The DOI matches its Crossref record; 51 of the 51 references it cites were found in a registry or an index.
A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress
Abstract
Tinnitus is defined as a sound in the ear(s) and/or head without external origin and is a serious health concern for millions worldwide. The aim of the present study was to determine whether Cognitive Behavior Therapy (CBT) is effective in reducing distress associated with tinnitus. Randomized, controlled trials that assessed the efficacy of CBT for tinnitus-related distress in adults were identified by searching electronic databases (PsychINFO, PubMed, the Cochrane Library), and by manual searches. Fifteen studies (total of 1091 participants) were included in the meta-analysis. CBT compared with a passive and active control at post-assessment yielded statistically significant mean effect sizes for tinnitus-specific measures (Hedges's g=0.70, and Hedges's g=0.44, respectively). The average weighted pre-to-follow-up effect size for the CBT group suggested that these effects were maintained over time. Smaller but yet statistically significant effects of CBT were found for mood outcome measures. Characteristics of the studies were unrelated to effect sizes. Methodological rigor, publication bias, and a series of sensitivity analyses did not influence the findings. The results suggest that CBT is an effective treatment of tinnitus distress. However, caution is warranted given that few large-scale, well-controlled trials were identified.
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In the citing paper
“Although a systematic review and meta-analysis of randomized controlled trials (RCTs) reported that CBT significantly decreased tinnitus distress (Hesser et al., 2011)”
From A Systematic Review and Meta-Analysis Exploring Effects of Third-Wave Psychological Therapies on Hearing-Related Distress, Depression, Anxiety, and Quality of Life in People With Audiological Problems. (2022) · cites this paper as Hesser et al., 2011
In the citing paper
“This is followed by “A systematic review and meta-analysis of randomized controlled trials of cognitive-behavioral therapy for tinnitus distress” (strength: 11.37, publication year: 2011) and “A Randomized Controlled Trial of Internet-Delivered Cognitive Behaviour Therapy and Acceptance and Commitment Therapy in the Treatment of Tinnitus” (strength: 10.1, publication year: 2012)”
From Research trends and hotspots of cognitive behavioral therapy for tinnitus: a bibliometric analysis (2025) · cites this paper as Hesser et al., 2011
In the citing paper
“Cognitive behavioral treatment approaches reproducibly help patients in managing chronic tinnitus.”
From Randomized controlled trial of a smartphone-based cognitive behavioral therapy for chronic tinnitus (2023) · cites this paper as [9]
In the citing paper
“Nevertheless, there is room for improvement, as a substantial number of patients continue to experience significant residual tinnitus distress after treatment[16]”
From The influence of tinnitus acceptance on the quality of life and psychological distress in patients with chronic tinnitus (2015) · cites this paper as [16]
In the citing paper
“Research evidence consistently demonstrates a superiority of clinical psychologist-delivered CBT over other treatments and waiting list control conditions for improving tinnitus-related distress, depression, and quality of life (Martinez-Devesa et al. 2010; Hesser et al. 2011; Hoare et al. 2011).”
From Psychological Therapy for People with Tinnitus: A Scoping Review of Treatment Components. (2017) · cites this paper as Hesser et al. 2011
Citations
Cites
Duval, S., & Tweedie, R. (2000) · Biometrics · doi:10.1111/j.0006-341x.2000.00455.x · Cited by 14,099
Fixed-and random-effects models in meta-analysis.
Hedges, L. V., & Vevea, J. L. (1998) · Psychological Methods · doi:10.1037/1082-989x.3.4.486 · Cited by 2,977
Wykes, T., Steel, C., Everitt, B., & Tarrier, N. (2007) · Schizophrenia Bulletin · doi:10.1093/schbul/sbm114 · Cited by 1,029
Tinnitus--a study of its prevalence and characteristics.
Axelsson, A., & Ringdahl, A. (1989) · British Journal of Audiology · doi:10.3109/03005368909077819 · Cited by 802
Muthén, B., & Curran, P. J. (1997) · Psychological Methods · doi:10.1037/1082-989x.2.4.371 · Cited by 768
Henry, J. A., Dennis, K. C., & Schechter, M. A. (2005) · Journal of Speech Language and Hearing Research · doi:10.1044/1092-4388(2005/084 · Cited by 615
Coles, R. (1987) · Medical Entomology and Zoology · Cited by 541
Difficulties Experienced by Tinnitus Sufferers
Tyler, R. S., & Baker, L. J. (1983) · Journal of Speech and Hearing Disorders · doi:10.1044/jshd.4802.150 · Cited by 525
Cognitive behavioural therapy for tinnitus
Martinez-Devesa, P., Perera, R., Theodoulou, M., & Waddell, A. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005233.pub3 · Cited by 477
Psychometric adequacy of the Tinnitus Handicap Inventory (THI) for evaluating treatment outcome.
