By Hashir Aazh This article is a part of the November/December 2019, Volume 31, Number 6, Audiology Today issue. Tinnitus is the sensation of sound without any external sound source. Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities (Aazh et al, 2016). The sounds may be perceived as uncomfortably loud, unpleasant, frightening, or painful (Tyler et al, 2014). A recent study suggests that over 60 percent of help-seeking patients with tinnitus and/or hyperacusis reported symptoms of anxiety disorders and/or depression (Aazh and Moore, 2017). It has been reported that adverse childhood experiences (ACE) increase the risk of poor mental health later in life (Anda et al, 2006). These experiences are defined as exposures to different forms of abuse (physical, emotional, and sexual) and family dysfunction (substance abuse, mental illness, mother treated violently, incarcerated household member and parental separation) (Felitti et al, 1998). Parental separation and poor parental mental health are important forms of ACEs with prevalence of 23.3 percent and 19.4 percent, respectively (Anda et al, 2006; Lee and Chen, 2017). ACEs seem to influence the process in which a health condition leads to development of disability (activity limitations and participation restrictions) (Schussler-Fiorenza Rose et al, 2014). However, no study prior to this trilogy of studies (Aazh et al, 2018a; Aazh et al, 2018b; Aazh et al, 2019) has assessed whether the individuals with a history of parental separation and poor parental mental health in their childhood are at more risk of developing tinnitus and hyperacusis disability. Trilogy of Studies In a trilogy of studies conducted at the Tinnitus and Hyperacusis Therapy Specialist Clinic (THTSC) at the Royal Surrey County Hospital, the relationships between parental mental health and parental separation in childhood and the psychological impact of tinnitus/hyperacusis on the individual in their adulthood have been explored. An international network of researchers from different disciplines collaborated in these studies. The collaborators consisted of Professor Brian C. J. Moore (Department of Experimental Psychology, University of Cambridge, United Kingdom), Professor Ali A. Danesh (Department of Communication Sciences and Disorders, Florida Atlantic University, United States), Dr. Michael Landgrebe (Department of Psychiatry, Psychosomatics and Psychotherapy, kbo Lech-Mangfall-Hospital Agathried, Germany), and Professor Berthold Langguth (Department of Psychiatry and Psychotherapy at the University of Regensburg, Germany) See Figure 1. The study populations in the studies cited here consist of patients who sought help from their general practitioners concerning their tinnitus and/or hyperacusis and who were referred to an audiology clinic. Therefore, the data reported in these studies may not be generalizable to other populations. However, these data are very relevant to audiology clinics that provide therapy and support for patients with tinnitus and hyperacusis. The aim of this article is to review the key outcomes of these studies. This content is an exclusive benefit for American Academy of Audiology members. If you're a member, log in and you'll get immediate access. Member Login If you're not yet a member, you'll be interested to know that joining not only gives you access to top-notch resources like this one, but also invitations to member-only events, inclusion in the member directory, participation in professional forums, and access to patient resources, tools, and continuing education. Join today!