Research and Evidence

This article explores the effects of cognitive behavioral therapy and meditation as a form of treatment in tinnitus sufferers. It discusses the aim of the study, the independent and dependent variables, the main findings, and potential threats to validity and reliability. The article also provides solutions to mitigate these threats.

Running head: RESEARCH AND EVIDENCE 1
Research and Evidence
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Professor’s Name
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RESEARCH AND EVIDENCE 2
RESEARCH AND EVIDENCE
ARTICLE 1
1. Aim/ Purpose of the study and the hypothesis study
Yes, the main aim/purpose and the hypothesis that led to the study were explicitly stated.
The main objective of the research study was to investigate the effects of cognitive
behavioral therapy and meditation as a form of treatment in tinnitus sufferers. The
hypothesis of the study was that both the active and the control groups that were selected
and used in the study would significantly indicate a positive improvement after
application of the cognitive behavioral therapy and meditation. The hypothesis in the
study was based work that had earlier been done by Sadler and Stephens (Sadlier,
Stephens, & Kennedy, 2008).
2. The independent variables and how participants were allocated to each group
The independent variable was the response to the therapy and the meditation as a way of
treatment of tinnitus sufferers.
The study involved a group of twenty-five patients who had been confirmed to have been
complaining about tinnitus and thus were identified to significantly benefit from the
therapies. The venue of the research study was at the Welsh Hearing Institute in Cardiff.
The selected sample was obtained from those individuals who were attending the
specified tinnitus clinic for the first time. A study design that involved a waiting list
control was applied to determine the behavioral therapy and mindfulness meditation in
chronic tinnitus sufferers. The patients were divided into two groups on a consecutive
basis. The first group was treated after consultation with audiological physician in a one
four-hour session while the second group had to wait a period of not less than three

RESEARCH AND EVIDENCE 3
months and thus acted as control for themselves. The patients were placed in the groups
strictly on a consecutive basis (Sadlier, Stephens, & Kennedy, 2008).
3. The dependent variables and how they were measured
The dependent variables included pessimism/helplessness, impact on hearing, ability to
ignore the disease, relaxation, impacts on emotions as a result of tinnitus among others.
The dependent variables were assessed using six measures that assessed the various
aspects of tinnitus such as severity, general view of their life and mood and the effects of
the ailment on them. The six measures were:
 The tinnitus questionnaire: It was a scale comprising of thirty-three items that was
developed to measure the severity of the disease. Items measured included,
pessimism, impact on hearing, ability to assume the disease, relaxation,
acceptance and emotional effects of the disease. The variables were measured on
a visual analogue scale that ranged from true to not true.
 Hospital anxiety and depression scale: the fourteen-item scale measured anxiety
and depression in the patients. Scores ranged from zero to twenty-one where
scores above 10 were regarded as extreme problems.
 Tinnitus visual analogue scale. It measured the effects of the disease on the
patients, scale ranged from 0-100. 0 represented lack of problems while 100
represented serious problem
 Life satisfaction scale: the five-item scale was used to measure a patient’s general
view on their lives and the influence the modification of tinnitus had on these
perceptions. The answers ranged from strongly disagree to strongly agree.

RESEARCH AND EVIDENCE 4
 Tinnitus trigger questionnaire: The questionnaire involved asking patients the
existence of life events that would be linked with the disease.
 Post therapy questionnaire: It was sent four to six months after the therapy to
access how they felt after the treatment and compare with how the felt before the
therapy. The answers ranged from better, worse or no change.
4. The main finding and whether they support the hypothesis
The study found that there was significant statistical reduction in tinnitus problems for
both the active and the control group. However, post therapy there was no any valuable
change that was observed after the waiting period was over. The improvement remained
stagnant at four to six-month (Sadlier, Stephens, & Kennedy, 2008). Since the objective
was to examine the impact of cognitive behavioral therapy and meditation in tinnitus
sufferers while the hypothesis was aimed to examine that there would be significant
improvement on patients in both the active and the control group, it is true to say that the
findings support the purpose and hypothesis. The author argues that the positive findings
give support to the use of cognitive and behavioral therapy/meditation for chronic tinnitus
sufferers (Sadlier, Stephens, & Kennedy, 2008).
5. Problem the author mentioned about the study
Yes, the author mentioned problems that were encountered in the study. The author says
that the research was limited by the sample of the participants that ware chosen being
very small and thus would only act as a preliminary study. Additionally, the author says
that the other weakness of the study was that the patients involved in the study were not
randomized before the study had commenced and instead, they were allocated to the
groups on a consecutive basis. The author argues that the external validity of the study