Newman, C. W., Sandridge, S. A., & Jacobson, G. P. (1998) · PubMed · Cited by 474
Negative effects from psychological treatments: a perspective
Barlow, D. H. (2010) · American Psychologist · doi:10.1037/a0015643 · Cited by 426 · cited 1×
“Some individuals may not profit from CBT or even deteriorate (Barlow, 2010).”
BackgroundWilson, P. H., Henry, J. L., Bowen, M., & Haralambous, G. (1991) · PubMed · Cited by 389
Cuijpers, P., Li, J., Hofmann, S. G., & Andersson, G. (2010) · Clinical Psychology Review · doi:10.1016/j.cpr.2010.06.001 · Cited by 383
Self-citationTinnitus Reaction Questionnaire
Wilson, P. H., Henry, J. L., Bowen, M., & Haralambous, G. (1991) · Journal of Speech Language and Hearing Research · doi:10.1044/jshr.3401.197 · Cited by 353
A Review of Randomized Clinical Trials in Tinnitus
Dobie, R. A. (1999) · The Laryngoscope · doi:10.1097/00005537-199908000-00004 · Cited by 349
Andersson, G. (2002) · Psychosomatic Medicine · doi:10.1097/01.psy.0000031577.42041.f8 · Cited by 312 · cited 2×
“Duration (weeks) Type Format Control condition Tinnitus Mood CTAM (total score) Andersson et al., 2002 117 47.0 48.5 6.4 49 6 CBT 0 0 TRQ VAS ASI HADS 42 Andersson et al., 2005 23 48.0 70.1 13 0 6 CBT 2 0 TRQ VAS ASI HADS 37 Andersson et al., 2010 99 43.0 48.5 n/a 6 8 CBT (C)BT 0 0 THI HADS 55…”
InfluentialSelf-citationTarrier, N., & Wykes, T. (2004) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.06.020 · Cited by 312
Gooding, P., & Tarrier, N. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.04.002 · Cited by 267 · cited 2×
“The CTAM was specifically designed to assess the quality of psychological clinical trials according to the CONSORT guidelines and has been used in several meta-analyses to evaluate clinical trials of CBT (e.g., Gooding & Tarrier, 2009; Wykes et al., 2008).”
MethodPsychological aspects of tinnitus and the application of cognitive–behavioral therapy
Andersson, G. (2002) · Clinical Psychology Review · doi:10.1016/s0272-7358(01)00124-6 · Cited by 262
Self-citationOgles, B. M., Lunnen, K. M., & Bonesteel, K. (2001) · Clinical Psychology Review · doi:10.1016/s0272-7358(99)00058-6 · Cited by 255
A meta-analytic review of psychological treatments for tinnitus
Andersson, G., & Lyttkens, L. (1999) · British Journal of Audiology · doi:10.3109/03005369909090101 · Cited by 223
Self-citationTinnitus: A Multidisciplinary Approach
Baguley, D., Andersson, G., McFerran, D. J., & McKenna, L. (2013) · Wiley eBooks · doi:10.1002/9781118783009 · Cited by 187
Self-citationTHEORETICAL FOUNDATIONS OF COGNITIVE-BEHAVIOR THERAPY FOR ANXIETY AND DEPRESSION
Brewin, C. R. (1996) · Annual Review of Psychology · doi:10.1146/annurev.psych.47.1.33 · Cited by 184
Tinnitus Retraining Therapy (TRT) for tinnitus
Phillips, J. S., & McFerran, D. J. (2010) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007330.pub2 · Cited by 183
Westin, V. Z., Schulin, M., Hesser, H., Karlsson, M., Noe, R. Z., Olofsson, U., Stalby, M., Wisung, G., & Andersson, G. (2011) · Behaviour Research and Therapy · doi:10.1016/j.brat.2011.08.001 · Cited by 175
Self-citationGrissom, R. J. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.5.973 · Cited by 159
How interchangeable are different estimators of effect size?
