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J Am Acad Audiol 2024; 35(01/02): 001-012
DOI: 10.1055/a-2192-5668
Research Article

Psychometric Evaluation of the Misophonia Impact Questionnaire using a Clinical Population of Patients Seeking Help for Tinnitus, Hyperacusis, and/or Misophonia

Hashir Aazh 
1   Audiology Department, Royal Surrey NHS Foundation Trust, Guildford, United Kingdom
2   Department of Communication Sciences and Disorders, Florida Atlantic University, Boca Raton, Florida
3   Faculty of Engineering and Physical Sciences, Department of Physics, University of Surrey, Guildford, United Kingdom
4   Hashir International Specialist Clinics and Research Institute for Misophonia, Tinnitus and Hyperacusis, R&D Department, Guildford, United Kingdom
,
Brian C.J. Moore
4   Hashir International Specialist Clinics and Research Institute for Misophonia, Tinnitus and Hyperacusis, R&D Department, Guildford, United Kingdom
5   Department of Psychology, Cambridge Hearing Group, Cambridge, United Kingdom
,
Tricia Scaglione
6   Division of Audiology, Department of Otolaryngology, University of Miami Health System, Miami, Florida
,
Nico Remmert
7   Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
› Author Affiliations Funding HA was supported by an R&D fund from Hashir International Specialist Clinics & Research Institute for Misophonia, Tinnitus and Hyperacusis Ltd.
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Abstract

Background Misophonia is a decreased tolerance of certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds, and tapping. While several validated self-report misophonia questionnaires exist, none focus solely on the impact of misophonia on the patient's life. Additionally, there are no available validated pediatric self-report measures of misophonia. Therefore, a tool was needed to assess the impact of misophonia on both adult and pediatric patients.

Purpose To evaluate the psychometric properties of the 8-item Misophonia Impact Questionnaire (MIQ).

Research Design This was a retrospective cross-sectional study.

Study Sample Patients who attended the Tinnitus and Hyperacusis Therapy Specialist Clinic in the United Kingdom seeking help for tinnitus, hyperacusis, and/or misophonia (n = 256). A subsample of children aged 16 years or younger (n = 15) was included for preliminary analyses of a version of the MIQ to be filled in by a parent (MIQ-P).

Data Collection and Analysis Data were collected retrospectively from the records of patients held at the audiology department. These included demographic data, audiological measures, and self-report questionnaires taken as part of routine care. Descriptive statistics and psychometric analyses were conducted. The MIQ was analyzed for item difficulty, factor structure, reliability, and construct validity.

Results Confirmatory factor analysis revealed that a one-factor model for the MIQ gave an excellent fit and its estimated reliability was excellent, with Cronbach's α = 0.94. The total MIQ scores were highly correlated with scores for the Hyperacusis Impact Questionnaire and Sound Sensitivity Symptoms Questionnaire. MIQ scores were not significantly correlated with scores for the Tinnitus Impact Questionnaire or average hearing thresholds. Preliminary data from the subsample indicated excellent internal consistency for the MIQ-P, with Cronbach's α = 0.92.

Conclusions The MIQ is a promising questionnaire for assessing the impact of misophonia. Future studies should focus on establishing test/retest reliability, identifying clinically significant change in MIQ scores, defining the severity of misophonia impact categories, and further exploring the psychometric properties of the MIQ-P.

