J Am Acad Audiol
DOI: 10.1055/a-1896-5032
Review Article

Hyperacusis and Misophonia: A Systematic Review of Psychometric Measures

1   Department of Psychology, The University of Surrey, Guildford, United Kingdom
Mark Cropley
1   Department of Psychology, The University of Surrey, Guildford, United Kingdom
2   Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
3   Department of Communication Sciences & Disorders, Florida Atlantic University, Boca Raton, Florida
4   Department of Physics, Faculty of Engineering and Physical Sciences, The University of Surrey, Guildford, United Kingdom
› Author Affiliations


Background Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. Misophonia is defined as a high magnitude of emotional and behavioral reaction to certain sounds produced by human beings, such as eating sounds and breathing sounds. Several psychometric instruments have been developed to assess symptoms and the impact of hyperacusis and misophonia; however, to the authors' knowledge, no study has evaluated and compared the methodological quality of the studies on psychometric properties of the existing instruments.

Purpose This article systematically reviews the research studies assessing the psychometric properties of the instruments used for hyperacusis and misophonia and assesses the quality and appropriateness of the methodologies used.

Research Design Systematic review.

Data Collection and Analysis A systematic literature search was performed using five electronic literature databases (PubMed, Scopus, PsycINFO, Google Scholar, and Web of Science). Studies were included if they were written in English and reported information about the psychometric properties of instruments measuring hyperacusis or misophonia symptoms or their impact. The quality of the studies and that of the psychometric instruments were evaluated using the consensus-based standards for the selection of health-measurement instruments (COSMIN) tool.

Results The title and abstracts of 916 articles were screened and 39 articles were selected for full-text evaluation, with 14 articles meeting the inclusion criteria. From these 14 articles, 8 different instruments (5 for hyperacusis and 3 for misophonia) were identified and reviewed comprising: (1) Hyperacusis Questionnaire (HQ), (2) Inventory of Hyperacusis Symptoms, (3) questionnaire on hypersensitivity to sound, (4) Hyperacusis Handicap Questionnaire, (5) short HQ, (6) Amsterdam Misophonia Scale, (7) MisoQuest, and (8) the Misophonia Questionnaire.

Conclusion None of the papers reviewed reported all the information required to meet the COSMIN standards. The studies' methodological quality varied between “very good” and “inadequate” depending on their grade on the COSMIN tool. There is a need for further research on the psychometric properties of the instruments included in this review.

Publication History

Received: 13 October 2021

Accepted: 05 July 2022

Accepted Manuscript online:
11 July 2022

Article published online:
22 February 2023

© 2023. American Academy of Audiology. This article is published by Thieme.

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333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

