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Tinnitus, Hyperacusis, Misophonia: Where Are We Now? in partnership with the American Academy of Audiology

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1.  According to the Neurophysiological Model, tinnitus is best understood as which of the following?
  1. A peripheral, cochlea-based mechanical event
  2. A central, brain-based phantom auditory perception
  3. A symptom that occurs exclusively with hearing loss
  4. A form of somatosound originating in the middle ear
2.  Which finding from research on masking of tinnitus by external sounds supported the conclusion that tinnitus is a phantom auditory perception?
  1. Tinnitus loudness always matched the loudness of an equivalent external sound
  2. Tinnitus could be eliminated through phase-based cancellation
  3. The interaction between tinnitus and external sounds did not follow the same pattern seen between interaction of two external sounds
  4. Tinnitus consistently shifted in pitch when masked by narrow-band noise
3.  In Tinnitus Retraining Therapy (TRT), the primary treatment target is:
  1. The auditory periphery (cochlea), to reduce tinnitus loudness
  2. The subconscious connections between the auditory system and the limbic/autonomic systems
  3. Conscious cortical evaluation of tinnitus only
  4. Complete elimination of the tinnitus signal at its source
4.  When comparing a basic sound-therapy group to a group receiving Cognitive Behavioral Therapy (CBT) plus audiological rehabilitation, what conclusion does the Occam's Razor argument support?
  1. CBT provides substantially greater benefit than sound therapy alone
  2. The similar outcomes between groups could be explained simply by the effect of sound use, rather than CBT itself
  3. Audiological rehabilitation had no measurable effect in either group
  4. The CBT group's results could not be compared to the sound therapy group at all
5.  What does the Cochrane review of Cognitive Behavioral Therapy (CBT) for tinnitus conclude regarding its overall certainty of benefit?
  1. CBT provides high-certainty, large improvements across all outcomes measured
  2. Evidence for CBT is limited to outcomes of quality of life, anxiety, and depression with moderate-to-low certainty of benefits
  3. CBT was shown to be clearly superior to Tinnitus Retraining Therapy (TRT)
  4. CBT has no measurable effect on any tinnitus-related outcome
6.  A trial's "usual care" group performed worse than a comparable basic sound-therapy group. What procedural factor was proposed as a possible cause?
  1. The usual care group received fewer counseling contacts overall
  2. The usual care group used a lower level of background sound
  3. The usual care group involved many contacts using a social-work-style counseling approach that may have acted as negative counseling
  4. The usual care group excluded patients with hearing loss
7.  Which clinical practice is identified as a common obstacle that can worsen hyperacusis and Decreased Sound Tolerance (DST)?
  1. Encouraging avoiding sound
  2. Overuse of hearing protection (earplugs/earmuffs), leading to sound deprivation
  3. Fitting hearing aids without compression
  4. Performing routine speech-in-noise testing
8.  Performing routine speech-in-noise testing
  1. Relying on LDLs alone without a detailed interview, since low LDLs may instead reflect misophonia
  2. Measuring LDLs before beginning sound therapy
  3. Including ultra-high frequencies in the evaluation
  4. Comparing LDL shape to audiogram shape
9.  Why can testing acoustic reflexes be problematic as a routine procedure for patients with DST?
  1. It provides more diagnostic value than speech roll-over testing
  2. It is a procedure patients commonly complain about and can trigger or worsen misophonia and hyperacusis
  3. It cannot be performed in patients with normal hearing
  4. It replaces the need for an audiogram
10.  Which of the following represents a current, evolving direction being discussed within the field of audiology?
  1. A move away from evidence-based publication standards
  2. Proposals to classify tinnitus and misophonia as psychiatric/mental disorders, alongside calls to shift audiology from instrument-oriented to profession-centered, distinctive services
  3. Elimination of hearing aid fitting from the audiologist's scope of practice
  4. Declining interest in brain imaging research related to tinnitus