RESEARCH AND EVIDENCE 5
could be limited by the patients representing tertiary referrals hence could not be
applicable to the whole population of tinnitus sufferers. The author also reported that
there were more women in the active group, a factor that would lead to the study not
reflecting the general trends showing an even distribution.
6. Potential threats to validity and reliability
The threats to validity and reliability that were observed are shown in the table below.
7. How the threats could be avoided.
The solutions to the threats of validity are shown in the table below:
Threat Type Specific threat Solution
Internal Validity  Small Sample size
 Sample dominated with a
single gender
 Respondents aware of being
used in the study
 Use of appropriate
sample size
 Randomly select
individuals to
include both
genders
 Using volunteer
sample unaware of
the study or not
influenced in any
way
External Validity  Lack of guarantee that the
study could be applied to a
similar situation, with
 Perform the same
study at different
times with different

RESEARCH AND EVIDENCE 6
different people and
different time
people to confirm
the ability to be
used in a different
study
Measurement
Validity
 Lack of comparison with
result from another study
limiting criterion validity
 Perform as many
tests as possible
and compare the
results if the
correlate with each
other.
Reliability  Questionnaires filled by
respondents only once
limiting test-retest validity
 Result only measured once
limiting inter-rater
reliability
 Ensure that the
respondents fill the
questionnaires at
different times and
the result match
 Measure the results
over and over again
to ensure that the
results agree.

RESEARCH AND EVIDENCE 7
ARTICLE 2
1. Appropriateness of the measurement considering the aspects of validity and
reliability.
The type applied in this article seems to be appropriate and dependable looking into the
aspects of validity and reliability as follows:
Firstly, the study employs all potential threats to internal validity. The sample size
selected is convenient enough to perform the study. It is neither too small nor too large.
Besides, the duration of the study which was between July 2006 and 2007 is appropriate
to guarantee validity (Javanbakht, Ghasemi, & Kenari, 2009). The appropriateness of the
measurement is further confirmed by the fact that no respondent volunteered or had the
idea of being included the study hence reducing the possibility of sample bias. The
respondents involved individuals who decided to experience the without any known
psychological disorders or without recommendation from a specialist for taking the
therapy. Additionally, the sample only included only new cases that were evaluated on
admission through the utilization of different tests such as personal questionnaires, the
Beck depression inventory and the State-Trait Inventory.
Internal validity is further justified by the fact that the tests involved had adequate
measures. For example, the Beck depression inventory had 21 items to measure the
depressive patient symptoms while the State-Trait inventory had 20 items to measure the
symptoms of anxiety. This ensured that no measurement or detection bias was
experienced.
External validity was guaranteed by the fact that the study included active and control
samples and the that the therapy performed was at different times. This made it possible

RESEARCH AND EVIDENCE 8
to yield results that had the possibility of being applied to other similar situations for
different people at different time. On the other hand, reliability was facilitated by
carrying out the study to different people at different times and the results of the different
studies compared to ensure they were consistent (Javanbakht, Ghasemi, & Kenari, 2009).
2. Potential threats to both the internal and the external validity
The potential threats to both the internal and external validity are shown in the table
below.
3. How the threats could have been avoided
The solutions to how the threats could have been mitigated are shown in the table below.
Threat Type Specific Threat Solution
Internal Validity  The sample purely
consisted of female
gender hence was not
representative of the
population which
included male gender
as well
 The fact that the
researcher was aware
of the study and the
expected results
could influence the
study.
 Randomly select
people from the
population and
include both
genders. Ensure
that every
respondent has an
equal chance of
being selected,
 Use researchers
even though might
have the
knowledge of

RESEARCH AND EVIDENCE 9
study don’t know
the expected
results.
External Validity  Lack of guarantee
that the study could
be applied to a
similar situation,
with different people
and different time
 Perform the same
study at different
times with
different people to
confirm the ability
to be used in a
different study
Measurement Validity  Lack of comparison
with result from
another study
limiting criterion
validity
 Perform as many
tests as possible
and compare the
results if the
correlate with
each other.
Reliability  Questionnaires filled
by respondents only
once limiting test-
retest validity
 Ensure that the
respondents fill
the questionnaires
at different times
and the result
match

RESEARCH AND EVIDENCE 10
References
Javanbakht, M., Ghasemi, M., & Kenari, R. H. (2009). Effect of yoga on depression and
anxiety of women referred to yoga clinic. Complimentary Therapies in Clinical
Practice, 23, 102-104. Retrieved from https://www.elservier.com/locate/ctnm
Sadlier, M., Stephens, S. D., & Kennedy, V. (2008). Tinnitus rehabilitation: A
mindfulness meditation cognitive behavioral therapy approach. The Journal of
Laryngology & Otology, 122(1), 31-37. doi:10.1017/s0022215107007438