A mixed method study of a gratitude diary intervention on tinnitus-related distress in adults

Background:
Tinnitus is a persistent condition which constitutes a challenging and life-changing experience for which there is no medical cure. There is wide-spread consensus that individuals’ interpretation of tinnitus affects how distressing they find it. Research suggests individuals with greater levels of dispositional gratitude are less distressed by tinnitus. However, there is no published research examining whether an experimental manipulation of gratitude reduces tinnitus-related distress.

Method:
A mixed method design was adopted to evaluate the application and experience of a 3-week gratitude diary intervention in adults with distressing tinnitus. Measures were collected pre- and post-intervention. Primary outcome measures were tinnitus-related distress (Tinnitus Questionnaire) and psychological wellbeing (Warwick-Edinburgh Mental Wellbeing Scale). Outcomes were evaluated using paired t-tests and correlational analysis. In addition, semi-structured interviews were conducted to explore participants’ experience of the intervention and analysed using reflexive thematic analysis. Finally, quantitative and qualitative results were integrated to develop mixed methods inferences.

Results:
Fifteen participants completed the intervention and analysis showed a statistically significant reduction in tinnitus-related distress but no change in psychological wellbeing. Correlational analysis found a strong negative relationship between tinnitus duration and tinnitus-related distress, suggesting those who had tinnitus for longer received less benefit. In addition, thematic analysis identified three themes capturing participants (N = 6) broadening awareness, feeling empowered, and changing relationship with tinnitus.

Conclusion:
Findings suggest that a gratitude diary intervention is an acceptable intervention to reduce tinnitus-related distress in adults. Participants reported a changing relationship with tinnitus as greater awareness of the blessings in their lives seemed to have reduced their preoccupation with tinnitus. However, further research is required to compare the intervention against an active control condition and examine its utility in clinical samples.