Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping.

Misophonia is a condition characterized by hypersensitivity and strong emotional reactivity to specific auditory stimuli. Misophonia clinical presentations are relatively complex and reflect individualized experiences across clinical populations. Like some overlapping neurodevelopmental and neuropsychiatric disorders, misophonia is potentially syndromic where symptom patterns rather than any one symptom contribute to diagnosis. The current study conducted an exploratory k-means cluster analysis to evaluate symptom presentation in a non-clinical sample of young adult undergraduate students (N = 343). Individuals participated in a self-report spectrum characteristics survey indexing misophonia, tinnitus severity, sensory hypersensitivity, and social and psychiatric symptoms. Results supported a three-cluster solution that split participants on symptom presentation: cluster 1 presented with more severe misophonia symptoms but few overlapping formally diagnosed psychiatric co-occurring conditions; cluster 3 was characterized by a more nuanced clinical presentation of misophonia with broad-band sensory hypersensitivities, tinnitus, and increased incidence of social processing and psychiatric symptoms, and cluster 2 was relatively unaffected by misophonia or other sensitivities. Clustering results illustrate the spectrum characteristics of misophonia where symptom patterns range from more "pure" form misophonia to presentations that involve more broad-range sensory-related and psychiatric symptoms. Subgroups of individuals with misophonia may characterize differential neuropsychiatric risk patterns and stem from potentially different causative factors, highlighting the importance of exploring misophonia as a multidimensional condition of complex etiology.

Determining Emotional Tone and Verbal Behavior in Patients With Tinnitus and Hyperacusis: An Exploratory Mixed-Methods Study.

Purpose The purpose of this study was to evaluate the emotional tone and verbal behavior of social media users who self-identified as having tinnitus and/or hyperacusis that caused self-described negative consequences on daily life or health. Research Design and Method An explanatory mixed-methods design was utilized. Two hundred "initial" and 200 "reply" Facebook posts were collected from members of a tinnitus group and a hyperacusis group. Data were analyzed via the LIWC 2015 software program and compared to typical bloggers. As this was an explanatory mixed-methods study, we used qualitative thematic analyses to explain, interpret, and illustrate the quantitative results. Results Overall, quantitative results indicated lower overall emotional tone for all categories (tinnitus and hyperacusis, initial and reply), which was mostly influenced by higher negative emotion. Higher levels of authenticity or truth were found in the hyperacusis sample but not in the tinnitus sample. Lower levels of clout (social standing) were indicated in all groups, and a lower level of analytical thinking style (concepts and complex categories rather than narratives) was found in the hyperacusis sample. Additional analysis of the language indicated higher levels of sadness and anxiety in all groups and lower levels of anger, particularly for initial replies. These data support prior findings indicating higher levels of anxiety and depression in this patient population based on the actual words in blog posts and not from self-report questionnaires. Qualitative results identified 3 major themes from both the tinnitus and hyperacusis texts: suffering, negative emotional tone, and coping strategies. Conclusions Results from this study suggest support for the predominant clinical view that patients with tinnitus and hyperacusis have higher levels of anxiety and depression than the general population. The extent of the suffering described and patterns of coping strategies suggest clinical practice patterns and the need for research in implementing improved practice plans.

Implications and attitudes of audiologists towards smartphone integration in hearing healthcare.

In a relatively short period of time, modern societies have been transformed by the ubiquitous uptake of advanced and portable mobile communication, computation, and sensors available on smartphones. Looking forward, it is anticipated that smartphones will have an increasingly important role in health management including the delivery of hearing healthcare and operation of hearing instruments. OBJECTIVE: This paper provides a brief overview of the role of smartphones in audiologic rehabilitation and hearing research and reports on the findings of a survey assessing attitudes of audiologists towards smartphone integration in hearing healthcare. DESIGN: A total of 258 audiologists working in the United States completed the 10-item survey. RESULTS: The key finding from the survey is that practitioners generally expressed a high willingness to integrate smartphone technology in patient care. Counterintuitively, it was observed that clinicians with the least number of years of experience had relatively more negative attitudes toward smartphone integration in hearing healthcare than clinicians with comparatively more years of experience. CONCLUSIONS: The findings suggest that the attitudes of audiologists likely do not represent a barrier regarding smartphone integration in audiologic rehabilitation.

Hearing Aids as a Treatment for Tinnitus Patients with Slight to Mild Sensorineural Hearing Loss.

Persons with clinically significant tinnitus also may have mild sensorineural hearing loss (MSNHL). The purpose of this study was to describe patients with tinnitus and MSNHL and factors predicting hearing-aid uptake (HAU). We conducted a retrospective chart review with regression modeling of patients presenting to a specialty tinnitus clinic over a 2.5-year period. Stepwise logistic regression on data from patient charts was conducted. Of 133 patients seen, two-thirds had MSNHL (95% confidence interval [CI]: 58.9-75.0; mean age = 53.4 years; standard deviation = 14.5); approximately 50% had severe-to-catastrophic tinnitus. Logistic regression indicated that four-frequency pure-tone average (FFPTA; left) ( ß = 0.3899, χ2 = 10.96, degrees of freedom [DF] = 1, p = 0.0009) and age ( ß = 0.1273, χ2 = 4.86, DF = 1, p = 0.0274) were positively associated with HAU; tinnitus severity was inversely related ( ß = - 1.0533, χ2 = 4.24, DF = 1, p = 0.0395). Adjusting for key variables, odds of receiving hearing aids was 1.14 (95% CI: 1.01-1.27) times higher with every year increase in age, 1.48 (95% CI: 1.17-1.86) times higher per one point increase in FFPTA (left), and 0.35 (95% CI: 0.13-0.95) times less per one point increase in tinnitus severity score. Reasons why HAU was not high for this special sample of young adults with severe tinnitus and MSNHL are discussed; hearing aid treatment requires extensive counseling and follow-up for this population.

Toward the Future of Early Intervention for Adult Hearing Loss.

This issue of Seminars in Hearing has focused on the early intervention of adult sensorineural hearing loss (SNHL). Contributions to this monograph have taken a contemporary issues approach to the prevention, diagnosis, and treatment of mild SNHL. This article looks toward the future and discusses clinical and research implications for the early intervention of adult SNHL.