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Acquired Hearing Loss, Anger, and Emotional Distress

The Mediating Role of Perceived Disability

Ferrari, Silvia, MD, PhD*†; Monzani, Daniele, MD; Gherpelli, Chiara, Biotechnician; MacKinnon, Andrew, MD§∥; Mongelli, Francesca, MD; Federici, Gaia, MD; Forghieri, Matilde, MD, PhD#; Galeazzi, Gian Maria, MD, PhD*†

The Journal of Nervous and Mental Disease: June 2019 - Volume 207 - Issue 6 - p 459–466
doi: 10.1097/NMD.0000000000000995
Original Articles

The aim of the study was to test whether acquired hearing loss (AHL)–related perceived disability mediates the association between AHL and psychological outcomes, including anger. Two-hundred ninety-seven consecutive outpatients with AHL assessed by pure tone average (PTA) loss completed the following: Hearing Handicap Inventory for Adults (HHIA), State-Trait Anger Expression Inventory–2 (STAXI-2), Brief Symptom Inventory (BSI), Diagnostic Criteria for Use in Psychosomatic Research (DCPR), and Social Functioning Questionnaire. In the sample, composed of 44.5% males with a mean age of 53.8 and a mean PTA of 30.7, AHL was associated to perceived hearing handicap, also correlating to all psychological measures except DCPR demoralization. Associations were stronger between the HHIA–Emotional Subscale, STAXI-2 State Anger and Feeling Angry, and BSI-Somatization, Interpersonal Sensitivity, Depression, and Psychoticism. Perceived disability predicted the presence of almost all psychosocial outcomes and confirms to be the most significant target of clinical action.

*Section of Psychiatry, Department of Biomedical, Metabolic, and Neural Sciences,

Center for Neuroscience and Neurotechnology, and

Section of ENT, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy;

§Black Dog Institute, University of New South Wales, Randwick, New South Wales;

Centre for Mental Health, University of Melbourne, Melbourne, Victoria, Australia;

School of Specialization in Psychiatry, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia; and

#Private Practice, Modena, Italy.

Send reprint requests to Silvia Ferrari, MD, PhD, Servizio di Consulenza Psichiatrica-Psicosomatica, Policlinico di Modena, Via del Pozzo 71, 41124 Modena, Italy. E-mail:

Online date: May 3, 2019

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