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in a 2026 paper, Yamazawa describes three conceptual models for the relationship between Misophonia, hyperacusis, and autism traits, ultimately finding the most support for the hyperacusis meditated model. (Yamazawa & Midorikawa, 2026)

Autism-Interdependent Model

This model proposes that autistic traits independently contribute to both hyperacusis and misophonia. In this framework, each condition is directly linked to autistic traits but not causally linked to each other. Hyperacusis and misophonia are assumed to arise from separate underlying mechanisms. The model suggests parallel but distinct pathways from autistic traits to each form of decreased sound tolerance.

Hyperacusis-Mediated Model

This model proposes that autistic traits first contribute to hyperacusis, which then leads to misophonia. Hyperacusis functions as a mediating mechanism between autistic traits and misophonia. In this account, general sound intolerance precedes and contributes to the development of selective sound aversion. The model supports a hierarchical and potentially developmental progression.

Misophonia-Mediated Model

This model proposes that autistic traits first contribute to misophonia, which then leads to hyperacusis. Misophonia serves as the mediating mechanism linking autistic traits to broader sound intolerance. In this framework, selective emotional reactivity to specific sounds precedes generalized sound sensitivity. The model implies that misophonia may be the primary alteration driving later hyperacusis