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   Abstract
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ARTICLE  
Year : 2011  |  Volume : 13  |  Issue : 55  |  Page : 407-414
Gender perspectives in psychometrics related to leisure time noise exposure and use of hearing protection

1 Department School of Health and Medical Sciences, Swedish Institute for Disability Research, S-701 82 Örebro University, Trollhättan, Sweden
2 Department of Psychology and Organizational Studies, Institution of Social and Behavioural Studies, University West, Trollhättan, Sweden

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Date of Web Publication28-Nov-2011
 
  Abstract 

The purpose of the present study was to investigate possible gender differences regarding psychometric scales measuring risk perception in noisy situations, attitudes towards loud music, perceived susceptibility to noise, and individual norms and ideals related to activities where loud music is played. In addition the purpose was to analyze whether these variables are associated with protective behavior such as the use of hearing protection. A questionnaire was administered to a Swedish sample including 543 adolescents aged 16 to 20. The result revealed significant gender differences for all the psychometric scales. In addition, all psychometric measures were associated with hearing protection use in musical settings. Contrary to previous studies, gender did not contribute to any explanation of protective behavior by itself in the analysis. One conclusion is that although gender does not contribute by itself for the explanation of protective behavior, gender may affect psychological variables such as risk perception, attitudes and perceived susceptibility and that these variables may in turn be valuable for decision-making and protective behavior in noisy situations. Although women tend to be more 'careful' psychologically, they nevertheless tend to behave in the same way as men as regards actual noise-related risk taking.

Keywords: Attitudes, gender, music, noise, protective behavior, risk-taking behavior

How to cite this article:
Widén S, Bohlin M, Johansson I. Gender perspectives in psychometrics related to leisure time noise exposure and use of hearing protection. Noise Health 2011;13:407-14

How to cite this URL:
Widén S, Bohlin M, Johansson I. Gender perspectives in psychometrics related to leisure time noise exposure and use of hearing protection. Noise Health [serial online] 2011 [cited 2020 Apr 10];13:407-14. Available from: http://www.noiseandhealth.org/text.asp?2011/13/55/407/90299

  Introduction Top


Music and high levels of sound have not traditionally been associated with risk-taking behaviors. However, adolescents often expose themselves to loud music at gyms, concerts, clubs, etc.; the reasons seeming to be that loud music may intensify and make the musical experience more powerful, thus increasing the quality of life. [1],[2],[3],[4] Research has indicated that frequent exposure to amplified music over longer periods of time may have negative auditory effects. [5] Other studies have focused hearing symptoms that may be linked to noise exposure among adolescents. For instance, Bohlin and Erlandsson [2] found that 6.1% of the adolescents in a Swedish study reported permanent tinnitus, 15.8% temporary tinnitus, 5.8% hearing impairment, and 20.6% noise sensitivity. Women reported experience of noise sensitivity significantly more than men, whilst men reported temporary tinnitus significantly more often than women. The numbers of self-reported hearing problems among Swedish adolescents are also supported by the findings of Olsen Widén and Erlandsson. [6] They concluded that gender and socioeconomic status affected attitudes toward noise and risk engagement. Worrying about noise and the risk of damaging hearing were significantly higher among those with high SES compared to those with low SES and significantly higher among young women compared to young men. Both positive attitudes towards noise as well as low use of hearing protection were found among younger adolescents with low SES. [7] It is reasonable to believe that negative attitudes towards noise among adolescents encourage them to avoid noise exposure if it is perceived as unsafe. [7],[8] Whilst young persons from other countries such as Brazil and USA seem to have similar music listening patterns as in Sweden, the use of hearing protection in comparison is remarkably lower. [9],[10]

Hearing loss among young people in different parts of the world is becoming increasingly common and a major public health concern. For example, among Mexican high school students hearing loss is significantly related to recreational activities such as club and concert visits, [11] as is also the case among Brazilian [9] and American students. [12] A study of 258 American adolescents indicated that 26% had thresholds poorer than the screening level of 20 dBHL. [13] Attitudes were also significantly related to self-experienced hearing symptoms, but not to threshold shifts itself, indicating that self-experienced symptoms may function as a cue to attitudinal and behavioral change, whereas smaller and probably unnoticed threshold shifts do not appear to have any impact on attitudes and behaviors. Additionally, the study revealed that hearing protection was preferred to a greater degree when using firearms, mowing lawns, and working with noisy tools, than when attending concerts and clubs. Hence, young adults exposed themselves to hearing risks, since the use of hearing protection among young American adults in general was found to be very low.

