Properties (14)
Id 6e068a6a-2923-4358-8ac7-2c9169dc9d3f
Year 2025
Abstract
Cssclasses
  • purpleRed
Aliases
  • (Vijayakumar & Ahmmed, 2025)
Import Date 01-20-2026
Dv Authors Sabarinath Vijayakumar, A.U. Ahmmed,
Dv Initial Source Misophonia MOCMisophonia
Dv Status #status/Bare-bones-review
Dv Limitations • Misophonia rarely exists without hyperacusis; small sample sizes limit subgroup analysis. • Definitions of hyperacusis/misophonia still lack standardization. • SRT and ULL may cause distress and have poor diagnostic specificity.
Dv Future Directions • Clarify audiological profiles of misophonia without hyperacusis. • Investigate ear asymmetries and neural mechanisms underlying DST. • Integrate DST evaluation into APD diagnosis using frameworks like RDoC for holistic assessment.
Dv Relevance • looked at the utility of routine audiological evaluations for differentiating hyperacusis from Misophonia, finding that standard assessments fail to differentiate between the conditions. • a good source for background info/details on various audiological features debated for use as measures of various sound sensitivities ( ex hyperacusis, decreased sound tolerance, etc)
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A Retrospective Study of Audiological Characteristics of Hyperacusis versus Misophonia in Children with Auditory Processing Disorder.

Status:: #status/Bare-bones-review

Metadata

Abstract
Background/Purpose Background-
• despite growing hopes of distinguishing hyperacusis from Misophonia, particularly using observed associations of increased high frequency sensitivities and DST, there is little info on how kids with hyperacusis, Misophonia, and those without DST differ in regards to pure tone thresholds for low/high frequency tones
• DST (including hyperacusis and misophonia) complicates clinical audiological evaluation due to symptom overlap and vague definitions.
• Past literature shows inconsistencies in defining and differentiating misophonia and hyperacusis, particularly in children with APD.
• Audiological measures such as ULL, SRT, and pure-tone thresholds may help distinguish these conditions, though their diagnostic reliability is debated.
• There is limited information on how tinnitus and past OME history relate to DST in children with normal hearing thresholds.

Purpose-
• Assess whether routine audiological tests can differentiate hyperacusis from misophonia in children with APD.
• Evaluate associations between tinnitus and DST-related audiological findings.
• Examine if past OME history contributes to DST presentation in APD.
Participants/samples • N = 278 children diagnosed with APD (ages 6–16; Mean = 11.68, SD = 2.21).
• Hyperacusis only (n = 107)
• Misophonia with hyperacusis (n = 35)
• No DST (n = 136)

• Nonverbal IQs ranged from 80–128 (Mean = 98.74, SD = 9.92).
• All children were healthy, English-speaking, and attended mainstream schools.
Measures • Pure-tone audiometry: .25–12.5 kHz thresholds.
• Ipsilateral stapedial reflex thresholds (SRTs): measured at 1 and 4 kHz.
• ULLs: measured at 1 and 4 kHz using ascending tone presentation.
• Structured questionnaire: DST triggers, daily impact, emotional response, tinnitus, OME history.
Procedures • Pure-tone stimuli presented via audiometer using standard procedures.
• SRTs measured with tympanometry using 226 Hz probe tone.
• ULL measured via participant indication of sound discomfort during ascending tone presentation.
Results • High PTAvg significantly lower than Low PTAvg in all groups; only the misophonia + hyperacusis group showed significantly larger slope (high-low PTAvg) in the right ear.
• SRTs showed no significant differences across groups.
• ULLs were significantly lower in DST groups (hyperacusis and misophonia + hyperacusis) vs. No DST group, especially for 4 kHz.
• ULLs did not correlate with the degree of daily life impact.
• Tinnitus was more prevalent in DST groups (30–45%) compared to No DST group (18%); within No DST group, tinnitus associated with lower 4 kHz ULLs in the right ear.
• Past OME history did not differ significantly between groups.
Discussion/Limits Conclusion-
• Routine audiological evaluations (pure-tone thresholds, SRT, ULL) cannot reliably distinguish hyperacusis from misophonia.
• Lower ULLs in DST and in children with tinnitus (without DST) suggest involvement of higher-order brain networks.
• Right-ear dominance observed in high-frequency sensitivity and ULLs may require further study.
• DST and tinnitus should be considered auditory disabilities alongside other APD listening challenges.

Limitations:: • Misophonia rarely exists without hyperacusis; small sample sizes limit subgroup analysis.
• Definitions of hyperacusis/misophonia still lack standardization.
• SRT and ULL may cause distress and have poor diagnostic specificity.
Future Directions:: • Clarify audiological profiles of misophonia without hyperacusis.
• Investigate ear asymmetries and neural mechanisms underlying DST.
• Integrate DST evaluation into APD diagnosis using frameworks like RDoC for holistic assessment.
Relevance:: • looked at the utility of routine audiological evaluations for differentiating hyperacusis from Misophonia, finding that standard assessments fail to differentiate between the conditions.
• a good source for background info/details on various audiological features debated for use as measures of various sound sensitivities ( ex hyperacusis, decreased sound tolerance, etc)

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Vijayakumar & Ahmmed 2025 implications for audiological traits in Misophonia

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