A Comparison of Misophonia Proportion and Patterns of Uncomfortable Loudness Levels Between Individuals With and Without Hyperacusis Reporting Sensitivity to Environmental Sounds Publisher



Rasouli A ; Rahimi V ; Fatahi F ; Zaree M ; Aazh H
Source: International Journal of Audiology Published:2026

Abstract

Objective: To compare audiological characteristics and misophonia symptoms proportion in young adults with normal hearing and self-reported sound sensitivity (without tinnitus), classified as having hyperacusis status. Design: Cross-sectional study. Participants classified as having hyperacusis (ULLmin ≤77 dB HL) or non-hyperacusis (>77 dB HL). Misophonia symptoms were identified using screening thresholds: Sound Sensitivity Symptoms Questionnaire item 4 (SSSQ4 ≥ 2) or Misophonia Questionnaire-Misophonia Severity Scale (MQ-MSS ≥7). Audiological variables included ULLmin (uncomfortable loudness level minimum), slopes, asymmetry, and repetition differences. Study Sample: 153 participants (19–31 years), recruited via social media. Results: 31.4% met the hyperacusis criterion. The hyperacusis group showed lower ULLmin, steeper ULL slopes, and higher HQ, SSSQ, and MQ scores (p ≤ 0.002). Misophonia was more prevalent in the hyperacusis group (52.1% vs. 32.4%, p = 0.020). Multivariable analysis showed that hyperacusis was the strongest predictor of misophonia, with ULLmin and slope contributing. Conclusions: Many individuals reporting sound sensitivity did not meet objective criteria for hyperacusis, underscoring the value of measures such as ULLmin. The higher prevalence of misophonia symptoms in hyperacusis and their shared audiological correlates suggest substantial overlap between decreased sound tolerance subtypes. These findings support integrated audiological–psychometric assessment and highlight the need for longitudinal and neuroimaging studies. © 2026 British Society of Audiology, International Society of Audiology, and Nordic Audiological Society.