Bohlin et al. [3] and Widén and Erlandsson [14] have found that adolescents do not consider noisy environments (clubs and rock concerts) to be as risky as traditional risk situations (e.g. drug and speeding). On the other hand, adolescents often engage in hearing-related and traditional risk-taking activities at the same time. Bohlin and Erlandsson [2] have shown that adolescents' behaviors in different traditional risk situations are correlated with behavior in noisy environments, whilst judgments about traditional risks are correlated with judgments regarding noise exposure. Although young women judge risk situations as generally more dangerous than young men, they nevertheless behave in the same way. The researchers suggest that this difference may be due to social and culturally based phenomena.

A qualitative study by Widén and Erlandsson [14] among 16 young adolescents indicated that self- image (e.g. perceived vulnerability), risk perception, norms, and ideals were important aspects involved in hearing-related risk taking. The authors discuss the possibility that social norms (e.g. expectations about how you should behave) and normative ideals (e.g. expectations about the type of person you should be) are important for engagement in risky behaviors. A conclusion from that study was that men seemed to have more difficulties in acknowledging vulnerability than women. Widén [15] suggests that variables such as attitudes towards noise, perceived vulnerability to noise exposure, risk perception, the norms, and the ideals a person identifies with are important variables to include in analyzing protective behavior such as using hearing protection under noisy conditions. In a study in the Netherlands, it was found that adolescents and adolescent males in particular, expressed low personal vulnerability to music-induced hearing loss and that they were less likely to change their music-hearing habits. [16],[17] Another qualitative study by Bohlin et al., [3] among 16 young men and women (aged 15-20) revealed that risk taking (e.g. listening to loud music, speeding, alcohol use) among these adolescents was constituted of both social and existential aspects of identity. A deeper analysis of these aspects revealed that risk taking was found to be gender-related in the sense that young women and men felt expected to fit in to female and male norms, findings of which are consistent with those obtained by Widén and Erlandsson. [14] Deaux and Kite [18] and Witley and Aegisdóttir 19] assert that people are expected to fit into and reproduce stable gender roles, which includes fixed gender-related qualities and physical attributes. People are not supposed to change between "feminine" and "masculine" expressions. Furthermore, in a study of adolescents and young adults conducted by Bohlin et al., [20] an Australian instrument (ARQ) [21] was used with additional questions on hearing risk taking. [2] The main results showed that the factor structure in the judgment and behavior scale for Swedish adolescents was rather different from the factor structure in the Australian sample. Another finding was that the factor structure differed between men and women in the study. A plausible explanation is that the questions about risk taking in specific situations may fit men's experiences more than women's. This can be due to a bias in traditional theories and questionnaires on risk taking towards a tendency to fit a "male" norm. [2],[3]

There are some reported studies that have looked into potential gender differences concerning protective behavior or risk-taking behavior regarding exposure to noise and loud music. For instance, Jokitulppo et al. [22] found that there were significant differences between the genders in their choices of leisure time activities. Activities which involved loud levels of noise (e.g. playing in a rock band, take part in motor sports) were preferred by boys. Olsen Widén and Erlandsson [7] did not find any significant differences between young men and women in Sweden regarding their use of hearing protection at concerts and discotheques. Rawool and Collingon-Wayne [12] found that the probability for men to use noisy tools without using hearing protection were almost twice as high compared to women. Widén et al. [10] found in an inter-cultural study between Sweden and the US that 26.6% of the men reported hearing protection use at concerts, whereas 36.5% of the women reported hearing protection use. However, when country and attitudes toward noise was controlled for, gender as a variable did not contribute to the explanation of hearing protection use. The authors concluded that gender covaries with both cultural norms and attitudes, which have stronger effect on the outcome variable than gender by itself has.

Aim

Based on theoretical suggestions in previous work, [14],[15] five new psychometric scales have been constructed in order to measure the following variables; perceived susceptibility to noise, risk perception, individual norms, normative ideals, and attitudes towards loud music. Hence, one purpose of the present study is to discover whether these new measurements covariate with hearing-related protective behavior; in this case the use of hearing protection. Another purpose is to investigate possible gender differences regarding these psychometric scales related to activities where loud music is played.


