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Exploring the Link Between Clinical Hearing Loss and Perceptions of Stress and Anxiety
Journal article   Peer reviewed

Exploring the Link Between Clinical Hearing Loss and Perceptions of Stress and Anxiety

Aaron Michael Roman and Elizabeth Sedunov
Journal of the American Academy of Audiology
25 Jul 2025
DOI: https://doi.org/10.3766/jaaa.240129
PMID: 40708238

Abstract

Auditory Rehabilitation hearing aids and assistive listening devices Hearing Science Speech Perception Stress
Purpose: Current literature is conflicting and unclear when comparing perceived stress and anxiety with hearing loss. This study assesses the relationship of standard audiometric measurements to perceived stress, anxiety, and hearing impairment. Research Design: All participants were seen for a comprehensive audiological evaluation. Participants’ best pure tone average (PTA) and high-frequency pure tone average (HF-PTA) were calculated from measured behavioral thresholds to pure tones of 500–8000 Hz. Word recognition scores (WRS) were obtained for each ear. Participants completed the Reduced Hearing Handicap Index Screening (RHHI-S), Perceived Stress Scale (PSS), and Generalized Anxiety Disorder – 7 item (GAD-7) questionnaires. Study Sample: Sixty-two participants seen for audiological evaluations participated in this study. The mean age of participant was 62.6 (±16.8) years. Data Collection and Analysis: Participants were grouped into age categories and analyses of variance were used to determine whether a significant difference existed among the questionnaires across the four age groups. Pearson’s r correlation coefficients were used to determine a relationship between all measurements, and t tests were used to determine whether a difference in questionnaire score existed between previous hearing aid users and non-hearing aid users. Hierarchical regression analyses were applied to determine whether perceived stress or perceived hearing loss has a significant predictor in audiometric testing. Results: RHHI scores were significantly higher in those with hearing loss and the participant group containing those with hearing loss that wore hearing aids compared to those who did not. Additionally, GAD-7 scores significantly predicted PSS scores. All other comparisons were nonsignificant. Conclusions: The results from this study suggest that insights into stress and anxiety may be beneficial for counseling, but they do not seem to be related to severity of hearing impairment or speech in quiet performance. Clinical Relevance Statement: Questionnaires can provide significant insight into the perceptions of patients seeking clinical care. The findings from this study find that the RHHI-S significantly correlates with common behavioral measurements of hearing. Questionnaires that reflect on anxiety and perceived stress levels have no correlation to these measurements.

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