Keywords

misophonia - psychometrics - questionnaire - hyperacusis - tinnitus

Supplementary Material



Publication History

Received: 31 March 2023

Accepted: 12 October 2023

Accepted Manuscript online:
16 October 2023

Article published online:
26 November 2024

© 2024. American Academy of Audiology. This article is published by Thieme.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Jastreboff MM, Jastreboff PJ. Decreased sound tolerance and tinnitus retraining therapy (TRT). Aust N Z J Audiol 2002; 24 (02) 74-84
    CrossrefSearch in Google Scholar
  • 2 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):2021.04.05.21254951
  • 3 Edelstein M, Brang D, Rouw R, Ramachandran VS. Misophonia: physiological investigations and case descriptions. Front Hum Neurosci 2013; 7: 296
    CrossrefPubMedSearch in Google Scholar
  • 4 Schröder A, Vulink N, Denys D. Misophonia: diagnostic criteria for a new psychiatric disorder. PLoS One 2013; 8 (01) e54706
    CrossrefPubMedSearch in Google Scholar
  • 5 Rinaldi LJ, Simner J, Koursarou S, Ward J. Autistic traits, emotion regulation, and sensory sensitivities in children and adults with misophonia. J Autism Dev Disord 2023; 53 (03) 1162-1174
    CrossrefPubMedSearch in Google Scholar
  • 6 Jakubovski E, Müller A, Kley H, de Zwaan M, Müller-Vahl K. Prevalence and clinical correlates of misophonia symptoms in the general population of Germany. Front Psychiatry 2022; 13: 1012424
    CrossrefPubMedSearch in Google Scholar
  • 7 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
    CrossrefPubMedSearch in Google Scholar
  • 8 Vitoratou S, Hayes C, Uglik-Marucha N, Pearson O, Graham T, Gregory J. Misophonia in the UK: prevalence and norms from the S-Five in a UK representative sample. PLoS One 2023; 18 (03) e0282777
    CrossrefPubMedSearch in Google Scholar
  • 9 Jager I, de Koning P, Bost T, Denys D, Vulink N. Misophonia: phenomenology, comorbidity and demographics in a large sample. PLoS One 2020; 15 (04) e0231390
    CrossrefPubMedSearch in Google Scholar
  • 10 Lewin AB, Dickinson S, Kudryk K. et al. Transdiagnostic cognitive behavioral therapy for misophonia in youth: methods for a clinical trial and four pilot cases. J Affect Disord 2021; 291: 400-408
    CrossrefPubMedSearch in Google Scholar
  • 11 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; 33 (05) 248-258
    Thieme ConnectPubMedSearch in Google Scholar
  • 12 Palumbo DB, Alsalman O, De Ridder D, Song JJ, Vanneste S. Misophonia and potential underlying mechanisms: a perspective. Front Psychol 2018; 9: 953
    CrossrefPubMedSearch in Google Scholar
  • 13 Holohan D, Marfilius K, Smith CJ. Misophonia: a review of the literature and its implications for the social work profession. Soc Work 2023; 68 (04) 341-348
    CrossrefPubMedSearch in Google Scholar
  • 14 McKenna L, Handscomb L, Hoare DJ, Hall DA. A scientific cognitive-behavioral model of tinnitus: novel conceptualizations of tinnitus distress. Front Neurol 2014; 5: 196
    CrossrefPubMedSearch in Google Scholar
  • 15 Aazh H, Landgrebe M, Danesh AA, Moore BC. Cognitive behavioral therapy for alleviating the distress caused by tinnitus, hyperacusis and misophonia: current perspectives. Psychol Res Behav Manag 2019; 12: 991-1002
    CrossrefPubMedSearch in Google Scholar
  • 16 Jager IJ, Vulink NCC, Bergfeld IO, van Loon AJJM, Denys DAJP. Cognitive behavioral therapy for misophonia: a randomized clinical trial. Depress Anxiety 2020; 38 (07) 708-718
    CrossrefPubMedSearch in Google Scholar
  • 17 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
    CrossrefPubMedSearch in Google Scholar
  • 18 WHO. International Classification of Functioning, Disability and Health (ICF). Geneva, Switzerland:: The World Health Organization;; 2001
    Search in Google Scholar
  • 19 Danermark B, Cieza A, Gangé JP. et al. International classification of functioning, disability, and health core sets for hearing loss: a discussion paper and invitation. Int J Audiol 2010; 49 (04) 256-262