Ray, J. W., & Shadish, W. R. (1996) · Journal of Consulting and Clinical Psychology · doi:10.1037/0022-006x.64.6.1316 · Cited by 137
Bartels, H., Middel, B. L., van der Laan, B. F. A. M., Staal, M. J., & Albers, F. W. J. (2008) · Ear & Hearing · doi:10.1097/aud.0b013e3181888f83 · Cited by 113
The management of chronic tinnitus
Kröner‐Herwig, B., Frenzel, A., Fritsche, G., Schilkowsky, G., & Esser, G. (2003) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00400-2 · Cited by 109
Cognitive behavioural therapy for tinnitus
Martinez‐Devesa, P., Waddell, A., Perera, R., & Theodoulou, M. (2007) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005233.pub2 · Cited by 105
The management of chronic tinnitus—Comparison of a cognitive-behavioural group training with yoga.
Kröner-Herwig, B., Hebing, G., Van Rijn-Kalkmann, U., Frenzel, A., Schilkowsky, G., & Esser, G. (1995) · Journal of Psychosomatic Research · doi:10.1016/0022-3999(94)00098-p · Cited by 101
Kaldo, V., Cars, S., Rahnert, M., Larsen, H. C., & Andersson, G. (2007) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2007.04.007 · Cited by 97
Self-citationHesser, H., Westin, V., Hayes, S. C., & Andersson, G. (2009) · Behaviour Research and Therapy · doi:10.1016/j.brat.2009.02.002 · Cited by 92
Self-citationPsychological Treatment of TinnitusAn Experimental Group Study
Scott, B., Lindberg, P., Lyttkens, L., & Melin, L. (1985) · Scandinavian Audiology · doi:10.3109/01050398509045945 · Cited by 90
Reliability of self‐rated tinnitus distress and association with psychological symptom patterns
Hiller, W. F. A., Goebel, G., & Rief, W. (1994) · British Journal of Clinical Psychology · doi:10.1111/j.2044-8260.1994.tb01117.x · Cited by 90
Treating chronic tinnitus: Comparison of cognitive-behavioural and habituation-based treatments
Zachriat, C., & Kröner‐Herwig, B. (2004) · Cognitive Behaviour Therapy · doi:10.1080/16506070410029568 · Cited by 89
Weise, C., Heinecke, K., & Rief, W. (2008) · Journal of Consulting and Clinical Psychology · doi:10.1037/a0013811 · Cited by 85
Self-citationSeydel, C., Haupt, H., Szczepek, A. J., Klapp, B. F., & Mazurek, B. (2009) · Audiology and Neurotology · doi:10.1159/000231632 · Cited by 79
Henry, J. L., & Wilson, P. H. (1996) · PubMed · Cited by 79
Psychophysiologic Treatment of Chronic Tinnitus: A Randomized Clinical Trial
Rief, W., Weise, C., Kley, N., & Martin, A. (2005) · Psychosomatic Medicine · doi:10.1097/01.psy.0000174174.38908.c6 · Cited by 74
Self-citationTreatment of tinnitus in the elderly: a controlled trial of cognitive behavior therapy
Andersson, G., Porsaeus, D., Wiklund, M., Kaldo, V., & Larsen, H. C. (2005) · International Journal of Audiology · doi:10.1080/14992020500266720 · Cited by 68
Self-citationGroup cognitive therapy for medical patients: An application to tinnitus
Jakes, S. C., Hallam, R., McKenna, L., & HINCHCLIFFE, R. (1992) · Cognitive Therapy and Research · doi:10.1007/bf01172957 · Cited by 67
Retest Stability of the Tinnitus Handicap Questionnaire
Newman, C. W., Wharton, J. A., & Jacobson, G. P. (1995) · Annals of Otology Rhinology & Laryngology · doi:10.1177/000348949510400910 · Cited by 66
The psychological treatment of tinnitus: An experimental evaluation
Lindberg, P., Scott, B., Melin, L., & Lyttkens, L. (1989) · Behaviour Research and Therapy · doi:10.1016/0005-7967(89)90143-5 · Cited by 53
An Evaluation of Two Types of Cognitive Intervention in the Management of Chronic Tinnitus
Henry, J. L., & Wilson, P. H. (1998) · Scandinavian Journal of Behaviour Therapy · doi:10.1080/02845719808408510 · Cited by 50
(2008) · PubMed · Cited by 42
Bias in Meta-Analytic Estimates of the Absolute Efficacy of Psychotherapy
Staines, G. L., & Cleland, C. M. (2007) · Review of General Psychology · doi:10.1037/1089-2680.11.4.329 · Cited by 32
A Review of psychological treatment approaches for patients suffering from tinnitus
Andersson, G., Melin, L., Hägnebo, C., Scott, B., & Lindberg, P. (1995) · Annals of Behavioral Medicine · doi:10.1007/bf02888601 · Cited by 30
Self-citationNoble, W. G. (2008) · Trends in Amplification · doi:10.1177/1084713808320552 · Cited by 28
Is psychology really the best treatment for tinnitus?
