Marc A Fagelson

East Tennessee State University | ETSU · Department of Audiology and Speech-Language Pathology

Subjective tinnitus is a highly prevalent sound sensation produced in most cases by persistent neural activity in the auditory pathway of the patient. Audiologists should be confident that they can employ elements of sound therapy and related counseling to support patients in coping. However, patients with bothersome tinnitus may be challenged by m...

Events linked to post-traumatic stress disorder (PTSD) influence psychological and physical health through the generation, exacerbation, and maintenance of symptoms such as anxiety, hyperarousal, and avoidance. Depending upon circumstance, traumatic events may also contribute to the onset of tinnitus, post-traumatic headache, and memory problems. P...

Objective The primary aim of the study was to examine the automated linguistic analysis of the open-ended problem (PQ) and life-effects (LEQ) questionnaires to understand the psychological effects of tinnitus. Design The study used a cross-sectional design. Participants completed online questionnaires which included demographic questions, several...

Purpose This study examined medication use by individuals with tinnitus who were seeking help for their tinnitus by means of a psychological intervention. Method This study used a cross-sectional survey design and included individuals with tinnitus enrolled in an Internet-based cognitive behavioral therapy trial ( n = 439). Study participants prov...

Background Patients often report that living with a condition such as tinnitus can be debilitating, worrying, and frustrating. Efficient ways to foster management strategies for individuals with tinnitus and promoting tinnitus self-efficacy are needed. Internet-based cognitive behavioral therapy (ICBT) for tinnitus shows promise as an evidence-base...

Background Internet-based cognitive behavioral therapy (ICBT) for tinnitus is an evidence-based intervention. The components of ICBT for tinnitus have, however, not been dismantled and thus the effectiveness of the different therapeutic components is unknown. It is, furthermore, not known if tinnitus subgroups with different clinical profiles respo...

BACKGROUND Tinnitus is a symptom that can be very distressing due to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult and access to evidence-based care is limited. Cognitive Behavioral Therapy is the tinnitus management strategy with the most evidence of effectiveness, but is rarely offered to thos...

Background: Tinnitus is a symptom that can be very distressing owing to hearing sounds not related to any external sound source. Managing tinnitus is notoriously difficult, and access to evidence-based care is limited. Cognitive behavioral therapy (CBT) is a tinnitus management strategy with the most evidence of effectiveness but is rarely offered...

Objective Although tinnitus is one of the most commonly reported symptoms in the general population, patients with bothersome tinnitus are challenged by issues related to accessibility of care and intervention options that lack strong evidence to support their use. Therefore, creative ways of delivering evidence-based interventions are necessary. I...

Purpose An Internet-based tinnitus intervention for use in the United States could improve the provision of tinnitus-related services. Although clinical trials of such interventions were completed in Europe, the United Kingdom, and Australia, their suitability for adults with tinnitus in the United States is yet to be established. The aim of this s...

Objective: The objective of this study was to improve the range of standardised tinnitus Spanish Patient-Reported Outcome Measures (PROMS) available by translating and ensuring cross-cultural adaptation of three English PROMs to Spanish. Design: The Tinnitus and Hearing Survey, Tinnitus Cognition Questionnaire, and Tinnitus Qualities Questionnaire...

An Internet-based tinnitus intervention for use in the USA can address barriers that weaken the provision of tinnitus-related services. Although such interventions exist, their suitability for this population was questioned. The aim of this study was to adapt an Internet-based cognitive behavioural therapy intervention (ICBT) for tinnitus to ensure...

Tinnitus has the potential to influence a wide range of routine and important activities in a person's life. It can impair sleep, communication, concentration, and in severe cases can be affected by depression, anxiety, and other mental health issues. Perhaps more important, tinnitus may influence the patient's psychological state; its bidirectiona...

Objective: Individuals with tinnitus and co-occurring psychological conditions typically rate their tinnitus as more disturbing than individuals without such comorbidities. Little is known about how tinnitus self-efficacy, or the confidence that individuals have in their abilities to successfully manage the effects of tinnitus, is influenced by me...

Objective: Individuals with tinnitus and co-occurring psychological conditions typically rate their tinnitus as more disturbing than individuals without such comorbidities. Little is known about how tinnitus self-efficacy, or the confidence that individuals have in their abilities to successfully manage the effects of tinnitus, is influenced by men...