  • References

  • 1 Aazh H, Hayes C, Moore BCJ, Danesh AA, Vitoratou S. Psychometric evaluation of the Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity Symptoms Questionnaire (SSSQ) using a clinical population of adult patients with tinnitus alone or combined with hyperacusis. J Am Acad Audiol 2022; DOI: 10.1055/a-1780-4002.
  • 2 Adams B, Sereda M, Casey A, Byrom P, Stockdale D, Hoare DJ. A Delphi survey to determine a definition and description of hyperacusis by clinician consensus. Int J Audiol 2021; 60 (08) 607-613
  • 3 Aazh H, Moore BCJ, Lammaing K, Cropley M. Tinnitus and hyperacusis therapy in a UK National Health Service audiology department: Patients' evaluations of the effectiveness of treatments. Int J Audiol 2016; 55 (09) 514-522
  • 4 Tyler RS, Pienkowski M, Roncancio ER. et al. A review of hyperacusis and future directions: part I. Definitions and manifestations. Am J Audiol 2014; 23 (04) 402-419
  • 5 Swedo S, Baguley DM, Denys D. et al. A consensus definition of misophonia: using a Delphi process to reach expert agreement. Front Neurosci 2022;16(March 17). Doi: 2021.04.05.21254951
  • 6 Andersson G, Lindvall N, Hursti T, Carlbring P, Andersson G. Hypersensitivity to sound (hyperacusis): a prevalence study conducted via the Internet and post. Int J Audiol 2002; 41 (08) 545-554
  • 7 Smit AL, Stegeman I, Eikelboom RH. et al. Prevalence of hyperacusis and its relation to health: the Busselton Healthy Ageing Study. Laryngoscope 2021; 131 (12) E2887-E2896
  • 8 Zhou X, Wu MS, Storch EA. Misophonia symptoms among Chinese university students: Incidence, associated impairment, and clinical correlates. J Obsessive Compuls Relat Disord 2017; 14: 7-12
  • 9 Naylor J, Caimino C, Scutt P, Hoare DJ, Baguley DM. The prevalence and severity of misophonia in a UK undergraduate medical student population and validation of the Amsterdam Misophonia Scale. Psychiatr Q 2021; 92 (02) 609-619
  • 10 Wu MS, Lewin AB, Murphy TK, Storch EA. Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample. J Clin Psychol 2014; 70 (10) 994-1007
  • 11 Sürücü L, Maslakçi A. Validity and reliability in quantitative research. Bus. Manage Stud 2020; 8 (03) 2694-2726
  • 12 Gillespie DF, Perron BE. 2015 Key concepts in measures. Oxford University Press.
  • 13 Altheide DL, Johnson JM. Criteria for Assessing Interpretive Validity in Qualitative Research. Handbook of Qualitative Research. Thousand Oaks, CA: Sage Publications, Inc; 1994: 485-499
  • 14 Creswell JW. Educational Research: Planning, Conducting, and Evaluating Quantitative. Upper Saddle River, NJ: Prentice Hall; 2002
  • 15 Aazh H, Danesh AA, Moore BCJ. Internal consistency and convergent validity of the inventory of hyperacusis symptoms. Ear Hear 2021; 42 (04) 917-926
  • 16 Bläsing L, Goebel G, Flötzinger U, Berthold A, Kröner-Herwig B. Hypersensitivity to sound in tinnitus patients: an analysis of a construct based on questionnaire and audiological data. Int J Audiol 2010; 49 (07) 518-526
  • 17 Fioretti A, Tortorella F, Masedu F, Valenti M, Fusetti M, Pavaci S. Validity of the Italian version of Khalfa's questionnaire on hyperacusis. Acta Otorhinolaryngol Ital 2015; 35 (02) 110-115
  • 18 Khalfa S, Dubal S, Veuillet E, Perez-Diaz F, Jouvent R, Collet L. Psychometric normalization of a hyperacusis questionnaire. ORL J Otorhinolaryngol Relat Spec 2002; 64 (06) 436-442
  • 19 Siepsiak M, Śliwerski A, Łukasz Dragan W. Development and psychometric properties of MisoQuest-a new self-report questionnaire for misophonia. Int J Environ Res Public Health 2020; 17 (05) E1797
  • 20 Green S. Systematic reviews and meta-analysis. Singapore Med J 2005; 46 (06) 270-273 , quiz 274
  • 21 Prinsen CAC, Mokkink LB, Bouter LM. et al. COSMIN guideline for systematic reviews of patient-reported outcome measures. Qual Life Res 2018; 27 (05) 1147-1157
  • 22 Mokkink LB, Terwee CB, Patrick DL. et al. The COSMIN checklist for assessing the methodological quality of studies on measurement properties of health status measurement instruments: an international Delphi study. Qual Life Res 2010; 19 (04) 539-549
  • 23 Terwee CB, Mokkink LB, Knol DL, Ostelo RW, Bouter LM, de Vet HC. Rating the methodological quality in systematic reviews of studies on measurement properties: a scoring system for the COSMIN checklist. Qual Life Res 2012; 21 (04) 651-657
  • 24 Moher D, Liberati A, Tetzlaff J, Altman DG, Group P. PRISMA Group. Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA statement. Int J Surg 2010; 8 (05) 336-341
