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Biomedical subjects

R S Hallam

Publications and source records attributed to R S Hallam.

At least 19 recordsLinked to original sources
PubMed2004

Tinnitus impairs cognitive efficiency.

Many people who complain of tinnitus say that the noises impair their mental concentration. This complaint was investigated by self-report (primarily the Cognitive Failures Questionnaire) and by means of five cognitive tasks, four presented via laptop computer and one given manually. The tasks measured performance under single- and dual-task conditions and included tests of sustained attention, reaction time, verbal fluency and immediate and delayed memory. Two groups of outpatients attending audiological clinics (tinnitus, n = 43; hearing impairment, n = 17) were compared with non-clinical volunteers (n = 32). The results replicated earlier findings that tinnitus outpatients report significantly more everyday cognitive failures than do controls. The tinnitus group responded significantly more slowly than the two control groups on the variable fore-period reaction time task under dual-task conditions. In general, comparisons between the groups on other tasks showed equivalent performance, but both clinical groups performed more poorly than non-clinical controls on verbal fluency. We conclude that cognitive inefficiency in tinnitus participants is related to the control of attentional processes, consistent with our earlier theoretical speculation about the nature of tinnitus complaint and with published findings on the effects of chronic pain on cognitive processes.

Adult↗
PubMed2002

A dialogical approach to obsessions.

Cognitive conceptualizations of obsessions based on the information-processing metaphor are contrasted with a dialogical approach to understanding obsessive compulsive disorder (OCD). The dialogical approach views obsessions as one-sided conversations. The unit of analysis is the narrative or 'voice', which engages the person in the neutralizing behaviour. The dialogical approach accommodates well the apparent paradox that obsessions are both self and other generated, and that people can be positioned differently regarding the senselessness of their obsessions at different times. Also, people themselves characterize their obsessions in dialogical terms as: voice, conversation, or argument. The focus of therapy is the language and power of the narrative rather than discrete cognitive biases or representations, and dialogical therapy emphasizes role-play and narrative techniques. Cognitive therapy has already shown signs of adopting a narrative turn, and cognitive and dialogical conceptualizations of OCD are alternative perspectives rather than competing explanations.

Cognitive Behavioral Therapy↗
PubMed2001

The effects on significant others of providing a hearing aid to the hearing-impaired partner.

Communication is a shared experience which can be substantially affected by hearing impairment. Significant others may experience difficulties not only in direct communication but also in personal and social relationships. The present study was designed to investigate the impact on significant others of hearing loss in a partner and the benefits that accrued from the provision of personal amplification. The results suggested that before the provision of a hearing aid significant others experienced difficulties with person-to-person conversation, with group conversation and in viewing (listening to) television of the same order as did the hearing impaired individual. After appropriate intervention the difficulties were greatly reduced with resultant improvement in quality of life for both parties.

Affect↗
PubMed1998

Attitudes to hearing difficulty and hearing aids and the outcome of audiological rehabilitation.

First time hearing aid candidates (N = 135) in a NHS setting were administered the Hearing Attitudes in Rehabilitation Questionnaire (HARQ) designed to assess attitudes to acquired hearing loss and hearing aids and 92% of them were followed up 3-9 months after fitting. Attitude scores, age, sex and sensory thresholds were related to six self-report outcome measures by use of logistic regression. The major findings were that patients who were least distressed by their hearing difficulties and reported not wanting or needing a hearing aid used their aids least frequently and evaluated them less highly in listening situations. An attitude that wearing a hearing aid was stigmatizing was not predictive of outcome except a report of more difficulty in handling the aid. There were some low but significant correlations between attitudes and sensory thresholds and thresholds also contributed to the prediction of outcome in a few instances.

Adult↗
PubMed1998

A critical analysis of directive counselling as a component of tinnitus retraining therapy.

