Audiologic Characteristics of Military Service Members and Veterans With and Without Tinnitus and Comorbid...

The purpose of this study was to evaluate audiologic characteristics of service members (SMs) and veterans who have tinnitus alone or have both tinnitus and posttraumatic stress disorder (T&P), as compared to healthy controls.

Participants included active duty military SMs and veterans with both T&P (n = 16), tinnitus only (TO; n = 25), and healthy controls (HCs) without posttraumatic stress disorder (PTSD) or tinnitus (n = 20). All participants underwent audiologic evaluation composed of tympanometry, distortion product otoacoustic emissions, pure-tone audiometry, speech audiometry, and loudness discomfort levels. Multivariate analysis of variance was conducted to determine differences in hearing thresholds between the three groups (T&P, TO, and HC). All participants completed the Hyperacusis Questionnaire. Participants with tinnitus (T&P, TO) also received a tinnitus psychoacoustic assessment and completed tinnitus-specific questionnaires. Tinnitus questionnaires included the Tinnitus Functional Index, tinnitus annoyance and loudness rating scales (visual analogue scale), and the Tinnitus Acceptance Questionnaire. Independent-samples t tests were conducted to test for differences between these two groups.

Pure-tone and speech audiometry results between the TO and TP groups did not significantly differ. Compared to the TO group, the T&P group reported significantly greater functional impairment due to their tinnitus, perceived their tinnitus as significantly more annoying, and endorsed significantly less acceptance of their tinnitus. Although not statistically significant, participants in the T&P group perceived their tinnitus louder than those in the TO group.

Study findings suggest that PTSD is associated with increased tinnitus distress and annoyance. Symptoms of PTSD may also reduce the capacity to accept tinnitus. These results are consistent with previous studies that demonstrate the additive and negative effects that PTSD may have on health conditions, such as tinnitus. Clinicians within audiology clinics may consider screening specifically for PTSD and make appropriate referrals to behavioral health. Future studies should examine the best sequence of interventions for efficient and effective clinical outcomes among individuals with both conditions.