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Id dc5420f1-7380-485b-8f9e-261f34bd3ab5

Year 2024

Abstract Purpose: The aim of this study was to describe the audiological test results from a sample of 60 adults with self-reported misophonia. Method: Audiological testing was completed prior to participant randomization in a controlled trial for misophonia treatment. Participants completed the Inventory of Hyperacusis Symptoms Survey (IHS), the Tinnitus and Hearing Survey (THS), the Misophonia Questionnaire (MQ), and behavioral and objective audiometric measures. Results: Hearing thresholds were less than 25 dBHL for 97% of the participants. Loudness discomfort levels for tonal stimuli suggested hyperacusis in 25% of the sample. Total scores on the IHS indicated that 12% met the clinical cutoff for hyperacusis, and, on the THS, 27% experienced problems with tinnitus, 77% experienced problems with hearing, and 53% experienced problems with sound tolerance. On the MQ, 37% indicated mild levels of misophonia and 58% indicated moderate levels. For speech-in-noise testing, a mild signal-to-noise ratio loss was present for 15% of participants. Most of the participants had present distortion product otoacoustic emissions (DPOAEs). Conclusions: Audiological data on individuals with misophonia are lacking. In this article, we present results from audiological testing on 60 adults with self-reported misophonia. Most had normal peripheral hearing sensitivity based on pure-tone audiometry and DPOAE measures; some had difficulties with sound sensitivities and understanding speech-in-noise, self-report indicated problems with hyperacusis, tinnitus, and hearing difficulty.

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(Muñoz et al., 2024)

Import Date 01-27-2026

Dv Authors Karen Muñoz, Mercedes G. Woolley, Doris Velasquez, Diana Ortiz, Guadalupe G. San Miguel, Julie M. Petersen, Michael P. Twohig,

Dv Initial Source Misophonia MOC

Dv Status #status/Bare-bones-review

Dv Limitations • Lack of electrophysiological or central auditory processing tests • No further tinnitus characterization (e.g., matching, severity) • Sample limited to adults; misophonia onset often in childhood • Demographically homogenous (wealthy White women), limiting generalizability

Dv Future Directions • Include broader age and demographic ranges • Compare audiological profiles by misophonia severity and to healthy controls • Establish standardized audiological protocols for misophonia assessment • Incorporate multidisciplinary assessment tools (e.g., psychological, electrophysiological)

Dv Relevance • an audiological study looking at Misophonia. • in a group of 60 Misophonics found normal hearing sensitivity but did find increased issues with with speech in noise and co-occurring tinnitus and hyperacusis. • a good source for audiology stuff in Misophonia

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Audiological Characteristics of a Sample of Adults With Misophonia

Status:: #status/Bare-bones-review

Metadata

Item Type: #journalArticle
Authors:: Karen Muñoz, Mercedes G. Woolley, Doris Velasquez, Diana Ortiz, Guadalupe G. San Miguel, Julie M. Petersen, Michael P. Twohig,
Date:
Date Added: 1729478564000
URL: https://pubs.asha.org/doi/10.1044/2024_AJA-24-00111
DOI: 10.1044/2024_AJA-24-00111
Cite Key: munozAudiologicalCharacteristicsSample2024
Topics: [object Object]
Tags:: #Misophonia, #Bare-bones-review-🦴, #clinical, #audiology,
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Abstract