  Methods Top


Participants and procedure

The study population consisted of 567 individuals between 16 and 20 years of age. All subjects were recruited from a single upper secondary school in the west of Sweden. Since the questionnaire was distributed and collected simultaneously, there were no external dropouts. Some questionnaires (24 in number) were incomplete regarding important measurements and were therefore excluded from the data, resulting in a sample based on 543 subjects. The gender distribution in the sample is 270 (49.7%) women and 273 (50.3%) men. All subjects got written information about the study's purpose, and were informed that the participation was voluntary and that they could end the questionnaire at any time. The participants were also informed about that the results will be presented in a way that assured the participant's confidentiality.

Measurements

The questionnaire consisted of 70 items. In the questionnaire questions about the participants' gender and age were included. Five measurements have been constructed for the present study based on previous studies by Widén. [15] The psychometric scales are new and have not yet been sufficiently validated. A pilot study on 60 university students was conducted in order to test the measurements reliability. The analyses resulted in reduction of items and in some cases new formulations of items. Homogeneity (Cronbach's alpha) of the items in the scales based on the present sample is presented below. A more complete evaluation of the five measurements by means of explorative factor analysis (EFA) are under preparation, however the results from the evaluation of the measurements is beyond the scope of the present article and needs to be reported in a separate article.

Youth attitude towards noise scale revised

The youth attitudes towards noise scale (YANS) Olsen-Widen and Erlandsson [15] measures adolescents' attitudes towards noise. The original scale is based upon 19 items formulated as statements measured on a five degree Likert scale where the code 5 indicates total agreement with the statement, whereas 1 indicates total disagreement. Work has been done in order to create a shorter version of the scale focusing on attitudes towards loud music in certain environments (YANS-R). The present scale is based on the first factor in YANS (attitudes towards noise associated with youth culture) and consists of 11 items. A high score on the scale indicates a positive attitude towards loud music (e.g. "Music is at its best when it is played really loud"), whereas a low score indicates a negative attitude. Cronbach's alpha for the YANS-R was α = 0.81.

Perceived susceptability to noise

The perceived susceptibility to noise (PSN) scale consists of 14 items measuring the individuals' own perception of being vulnerable or invulnerable to noise and loud levels of music. High scores on the scale indicate a perception of oneself as being susceptible to noise, whereas low scores indicate a perception of not being affected negatively by high levels of noise. A five-point degree Likert scale is used to ascertain the extent to which the individual agrees with statements such as "Listening to music at high volumes may cause harm to my hearing" or "Sound or beeps in my ears are to be expected after a night out". Cronbach's alpha for this scale was α = 0.74.

Norms and ideals

The norms and ideals scale (NAIS) is based upon 14 items measuring 1) the norm of acting invulnerably to negative outcomes of a certain hearing-related risk-taking behavior (7 items α = 0.70) and 2) the ideal of being a risk taker (7 items α = 0.80). The scale is constructed as statements measured on a five-point Likert scale, where 5 indicates total agreement with the norm of being invulnerable, or total agreement with the ideal of being a risk taker, and 1 stands for totally disagreement with the statement. Cronbach's alpha for the total scale was α = 0.84.

Risk perception inventory

The risk perception inventory (RPI) consists of 14 items. The scale is constructed as statements measured on a five-degree Likert scale. Code five represents total agreement with the statement and indicates a high level of risk perception regarding activities where loud music is played, for example being aware that loud music may be harmful to hearing, whereas the code 1 (total disagreement) indicates a low level of risk perception (e.g. loud levels of music as not harmful to hearing). Cronbach's alpha was α = 0.81.

The correlations between attitudes towards loud music, perceived susceptibility to noise, norms, ideals, risk perception, use of hearing protection at concerts and discotheques/dances, and gender are presented in [Table 1].
Table 1: Correlation matrix of the measurements used in the study

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Adolescent habits and use of hearing protections

Adolescent habits and use of hearing protections (AHH-R) is based on AHH [6],[7] and measures how often the participant engages in noisy activities, and for how long period of time. Additionally there is a question asked about the person's use of hearing protection at a specific activity. The question is formulated as: "If you make a judgment about how often you use hearing protection during this activity, what percentage of the time do you use hearing protection?" The informant can mark on a 11-degree scale an alternative from 0% of the times to 100% of the times. The scale consists of 15 questions.

Procedure

A questionnaire was distributed to students aged between 16 and 20 years of age in a single school in the west of Sweden. A researcher contacted the school principal and provided them information about the study. A short informational letter was given to class teachers, who in turn administered the questionnaire to the participants during school time. A short letter containing information about the study was attached to the questionnaire. The completed questionnaires were put in an envelope, which was collected by a researcher at a predetermined time. The average completion time for the questionnaires was about 20 min.