Tinnitus continues to challenge patients from all walks of life and clinicians from a variety of disciplines. The lack of an evidence base to support a specific treatment confounds efforts to provide consistent benefit to patients and in many instances creates in the patient the impression that nothing can be done to improve their situation. Part o...

T he sensory mislabelling of environ-mental events is one of the more pronounced disruptions associ-ated with posttraumatic stress disorder (PTSD) [1]. Mislabelling, in this context, results from an erroneous or exaggerated neural representation of a sound, sight, tactile sensation, or smell producing a perception that does not correspond accu-rate...

Self-efficacy refers to the beliefs (i.e., confidence) individuals have in their capabilities to perform skills needed to accomplish a specific goal or behavior. Research in the treatment of various health conditions such as chronic pain, balance disorders, and diabetes shows that self-efficacy beliefs play an important role in treatment outcomes a...

Posttraumatic stress disorder (PTSD) affects nearly 10% of the population, a prevalence comparable with that of tinnitus. Similarities between the way PTSD and tinnitus influence auditory behaviors include exaggerated startle responses and decreased loudness tolerance. Tinnitus loudness is often exacerbated by sounds that trigger PTSD-related anxie...

Transcranial routing of signal (TCROS) was accomplished using completely-in-the-canal (CIC) hearing aids in 5 profoundly unilaterally hearing-impaired individuals. The functional gain realized by the participants far exceeded the gain predicted by measuring the acoustic output and real ear aided response of the hearing aids. The difference between...

Bone conduction transmission and head‐shadow effects were determined with transcranial completely‐in‐the‐canal (TCCIC) CROS hearing aids. Five subjects with documented profound unilateral hearing loss and experience with traditional CROS/BICROS fittings (TCROS) were tested with a CIC hearing aid placed in their poorer ear. Peak SPL was measured at...

The relation between discrimination of silent gaps and speech‐in‐noise perception was measured in 20 normal‐hearing listeners using speech‐shaped noise as both the gap markers and the noise source for speech testing. In the gap discrimination experiment, subjects compared silent gaps marked by 60 dB SPL 250‐ms noise bursts to standards of either 5,...

Comparisons were made between changes in the audibility of bone-conduction stimuli to differences in the sound pressure present in the external auditory canal when ears were occluded. Fifteen listeners with normal middle ear function were tested using pure tones of 250, 500, and 1000 Hz, delivered via a bone-conduction oscillator placed on the mast...

Auditory filters were derived in 20 normal-hearing human listeners at center frequencies (CFs) of 913, 1095, 3651, and 4382 Hz using the roex (p,r) method. Comparisons were made between slopes of the filters' skirts at the neighboring CFs with filter output levels of 45 and 70 dB. The same comparisons were made with regard to filter equivalent rect...

Auditory‐filter shape parameters in 20 normal‐hearing listeners were determined at center frequencies (CFs) of 913, 1095, 3651, and 4382 Hz using the five‐point roex (p,r) method. Slopes of the filters’ skirts were correlated for the CFs in each frequency region at both low and high stimulus levels. In the λ=1000‐Hz region, the auditory filters’ lo...

Sound pressure levels (SPLs) were measured in the external auditory canals (EACs) of 16 subjects with normal hearing and normal middle ear immittance. SPLs were the result of bone-conduction (BC) stimulation at 500, 1000, 2000, and 4000 Hz, with the oscillator placed either on the forehead or on the mastoid process. At 1000, 2000, and 4000 Hz, sign...

The spectral center of gravity refers to a listener’s averaging of frequency and intensity components when formant peaks in a speechlike signal are separated by 3.5 Bark units or less. In this paper a total of 18 synthetic vowels whose spectra approximated /ae/ or /inverted vee/ were generated digitally; each stimulus contained the first 40 harmoni...

Although much research has focused on the temporal, spectral, and intensity relationships between a masker and a suppressor, there has been little attention directed towards relative amounts of suppression in different frequency regions. The purpose of this experiment was to compare the magnitude of suppression at 500 and 2000 Hz in two forward‐mas...

Tinnitus is the perception of a sound that has no acoustic source outside the perceiver's head (McFadden, 1982; Henry et al., 2002). Because there is no 'cure' for tinnitus perception, successful treatment prioritizes relief for the patient from the negative reactions to tinnitus. The Tinnitus Handicap Inventory (THI; Newman et al., 1998) measures...