Background/Purpose	Background- • Misophonia is a newly recognized condition that evokes disproportionate emotional reactions to specific “trigger” sounds. • It overlaps phenomenologically with hyperacusis and tinnitus but differs in trigger specificity. • No standard audiological protocol currently exists for assessing misophonia. • Existing misophonia research often omits comprehensive hearing assessments; few studies incorporate objective audiological data. Purpose- • To characterize the audiological profiles of 60 adults with clinically significant, self-reported misophonia using behavioral and objective audiological testing and validated self-report tools.
Participants/samples	• N = 60 adults (Mage = 33.8, range 18–67) • 70% female, 95% White, 97% non-Hispanic • Majority (93%) reported misophonia onset in childhood or adolescence • Recruited as part of a larger clinical trial on misophonia treatment Inclusion criteria: • Age ≥18 • Seeking treatment for misophonia • MQ sound sensitivity score ≥5 • DMI total score ≥20 confirming clinical-level misophonia
Measures	• Self-report questionnaires: • MQ – misophonia severity and emotional/behavioral impact • IHS – hyperacusis-related symptoms • THS – perceived tinnitus, hearing, and sound tolerance problems • Audiological testing: • Pure-tone audiometry (air and bone conduction) • Tympanometry and acoustic reflexes • Word recognition in quiet • QuickSIN (speech-in-noise test) • LDLs for warble tones and speech • DPOAEs (1000–5657 Hz)
Procedures	Stimuli used • Warble tones and speech stimuli for LDLs • Recorded word lists (NU-6) for speech recognition • QuickSIN for SNR assessment Task/experiment • Audiological battery performed in a soundproof booth • Behavioral thresholds and objective measures recorded across both ears • Participants also completed standardized questionnaires on an iPad at intake
Results	• Hearing sensitivity: 97% had normal hearing (<25 dB HL); 3% had mild bilateral sensorineural hearing loss • Speech-in-noise: 15% had mild SNR loss despite normal thresholds • DPOAEs: Mostly present, indicating normal outer hair cell function • LDLs: 25% had tonal LDLs <90 dB HL (suggestive of hyperacusis), though only 1 participant had severe IHS score • Self-report: • MQ mean total = 38.05 (SD = 8.13), severity mean = 6.83 • 58% rated moderate or higher misophonia severity (≥7) • IHS mean = 50.02; 12% scored above clinical cutoff • THS: • 27% reported tinnitus problems • 77% reported hearing problems • 53% reported sound tolerance problems -
Discussion/Limits	Conclusion- • Most adults with misophonia had normal audiometric thresholds and excellent word recognition in quiet. • Despite normal hearing, many reported difficulty understanding speech in noise and problems with sound tolerance, hearing, and tinnitus. • Audiological profiles alone do not capture the full extent of misophonia symptoms; perceptual and affective components are critical. • The variability across hyperacusis indicators (objective LDLs vs. IHS vs. THS) highlights a need for standardized diagnostic protocols.
Limitations::	• Lack of electrophysiological or central auditory processing tests • No further tinnitus characterization (e.g., matching, severity) • Sample limited to adults; misophonia onset often in childhood • Demographically homogenous (wealthy White women), limiting generalizability
Future Directions::	• Include broader age and demographic ranges • Compare audiological profiles by misophonia severity and to healthy controls • Establish standardized audiological protocols for misophonia assessment • Incorporate multidisciplinary assessment tools (e.g., psychological, electrophysiological)
Relevance::	• an audiological study looking at Misophonia. • in a group of 60 Misophonics found normal hearing sensitivity but did find increased issues with with speech in noise and co-occurring tinnitus and hyperacusis. • a good source for audiology stuff in Misophonia

Notes

key terms

Misophonia – A condition characterized by strong emotional responses (e.g., anger, disgust) to specific repetitive sounds (e.g., chewing, breathing), not currently listed in diagnostic classification systems.
Hyperacusis – Heightened sensitivity to everyday sounds, often volume-related, associated with discomfort or pain.
Tinnitus – The perception of sound (e.g., ringing) in the absence of an external auditory stimulus.
LDL (Loudness Discomfort Level) – The level at which sounds become uncomfortably loud, used to assess hyperacusis.
DPOAE (Distortion Product Otoacoustic Emission) – Objective measure of cochlear (outer hair cell) function, often used to assess peripheral hearing.
MQ (Misophonia Questionnaire) – A validated self-report scale assessing symptom severity, emotional/behavioral response, and impairment from misophonia.
IHS (Inventory of Hyperacusis Symptoms) – A self-report scale assessing hyperacusis-related difficulties across emotional, social, and cognitive domains.
THS (Tinnitus and Hearing Survey) – A screening tool assessing tinnitus, hearing, and sound tolerance difficulties.
SNR loss – Signal-to-noise ratio loss, an index of difficulty understanding speech in noisy environments.

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Sample recruitment context:

Audiological testing was part of a randomized controlled trial for misophonia psychosocial treatment
Participants received compensation at baseline, post-treatment, and follow-up

Clinical implications:

Self-report tools (MQ, IHS, THS) are valuable in capturing subjective difficulties
Audiologists should consider including misophonia-related assessments in their protocols
Misophonia may be under-identified in patients presenting for tinnitus or hyperacusis

Notable statistics (from Appendix: Figure on p.11):

Most frequent misophonia severity scores clustered around moderate (score 7), with a near-normal distribution

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Munoz 2024 findings on audiological assessments of Misophonics