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Id 006d8d01-ff62-48de-9c33-40752276b28e

Year 2026

Abstract Abstract This study aims to investigate the correlation between decreased sound tolerance disorders and sensory processing disorder, as well as the sensory systems that are affected when decreased sound tolerance disorders exist. The study included 315 individuals aged 18–35 with normal hearing and no neurological disorders. Participants completed the Decreased Sound Tolerance Disorder Scale (DSTS) and the Adult Sensory Processing Scale (ASPS). According to the DSTS, 278 individuals with decreased sound tolerance disorders were included as the study group, and 37 individuals without decreased sound tolerance were included as a control group. The DSTS includes 33 items assessing symptoms of hyperacusis, phonophobia, and misophonia. The ASPS consists of 48 items across 11 factors that assess the sensitivity of different sensory domains. The distribution of decreased sound tolerance disorders among the participants indicated that 113 participants (35.9%) had all three types of DSTs (triple DST), 85 participants (27.0%) had two types of DSTs (dual DST), 16 participants (5.1%) had hyperacusis only, 14 participants (4.4%) had phonophobia only, 50 participants (15.9%) had misophonia only, and 37 participants (11.7%) had no DSTs (non-DST). A moderately positive correlation was found between the total scores of the ASPS and hyperacusis ( , ), and misophonia ( , ) scores. Total ASPS scores were higher in those with misophonia compared to those without ( ). The results of this study indicate that individuals with decreased sound tolerance may have difficulty in processing not only auditory but also visual, vestibular, proprioceptive, and tactile stimuli.

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Beyond the Auditory System
(Meral Çetinkaya et al., 2026)

Import Date 02-26-2026

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Dv Authors Merve Meral Çetinkaya, Azize Arzu Koçyiğit Köroğlu, Ümit Can Çetinkaya,

Dv Initial Source Misophonia MOCMisophonia

Dv Status #status/Bare-bones-review

Dv Limitations • Only self-report scales used. • No objective sensory or sound discomfort measures. • Screening tools not diagnostic. • Small subgroup sizes (pure hyperacusis, pure phonophobia). • Overlap among DST types limits clarity and generalizability.

Dv Future Directions • Include objective and physiological sensory measures. • Larger and more balanced subgroup samples. • Assess quality of life, depression, and anxiety. • Collaborate with occupational therapists for targeted interventions. • Examine rehabilitation programs targeting proprioceptive integration. • Investigate balance and postural control mechanisms in hyperacusis.

Dv Statistics Sample: N=315; DST=278; non-DST=37. Triple=35.9%; Dual=27.0%; Hyperacusis only=5.1%; Phonophobia only=4.4%; Misophonia only=15.9%; None=11.7%. Correlations (ASPS total): Hyperacusis r=0.260, p<0.001; Phonophobia r=0.071, p=0.212 (NS); Misophonia r=0.348, p<0.001. Hyperacusis: Auditory OR r=0.400, p<0.001; Visual OR r=0.119, p=0.035; Social touch OR r=0.291, p<0.001; Overall underresponsiveness r=0.134, p=0.018; Proprioceptive–vestibular underresponsiveness r=0.158, p=0.005; Texture touch OR r=0.184, p=0.001; Auditory seeking r=−0.150, p=0.008; NS others. Phonophobia: Vestibular OR r=0.133, p=0.019; Auditory seeking r=−0.145, p=0.010; Texture touch OR r=−0.126, p=0.026; NS others. • Misophonia: Auditory OR r=0.341, p<0.001; Visual OR r=0.178, p=0.002; Social touch OR r=0.124, p=0.029; Proprioceptive seeking r=0.140, p=0.013; Proprioceptive–vestibular under responsiveness r=0.205, p<0.001; Auditory seeking r=0.248, p<0.001; Tactile under responsiveness r=0.172, p=0.002; Movement intolerance r=0.265, p<0.001; Texture touch OR r=0.198, p<0.001; NS others. • Logistic regression (ASPS total): • Pure hyperacusis OR=1.011, p=0.488, R²=0.013 (NS). • Pure phonophobia OR=0.997, p=0.845, R²=0.001 (NS). • Pure misophonia OR=1.038, p=0.009, R²=0.116. • Dual DST OR=1.086, p<0.001, R²=0.406. • Triple DST OR=1.090, p<0.001, R²=0.518. Group comparisons: Dual and triple DST > non-DST across multiple ASPS domains (p<0.05); pure hyperacusis and pure phonophobia NS; pure misophonia elevated in auditory overresponsiveness, proprioceptive–vestibular underresponsiveness, and total.

