The Mediating Role of Mindfulness and Self-Compassion in the Link between Tinnitus Distress and Anxiety

INTRODUCTION: Tinnitus is the perception of sound in the absence of external stimuli, often experienced as ringing or buzzing. While many individuals habituate to tinnitus, others develop chronic tinnitus (CT), which can severely affect emotional well-being. Psychological mechanisms such as anxiety and maladaptive coping are known contributors to tinnitus distress, yet the protective role of mindfulness and self-compassion remains underexplored. This study examined the associations between tinnitus distress, anxiety, depression, mindfulness, and self-compassion in a clinical sample. It further investigated whether mindfulness and self-compassion mediate the relationship between tinnitus distress and anxiety. METHODS: Ninety-two adults (mean age = 42.6 years; 64.1% female) with tinnitus lasting at least 2 months completed an online survey. Measures included the Tinnitus Functional Index, Hospital Anxiety and Depression Scale, Cognitive and Affective Mindfulness Scale-Revised, and Self-Compassion Scale-Short-Form. Correlational and mediation analyses were conducted using PROCESS. RESULTS: Tinnitus distress was strongly correlated with anxiety (r = 0.484, p < 0.001) and moderately with depression (r = 0.304, p < 0.01). Both mindfulness and self-compassion were negatively associated with tinnitus distress and anxiety. Mediation analyses showed that self-compassion (β = 0.145, 95% CI [0.053, 0.252]) and mindfulness (β = 0.167, 95% CI [0.071, 0.272]) partially mediated the relationship between tinnitus distress and anxiety. DISCUSSION: These findings support the role of mindfulness and self-compassion as protective factors in tinnitus-related anxiety. Interventions targeting these traits may help reduce emotional suffering in individuals with CT but require further evaluation. Longitudinal studies are recommended to confirm causal pathways.