  • 25 Viera AJ, Garrett JM. Understanding interobserver agreement: the kappa statistic. Fam Med 2005; 37 (05) 360-363
  • 26 Rice DB, Skidmore B, Cobey KD. Dealing with predatory journal articles captured in systematic reviews. Syst Rev 2021; 10 (01) 175
  • 27 Erinc M, Derinsu U. Turkish adaptation of Khalfa hyperacusis questionnaire. Medeni Med J 2020; 35 (02) 142-150
  • 28 Fackrell K, Fearnley C, Hoare DJ, Sereda M. Hyperacusis Questionnaire as a tool for measuring hypersensitivity to sound in a tinnitus research population. BioMed Res Int 2015; 2015: 290425
  • 29 Greenberg B, Carlos M. Psychometric properties and factor structure of a new scale to measure hyperacusis: introducing the inventory of hyperacusis symptoms. Ear Hear 2018; 39 (05) 1025-1034
  • 30 Meeus OM, Spaepen M, Ridder DD, Heyning PH. Correlation between hyperacusis measurements in daily ENT practice. Int J Audiol 2010; 49 (01) 7-13
  • 31 Oishi N, Yamada H, Kanzaki S. et al. Assessment of hyperacusis with a newly produced Japanese version of the Khalfa hyperacusis questionnaire. Acta Otolaryngol 2017; 137 (09) 957-961
  • 32 Prabhu P, Nagaraj MK. Development and validation of Hyperacusis Handicap Questionnaire in individuals with tinnitus associated with hyperacusis. J Otol 2020; 15 (04) 124-128
  • 33 Tortorella F, Pavaci S, Fioretti AB, Masedu F, Lauriello M, Eibenstein A. The short hyperacusis questionnaire: a tool for the identification and measurement of hyperacusis in the Italian tinnitus population. Audiology Res 2017; 7 (02) 182
  • 34 Johnston BC, Patrick DL, Devji T, Maxwell LJ, Bingham III CO, Beaton DE, Guyatt GH. Patient-reported outcomes. Cochrane Handbook for Systematic Reviews of Interventions. In Cochrane Handbook for Systematic Reviews of Interventions.. UK: Wiley-Blackwell; 2019: 479-492
  • 35 Shamseer L, Moher D, Clarke M. et al; PRISMA-P Group. Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) 2015: elaboration and explanation. BMJ 2015; 350: g7647
  • 36 Mokkink LB, de Vet HCW, Prinsen CAC. et al. COSMIN Risk of Bias checklist for systematic reviews of patient-reported outcome measures. Qual Life Res 2018; 27 (05) 1171-1179
  • 37 Dauman R, Bouscau-Faure F. Assessment and amelioration of hyperacusis in tinnitus patients. Acta Otolaryngol 2005; 125 (05) 503-509
  • 38 Rosenthal MZ, Anand D, Cassiello-Robbins C. et al. Development and initial validation of the Duke Misophonia Questionnaire. Front Psychol 2021; 12 (4197): 709928
  • 39 Dibb B, Golding SE, Dozier TH. The development and validation of the Misophonia response scale. J Psychosom Res 2021; 149: 110587
  • 40 Nolan DR, Gupta R, Huber CG, Schneeberger AR. An effective treatment for tinnitus and hyperacusis based on cognitive behavioral therapy in an inpatient setting: a 10-year retrospective outcome analysis. Front Psychiatry 2020; 11: 25
  • 41 Aazh H, Bryant C, Moore BCJ. Patients' perspectives about the acceptability and effectiveness of audiologist-delivered cognitive behavioral therapy for tinnitus and/or hyperacusis rehabilitation. Am J Audiol 2019; 28 (04) 973-985
  • 42 Aazh H, Landgrebe M, Danesh AA, Moore BCJ. Cognitive behavioral therapy for alleviating the distress caused by tinnitus, hyperacusis and misophonia: current perspectives. Psychol Res Behav Manag 2019; 12 (12) 991-1002
  • 43 Aazh H, Moore BCJ. Proportion and characteristics of patients who were offered, enrolled in and completed audiologist-delivered cognitive behavioural therapy for tinnitus and hyperacusis rehabilitation in a specialist UK clinic. Int J Audiol 2018; 57 (06) 415-425
  • 44 Aazh H, Moore BCJ. Effectiveness of audiologist-delivered cognitive behavioral therapy for tinnitus and hyperacusis rehabilitation: outcomes for patients treated in routine practice. Am J Audiol 2018; 27 (04) 547-558
  • 45 Schröder AE, Vulink NC, van Loon AJ, Denys DA. Cognitive behavioral therapy is effective in misophonia: An open trial. J Affect Disord 2017; 217: 289-294
  • 46 Jüris L, Andersson G, Larsen HC, Ekselius L. Cognitive behaviour therapy for hyperacusis: a randomized controlled trial. Behav Res Ther 2014; 54: 30-37
  • 47 Beukes EW, Andersson G, Allen PM, Manchaiah V, Baguley DM. Effectiveness of guided internet-based cognitive behavioral therapy vs face-to-face clinical care for treatment of tinnitus: a randomized clinical trial. JAMA Otolaryngol Head Neck Surg 2018; 144 (12) 1126-1133
  • 48 Beukes EW, Baguley DM, Allen PM, Manchaiah V, Andersson G. Audiologist-guided Internet-based cognitive behavior therapy for adults with tinnitus in the United Kingdom: a randomized controlled trial. Ear Hear 2018; 39 (03) 423-433