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Id 924c2adb-a39b-44be-8fe4-5bd65f191a24

Year 2026

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Hyperacusis, misophonia, and mental health in young adults in Canada
(Jafari & Bhandari, 2026)

Import Date 10-07-2026

Initial Source

Misophonia

Dv Authors Zahra Jafari, Aalya Bhandari,

Dv Limitations • Self-report only; hearing loss, tinnitus, and sound hypersensitivity not verified through objective audiological assessments. • High hyperacusis-misophonia co-occurrence may have been partly influenced by overlapping HQ and MAQ item content. • Symptom severity measured rather than clinically established disorders; symptom duration, frequency, and number of episodes not assessed, so transient symptoms cannot be distinguished from persistent or clinically significant conditions; proportions should not be interpreted as prevalence of clinically diagnosed disorders or as indicating a need for clinical intervention. • Other sound hypersensitivity phenotypes (e.g., phonophobia, noise-induced cognitive symptoms) not assessed. • Cross-sectional design precludes temporal or causal conclusions. • Sample primarily university students, limiting generalizability; women substantially overrepresented, which may have influenced estimated proportions and observed associations.

Dv Future Directions • Examine findings in more representative samples of young adults, including participants from different countries and populations. • Incorporate objective audiological assessments and clinically confirmed assessments alongside self-report measures. • Clarify mechanisms underlying the hyperacusis-misophonia association and factors distinguishing individuals with one condition from those with both. • Longitudinal studies to distinguish true comorbidity from measurement overlap and determine generalizability and robustness of associations.

Dv Relevance • a decent study looking at comorbidities of Misophonia , tinnitus, and hyperacusis. • not much use other then to grab some broad prevalence data.

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Hyperacusis, misophonia, and mental health in young adults in Canada: Estimated prevalence and associated factors

Status:: #status/Bare-bones-review

Metadata

Item Type: #journalArticle
Authors:: Zahra Jafari, Aalya Bhandari,
Date Added: September 29, 2026
URL: https://linkinghub.elsevier.com/retrieve/pii/S2666915326001484
DOI: 10.1016/j.jadr.2026.101170
Cite Key: jafariHyperacusisMisophoniaMental2026
Tags:: #anxiety, #Bare-bones-review-🦴, #comorbidity, #depression, #Hyperacusis, #Misophonia, #prevelence, #tinnitus,
PDF Attachments

