1. Becauseofyourtinnitus,isitdifficultforyoutoconcentrate?

Yes(4) Sometimes(2) No(0)

2. Doestheloudnessofyourtinnitusmakeitdif-ficultforyoutohearpeople?

Yes(4) Sometimes(2) No(0)

3. Doesyourtinnitusmakeyouangry? Yes(4) Sometimes(2) No(0)

4. Doesyourtinnitusmakeyouconfused? Yes(4) Sometimes(2) No(0)

5. Becauseofyourtinnitus,areyoudesperate? Yes(4) Sometimes(2) No(0)

6. Doyoucomplainagreatdealaboutyourtin-nitus?

Yes(4) Sometimes(2) No(0)

7. Becauseofyourtinnitus,doyouhavetroublefallingasleepatnight?

Yes(4) Sometimes(2) No(0)

8. Doyoufeelasthoughyoucannotescapefromyourtinnitus?

Yes(4) Sometimes(2) No(0)

9. Doesyourtinnitusinterferewithyourabilitytoenjoysocialactivities(suchasgoingouttodin-nerortothecinema)?

Yes(4) Sometimes(2) No(0)

10.Becauseofyourtinnitus,doyoufeelfrustrated? Yes(4) Sometimes(2) No(0)

11. Becauseofyourtinnitus,doyoufeelthatyouhaveaterribledisease?

Yes(4) Sometimes(2) No(0)

Thepurposeofthisquestionnaireistoidentifytheproblemsyourtinnitusmaybecausingyou.Check‘Yes’,‘Sometimes’,or‘No’foreachquestion.Pleaseanswerallquestions.

Name:________________________________________________

Date: _________________________________________________

TinniTus Handicap inventory (tHi)

1/3ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D

12. Doesyourtinnitusmakeitdifficulttoenjoylife? Yes(4) Sometimes(2) No(0)

13. Doesyourtinnitusinterferewithyourjoborhouseholdresponsibilities?

Yes(4) Sometimes(2) No(0)

14.Becauseofyourtinnitus,doyoufindthatyouareoftenirritable

Yes(4) Sometimes(2) No(0)

15.Becauseofyourtinnitus,isitdifficultforyoutoread?

Yes(4) Sometimes(2) No(0)

16.Doesyourtinnitusmakeyouupset? Yes(4) Sometimes(2) No(0)

17.Doyoufeelthatyourtinnitushasplacedstressonyourrelationshipswithmembersofyourfamilyand/orfriends?

Yes(4) Sometimes(2) No(0)

18.Doyoufinditdifficulttofocusyourattentionawayfromyourtinnitusandontootherthings?

Yes(4) Sometimes(2) No(0)

19.Doyoufeelthatyouhavenocontroloveryourtinnitus?

Yes(4) Sometimes(2) No(0)

20.Becauseofyourtinnitus,doyouoftenfeeltired?

Yes(4) Sometimes(2) No(0)

21.Becauseofyourtinnitus,doyoufeeldepressed? Yes(4) Sometimes(2) No(0)

22.Doesyourtinnitusmakeyoufeelanxious? Yes(4) Sometimes(2) No(0)

23.Doyoufeelyoucannolongercopewithyourtinnitus?

Yes(4) Sometimes(2) No(0)

24.Doesyourtinnitusgetworsewhenyouareunderstress?

Yes(4) Sometimes(2) No(0)

25.Doesyourtinnitusmakeyoufeelinsecure? Yes(4) Sometimes(2) No(0)

2/3ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D

For clinician use onlyTotalTHIScore:(numberof‘Yes’responsesx4)+(numberof‘Sometimes’responsesx2)=___________

DeterminepresenceofperceivedtinnitushandicapbasedontotalTHIscore.

0-16:Slightornohandicap(Grade1)18-36:Mildhandicap(Grade2)38-56:Moderatehandicap(Grade3)58-76:Severehandicap(Grade4)78-100:Catastrophichandicap(Grade5)

ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D

ReferencesNewman,C.W.,Jacobson,G.P.,&Spitzer,J.B.(1996).DevelopmentoftheTinnitusHandicapInventory.Arch Otolaryngol Head Neck Surg, 122,143-148.

McCombe,A.,Bagueley,D.,Coles,R.,McKenna,L.,McKinney,C.&Windle-Taylor,P.(2001).Guidelinesforthegradingoftinnitusseverity:TheresultsofaworkinggroupcommissionedbytheBritishAssociationofOtolaryngologists,HeadandNeckSurgeons,1999.Clin Otolaryngol,26,388-393.

ThisquestionnaireisreproducedwiththekindpermissionofCraigNewman,Ph.D 3/3