructured":"Manchaiah, V., Andersson, G., Beukes, E.W., Fagelson, M., Swanepoel, D.W., Heffernan, E., and Maidment, D.W. Development and psychometric validation of Tinnitus Qualities and Impact Questionnaire. Under review, 2025."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"11","DOI":"10.3988\/jcn.2009.5.1.11","article-title":"Tinnitus: Characteristics, causes, mechanisms, and treatments","volume":"5","author":"Han","year":"2009","journal-title":"J. Clin. Neurol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"947","DOI":"10.1080\/14992027.2018.1514538","article-title":"Participants experiences of an Internet-based cognitive-behavioral therapy for tinnitus","volume":"57","author":"Beukes","year":"2018","journal-title":"Int. J. Audiol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1044\/2021_AJA-20-00222","article-title":"Audiologist-Supported Internet-Based Cognitive Behavioral Therapy for Tinnitus in the United States: A Pilot Trial","volume":"30","author":"Beukes","year":"2021","journal-title":"Am. J. Audiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"100402","DOI":"10.1016\/j.invent.2021.100402","article-title":"Dismantling internet-based cognitive behavioral therapy for tinnitus. The contribution of applied relaxation: A randomized controlled trial","volume":"25","author":"Beukes","year":"2021","journal-title":"Internet Interv."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"e27584","DOI":"10.2196\/27584","article-title":"Internet-Based Audiologist-Guided Cognitive Behavioral Therapy for Tinnitus: Randomized Controlled Trial","volume":"24","author":"Beukes","year":"2022","journal-title":"J. Med. Internet Res."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2331216519851749","DOI":"10.1177\/2331216519851749","article-title":"Internet-Based Interventions for Adults With Hearing Loss, Tinnitus, and Vestibular Disorders: A Systematic Review and Meta-Analysis","volume":"23","author":"Beukes","year":"2019","journal-title":"Trends Hear."},{"key":"ref_15","unstructured":"Beukes, E.W., Andersson, G., Manchaiah, V., and Kaldo, V. (2021). Cognitive Behavioral Therapy for Tinnitus, Plural Publishing."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1097\/AUD.0b013e31822f67c0","article-title":"The tinnitus functional index: Development of a new clinical measure for chronic, intrusive tinnitus","volume":"33","author":"Meikle","year":"2012","journal-title":"Ear Hear."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1092","DOI":"10.1001\/archinte.166.10.1092","article-title":"A brief measure for assessing generalized anxiety disorder: The GAD-7","volume":"166","author":"Spitzer","year":"2006","journal-title":"Arch. Intern. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"606","DOI":"10.1046\/j.1525-1497.2001.016009606.x","article-title":"The PHQ-9: Validity of a brief depression severity measure","volume":"16","author":"Kroenke","year":"2001","journal-title":"J. Gen. Intern. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1016\/S1389-9457(00)00065-4","article-title":"Validation of the Insomnia Severity Index as an outcome measure for insomnia research","volume":"2","author":"Bastien","year":"2001","journal-title":"Sleep Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"337","DOI":"10.3109\/07853890109002087","article-title":"EQ-5D: A measure of health status from the EuroQol Group","volume":"33","author":"Rabin","year":"2001","journal-title":"Ann. Med."},{"key":"ref_21","unstructured":"Hillsdale, N.J. (1988). Statistical Power Analysis for the Behavioral Sciences, Lawrence Erlbaum Associates, Publishers. [2nd ed.]."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1097\/AUD.0000000000000505","article-title":"Audiologist-Guided Internet-Based Cognitive Behavior Therapy for Adults With Tinnitus in the United Kingdom: A Randomized Controlled Trial","volume":"39","author":"Beukes","year":"2018","journal-title":"Ear Hear."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1016\/S0385-8146(03)00008-7","article-title":"Tinnitus loudness matchings in relation to annoyance and grading of severity","volume":"30","author":"Andersson","year":"2003","journal-title":"Auris Nasus Larynx"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e701","DOI":"10.1055\/s-0042-1743287","article-title":"Cortical Reorganization Following Psychoeducational Counselling and Residual Inhibition Therapy (RIT) in Individuals with Tinnitus","volume":"26","author":"Vasudevan","year":"2022","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"McFerran, D.J., Stockdale, D., Holme, R., Large, C.H., and Baguley, D.M. (2019). Why Is There No Cure for Tinnitus?. Front. Neurosci., 13.","DOI":"10.3389\/fnins.2019.00802"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"993","DOI":"10.1044\/2021_AJA-21-00158","article-title":"Online Discussions About Tinnitus: What Can We Learn From Natural Language Processing of Reddit Posts?","volume":"31","author":"Manchaiah","year":"2022","journal-title":"Am. J. Audiol."}],"container-title":["Clinics and Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2039-7283\/15\/4\/69\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:02:59Z","timestamp":1760029379000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2039-7283\/15\/4\/69"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,27]]},"references-count":26,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["clinpract15040069"],"URL":"https:\/\/doi.org\/10.3390\/clinpract15040069","relation":{},"ISSN":["2039-7283"],"issn-type":[{"value":"2039-7283","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,27]]}}}