Abstract


Background/Purpose	Background- • Hearing disorders affect communication, psychological well-being, and quality of life, but sound hypersensitivity disorders have received less attention than hearing loss and tinnitus. • Hyperacusis and misophonia are distinct but potentially co-occurring conditions that can occur independently of or alongside hearing loss and tinnitus. • Prevalence estimates vary by definition, measurement, and population: approximately 0.2–17% for hyperacusis and 5–35% for misophonia symptoms, with severity varying along a continuum. • Hearing loss and tinnitus are associated with elevated anxiety and depressive symptoms. Similarly, hyperacusis and misophonia are linked to psychological distress, psychiatric comorbidities, and reduced quality of life, although methodological limitations complicate conclusions. • Mechanisms linking sound hypersensitivity to mental health remain unclear, particularly given the multifactorial nature of anxiety and depression. • Research on hyperacusis and misophonia in young adults remains limited, particularly regarding prevalence, associated factors, and relationships with current anxiety and depressive symptoms. Purpose- • Estimate prevalence of hyperacusis, misophonia, and tinnitus in young adults in Canada using validated questionnaires. • Examine demographic, hearing-related, and health-related factors associated with hyperacusis and misophonia reports. • Investigate relationships between hyperacusis and misophonia severity and current anxiety and depression symptom severity after accounting for demographic and health-related factors.
Participants/samples	• 726 participated; 606 with complete questionnaires analyzed. • Young adults recruited via flyers across Dalhousie University campuses (Halifax, Nova Scotia), social media, and email. • Majority women, majority White, majority university students. • Inclusion: age 19 to 32; no confirmed neuropsychiatric disorders; able to read and understand English.
Measures	• Background questionnaire: Demographics (gender, age, ethnicity, education, employment), hearing history (tinnitus, confirmed hearing loss, family history), and health history (medical conditions, head trauma). • Visual Analogue Scale (VAS): Self-rated overall health (1 = poor, 10 = excellent). • Hyperacusis Questionnaire (HQ): 14 items assessing attentional, social, and emotional dimensions; primary measure of hyperacusis severity, with a cutoff for strong auditory hypersensitivity. • Hyperacusis Assessment Questionnaire (HAQ): 14 items assessing loudness, fear, and pain subtypes. • Misophonia Assessment Questionnaire (MAQ): 21 items assessing emotional distress, social interference, pessimism, and non-recognition; severity classified from subclinical to extreme. • Generalized Anxiety Disorder-7 (GAD-7): Anxiety symptoms over the past two weeks, categorized from minimal to severe. • Patient Health Questionnaire-9 (PHQ-9): Depressive symptoms over the past two weeks, categorized from minimal to severe.
Procedures	• Hybrid approach: electronically via REDCap (QR code on study flyers) or on paper in person. • Demographic questionnaire completed first, followed by battery of self-report measures. • Instruments assessed self-reported symptoms and severity; not intended to establish clinical diagnoses or confirm absence of neuropsychiatric disorders. • Analysis: Cronbach’s alpha per measure; Wilson score CIs for prevalence estimates; separate multiple linear regressions per outcome (hyperacusis, misophonia, anxiety, depression) with a priori demographic, hearing-related, and health-related variables; HMLRAs for incremental variance by block; VIF and tolerance for multicollinearity.
Results	• A minority met criteria for significant hyperacusis or mild-to-severe misophonia or reported constant tinnitus. Loudness was the most common hyperacusis subtype, followed by pain and fear. • Moderate or greater anxiety and depressive symptoms were common. • Most participants with hyperacusis or tinnitus also reported misophonia, whereas tinnitus was less common among those with hyperacusis or misophonia. • Hyperacusis (HQ): Misophonia severity was the strongest predictor, with smaller associations for tinnitus, health issues, gender, and hearing history. • Misophonia (MAQ): Hyperacusis severity was the strongest predictor, with smaller associations for hearing history, tinnitus, poorer overall health, head trauma, and gender. • Anxiety (GAD-7): Depression was the strongest predictor, with additional associations for hyperacusis, ethnicity, and gender; misophonia was not significantly associated. • Depression (PHQ-9): Anxiety was the strongest predictor, with additional associations for poorer overall health, ethnicity, and family hearing history; neither hyperacusis nor misophonia was significantly associated. • Other examined demographic, hearing, and health factors were nonsignificant in their respective models. No problematic multicollinearity was detected.
Discussion/Limits	Conclusion- • Hyperacusis, misophonia, and tinnitus frequently co-occur, suggesting shared auditory and affective mechanisms, including heightened auditory sensitivity, salience, emotional reactivity, and altered auditory-limbic interactions. • Hyperacusis and misophonia were more strongly associated with each other than with traditional hearing problems, potentially reflecting shared mechanisms and the relatively low prevalence of hearing issues in young adults. • Associations with health status, medical conditions, and gender suggest broader biopsychosocial influences on sound hypersensitivity. • Elevated anxiety and depressive symptoms were common and strongly associated, consistent with shared psychological and neurobiological mechanisms. • Hyperacusis was the only hearing-related factor independently associated with anxiety, potentially reflecting heightened auditory vigilance, discomfort, and avoidance. • Depression was associated with poorer perceived health, ethnicity, and family hearing history, although the mechanisms underlying these relationships remain unclear. • Overall, sound hypersensitivity and psychological distress appear interconnected, supporting integrated auditory and mental health assessment.
Limitations::	• Self-report only; hearing loss, tinnitus, and sound hypersensitivity not verified through objective audiological assessments. • High hyperacusis-misophonia co-occurrence may have been partly influenced by overlapping HQ and MAQ item content. • Symptom severity measured rather than clinically established disorders; symptom duration, frequency, and number of episodes not assessed, so transient symptoms cannot be distinguished from persistent or clinically significant conditions; proportions should not be interpreted as prevalence of clinically diagnosed disorders or as indicating a need for clinical intervention. • Other sound hypersensitivity phenotypes (e.g., phonophobia, noise-induced cognitive symptoms) not assessed. • Cross-sectional design precludes temporal or causal conclusions. • Sample primarily university students, limiting generalizability; women substantially overrepresented, which may have influenced estimated proportions and observed associations.
Future Directions::	• Examine findings in more representative samples of young adults, including participants from different countries and populations. • Incorporate objective audiological assessments and clinically confirmed assessments alongside self-report measures. • Clarify mechanisms underlying the hyperacusis-misophonia association and factors distinguishing individuals with one condition from those with both. • Longitudinal studies to distinguish true comorbidity from measurement overlap and determine generalizability and robustness of associations.
Relevance::	• a decent study looking at comorbidities of Misophonia , tinnitus, and hyperacusis. • not much use other then to grab some broad prevalence data.

Notes

key terms and concepts

hyperacusis – sound hypersensitivity characterized by increased sensitivity to everyday sounds typically well tolerated by most individuals; ordinary environmental sounds perceived as excessively loud, uncomfortable, distressing, or even painful.
loudness hyperacusis – moderately loud sounds perceived as excessively loud.
fear hyperacusis – fear of or avoidance of sounds generally considered safe.
pain hyperacusis – sounds elicit pain at intensity levels well below those perceived as painful by most people.
misophonia – disorder characterized by strong negative emotional, physiological, and behavioral responses to specific sounds (e.g., chewing, breathing, pen clicking); typically triggered by the specific pattern, meaning, or context of a sound, regardless of loudness.
tinnitus – perception of sound (e.g., ringing, buzzing, hissing, whistling, clicking) in the ears or head without an actual external acoustic source.
HMLRA – hierarchical multiple linear regression analysis; variables entered in sequential blocks to assess additional variance explained after controlling for previously entered variables.

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source inconsistencies

Eligibility age stated as 19 to 32; reported sample range 18 to 32.
At least mild misophonia reported as 24.50% (Abstract, Results, Discussion) and 24.60% (Section 2.4.1).
Anxiety model variance stated as 51.30% alongside R² = 0.514.
Discussion states around two-thirds of those with hyperacusis or tinnitus reported misophonia; Table 3 shows approximately 70% to 78%.
Discussion describes “a history of tinnitus”; measure was constant tinnitus.
Pain hyperacusis listed as unassessed in Limitations, though the HAQ pain subscale was administered.
Hearing problem history in HQ model: text reports β = 0.072; Table 4 reports β = -0.07 (B = -2.71).

contextual statement

In a 2026 study, Jafari attempted to estimate the prevalence of hyperacusis, misophonia, and tinnitus and their associations with current anxiety and depressive symptoms by administering the HQ, HAQ, MAQ, GAD-7, and PHQ-9 to 606 young adults in Canada, primarily university students.

Zettelkasten

prevalence of hyperacusis, Misophonia and tinnitus in a Canadian sample