What Should Be Considered When Assessing Hyperacusis? A Qualitative Analysis of Problems Reported by Hyperacusis Patients

Abstract

Hyperacusis (decreased sound tolerance) is a prevalent complaint. Yet, to date, no research has qualitatively evaluated the types of problems experienced by adults with hyperacusis. Our service evaluation aims to determine the hyperacusis-related problem domains reported by patients and the degree to which these domains were reported together. Retrospective analysis was conducted on an anonymised clinical dataset from 306 patients who attended a UK tinnitus and hyperacusis treatment centre between 1994 and 2017. Conventional content analysis was used to categorise responses to the question ‘Why is hyperacusis a problem?’ into domains which were then subjected to a cluster analysis. Twenty-five problem domains were identified, of which 12 were further classified into three overarching categories. ‘Fear’, ‘Reduced quality of life’ and ‘Physical reaction to sound’ were most frequently reported problems. Cluster analysis revealed that ‘Sleep difficulties’ and ‘Despondency’, were commonly reported together. Adults with hyperacusis face many challenges in their everyday lives. The nature of these problems indicates the need to develop complex interventions and assessments to aid management of hyperacusis. Current hyperacusis questionnaires may be useful in identifying some problem domains, but further assessment thorough patient interviews is required to fully explore all potential problems and make informed decisions about treatment.

Hyperacusis Assessment Questionnaire—A New Tool Assessing Hyperacusis in Subjects with Tinnitus

“…Our position is, to some extent, consistent with the findings made by Fackrell et al [13]. A qualitative analysis of the types of problems experienced by adults with hyperacusis showed that they could be categorized into three general categories: fear, reduced quality of life, and physical reaction to sound.…”

“…The category "physical reaction to sound" referred to physical pain and physical discomfort due to sounds. Therefore, the three categories that we have named following Tyler (loudness, fear, pain) are broadly in line with those identified by Fackrell et al [13].…”

“…Fackrell et al [13] identified the hyperacusis-related problems reported by patients. Twelve domains were grouped into three overarching categories: "Anxiety", "Reduced quality of life", and "Physical reaction to sound".…”

Prevalence of Hyperacusis Diagnosis in Veterans Who Use VA Healthcare

“…Additionally, work is needed to develop clinical consensus on best practices to diagnose hyperacusis and identify subtypes. Current methods to diagnose hyperacusis include behavioral loudness testing and validated questionnaires such as the Hyperacusis Questionnaire (Khalfa et al 2002), but there is a lot of debate in the field on this topic (see Fackrell et al 2017Fackrell et al , 2022 for reviews on assessment and treatment of hyperacusis). Recent work by Adams et al (2021) proposed a consensus-based definition of hyperacusis to be: "A reduced tolerance to sound(s) that are perceived as normal to the majority of the population or were perceived a normal to the person before their onset of hyperacusis, where 'normal' refers to sounds that are generally well tolerated."…”