Document Type

Article

Journal/Book Title/Conference

American Journal of Audiology

Author ORCID Identifier

Mercedes G. Wooley  https://orcid.org/0000-0002-4801-1177  

Karen Muñoz  https://orcid.org/0000-0002-3936-1079

Publisher

American Speech - Language - Hearing Association

Publication Date

2-10-2026

Journal Article Version

Accepted Manuscript

First Page

1

Last Page

25

Abstract

Purpose:

Misophonia and hyperacusis are distinct sound sensitivity conditions that can co-occur and are linked to heightened emotional distress and impaired functioning. This study investigated the convergence between audiometric-based and self-reported indicators of hyperacusis and examined how each related to misophonia severity and psychological outcomes in adults with misophonia.

Method:

Participants (N = 60) completed self-report measures and underwent loudness discomfort level (LDL) testing.

Results:

Analyses revealed discrepancies between self-reported and LDL-defined hyperacusis, with no significant associations between LDL-based classifications and psychological or misophonia-related outcomes. In contrast, hyperacusis identified via a standardized self-report measure was significantly associated with heightened emotional and behavioral reactivity in misophonia, as well as greater severity and elevated internalizing symptoms, including depression, anxiety, and stress.

Conclusions:

Findings raise concerns about the clinical utility of LDLs as standalone indicators in misophonia populations. They highlight the value of subjective assessments for identifying clinically relevant variables associated with hyperacusis and misophonia comorbidity. Our results support that self-report tools may better capture the lived experience and psychological features associated with co-occurring hyperacusis and misophonia. However, until more research is established, we recommend employing audiometric and self-report metrics to assess for hyperacusis in this population. Future research should focus on identifying psychometric measures that can accurately distinguish between the two conditions and on developing standardized protocols for assessing hyperacusis in individuals with misophonia.

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