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The Fear of Tinnitus Questionnaire

Toward a Reliable and Valid Means of Assessing Fear in Adults with Tinnitus

Fuller, Thomas E.1; Cima, Rilana F. F.1,2,3; Van den Bussche, Eva4,5; Vlaeyen, Johan W. S.1,3

doi: 10.1097/AUD.0000000000000728
Research Article: PDF Only

Objectives: The purpose of this study was to assess the factor structure, reliability, and validity of the Fear of Tinnitus Questionnaire (FTQ); a brief self-report measure of people’s fears about potential cognitive, emotional, behavioral, and social consequences of living with tinnitus.

Design: Five hundred eighty-eight Dutch-speaking adults with tinnitus completed an online battery of questionnaires measuring tinnitus-related distress, fear, catastrophizing, and quality of life. The sample was randomly split into two to perform exploratory and Bayesian confirmatory factor analyses. A subsample of participants (n = 144) completed the battery of questionnaires a second time after a 2-week interval to calculate test-retest reliability and conduct a Bland-Altman analysis. Convergent and concurrent validity of the FTQ was assessed with the complete data set and measures of tinnitus-related distress as the outcome.

Results: Exploratory factor analyses indicated that single- and three-factor FTQ models were both valid solutions. Posterior predictive p values for the Bayesian confirmatory factor analyses ranged between 0.51 and 0.53 indicating that the respective models were an excellent fit for the data. The FTQ showed excellent test-retest reliability (average value intraclass correlation coefficient (ICC) = 0.92; 95% confidence interval, 0.89–0.95) and in the Bland-Altman analysis, satisfactory agreement between participants’ scores after a 2-week interval. Furthermore, the FTQ demonstrated good internal reliability (α = 0.83, 95% confidence interval, 0.81–0.85) and added statistically significant amounts of variance to models predicting tinnitus-related distress and interference in daily life.

Conclusions: The FTQ has good psychometric properties and can be used to assess people’s fear of tinnitus in research or clinical settings. Further work to establish the reliability and validity should be conducted and include an examination of a version of the FTQ that uses Likert-type response scales which might offer improved sensitivity.

1Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands;

2Adelante, Centre for expertise in Rehabilitation & Audiology, Hoensbroek, The Netherlands;

3Research Group Health Psychology, Faculty of Psychology and Educational Sciences, KU Leuven University, Leuven, Belgium;

4Department of Experimental and Applied Psychology, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; and

5Brain & Cognition Research Unit, KU Leuven University, Leuven, Belgium.

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ACKNOWLEDGMENTS: This research was supported by funding from SWOL Limburgs Fonds voor Revalidatie and Adelante, Centre for expertise in Rehabilitation and Audiology. R. F. F. Cima is funded through The Netherlands Organization for Scientific Research (NWO) through the Innovational Research Incentives Scheme: Veni (Project number 451-15-032). J. W. S. V. is supported by the “Asthenes” long-term structural funding–Methusalem grant (METH/15/011), funded by the Flemish Government, Belgium. The funders are not involved in any aspect of the project’s protocol, collection, and analysis of data, and nor have they had input regarding the interpretation and dissemination of the study’s results.

The authors have no conflicts of interest to disclose.

T. E. F. analyzed data and wrote the article. R. F. F. C. designed the study, collected the data, and provided critical revision. E. V. d. B. provided statistical advice and critical revision. J. W. S. V. provided critical revisions and study oversight.

Received January 26, 2018; accepted February 13, 2019.

For further discussion of posterior predictive p values see Meng (1994) and Rubin (1984).

Address for correspondence: Thomas Fuller, Department of Clinical Psychological Science, Faculty of Psychology and Neuroscience, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands. E-mail:

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