The Challenge of Non-Audiological Variables

Just over ten years ago, Gatehouse (1994) provided research evidence of the powerful impact that psychological variables may have on adjustment to hearing loss, as well as hearing aid benefit, use, and satisfaction. Using a regression model analysis, Gatehouse found that none of the audiological variables that he included in his study actually entered into the equation for social and psychological effects of hearing disability, whereas over 20% of the variance was explained by age and aspects of personality, particularly anxiety, and to a lesser extent depression. Gatehouse found that four psychological variables accounted for over 30% of the variation of hearing aid satisfaction ratings: hysteria, depression, sickness, and anxiety. Perceived help from hearing aids was also strongly influenced by certain aspects of personality. Thus, it appeared from Gatehouse’s analyses that psychological and social variables may be more closely linked to hearing aid success than audiological and electro-acoustic parameters. Since Gatehouse’s groundbreaking research study, there have been a number of other research efforts regarding psychosocial and sociological effects on treatment outcomes (Kricos, 2000; Kricos, 2006a). For example, the following personality traits have been linked to successful hearing aid use: external locus of control (Cox, Alexander, & Gray, 1999; Cox, Alexander, & Gray, 2005; Garstecki & Erler, 1998); anxiety/neuroticism (Gatehouse, 1994; Saunders & Cienkowski, 1996; Cox, Alexander, & Gray, 2007); introversion/extroversion (Cox et al., 1999; Saunders & Cienkowski, 1996); self-esteem (Saunders & Cienkowski, 1996); and lethargy/depression (Garstecki & Erler, 1998), and other personality traits, such as openness and conscientiousness (Cox, et al., 2007).