Tinnitus retraining therapy (TRT) has been presented as a new approach to tinnitus management. In this paper a number of theoretical and practical problems with TRT are identified. These problems relate to the distinction between directive counselling and cognitive therapy, the adequacy of the cognitive therapy components, the nature of the outcome data which have been presented to date, the theoretical basis for the treatment, and the conceptual clarity of terms such as perception, attention and coping. The stated goal of removal of the perception of tinnitus may lead to confusion about the likely outcome of TRT for most patients. Methodological limitations in the research which has been published to date preclude any claims about the efficacy of TRT at the present time. It is suggested that randomized, controlled studies which include no-treatment and placebo conditions need to be undertaken. Studies are required in which the efficacy of the counselling and white noise components can be clearly isolated. Suggestions are made about the role of psychologists and non-psychologists in the provision of counselling and cognitive therapy services to tinnitus patients.

Adaptation, Psychological↗
PubMed1996

Correlates of sleep disturbance in chronic distressing tinnitus.

Sleep disturbance was recorded for a 1-week period prior to a follow-up assessment of 26 patients who had completed a study of psychological therapy reported elsewhere (Davies et al., 1995). The absence of reported sleep disturbance was associated with essentially normal hearing over the range 250 Hz to 2 kHz; hearing impairment was present in mild or severe sleep disturbance. Patients whose sleep was most disturbed rated significantly greater tinnitus annoyance in the evening. Measures of mood and emotional distress did not relate to degree of sleep disturbance.

Affect↗
PubMed1996

Development of the Hearing Attitudes in Rehabilitation Questionnaire (HARQ).

A questionnaire devised by Brooks to measure attitudes towards hearing impairment and provision of a hearing aid in older people was factor analysed and subsequently enlarged and modified into a new 40 item self-report scale. The Hearing Attitudes in Rehabilitation Questionnaire (HARQ) assesses three attitudes towards hearing impairment (personal distress/inadequacy, hearing loss stigma and minimization of loss) and four attitudes towards provision of a hearing aid (hearing aid stigma, aid-not-wanted, pressure to be assessed and positive expectation). Scale development, reliability and other psychometric properties are reported. Potential uses of the scale include identification of patients who may require counselling, evaluation of audiological rehabilitation and further empirical investigations of attitudes in this area.

Adult↗
PubMed1991

Emotional stability; its relationship to confidence in maintaining balance.

Previous failures to find an association between postural test results and the complaints of dizziness/imbalance were further investigated in neuro-otology out-patients, testing in a range of everyday situations requiring balance. Three matched groups of patients were compared: those complaining of dizziness/imbalance; those reporting but not complaining of dizziness/imbalance; and those who had never experienced these symptoms as noteworthy. No difference was found between the groups in measures of postural performance, self-reported confidence in balance, or in several trait measures of fear/anxiety. However, confidence in balance was significantly correlated with fear/anxiety measures across the sample. The correlations were strongest in complaining patients and weakest in patients reporting but not complaining of dizziness/imbalance. The results suggest that psychological characteristics are likely to influence the reporting of symptoms of dizziness/imbalance. The contribution of vestibular and other balance disorders is unclear given that the three groups performed equally well on postural tests.

Adaptation, Psychological↗
PubMed1991

The prevalence of psychological disturbance in neurotology outpatients.

This study assesses the prevalence of psychological disturbance among a consecutive series of 120 neuro-otology outpatients, using a structured interview conducted by a clinical psychologist. 42% of all patients were found to be in need of, and were offered, psychological help (27% of those with hearing loss, 45% of those with tinnitus and 64% of those with dizziness). 86% of those offered psychological help accepted it. Current psychological distress was associated with the number of symptoms complained of and past psychiatric history. Patients completed the General Health Questionnaire which was found to have a sensitivity rate of 82% and a specificity rate of 87% in this setting. Physicians were also asked to rate patients' psychological state; close agreement was found between these ratings and those of a psychologist. The contribution of psychological assessment of neuro-otology patients is discussed.

Ambulatory Care↗
PubMed1991

The effect of written reassuring information on out-patients complaining of tinnitus.

