A new cognitive model of chronic tinnitus and its implications for current audiological management: systematic evaluation using structural equation modelling and established qualitative techniques

PhD student

Lucy Handscomb

Supervisory team

Professor Deborah Hall
Dr Derek Hoare

Dr Gillian Shorter


British Tinnitus Association

Study period


One of the prevailing audiological views on subjective tinnitus is that it is caused by an increase in neural activity in the hearing brain to compensate for the reduced input from the ear following hearing loss. Nevertheless, clinical reports from tinnitus patients indicate no straightforward relationship between tinnitus loudness (usually low) and how distressing it is (usually high). Recent opinion suggests that distinct mechanisms underlie the tinnitus percept and those involved in the ‘interpretation’ of it.  Long-standing tinnitus therefore is a multi-factorial, complex disability with both perceptual components (sound qualities) and emotional components (distress).  Both components are important for understanding the disorder and yet the second is often neglected within hearing research (because it is not easily accessed), and within audiological management (because there is no standard care, and little appropriate awareness or training to deal with the emotional consequences of tinnitus).

This PhD project will use powerful scientific methods to:

1) Fully test how well data from a series of validated health questionnaires fit with a new model of tinnitus persistence.

2) Evaluate the components of the model from the perspective of tinnitus patients, audiologists and hearing therapists, and gain a reflective perspective from patients on the suitability of the cognitive model.

3) Identify, promote and recommend core elements of assessment and subsequent management of tinnitus that should be implemented as basic standards of care for patients.