limitations of LDL as a Misophonia-hyperacusis differentiation measure and a push for inclusion of self reports

In a 2026 study, Woolley examined whether audiometric and self-report indicators of hyperacusis converged, and how each related to misophonia severity and psychological outcomes in adults with misophonia. They found that LDL-based hyperacusis classifications were unrelated to self-reported hyperacusis and showed no association with misophonia severity or psychological outcomes, whereas self-reported hyperacusis was associated with greater misophonia-related emotional/behavioral reactivity, severity, and elevated depression, anxiety, and stress. From this they concluded that LDLs have limited utility as a standalone indicator of hyperacusis in misophonia populations, and that self-report tools may better capture the clinically relevant features of co-occurring hyperacusis and misophonia (Woolley et al., 2026b).