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Objectives: Misophonia is a little-understood disorder in which certain sounds cause a strong emotional response in those who experience it. People who are affected by misophonia may find that noises like loud chewing, pen clicking, and/or sniffing trigger intense frustration, anger, or discomfort. The relationship of misophonia with other auditory disorders including loudness hyperacusis, tinnitus, and hearing loss is largely underexplored. This project aimed to investigate the prevalence and hearing-health comorbidities of misophonia in a college-aged population by using an online survey., Design: A total of 12,131 undergraduate and graduate students between the ages of 18 and 25 were given the opportunity to answer an in-depth online survey. These students were sampled in a roughly 50 of 50 sex distribution. The survey was created using Qualtrics and included the following components: electronic consent, demographics questionnaire, Misophonia Questionnaire (MQ), Khalfa's Hyperacusis Questionnaire (HQ), Tinnitus and Hearing Survey, and Tinnitus Functional Index (TFI). To be eligible for compensation, answers for each of the above components were required, with the exception of the TFI, which was only presented to students who indicated that they experienced tinnitus. Respondents were determined to have high or possible likelihood of having misophonia if they gave specific answers to the MQ's Emotion and Behavior Scale or the MQ Severity Scale., Results: After excluding duplicate responses and age-related outliers, 1,084 responses were included in the analysis. Just over 20% (n = 217) of the sample was determined to have a high or probable likelihood of having misophonia. The sample was primarily White, female, and of mid-to-high socioeconomic status. There was a strong positive correlation between MQ total scores and HQ total scores. High likelihood misophonia status showed a significant relationship with self-reported hearing loss and tinnitus. No statistically significant relationship was found between misophonia and age, ethnicity, or socioeconomic status. MQ total scores differed significantly when separating respondents by sex, self-reported tinnitus, and loudness hyperacusis. White respondents had significantly higher MQ total scores than Asian/Asian American respondents., Conclusions: The estimated prevalence of misophonia was about 8% to 20% of the sample, which agrees with most of the currently published research examining misophonia symptoms in collegiate populations. Results of data analysis suggest that misophonia severity may be related to loudness hyperacusis, sex, and possibly tinnitus. Future studies are needed to further examine the characteristics of these relationships, possibly in populations more optimized to reflect the general population or those with hearing-health disorders., Competing Interests: The authors have no conflicts of interest to declare., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: The primary objective was to estimate the prevalence of hyperacusis diagnosis in treatment-seeking Veterans, paying attention to when it is diagnosed in conjuncture with common comorbid conditions., Design: This retrospective observational study used Veteran electronic health records from January 2015 to July 2021. Hyperacusis and comorbid conditions were identified using International Classification of Disease diagnostic codes., Results: The prevalence of hyperacusis diagnosis was 0.06%. Veterans diagnosed with tinnitus, posttraumatic stress disorder, headache, or traumatic brain injury were between two and seven times more likely to have an International Classification of Disease code for hyperacusis., Conclusions: The estimated prevalence of hyperacusis diagnosis using electronic health records is grossly below what is reported in the literature. This is likely due to lack of standardized methods to diagnosis hyperacusis and when present with comorbid conditions, uncertainty when it should be coded as a secondary diagnosis. Future clinical and research efforts prioritizing hyperacusis are desperately needed., Competing Interests: The authors have no conflicts of interest to disclose.