    CrossrefPubMedSearch in Google Scholar
  • 20 Granberg S, Pronk M, Swanepoel W. et al. The ICF core sets for hearing loss project: functioning and disability from the patient perspective. Int J Audiol 2014; 53 (11) 777-786
    CrossrefPubMedSearch in Google Scholar
  • 21 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
    CrossrefPubMedSearch in Google Scholar
  • 22 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) 1797
    CrossrefPubMedSearch in Google Scholar
  • 23 Rosenthal MZ, Anand D, Cassiello-Robbins C. et al. Development and initial validation of the Duke Misophonia Questionnaire. Front Psychol 2021; 12 (4197) 709928
    CrossrefPubMedSearch in Google Scholar
  • 24 Dibb B, Golding SE, Dozier TH. The development and validation of the misophonia response scale. J Psychosom Res 2021; 149: 110587
    CrossrefPubMedSearch in Google Scholar
  • 25 Vitoratou S, Uglik-Marucha N, Hayes C, Gregory J. Listening to people with misophonia: exploring the multiple dimensions of sound intolerance using a new psychometric tool, the S-Five, in a large sample of individuals identifying with the condition. Psych 2021; 3 (04) 639-662
    CrossrefSearch in Google Scholar
  • 26 Remmert N, Schmidt KMB, Mussel P, Hagel ML, Eid M. The Berlin Misophonia Questionnaire Revised (BMQ-R): development and validation of a symptom-oriented diagnostical instrument for the measurement of misophonia. PLoS One 2022; 17 (06) e0269428
    CrossrefPubMedSearch in Google Scholar
  • 27 Rinaldi LJ, Smees R, Ward J, Simner J. Poorer well-being in children with misophonia: evidence from the Sussex Misophonia Scale for adolescents.. Front Psychol 2022; 13: 808379
    CrossrefPubMedSearch in Google Scholar
  • 28 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
    CrossrefPubMedSearch in Google Scholar
  • 29 British Society of Audiology. Pure-Tone Air-Conduction and Bone Conduction Threshold Audiometry with and without Masking: Recommended Procedure. UK: British Society of Audiology;; 2018
    Search in Google Scholar
  • 30 Aazh H, Moore BCJ. Incidence of discomfort during pure-tone audiometry and measurement of uncomfortable loudness levels among people seeking help for tinnitus and/or hyperacusis. Am J Audiol 2017; 26 (03) 226-232
    CrossrefPubMedSearch in Google Scholar
  • 31 Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001; 16 (09) 606-613
    CrossrefPubMedSearch in Google Scholar
  • 32 Spitzer RL, Kroenke K, Williams JB, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med 2006; 166 (10) 1092-1097
    CrossrefPubMedSearch in Google Scholar
  • 33 Aazh H, Hayes C, Moore BC, Vitoratou S, Aazh H, Hayes C, Moore BCJ, Vitoratou S. Psychometric evaluation of the tinnitus impact questionnaire using patients seeking help for tinnitus or tinnitus with hyperacusis. Int J Audiol 2023; 62 (09) 835-844
    CrossrefPubMedSearch in Google Scholar
  • 34 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
    CrossrefPubMedSearch in Google Scholar
  • 35 Kroenke K, Spitzer RL, Williams JB, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics 2009; 50 (06) 613-621
    PubMedSearch in Google Scholar
  • 36 Aazh H, Moore BCJ. Usefulness of self-report questionnaires for psychological assessment of patients with tinnitus and hyperacusis and patients' views of the questionnaires. Int J Audiol 2017; 56 (07) 489-498
    CrossrefPubMedSearch in Google Scholar
  • 37 Core Team. R: A Language And Environment For Statistical Computing. Vienna, Austria: R Foundation for Statistical Computing; 2022 . Accessed at: https://www.R-project.org/
    Search in Google Scholar
  • 38 Cohen J. Statistical Power Analysis for the Behavioral Sciences. New Jersey:: Lawrence Erlbaum Associates, Inc. Publishers;; 1988
    Search in Google Scholar