Statistical analysis

In order to control for covariance between the dependent variables, MANOVA (multivariate analysis of variance) was used in order to analyze gender differences (independent variable) between the dependent variables (attitudes, perceived susceptibility, norms, ideals, and risk perception). MANOVA is the multivariate extension of univariate techniques for assessing the differences between group means. When two or several dependent variables are correlated, the use of separate univariate ANOVAs or t-tests can create a problem when trying to control the experiment-wide error rate. [23] Thus we have chosen to use MANOVA, since the dependent variables are correlated with one another [Table 1]. Multiple regression analysis was conducted in order to analyze the independent variables (attitudes, perceived susceptibility, norms, ideals and risk perception) that might be associated with hearing protection use (dependent variable).


  Results Top


[Table 2] presents mean (m) and standard deviation (SD) for men and women distributed on attitudes towards music, perceived susceptibility, norms, ideals, and risk perception.
Table 2: Mean (m) and standard deviation (SD) for men and women distributed on attitudes towards music, perceived susceptibility, norms, ideals, and risk perception

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A MANOVA was conducted in order to analyze the gender differences regarding attitudes towards loud music, perceived susceptibility to noise, norms and ideals, and risk perception in noisy environments. The result is presented in [Table 3]. Significant differences between men and women were found for all dependent variables. As can be seen in [Table 2], men were found to report significantly more positive attitudes towards loud music and they identified themselves to a higher degree to the norm of being invulnerable, and to the ideal of being a risk taker. Women, on the other hand, tended to report a higher degree of perceived susceptibility to noise as well as having a higher degree of risk perception regarding noise exposure.
Table 3: Analysis (MANOVA) of gender differences regarding attitudes towards loud music, perceived susceptibility to noise, norms and ideals, and risk perception in noisy environments

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The analysis of self-reported habits and use of hearing protection was made using t-test for independent groups. Whilst both women and men reported similar behavioral patterns, significant gender differences were found in two types of activities; the frequency in a month that the person attended discotheques or dances, and the frequency in a year that the person attended concerts. There was a significant difference between women and men with regard to the frequency of attendance at discos or dances. Women reported significantly more visits (m=2.18/month) compared to men (m=1.68/month). There were no significant differences between men and women's behavior regarding use of hearing protection or in the number of hours they stayed at discotheques or dances.

No significant differences between men and women were found in reported number of visits at concerts during a year. However, significant gender differences were found for the number of hours they stayed. Men reported staying longer (m = 4.64 hours/visit) compared to women (m = 3.74 hours/visit). There were no significant difference between men and women regarding the use of hearing protection at concerts. The results are presented in [Table 4].
Table 4: Statistical analysis on gender-related behavioral differences

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In order to analyze variables associated with protective behavior (use of hearing protection), two multiple regression analysis were carried out, one for discotheques/dances and another for attending concerts [Table 5]. Since we had already found gender differences regarding attitudes, perceived susceptibility to noise, norms, ideals, and risk perception, we wanted to analyze gender together with these independent variables in order to see whether gender itself contributes to the model in terms of explained variance.
Table 5: Explanatory variables to the use of hearing protection at disco/dances and concerts

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The regression analyses indicate that attitudes and risk perception together explain 15% of the variance regarding the use of hearing protection at discotheques/dances. Persons who are negative towards high levels of noise are more likely to use hearing protection at discos. Additionally, individuals who have a high risk perception are more likely to use hearing protection during this activity. Gender, perceived susceptibility norms and ideals do not contribute significantly to the model.

Use of hearing protection were found to be associated with perceived susceptibility to noise, the norm of being invulnerable and risk perception regarding noise exposure. These three variables explained about 36% of the variance in use of hearing protection at concerts. Gender, attitudes towards loud music, and ideals regarding being a risk taker did not contribute significantly to the model.


  Discussion Top


The aims of the present study were to investigate possible gender differences regarding attitudes towards loud music, perceived susceptibility to noise, norms, normative ideals, and risk perception related to activities where loud music is played. An additional aim was to consider whether attitudes towards loud music, perceived susceptibility to noise, norms, normative ideals and risk perception are associated with use of hearing protection. Three main results are highlighted in this article.