Objectives: The aim was to assess the internal consistency and convergent and discriminant validity of a new questionnaire for hyperacusis, the Inventory of Hyperacusis Symptoms (IHS; Greenberg & Carlos 2018), using a clinical population., Design: This was a retrospective study. Data were gathered from the records of 100 consecutive patients who sought help for tinnitus and/or hyperacusis from an audiology clinic in the United Kingdom. The average age of the patients was 55 years (SD = 13 years). Audiological measures were the pure-tone average threshold (PTA) and uncomfortable loudness levels (ULL). Questionnaires administered were: IHS, Tinnitus Handicap Inventory (THI), Hyperacusis Questionnaire (HQ), Insomnia Severity Index, Generalized Anxiety Disorder, and Patient Health Questionnaire-9., Results: Cronbach's alpha for the 25-item IHS questionnaire was 0.96. Neither the total IHS score nor scores for any of its five subscales were correlated with the PTA of the better or worse ear. This supports the discriminant validity of the IHS, as hyperacusis is thought to be independent of the PTA. There were moderately strong correlations between IHS total scores and scores for the HQ, Tinnitus Handicap Inventory, Generalized Anxiety Disorder, and Patient Health Questionnaire-9, with r = 0.58, 0.58, 0.61, 0.54, respectively. Thus, although IHS scores may reflect hyperacusis itself, they may also reflect the coexistence of tinnitus, anxiety, and depression. The total score on the IHS was significantly different between patients with and without hyperacusis (as diagnosed based on ULLs or HQ scores). Using the HQ score as a reference, the area under the receiver operating characteristic for the IHS was 0.80 (95% confidence interval = 0.71 to 0.89) and the cutoff point of the IHS with highest overall accuracy was 56/100. The corresponding sensitivity and specificity were 74% and 82%., Conclusions: The IHS has good internal consistency and reasonably high convergent validity, as indicated by the relationship of IHS scores to HQ scores and ULLs, but IHS scores may also partly reflect the co-occurrence of tinnitus, anxiety, and depression. We propose an IHS cutoff score of 56 instead of 69 for diagnosing hyperacusis., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Objectives: Despite increasing interest in hyperacusis and other disorders of auditory sensitivity, there is still a lack of valid, standardized assessment tools to measure symptom severity, treatment outcomes, and diagnostic differentiation. Accordingly, this study sought to create a new scale that is reliable, valid, brief, and easy to score with the purpose of filling this gap., Design: Original items were constructed through review of currently existing models of hyperacusis measurement, as well as qualitative data collected from professional audiologists and individuals reporting heightened audiological sensitivity with tinnitus. An initial 26-item scale yielded sound reliability and validity properties. Refinement based on review of initial data resulted in a 25-question second version with a maximum score of 100. A total of 450 completed survey protocols were analyzed from 469 refined Inventory of Hyperacusis Symptoms (IHS) administrations collected online, representing individuals from 37 countries with a mean age of 34.8 years., Results: Internal consistency reliability analysis yielded a Cronbach's α of 0.93, indicating excellent reliability. Furthermore, the IHS showed sound convergent validity with established measures of quality of life, anxiety, and depression in bivariate correlation analysis of Pearson's r. Factor analysis revealed a dimensional structure containing five factors, which were designated psychosocial impact, emotional arousal, functional impact, general loudness, and communication. Analysis of variance between perceived global hyperacusis severity categories provided a preliminary framework for scoring thresholds. Although the level of hearing loss did not correlate with IHS scores, increased tinnitus symptoms were a significant factor in predicting hyperacusis distress and severity., Conclusions: These initial results demonstrated sound statistical properties of the IHS and usefulness as a hyperacusis measurement tool in research and clinical practice. Factor structure and scale dimensions allow for differentiation between subtypes of loudness, annoyance, fear, and pain based on responses to clusters of specific items within the dimensional factor structure of the scale, and may thus prove useful in clinical practice and research.

The acoustical problems involved in matching the saturation sound pressure level for a 90 dB input signal (SSPL90) of a hearing aid to individual discomfort level were investigated. The real ear SPL (RE/SSPL90) produced by a supra-aural earphone used when measuring uncomfortable loudness (UCL), and RE/SSPL90 produced by three different hearing aids at 90 dB SPL input, were measured for nine subjects, using a miniature microphone technique, and compared to the corresponding coupler levels used when matching hearing aid maximum output to UCL. It was found that a hearing aid often gives about 5 dB, and sometimes 10 dB, higher RE/SPLs than the earphone, if the hearing aid output levels, as measured in a 2-cc coupler (IEC126), are equal to the earphone output levels as measured in a 6-cc coupler (NBS9A). It is recommended that a safety margin of at least 5 dB be used in the preliminary fitting when matching hearing aid SSPL90 to the patient's UCL, converted to dB SPL.

Reaction time (RT) to auditory stimuli has been suggested as a measure of loudness recruitment in humans and in subhuman primates. In this investigation, RT's were obtained for hearing-impaired subjects with tinnitus (the experimental group) and normal-hearing subjects without tinnitus (the control group) to three sets of frequencies. For the experimental group, these were the tinnitus frequencies (associated with abnormal thresholds), nontinnitus frequencies with thresholds similar to the thresholds of the tinnitus frequencies, and nontinnitus frequencies with thresholds within normal limits. For the control group, these frequencies were all associated with thresholds within normal limits. The only significant difference for RT's for the experimental group versus the control group was to the tinnitus frequencies. There were no significant differences for RT's for the control group among the three sets of frequencies. However, for the experimental group, RT's to each of the three sets of frequencies differed significantly from each other. This study suggests that the measurement of RT's to auditory stimuli provides an objective measure of tinnitus, a means for comparing human and subhuman data on tinnitus, a method for determining recruitment, and a possible technique for mapping areas of tinnitus.

Fifteen subjects with unilateral sensorineural hypacusis were tested to determine the sound intensity eliciting the acoustic reflex in normal and impaired ears and the sound intensity in the normal ear which is equal in loudness to the intensity eliciting the acoustic reflex in the abnormal ear. Results suggest that loudness is not the mediating factor in the acoustic reflex, justifying the suggestion that low sensation level reflexes observed in hearing-impaired patients should not be considered an unequivocal indicant of recruitment.