Defense Date


Document Type


Degree Name

Doctor of Philosophy


Clinical Psychology

First Advisor

Scott R. Vrana


Hyperacusis and misophonia are two conditions of decreased sound tolerance (DST) studied in the psychological literature due to their association with psychological symptoms and mechanisms. DSTs are differentiated from normal sound sensitivity due to the reported impairment and distress individuals experience. Researchers suggest that DSTs are differentiated by types of sounds and emotional reactions elicited, such that hyperacusis is a fear and pain response to ordinary environmental sounds perceived as uncomfortably loud, and misophonia is an anger and disgust response to human-made sounds, but these distinctions, and associated characteristics, have not been empirically demonstrated. Undergraduate students (N = 1572) completed self-report measures assessing DST symptoms, clinical correlates, and psychological symptoms and mechanisms. Latent class analysis revealed six clusters, including no DST symptoms (28.6%), hyperacusis (10.1%), misophonia (13.7%), comorbid hyperacusis/misophonia (23.9%), and two mixed symptom clusters (13.2 and 10.6%). People with DST symptoms exhibited more symptoms on psychopathology measures than the no symptom cluster, and individuals with comorbid hyperacusis and misophonia reported the greatest number of symptoms. Hyperacusis is associated with more severe psychopathology than misophonia. Hyperacusis and misophonia were not easily differentiated by specific emotions or sounds, and total emotions appeared to be a better indicator of impairment and a better method to differentiate DSTs than a single emotion. On average, participants found human-made/mouth sounds more aversive than loud sounds and examining hyperacusis-specific sounds was a better method to differentiate “pure” hyperacusis and misophonia clusters than misophonia-specific sounds. This study empirically characterizes DSTs and offers insight into their distinctions.


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