The study investigated the effect of a two-page leaflet designed to reassure patients complaining of tinnitus. One half of new attenders at a tinnitus clinic received the leaflet while the other half did not. Clinic staff were blind to the condition to which patients were assigned. Tinnitus distress was assessed at the second appointment by means of a standardized questionnaire. Results indicated that questionnaire scores for the informed and non-informed subjects did not differ. However the informed group reported having significantly fewer 'unfulfilled needs'. They were less likely to want a medical cure or professional guidance. The level of general emotional distress as measured by the General Health Questionnaire did not moderate these effects.

Adaptation, Psychological↗
PubMed1989

Evaluation of a computer interview system for use with neuro-otology patients.

The effectiveness, feasibility and credibility of a computer assessment package was evaluated in a group of 60 neuro-otological outpatients. The computer system was compared with a standard questionnaire and used to elicit basic neuro-otological information prior to clinical interview. The majority of patients (81%) preferred computer assessment. There were no differences in attitude or difficulties between diagnostic groups. Older patients had more difficulties and took longer than younger patients. The computer system was also more efficient than the form from an information handling and administrative point of view.

Attitude to Computers↗
PubMed1988

Cognitive variables in tinnitus annoyance.

Two new questionnaires were devised to investigate dimensions of complaint about tinnitus. Following a factor analysis of data provided by a sample of tinnitus patients who were administered the first questionnaire, the second questionnaire was developed. This included questions concerning coping attitudes and beliefs about tinnitus. The results of the two analyses were similar and they indicated the presence of three main dimensions of complaint (emotional distress, auditory perceptual difficulties, and sleep disturbance). However several smaller factors suggested that complaint was more complex than originally predicted. The second questionnaire successfully discriminated complaining from non-complaining patients.

Adolescent↗
PubMed1986

Tinnitus: a management model.

A comprehensive model of tinnitus management is proposed. As it is rarely possible to abolish the symptom, management of the tinnitus patient must aim at precipitating the habituation process. The model is split into 'evaluation' and 'remediation' sections. In each section the various aspects of management are discussed. Together with traditional factors, the importance of psychological processes is stressed. The role of the expectations of the patient in limiting remedial possibilities is also discussed.

Adaptation, Psychological↗
PubMed1986

Matched and self-reported loudness of tinnitus: methods and sources of error.

A consecutive series of 62 patients who reported tinnitus at the time of their first attendance at a neuro-otology clinic were studied. Loudness matches were obtained both at the frequency of the tinnitus and at 1 kHz. These matches were expressed in dB HL, dB SL and in units derived from individualised loudness functions (personal loudness units; PLUs). Self-reports of the loudness of tinnitus at the time of loudness matching were obtained on five different scales. Moderate correlations were found between self-reported loudness and some of the scales by which the loudness match was expressed. When subjects who had some difficulty with the test procedures were excluded, the correlations between PLU expressions of the matched loudness and certain of the self-report scales were found to be markedly improved. Correlations of traditional expressions of matched loudness with self-report improved to a limited extent. It was concluded that: measurement error can appreciably reduce the maximum correlation between the best self-report measure and loudness match measures; PLU conversions of matched loudness data produce the highest correlations with self-report measures of loudness, and explicitly labelled self-report scales (Guttman and adjectival) produce better correlations with loudness match values than other self-report scales.

Adolescent↗
PubMed1986

[Tinnitus--a treatment model].

In the management of any patient suffering from tinnitus, it is essential first to identify and treat any underlying cause and then to apply proven tinnito-suppressive treatment to any persistent tinnitus. The present model is concerned with the management of patients whose tinnitus persists despite this approach. It indicates how all relevant information about the patient should be obtained and subsequently applied in determining the approach(es) most pertinent to the particular patient. It aims to be independent of any specific setting and applicable to all clinicians concerned with helping the patient suffering from tinnitus.

Combined Modality Therapy↗