Dv Relevance • study looked at correlation between decreased sound tolerance disorders ( including Misophonia) and sensory processing disorder, finding that decreased sound tolerance was associated with processing issues in other modalities including visual, vestibular, proprioceptive, and tactile. • a good sources for info on co occurrences of different sensory processing issues as well as Misophonia

•

Beyond the Auditory System: Sensory Processing in Decreased Sound Tolerance Disorders

Status:: #status/Bare-bones-review

Metadata

Item Type: #journalArticle
Authors:: Merve Meral Çetinkaya, Azize Arzu Koçyiğit Köroğlu, Ümit Can Çetinkaya,
Date:
Date Added: 1771106105000
URL: https://brill.com/view/journals/msr/aop/article-10.1163-22134808-bja10185/article-10.1163-22134808-bja10185.xml
DOI: 10.1163/22134808-bja10185
Cite Key: meralcetinkayaAuditorySystemSensory2026
Topics: [object Object]
Tags:: #Misophonia, #sensory-processing, #decreased-sound-tolerance-(DST), #sound-tolerance-disorders,
PDF Attachments

Abstract


Background/Purpose	Background- • DST includes hyperacusis, misophonia, and phonophobia. • DST forms may co-occur. • Research has focused on auditory processing in DST. • Limited research examines non-auditory sensory systems in DST. • No prior study examined DST and sensory processing sensitivities in normally hearing adults without neurological disease. Purpose- • To investigate the correlation between DST and SPD. • To identify which sensory systems are affected when DST exists.
Participants/samples	• N = 315 adults (18–35 years). • Normal hearing (≤20 dB HL); no neurological disorders. • DST group: n = 278 (≥1 DST type). • Control (non-DST): n = 37. • Excluded: hearing loss, neurological disease, ear surgery/infection.
Measures	• DSTS-S (hyperacusis, phonophobia, misophonia subscales; cut-offs applied). • ASPS (11 sensory factors; total score; categorical classification). • Demographic questionnaire (age, gender, income, tinnitus, psychotropic medication).
Procedures	• Pure-tone audiometry (125 Hz–8 kHz). • Self-report completion of DSTS-S and ASPS. • Partial correlations controlling for other DST types. • Independent t-tests. • Binary logistic regression using ASPS total score predicting DST categories.
Results	Prevalence/Distribution • Triple DST most common; dual and pure forms also present. • Small non-DST control group. Hyperacusis • Positively associated with ASPS total. • Positively associated with auditory overresponsiveness. • Positively associated with visual, social touch, texture-related touch overresponsiveness. • Positively associated with overall underresponsiveness and proprioceptive–vestibular underresponsiveness. • Negatively associated with auditory seeking. • No significant group differences vs non-DST; logistic regression non-significant. Phonophobia • Positively associated with vestibular over responsiveness. • Negatively associated with auditory seeking. • No other significant associations. • No significant group differences or regression findings. Misophonia • Positively associated with ASPS total. • Positively associated with auditory over responsiveness and auditory seeking. • Positively associated with visual, social touch, texture-related touch over responsiveness. • Positively associated with proprioceptive seeking, tactile under responsiveness, movement intolerance, proprioceptive–vestibular under responsiveness. • Pure misophonia higher than non-DST on selected ASPS domains and total. • ASPS total predicted pure misophonia. Dual and Triple DST • Higher ASPS total than non-DST. • Higher vestibular, auditory, visual, social touch over responsiveness. • Higher movement intolerance and texture-related touch over responsiveness. • Higher overall under responsiveness and proprioceptive–vestibular under responsiveness. • Tactile under responsiveness elevated in triple DST. • ASPS total predicted dual and triple DST. Demographics, tinnitus, medication, income, education: not significantly different between DST and non-DST.
