Audiological and Other Factors Predicting the Presence of Misophonia Symptoms Among a Clinical Population Seeking Help for Tinnitus and/or Hyperacusis

Abstract

This paper evaluates the proportion and the audiological and other characteristics of patients with symptoms of misophonia among a population seeking help for tinnitus and/or hyperacusis at an audiology clinic (n = 257). To assess such symptoms, patients were asked “over the last 2 weeks, how often have you been bothered by any of the following problems? Feeling angry or anxious when hearing certain sounds related to eating noises, lip-smacking, sniffling, breathing, clicking sounds, tapping?”. The results of routine audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Measures included: pure tone audiometry, uncomfortable loudness levels (ULLs), and responses to the tinnitus impact questionnaire (TIQ), the hyperacusis impact questionnaire (HIQ), and the screening for anxiety and depression in tinnitus (SAD-T) questionnaire. The mean age of the patients was 53 years (SD = 16) (age range 17 to 97 years). Fifty four percent were female. Twenty-three percent of patients were classified as having misophonia. The presence and frequency of reporting misophonia symptoms were not related to audiometric thresholds, except that a steeply sloping audiogram reduced the likelihood of frequent misophonia symptoms. Those with more frequent misophonia symptoms had lower values of ULLmin (the across-frequency average of ULLs for the ear with lower average ULLs) than those with less frequent or no reported symptoms. The reported frequency of experiencing misophonia symptoms increased with increasing impact of tinnitus (TIQ score ≥9), increasing impact of hyperacusis (HIQ score >11), and symptoms of anxiety and depression (SAD-T score ≥4). It is concluded that, when assessing individuals with tinnitus and hyperacusis, it is important to screen for misophonia, particularly when ULLmin is abnormally low or the TIQ, HIQ or SAD-T score is high. This will help clinicians to distinguish patients with misophonia, guiding the choice of therapeutic strategies.

Psychometric Evaluation of the Misophonia Impact Questionnaire using a Clinical Population of Patients Seeking Help for Tinnitus, Hyperacusis, and/or Misophonia

“…Discriminant validity was supported by the finding that the MIQ factor was not related to factors for the TIQ or PTA, both of which are thought to be unrelated to misophonia. The lack of relationship between PTA and the impact of misophonia is consistent with current scientific evidence (2,53). The non-significant correlation between MIQ and TIQ scores might be a result of low variances for both measures, which is likely to have occurred due the characteristics of the sample (e.g., 96% reporting tinnitus).…”

Letter to the Editor: Misophonia: A Need for Audiological Diagnostic Guidelines

“…The consensus definition states that neither misophonia's presence nor severity appear related to the patient's pure-tone sensitivity, although it is unclear what bearing hearing loss may have on this percept (Aazh et al 12 ). While tinnitus is a very different percept from misophonia, i.e., a phantom 'ringing' in the ears, significant comorbidity exists between the two pathologies (Jastreboff and Jastreboff 2 ), especially as tinnitus severity increases (Aazh et al 12 ). Similarly, as previously stated, hyperacusis appears to be highly comorbid with misophonia (Jastreboff and Jastreboff 2 ; Aazh et al 12 ).…”

“…While tinnitus is a very different percept from misophonia, i.e., a phantom 'ringing' in the ears, significant comorbidity exists between the two pathologies (Jastreboff and Jastreboff 2 ), especially as tinnitus severity increases (Aazh et al 12 ). Similarly, as previously stated, hyperacusis appears to be highly comorbid with misophonia (Jastreboff and Jastreboff 2 ; Aazh et al 12 ). While the consensus definition does not explicitly clarify the difference between hyperacusis and misophonia, hyperacusis has been described as an individual experiencing "physical discomfort or pain" in response to sound levels typically tolerable for much of the population (Henry et al 11 ; Baguley 13 ; Fackrell et al 14 ).…”

“…A Need for Audiologic Diagnostic Guidelines Due to the minimally researched audiologic assessment of misophonia, audiology clinics specializing in misophonia diagnosis have been left to the development of their own methodology (Aazh et al 12 ; Pellicori 17 ). Thus, it is evident that there is a need for consensus on the audiologic diagnostic assessment and criteria for misophonia, including guidelines for distinguishing misophonia and The current consensus definition on misophonia is an initial step toward defining the disorder rather than providing clinical guidance on assessment and treatment.…”

A symptom network model of misophonia: From heightened sensory sensitivity to clinical comorbidity

“…In this study we test the hypothesis that misophonia co-occurs with a number of symptoms and traits, specifically: autistic traits (measured via the Autism Spectrum Quotient [AQ]; Baron-Cohen et al, 2006), anxiety (measured by the Anxiety-Sensitivity Index [ASI-3]; Taylor et al, 2007), migraines (measured via the Penn Online Evaluation of Migraines [POEM]; Kaiser et al, 2019), obsessive-compulsive traits (measured via the Obsessive-Compulsive Inventory [OCI]; Foa et al, 1998), as well as other hearing-related conditions (e.g., tinnitus, hyperacusis; Aazh et al, 2022). We also hypothesize that misophonia is directly related to heightened sensory sensitivity, as measured by the self-report Glasgow Sensory Questionnaire (GSQ) (Robertson & Simmons, 2013) which asks about different sensory modalities, and a task-based measure of "visual stress" termed the Pattern Glare test (Braithwaite et al, 2013).…”