McFerran, D. J., & Baguley, D. (2009) · Clinical Otolaryngology · doi:10.1111/j.1749-4486.2009.01910.x · Cited by 21
Methodological considerations in treatment evaluations of tinnitus distress: A call for guidelines
Hesser, H. (2010) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2010.07.005 · Cited by 13
Self-citation
Research works printed but not linked: 2
- *Brenz, M. (2008). Evaluation einer biofeedbackgestuetzten kognitiv-behavioralen Intervention bei chronischem Tinnitus [Evaluation of a biofeedback-supported cognitive–behavioral intervention in chronic tinnitus]. Dissertation. Department of Psychology, University of Tuebingen, Germany.
- Tyler, 1989, A review of tinnitus loudness, Hearing Journal, 42, 52
Cited by
Sorted by citations
Baguley, D., McFerran, D., & Hall, D. (2013) · The Lancet · doi:10.1016/s0140-6736(13)60142-7 · Cited by 1,245
Tinnitus: causes and clinical management
Langguth, B., Kreuzer, P. M., Kleinjung, T., & Ridder, D. D. (2013) · The Lancet Neurology · doi:10.1016/s1474-4422(13)70160-1 · Cited by 807
Clinical practice guideline: tinnitus
Tunkel, D. E., Bauer, C. A., Sun, G. H., Rosenfeld, R. M., Chandrasekhar, S. S., Cunningham, E. R., Archer, S. M., Blakley, B. W., Carter, J. M., Granieri, E. C., et al. (2014) · Otolaryngology–Head and Neck Surgery · doi:10.1177/0194599814545325 · Cited by 769
“Hesser et al 166 reviewed 15 studies and found sustained benefits of CBT on tinnitus-specific outcome measures and smaller benefits for mood outcomes.”
Prevalence, Severity, Exposures, and Treatment Patterns of Tinnitus in the United States
Bhatt, J. M., Lin, H. W., & Bhattacharyya, N. (2016) · JAMA Otolaryngology–Head & Neck Surgery · doi:10.1001/jamaoto.2016.1700 · Cited by 460
A multidisciplinary European guideline for tinnitus: diagnostics, assessment, and treatment
Cima, R. F. F., Mazurek, B., Haider, H., Kikidis, D., Lapira, A., Noreña, A., & Hoare, D. J. (2019) · HNO · doi:10.1007/s00106-019-0633-7 · Cited by 442
Metadata
- Authors
- Hesser, H., Weise, C., Westin, V. Z., & Andersson, G.
- Affiliations
- Linköping University (SE)
- Corresponding author
- Hesser, Hugo
- Venue
- Clinical Psychology Review
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 31
- Issue
- 4
- Pages
- 545-553
- ISSN
- 0272-7358 (ISSN-L)
- OpenAlex
- W2142709786
- Cited by
- 340
- References
- 51
- Citations by year
- 2026: 13 · 2025: 9 · 2024: 38 · 2023: 34 · 2022: 20 · 2021: 21 · 2020: 31 · 2019: 18 · 2018: 29 · 2017: 26 · 2016: 20 · 2015: 18 · 2014: 20 · 2013: 24 · 2012: 13
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Health Sciences › Health Professions › Speech and Hearing › Hearing Loss and Rehabilitation
- Physical Sciences › Physics and Astronomy › Acoustics and Ultrasonics › Noise Effects and Management
- Keywords
- tinnitus, cognitive behavioral therapy, tinnitus distress, treatment efficacy, psychological intervention, effect size, maintenance of treatment effects
- MeSH terms
- Adult, Humans, Stress, Psychological, Tinnitus, Cognitive Behavioral Therapy, Randomized Controlled Trials as Topic, Treatment Outcome
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