Objective: Although previous research has demonstrated an association between hearing impairment (HI) and psychological distress, less work has explored the effect of transitions in hearing status on distress over time, or the explanatory pathways that may explain this association. Method: We use 2 waves of data from the Canadian National Population Health Survey to examine the effect of HI transitions on changes in distress during 6 years, and to test the potential mediating effects of psychosocial factors and chronic stressors. Results: Experiencing a decline in hearing was associated with increased distress at Wave 4, net of Wave 1 distress, although the significance of the relation was reduced to trend level following adjustment for sociodemographic variables ( P < 0.06). The introduction of mastery and self-esteem further reduced the size of the effect of reporting a decline in hearing in the full model. Conclusions: The association between declines in HI and psychological distress during a 6-year period did not reach a traditional level of statistical significance, and we discuss potential explanations for this finding. Mastery and self-esteem may be important explanatory variables in the HI–distress association and should be considered in future research. Can 2009;54(8):518–525.