Improving the assessment of functional impairment in tinnitus sufferers: validation of the German version of the Tinnitus Functional Index using a confirmatory factor analysis.

OBJECTIVES: Chronic tinnitus negatively impacts daily functioning. To specifically assess this impairment, the Tinnitus Functional Index (TFI) was developed. The current study investigated the hierarchical, eight-factorial structure for the German TFI and examined its psychometric properties. DESIGN: In an online assessment, the TFI and other validated health-related measurements were completed. Confirmatory factor analysis (CFA) was conducted to investigate the factorial structure by testing two competing models: (1) a general factor model, and (2) a hierarchical second-order factor model. STUDY SAMPLE: 316 research volunteers (59.8% female) with low to moderate tinnitus distress were included. RESULTS: CFA revealed an insufficient fit of the data to the general factor model. For the hierarchical second-order factor model, an acceptable model fit was shown (χ2/df ratio = 2.74, RMSEA = 0.07, SRMR = 0.05, CFI = 0.95, TLI = 0.95). Correlational analyses between the TFI and measures assessing tinnitus distress, depression, sleeping difficulties, subjective well-being, and personality dimensions indicated high convergent and moderate discriminant validity. Internal consistency reliability was excellent. CONCLUSIONS: The results confirm the hierarchical, eight-factorial structure of the German TFI. The TFI is a promising inventory that should be used on a regular basis.HighlightsThe results of our study confirm the hierarchical eight-factorial structure of the German TFI.Confirmatory factor analysis revealed an acceptable model fit of the data.Convergent validity of the German TFI was high.Discriminant validity of the German TFI was moderate.The German TFI is a reliable questionnaire to assess tinnitus functional impairment.

Psychometric assessment of mental health in tinnitus patients, depressive and healthy controls.

Tinnitus describes the perception of a sound without external source and is characterized by high comorbidity, e.g. depression. In many studies, tinnitus patients were compared to healthy controls while a comorbid psychiatric diagnosis was an exclusion criterion. Consequently, patients with severe tinnitus and psychiatric comorbidity were often neglected. In the current study, we tried to fill this gap and compared four groups including two control groups: (1) chronic tinnitus patients with mild tinnitus distress (N = 37), (2) chronic tinnitus patients with severe tinnitus distress (N = 24), (3) patients suffering from depression, but no tinnitus (major depressive disorder, MDD; N = 23) and (4) healthy controls (N = 42). We assessed their clinical profile with clinical questionnaires concerning anxiety, depression and somatoform symptoms. Data were analyzed with a canonical discriminant analysis resulting in two factors. Factor 1 was called general psychopathology, because most questionnaires loaded highly on it. Regarding this factor, patients with severe tinnitus distress and MDD controls were impaired equally strong. Patients with mild tinnitus distress were more strongly affected than healthy controls. Both tinnitus groups reached higher values than the two control groups with regard to factor 2, called somatization. These results stress the presence of significant general psychopathology even in mild tinnitus.