  • 39 Dahl G. Zur Berechnung des Schwierigkeitsindex bei quantitativ abgestufter Aufgabenbewertung. Diagnostica 1971; 17 (03) 139-142
    Search in Google Scholar
  • 40 Jöreskog KG. Statistical analysis of sets of congeneric tests. Psychometrika 1971; 36 (02) 109-133
    CrossrefSearch in Google Scholar
  • 41 Muthén B, du Toit SHC, Spisic D. Robust inference using weighted least squares and quadratic estimating equations in latent variable modelling with categorical and continuous outcomes;. 1997. . Report No.: Technical report.
    Search in Google Scholar
  • 42 Rosseel Y. lavaan: an R package for structural equation modeling. J Stat Softw 2012; 48: 1-36
    CrossrefSearch in Google Scholar
  • 43 Schermelleh-Engel K, Moosbrugger H, Müller H. Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods Psychol Res Online 2003; 8 (02) 23-74
    Search in Google Scholar
  • 44 McDonald RP. Test Theory: A Unified Treatment. UK:: Psychology Press;; 1999
    Search in Google Scholar
  • 45 Cronbach L. Coefficient alpha and the internal structure of tests. Psychometrika 1951; 16: 297-334
    CrossrefSearch in Google Scholar
  • 46 Siepsiak M, Rosenthal MZ, Raj-Koziak D, Dragan W. Psychiatric and audiologic features of misophonia: use of a clinical control group with auditory over-responsivity. J Psychosom Res 2022; 156: 110777
    CrossrefPubMedSearch in Google Scholar
  • 47 Raj-Koziak D, Gos E, Kutyba J, Skarzynski H, Skarzynski PH. Decreased sound tolerance in tinnitus patients. Life (Basel) 2021; 11 (02) 87
    PubMedSearch in Google Scholar
  • 48 Auerbach BD, Rodrigues PV, Salvi RJ. Central gain control in tinnitus and hyperacusis. Front Neurol 2014; 5: 206
    CrossrefPubMedSearch in Google Scholar
  • 49 Aazh H, Allott R. Cognitive behavioural therapy in management of hyperacusis: a narrative review and clinical implementation. Auditory and Vestibular Research. 2016; 25 (02) 63-74
    Search in Google Scholar
  • 50 McNeish D, Wolf MG. Thinking twice about sum scores. Behav Res Methods 2020; 52 (06) 2287-2305
    CrossrefPubMedSearch in Google Scholar
  • 51 Putnick DL, Bornstein MH. Measurement invariance conventions and reporting: the state of the art and future directions for psychological research. Dev Rev 2016; 41: 71-90
    CrossrefPubMedSearch in Google Scholar
  • 52 Aazh H, Erfanian M, Danesh AA, Moore BCJ. Audiological and other factors predicting the presence of misophonia symptoms among a clinical population seeking help for tinnitus and/or hyperacusis. Front Neurosci 2022; 16: 900065
    CrossrefPubMedSearch in Google Scholar
  • 53 Bennett-Levy J. Mechanisms of change in cognitive therapy: the case of automatic thought records and behavioural experiments. Behav Cogn Psychother 2003; 31: 261-277
    CrossrefSearch in Google Scholar
  • 54 Yektatalab S, Mohammadi A, Zarshenas L. The prevalence of misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of Shiraz University of Medical Sciences: a cross-sectional study. Int J Community Based Nurs Midwifery 2022; 10 (04) 259-268
    PubMedSearch in Google Scholar
  • 55 Guetta RE, Cassiello-Robbins C, Trumbull J, Anand D, Rosenthal MZ. Examining emotional functioning in misophonia: the role of affective instability and difficulties with emotion regulation. PLoS One 2022; 17 (02) e0263230
    CrossrefPubMedSearch in Google Scholar
  • 56 Siepsiak M, Sobczak AM, Bohaterewicz B, Cichocki Ł, Dragan WŁ. Prevalence of misophonia and correlates of its symptoms among inpatients with depression. Int J Environ Res Public Health 2020; 17 (15) 5464
    CrossrefPubMedSearch in Google Scholar
  • 57 Eiser C, Morse R. Quality-of-life measures in chronic diseases of childhood. Health Technol Assess 2001; 5 (04) 1-157
    CrossrefPubMedSearch in Google Scholar
  • 58 Smith H, Fackrell K, Kennedy V, Barry J, Partridge L, Hoare DJ. A scoping review to catalogue tinnitus problems in children. Int J Pediatr Otorhinolaryngol 2019; 122: 141-151
    CrossrefPubMedSearch in Google Scholar