The results suggest that, as group men tend to report more positive attitudes towards loud music, they identify themselves to a higher degree with the norm of acting invulnerably and the ideal of being a risk-taker. In contrast, women tend to report a higher degree of perceived susceptibility to noise and a higher degree of risk perception regarding noise exposure. It is important to underline that the gender differences found in the present study are small. The result regarding gender differences in attitudes is however consistent with previous findings obtained by Olsen Widén and Erlandsson [6] where an earlier version of the YANS attitude measurement was used. The YANS instrument has also been used in other studies in different cultural contexts where similar results have been obtained. [9],[8] In the present study, men compared to women report having greater difficulties in acknowledging vulnerability, which is consistent with results from a study in the Netherlands where men were found to express low personal vulnerability to music-induced hearing loss and where they even stated that they did not want to change their music-listening habits. [16],[17] A plausible explanation is that risk taking is gender-related in terms of the way young women and men adhere to the expectations of fitting in with gendered norms, something that is discussed in both Bohlin et al. [3] and Widén and Erlandsson. [14] In this study, the largest gender differences were found for the scales measuring norms and ideals, which could support the idea of gendered norms. Previous studies indicate that when risk judgment and behavior (both risks in noisy environments and other more "traditional" risk-taking behaviors such as drug use and speeding) are factor analyzed separately for women and men, the structure for judgment and behavior is rather dissimilar between men and women. [20] This result could also be explained from the result in the present study that men and women tend to hold different attitudes, norms, normative ideals, risk perceptions, and perceptions of vulnerability, all of which may have an impact of decision making and behavior.

No significant differences in noise exposure habits were found between men and women in the present study, except for duration of time they stayed at concerts and number of discotheque visits per month. Men stayed longer at concerts compared to women. We can only speculate about the reason for this result. One suggestion may be that women reported a higher degree of perceived susceptibility to noise and additionally they perceived exposure to loud music to be more risky than men, which could explain why women decided to leave concerts earlier. Another possible explanation is that we don't know from the data in this study if women and men attended the same kind of rock concerts even listening to the same musicians. There can be differences in what women and men prefer regarding, for example the duration of a specific concert, the sound levels that is preferred by a certain musician, etc. Hence, women and men choose to attend somewhat different types of rock concert, which might result in the observed difference. Maybe the result that men attend discos to a lower extent than women could be explained from a gender identity perspective. Attending discos and dances may be a kind of social activity that attracts young women more than it attracts young men. Maybe the expectations in the peer group about how to behave and in what types of situations are different between the genders. However, it is important to underline that the difference found in the present study in reported behavior between women and men are rather small, and it could be explained by random error as well. There is more research needed in the area of gender-related behavioral differences in noise exposure. We did not find any significant differences between men and women's use of hearing protection at concerts and discotheques. This is an interesting finding, which seems to be related to findings by Bohlin and Erlandsson, [2] who reported that young women judge risk situations as generally more dangerous than young men, but that they nevertheless behave in the same way. This might be a manifestation of norms and ideals in society and in adolescent social and cultural environments where gender stereotypical norms are produced. Within this context, however, judgments and attitudes are more resilient to change than behavior. [3],[14],[18],[19]

In the first regression analysis, attitudes and risk perception are found to be associated with the use of hearing protection. Attitudes and risk perception account for about 15% of the variance regarding the use of hearing protection at discos. Young people who are negative towards high levels of sound are also more likely to use hearing protection at discos, as are individuals who have a high perception of risks. The results support previous research, for example the studies by Olsen Widén and Erlandsson [7] and Chesky et al., [8] which show that negative attitudes towards noise appear to make people avoid exposure to noise if it is regarded as unsafe. The results of the second regression analysis indicate that the use of hearing protection at concerts is associated with factors such as perceived susceptibility to noise, the norm of acting invulnerably, and risk perception regarding noise exposure, all of which together account for about 36% of the variance in hearing protection use. Again, men seem to have greater difficulties in viewing themselves as being vulnerable to noise exposure in comparison to women. This result is supported by the studies conducted by Vogel et al., where men were found to express low personal vulnerability to music-induced hearing loss and were not inclined to change their listening habits. [16],[17] Other studies have come to the conclusion that women tend to worry about noise and the risk of damaging their hearing to a higher extent than men. [7] Therefore the finding in the present study that susceptibility to noise contributes to the regression model is interesting, in that gender differences in perceived vulnerability to noise are clearly evident. Such differences in perceived vulnerability to noise can be discussed from a gender perspective, where the perceived vulnerability can be explained as a result of stereotypical images of how young men and women are supposed to "be" and "behave". Hence culturally based variables such as norms and ideals may play an important role in the formation of gender-specific attitudes towards adolescent risk taking as well as the perception of oneself as being vulnerable or invulnerable to noise exposure.