Discussion/Limits	Conclusion- • The authors conclude that DST may involve sensitivity beyond the auditory system. • The findings indicate that hyperacusis includes broader sensory reactivity profiles. • The data support that misophonia presents a multidimensional sensory profile affecting multiple sensory domains. • The authors conclude that co-occurring DST types reflect complex sensory modulation patterns. • The findings indicate that sensory processing may be affected in the presence of single or multiple DST types. • The authors conclude that individuals with normal hearing and no neurological disorders with DST may have difficulty processing visual, vestibular, proprioceptive, and tactile stimuli.
Limitations::	• Only self-report scales used. • No objective sensory or sound discomfort measures. • Screening tools not diagnostic. • Small subgroup sizes (pure hyperacusis, pure phonophobia). • Overlap among DST types limits clarity and generalizability.
Future Directions::	• Include objective and physiological sensory measures. • Larger and more balanced subgroup samples. • Assess quality of life, depression, and anxiety. • Collaborate with occupational therapists for targeted interventions. • Examine rehabilitation programs targeting proprioceptive integration. • Investigate balance and postural control mechanisms in hyperacusis.
Statistics::	Sample: N=315; DST=278; non-DST=37. Triple=35.9%; Dual=27.0%; Hyperacusis only=5.1%; Phonophobia only=4.4%; Misophonia only=15.9%; None=11.7%. Correlations (ASPS total): Hyperacusis r=0.260, p<0.001; Phonophobia r=0.071, p=0.212 (NS); Misophonia r=0.348, p<0.001. Hyperacusis: Auditory OR r=0.400, p<0.001; Visual OR r=0.119, p=0.035; Social touch OR r=0.291, p<0.001; Overall underresponsiveness r=0.134, p=0.018; Proprioceptive–vestibular underresponsiveness r=0.158, p=0.005; Texture touch OR r=0.184, p=0.001; Auditory seeking r=−0.150, p=0.008; NS others. Phonophobia: Vestibular OR r=0.133, p=0.019; Auditory seeking r=−0.145, p=0.010; Texture touch OR r=−0.126, p=0.026; NS others. • Misophonia: Auditory OR r=0.341, p<0.001; Visual OR r=0.178, p=0.002; Social touch OR r=0.124, p=0.029; Proprioceptive seeking r=0.140, p=0.013; Proprioceptive–vestibular under responsiveness r=0.205, p<0.001; Auditory seeking r=0.248, p<0.001; Tactile under responsiveness r=0.172, p=0.002; Movement intolerance r=0.265, p<0.001; Texture touch OR r=0.198, p<0.001; NS others. • Logistic regression (ASPS total): • Pure hyperacusis OR=1.011, p=0.488, R²=0.013 (NS). • Pure phonophobia OR=0.997, p=0.845, R²=0.001 (NS). • Pure misophonia OR=1.038, p=0.009, R²=0.116. • Dual DST OR=1.086, p<0.001, R²=0.406. • Triple DST OR=1.090, p<0.001, R²=0.518. Group comparisons: Dual and triple DST > non-DST across multiple ASPS domains (p<0.05); pure hyperacusis and pure phonophobia NS; pure misophonia elevated in auditory overresponsiveness, proprioceptive–vestibular underresponsiveness, and total.
Relevance::	• study looked at correlation between decreased sound tolerance disorders ( including Misophonia) and sensory processing disorder, finding that decreased sound tolerance was associated with processing issues in other modalities including visual, vestibular, proprioceptive, and tactile. • a good sources for info on co occurrences of different sensory processing issues as well as Misophonia

Notes

key terms and concepts:

Decreased Sound Tolerance (DST) – adverse reactions to sounds that would not typically elicit a negative response in the average individual.
Hyperacusis – excessively loud perception of sounds available in daily life, caused by abnormally high activation of the auditory system.
Misophonia – excessive emotional responses to certain sounds.
Phonophobia – fear experienced in response to certain sounds, believed to be caused by abnormal activation of the limbic and autonomic nervous systems.
Sensory Processing Disorder (SPD) – difficulties in regulating sensory sensitivity or habituation across sensory domains.
Adult Sensory Processing Scale (ASPS) – 48-item scale assessing over responsiveness, under responsiveness, and seeking behaviors across sensory domains.
Decreased Sound Tolerance Scale–Screening (DSTS-S) – 33-item screening tool assessing hyperacusis, misophonia, and phonophobia.

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Meral Çetinkaya 2026 findings of decreased sound tolerance disorders and broader sensory processing differences