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Misophonia and co-occurring sound tolerance disorders linked to multimodal sensory over- and under-responsiveness, pointing to processing differences beyond the auditory system.

In a 2026 study, Meral Çetinkaya and colleagues investigated whether decreased sound tolerance disorders (hyperacusis, misophonia, and phonophobia) are associated with broader sensory processing differences in normally hearing adults without neurological disorders. They assessed 315 participants using pure-tone audiometry and two self-report measures: the Decreased Sound Tolerance Scale–Screening (DSTS-S) and the Adult Sensory Processing Scale (ASPS), and analyzed correlations and logistic regression models. They found that misophonia, and especially co-occurring (dual and triple) decreased sound tolerance, were associated with elevated sensory over responsiveness and under responsiveness across multiple non-auditory domains, whereas pure hyperacusis and phonophobia showed more limited patterns. From this they concluded that decreased sound tolerance may involve multimodal sensory processing difficulties beyond the auditory system, particularly when multiple DST types co-occur (Meral Çetinkaya et al., 2026).