The explanation as to why gender does not contribute to the use of hearing protection in the regression models, even though we find gender differences when women and men are compared in all psychometric scales, can also be understood from a gender theoretical framework. In comparison to women, men have more positive attitudes towards loud music; they are more strongly conditioned by the norm of acting invulnerably, and identify to a greater extent with the ideal of being a risk taker. Women, on the other hand, report a higher degree of perceived susceptibility to noise and to a higher degree perceive that exposure to noise is a risky form of behavior. As already mentioned, Deaux and Kite [18] maintain that people are expected to conform to socially stable gender roles. If men and women adopt behaviors that are associated with the opposite gender they may be perceived by others in a negative way. [19] Attitudes and behavior are influenced by gender norms, and everyday ideas are characterized by expectations based on gender identity. [2],[3],[24] Thus, as a consequence, young people's risk perceptions may be affected by stereotypical images of how masculinity and femininity are expressed. [3] Drawing on this theoretical background, it can be expected that social gender is experienced and expressed in ways that are both systematic yet unconscious. Thus the effect of gender on attitudes, adherence to norms and ideals, risk perceptions and perceived susceptibility may be so great that as a variable, gender itself does not have any significant impact in the regression analysis. In other words, we could for instance, say that the norm of acting invulnerably and perceptions of susceptibility are gendered phenomena.

Methodological implications

One limitation of the present study is that most of the psychometric scales are new and have not yet been sufficiently validated. Although the homogeneity (Cronbach's alpha) of the items in the scales seems acceptable, there is a need for validating and improving the measurements, and this work is currently ongoing. However, the results from the analysis correspond well with what could be expected from a theoretical standpoint. [15] For example, the concept of vulnerability is something that was investigated by Vogel et al., [16],[17] and their studies have delivered findings that are comparable with our own. Another example is the concept of "perceived susceptibility", which has previously been used in the Health Belief Model by Rosenstock [25] and recognized as an important variable for the understanding of health risk-taking behavior. Further, the new version of YANS produces results that are comparable with previous findings. Together these all offer some theoretical validation of the psychometric subscales used in the present study.

Another important issue for the present study is that it is likely that the different scales are somewhat "overlapping", meaning that they partly measure the same aspects. Some of the correlations in [Table 1] indicate that this might be the case. Hence, it is important to continue the work with making improvements on the measurements in order to make them more reliable and valid.

Another limitation in the study is that the measurements were quite extensive, the number of item were 70. This will probably cause fatigue to some respondents, especially when some of the items are quite similar. However, we wanted to test the new instruments in a large sample in order to do statistical analysis such as factor analysis, which must be conducted on large sample in order to be reliable. We believe that with this information given, the results from these not yet fully validated measurements in the present study still might be of some theoretical interest, though the interpretations and conclusions must be undertaken with some caution.


  Conclusions Top


In research about risk taking both in noisy environments (i.e. concerts, clubs) and in other contexts (i.e. speeding, smoking) gender is often used as a descriptive variable. In this study, the ambition was to use gender both as a descriptive variable and a departure for theoretical discussions on differences in the auditory risk-taking behaviors of young men and women. There has been a tendency to regard risk taking as experiences and as expressions on a male norm. [15],[22] In addition, there is a lack of instruments that measure noise exposure, which include aspects such as norms and ideals, vulnerability and susceptibility. These may be important aspects of young people's lives in both a social as well as an existential sense. Adolescence can be a period in life when questions about the meaning of life, the world, boundaries, and mortality become strongly in focus. In this process some actions (e.g. listening to music and speeding) are on the borderline of unhealthy risk behaviors. However, these types of behavior can at the same time also be necessary as part of the process of achieving maturity. [2],[3],[26]

When explaining why hearing problems such as tinnitus and noise-induced hearing loss are presumably increasing among adolescents, we believe it is important to consider variables such as norms, ideals, attitudes, and perceived susceptibility, since variables such as these may have an important explanatory role for decision-making and risk-taking behavior. For example, it could be argued that gendered identities may be so strong that young people are unable to express, or even experience vulnerability, which in turn can lead to difficulties in the development, and full expression, of an individual identity. Hence, gendered identities might be an important aspect to take under consideration in future hearing-related preventive work among adolescents.


  Acknowledgments Top


The authors are grateful for the funding provided by University West, Sweden.

 
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Correspondence Address:
Stephen Widén
School of Health and Medical Sciences, S-701 82, Örebro University
Sweden
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Source of Support: University West, Sweden, Conflict of Interest: None


DOI: 10.4103/1463-1741.90299

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