BackgroundDecreased sound tolerance (DST) is an increased sensitivity to sound at levels that would not bother most people. DST is highly prevalent in autistic adults; however, the extent to which DST differs across autistic and non-autistic adults is uncertain. This study explores multiple domains of DST symptoms and the severity of DST symptoms, as well as the behavioural reactions and coping strategies adopted to manage DST in both autistic and non-autistic adults. Lastly relationships between DST, autism characteristics, mental health, and quality of life were explored.MethodsThis study used online surveys to investigate the characteristics of DST in 77 autistic and 128 non-autistic adults who self-report DST, as well as the relationship between DST and autistic characteristics, mental health, and quality of life.ResultsThe results of this study indicated that misophonia, an aversion to specific sounds, was more severe in autistic adults. Similarly, hyperacusis, a reduced tolerance to everyday sounds at volumes that would not be distressing to most people, was also more severe in the autistic sample. Across the entire sample, misophonia symptoms were associated with more autistic traits and higher anxiety, while hyperacusis symptom severity was associated with more autistic traits, higher anxiety and depression symptoms, and poorer quality of life.ConclusionAlthough misophonia and hyperacusis appear to be more severe in autistic samples, these forms of DST may be related in similar ways to mental health and quality of life of both autistic and non-autistic adults. Future work should focus on differentiating the subtypes of DST in order to facilitate the development of treatments that specifically target the symptoms of each subtype (i.e. misophonia, and hyperacusis) rather than treating DST as a homogeneous problem.