Decreased sound tolerance (DST) conditions, including misophonia and hyperacusis, are emerging clinical conditions in behavioral medicine. Misophonia involves an extreme emotional response (often anger, disgust, or annoyance) to specific sounds (such as people chewing, swallowing, tapping their foot on the floor, etc.), while hyperacusis is defined by high sensitivity to sounds below normal sound sensitivity thresholds. Although research on these DST conditions is increasing, clearly defined prevalence rates, associations with other mental health conditions, and development of assessment tools that can identify and differentiate DST symptoms are needed. Research and clinical reports also suggest that DST problems are more likely to occur in individuals affected by tinnitus, and that drawing upon a bio-psychosocial conceptualization of tinnitus and other behavioral medicine conditions may be useful in understanding and treating DST conditions. This cross-sectional survey study was administered to college student (N=451) and community adult (N=375) samples and investigated DST prevalence rates, clinical correlates, and risk factors and mechanisms of action for misophonia and hyperacusis. In addition, the study developed and validated a new scale to identify misophonia and hyperacusis type sound sensitivity. Nearly 35% of individuals surveyed reported some degree of general auditory sensitivity, with 15-63% endorsing misophonia symptoms, and 17-26% endorsing hyperacusis symptoms, with rates depending on assessment method. Moderate to strong correlations were found between DST conditions and other mental and physical health conditions, including obsessive compulsive disorder, autism-spectrum traits, anxiety, depression, social phobia, medical conditions, and somatic and neurobehavioral symptoms. Mediation models revealed that the process by which misophonia symptoms become clinically significant and functionally impairing is partially mediated by amplification of bodily sensations and anxiety sensitivity. Risk factors for functional impairment related to misophonia symptoms were identified in moderation analyses and included neuroticism, synesthesia, and sensory sensitivity. An assessment instrument, the DST-10, and its subscales the Loudness Sensitivity Scale and Human Sounds Scale, was subjected to exploratory and confirmatory factor analysis and initial evidence for construct validity was demonstrated. This study was the first to assess hyperacusis, misophonia, and tinnitus rates in large general population samples and provides initial support for conceptualizing DST problems as behavioral medicine conditions.

Misophonia is a condition characterized by a strong physiological, emotional, and behaviouralresponse to specific auditory stimuli, which have a significant negative impact on the wellbeingof affected individuals. The present investigation focuses on emotional dysregulation, which arises due to the triggering of specific auditory stimuli. Individuals with misophoniastruggle to regulate their emotions when exposed to sounds, leading to emotional reactions, including anger, anxiety, disgust, avoidance behaviour, fight or flight, and feeling overwhelmed. These reactions might even lead to violent impulses directed towards the source of the sound. Despite its growing recognition, little is yet known about misophonia, and experts have not established any clear boundaries or criteria for the condition to be considered adisorder. As such, it is not yet included in any classification systems for disorders. The aim of this study is to understand how individuals with misophonia experience emotional dysregulation, how do they describe their experience, what is it like to live with misophonia ona day-to-day basis, and how do individuals understand and cope with emotional dysregulation caused by misophonia? The study utilized a qualitative approach with semi-structured interviews as the data collection method. Thematic analysis was used to identify patterns and themes within the data. Participants stated that misophonia causes significant distress and disruption impacting emotional well-being and daily functioning. Validation of this new condition can be very helpful and make a positive impact in their social circle, and that lack of awareness and effective treatment may hold back seeking professional help.

Misophonia and hyperacusis are relatively unknown and misunderstood auditory sensitivityconditions. Misophonia is characterised by strong negative emotional reactions to sounds andsound patterns, depending on the meaning or context of the sound. Hyperacusis is characterizedby negative reactions to sounds, depending on the physical characteristics of the sounds (e.g.,frequency and intensity). Research often fails to distinguish misophonia from hyperacusis, andresearch on both conditions is scare. Moreover, there are insufficient tools available to assessand study misophonia and hyperacusis. The purpose of the current study was topsychometrically validate the Hyperacusis and Misophonia Discrimination Scale (HMDS).The goal of this self-report measure was to discriminate people with hyperacusis from peoplewith misophonia. Various analyses were used to assess the reliability and validity of thequestionnaire. A total of 249 participants completed the online questionnaire. Results indicatedan excellent reliability using Cronbach’s alpha and group and item comparisons showed thediscriminatory effectiveness of the HMDS. However, the results of a factor analysis indicateda complex underlying factor structure which did not provide a sufficient fit to the data,suggesting that the dimensions of the questionnaire require further refinement to effectivelydifferentiate between misophonia and hyperacusis. Based on the results, a revision to theHMDS is presented and future research should explore the psychometric properties of thisrevised scale as well as validate the HMDS with participants who have undergone a clinicalscreening in order to confirm their status. / Misofoni och hyperakusis är relativt okända och missförstådda tillstånd av auditiv känslighet.Misofoni kännetecknas av starka negativa känslomässiga reaktioner på ljud och ljudmönster,beroende på ljudets betydelse eller sammanhang. Hyperakusis kännetecknas av negativareaktioner på ljud, beroende på ljudets fysiska egenskaper (t.ex. frekvens och intensitet).Forskningen misslyckas ofta med att skilja misofoni från hyperakusis, och forskningen ombåda tillstånden är knapphändig. Dessutom finns det inte tillräckligt med verktyg för attbedöma och studera misofoni och hyperakusis. Syftet med den aktuella studien var attpsykometriskt validera Hyperacusis and Misophonia Discrimination Scale (HMDS). Måletmed detta självrapportmått var att skilja personer med hyperakusis från personer med misofoni.Olika analyser användes för att bedöma frågeformulärets tillförlitlighet och giltighet. Totalt249 deltagare fyllde i onlineformuläret. Resultaten visade på en utmärkt tillförlitlighet enligtCronbachs alfa och jämförelser mellan grupper och objekt visade på HMDS diskriminerandeeffektivitet. Resultaten av en faktoranalys indikerade emellertid en komplex underliggandefaktorstruktur som inte gav en tillräcklig passning till data, vilket tyder på att frågeformuläretsdimensioner kräver ytterligare förfining för att effektivt skilja mellan misofoni ochhyperakusis. Baserat på resultaten presenteras en revidering av HMDS och framtida forskningbör utforska de psykometriska egenskaperna hos denna reviderade skala samt validera HMDSmed deltagare som har genomgått en klinisk screening för att bekräfta sin status.