Introduction
The Fear of Tinnitus Questionnaire (FTQ) is a brief 17-item self-report measure of people's fear about the cognitive, emotional, behavioral and social consequences of living with tinnitus. Thomas E. Fuller, Rilana F. F. Cima, Eva Van den Bussche and Johan W. S. Vlaeyen published its psychometric validation in 2019 in Ear and Hearing.
The FTQ itself was first referenced earlier, in Cima et al. (2011), and it belongs to a fear-avoidance framework for tinnitus. This guide explains its items, scoring, reliability evidence and intended use as an outcome measure.
Key Features of the Fear of Tinnitus Questionnaire (FTQ)
Purpose and Use
The FTQ produces a total score that indicates fear of tinnitus. The developers intended it as an outcome measure, for example to detect change after treatment, rather than as a diagnostic tool. Researchers and clinicians use it within a fear-avoidance model of tinnitus.
Target Population
The FTQ is intended for adults with tinnitus. Its validation study used a Dutch-speaking sample.
Structure
The FTQ contains 17 fear-related statements about tinnitus, such as fear that:
Tinnitus will worsen or affect hearingOne will lose the ability to copeTinnitus signals a serious underlying disease, such as a tumor or brain hemorrhageTinnitus will "drive me crazy," prevent a normal life or worsen one's mental conditionExploratory analyses suggested three possible subscales: future consequences (8 items), somatic (4 items) and deterioration (3 items).
Scoring Method
Respondents mark each statement as applicable (1) or not applicable (0) to their current situation.
Total score: the number of applicable statements, from 0 to 17.Interpretation: higher scores indicate more tinnitus-related fear.Not reported: reverse-scored items and cut-off values.Administration Format
The FTQ is a self-report questionnaire with a binary "applicable/not applicable" response format, so respondents complete it themselves.
Applications of the Fear of Tinnitus Questionnaire (FTQ)
The FTQ supports several uses:
Treatment outcomes: detecting change in tinnitus-related fear after treatment.Fear-avoidance research: studying fear as part of the fear-avoidance model of tinnitus.Clinical settings: describing tinnitus-related fear alongside measures of tinnitus distress.Languages and availability
The FTQ was validated in a Dutch-speaking sample. Researchers have also studied it in other languages:
Swedish: validation of online versions of tinnitus questionnaires translated into SwedishChinese: reliability and validity of the Chinese versionReliability and Validity
In the validation study, the FTQ showed excellent internal consistency and test–retest reliability. It also showed strong convergent and concurrent validity against measures of tinnitus distress and disability.
Validation studies:
The Fear of Tinnitus Questionnaire: toward a reliable and valid means of assessing fear in adults with tinnitus (2019): study linkValidation of online versions of tinnitus questionnaires translated into Swedish (2016): study linkLimitations and Considerations
Keep these points in mind:
Binary format: the applicable/not applicable format may limit sensitivity compared with a graded scale.No cut-off scores: no clinical cut-offs have been established.Further validation: interpret individual scores cautiously until it is validated in other populations.Item review: five items showed poor discriminatory power, and items 12 and 16 were considered for removal; a 15-item version was proposed for future study.Other Versions And Related Questionnaires
No published short-form, revised or population-specific version of the FTQ has been found. These questionnaires are related:
Tinnitus Questionnaire (TQ)Tinnitus Catastrophizing Scale (TCS)Tinnitus Disability Index (TDI)Tinnitus Fear Avoidance Cognitions and Behaviors Scale (T-FAS)Illness Attitude Scale (IAS) and Short Form-36 (SF-36)Tampa Scale for Kinesiophobia (TSK) and Pain Anxiety Symptoms Scale (PASS)For overall tinnitus impact, see the ResRef guides to the TFI and the THIAdditional Resources
The original article: linkFor inquiries, contact Thomas Fuller, Department of Clinical Psychological Science, Maastricht University, P.O. Box 616, 6200 MD Maastricht, The Netherlands, at thomas.fuller@maastrichtuniversity.nl.Browse more ENT questionnaires in the ResRef database.Frequently Asked Questions (FAQ)
What does the Fear of Tinnitus Questionnaire measure?The FTQ measures fear about the consequences of living with tinnitus, such as fear that it will worsen, damage hearing, signal a serious disease or make normal life impossible.
How is the FTQ scored?Each of the 17 statements is marked applicable (1) or not applicable (0). The total is the number of applicable statements, from 0 to 17, and higher scores mean more fear.
Is the FTQ a diagnostic tool?No. The developers intended it as an outcome measure, for example to detect change after treatment, and no clinical cut-off scores have been established.
Who can complete the FTQ?The FTQ is designed for adults with tinnitus. It was validated in a Dutch-speaking sample, and studies have also examined Swedish and Chinese versions.
A Word from ResRef About the Fear of Tinnitus Questionnaire (FTQ)
The FTQ is a concise 17-item self-report tool for assessing tinnitus-related fear in adults with tinnitus, developed within a fear-avoidance framework. It showed excellent internal consistency and test-retest reliability, along with strong convergent and concurrent validity against measures of tinnitus distress and disability, in this Dutch-speaking sample. Its binary response format may limit sensitivity compared to a graded scale, and no clinical cut-off scores have yet been established, so interpretation of individual scores should be cautious pending further validation in other populations.
References
Fuller, T. E., Cima, R. F. F., Van den Bussche, E., & Vlaeyen, J. W. S. (2019). The Fear of Tinnitus Questionnaire: Toward a Reliable and Valid Means of Assessing Fear in Adults with Tinnitus. Ear and Hearing, 40(6), 1467–1477. https://doi.org/10.1097/AUD.0000000000000728Müller, K., Edvall, N. K., Idrizbegovic, E., Huhn, R., Cima, R., Persson, V., Leineweber, C., Westerlund, H., Langguth, B., Schlee, W., Canlon, B., & Cederroth, C. R. (2016). Validation of Online Versions of Tinnitus Questionnaires Translated into Swedish. Frontiers in Aging Neuroscience, 8. https://doi.org/10.3389/fnagi.2016.00272