Yes / Knowledge of the underlying mechanisms of effortful listening could help to reduce cases of social withdrawal and mitigate fatigue, especially in older adults. However, the relationship between transient effort and longer-term fatigue is likely to be more complex than originally thought. Here, we manipulated the presence/absence of monetary reward to examine the role of motivation and mood state in governing changes in perceived effort and fatigue from listening. In an online study, 185 participants were randomly assigned to either a ‘reward’ (n = 91) or ‘no-reward’ (n = 94) group and completed a dichotic listening task along with a series of questionnaires assessing changes over time in perceived effort, mood, and fatigue. Effort ratings were higher overall in the reward group, yet fatigue ratings in that group showed a shallower linear increase over time. Mediation analysis revealed an indirect effect of reward on fatigue ratings via perceived mood state; reward induced a more positive mood state which was associated with reduced fatigue. These results suggest that: (a) listening conditions rated as more ‘effortful’ may be less fatiguing if the effort is deemed worthwhile, and (b) alterations to one’s mood state represents a potential mechanism by which fatigue may be elicited during unrewarding listening situations.

Yes / Objectives: Listening-related fatigue can be a significant problem for adults who struggle to hear and understand, particularly adults with hearing loss. However, valid, sensitive, and clinically useful measures for listening-related fatigue do not currently exist. The purpose of this study was to develop and validate a brief clinical tool for measuring listening-related fatigue in adults. Design: The clinical scale was derived from the 40-item version of the Vanderbilt Fatigue Scale for Adults (VFS-A-40), an existing, reliable, and valid research tool for measuring listening9 related fatigue. The study consisted of two phases. Phase 1 (N = 580) and Phase 2 (N = 607) participants consisted of convenience samples of adults recruited via online advertisements, clinical records review, and a pool of prior research participants. In Phase 1, results from item response theory (IRT) analyses of VFS-A-40 items were used to identify high quality items for the brief (10-item) clinical scale: the VFS-A-10. In Phase 2, the characteristics and quality of the VFS-A-10 were evaluated in a separate sample of respondents. Dimensionality was evaluated using exploratory factor analyses (EFA) and item quality and characteristics were evaluated using IRT. VFS-A-10 reliability and validity were assessed multiple ways. IRT reliability analysis was used to examine VFS-A-10 measurement fidelity. In addition, test-retest reliability was assessed in a subset of Phase 2 participants (n = 145) who completed the VFS-A-10 a second time approximately one month after their initial measure (range 5-90 days). IRT differential item functioning (DIF) was used to assess item bias across different age, gender, and hearing loss subgroups. Convergent construct validity was evaluated by comparing VFS-A-10 responses to two other generic fatigue scales and a measure of hearing disability. Known-groups validity was assessed by comparing VFS-A-10 scores between adults with and without self reported hearing loss Results: EFA suggested a unidimensional structure for the VFS-A-10. IRT analyses confirmed all test items were high quality. IRT reliability analysis revealed good measurement fidelity over a wide range of fatigue severities. Test-retest reliability was excellent (rs = .88, collapsed across participants). IRT DIF analyses confirmed the VFS-A-10 provided a valid measure of listening29 related fatigue regardless of respondent age, gender, or hearing status. An examination of associations between VFS-A-10 scores and generic fatigue/vigor measures revealed only weak31 to-moderate correlations (Spearman’s correlation coefficient rs = -.36 to .57). Stronger associations were seen between VFS-A-10 scores and a measure of perceived hearing difficulties (rs = .79 to .81) providing evidence of convergent construct validity. In addition, the VFS-A-10 was more sensitive to fatigue associated with self-reported hearing difficulties than generic measures. It was also more sensitive than generic measures to variations in fatigue as a function of degree of hearing impairment. Conclusions: These findings suggest that the VFS-A-10 is a reliable, valid, and sensitive tool for measuring listening-related fatigue in adults. Its brevity, high sensitivity, and good reliability make it appropriate for clinical use. The scale will be useful for identifying those most affected by listening-related fatigue and for assessing benefits of interventions designed to reduce its negative effects. / Starkey Inc, NIH National Institute on Deafness and Other Communication Disorders (NIDCD) Grant #R21DC012865, NICHD Grant P30HD15052 to the Vanderbilt Kennedy Center for Research on Human Development, Vanderbilt Institute for Clinical and Translational Research grant (UL1 TR000445 from NCATS/NIH)

Yes / Purpose: Listening-related fatigue is a potential negative consequence of challenges experienced during everyday listening, and may disproportionately affect older adults. Contrary to expectation, we recently found that increased reports of listening-related fatigue were associated with better performance on a dichotic listening task (McGarrigle et al., 2021a). However, this link was found only in individuals who reported heightened sensitivity to a variety of physical, social, and emotional stimuli (i.e., increased ‘sensory-processing sensitivity’; SPS). The current study examined whether perceived effort may underlie the link between performance and fatigue. Methods: 206 young adults, aged 18-30 years (Experiment 1) and 122 older adults, aged 60-80 years (Experiment 2) performed a dichotic listening task and were administered a series of questionnaires including: the NASA task load index of perceived effort, the Vanderbilt Fatigue Scale (measuring daily life listening-related fatigue) and the Highly Sensitive Person Scale (measuring SPS). Both experiments were completed online. Results: SPS predicted listening-related fatigue but perceived effort during the listening task was not associated with SPS or listening-related fatigue in either age group. We were also unable to replicate the interaction between dichotic listening performance and SPS in either group. Exploratory analyses revealed contrasting effects of age; older adults found the dichotic listening task more effortful, but indicated lower overall fatigue. Conclusions: These findings suggest that SPS is a better predictor of listening-related fatigue than performance or effort ratings on a dichotic listening task. SPS may be an important factor in determining an individual’s likelihood of experiencing listening-related fatigue irrespective of hearing or cognitive ability. / This research was supported by an ESRC New Investigator Award (ES/R003572/1) to Ronan McGarrigle.