Autistic and Non-Autistic Experiences of Decreased Sound Tolerance and Their Association with Mental Health and Quality of Life.

Background: Decreased 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 behavioral 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. Methods: This 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. Results: The results of this study indicated that clinically relevant misophonia, an aversion to specific sounds, was more prevalent in the sample of autistic adults who self-reported DST. Similarly, clinically relevant hyperacusis, a reduced tolerance to everyday sounds at volumes that would not be distressing to most people, was also more prevalent in the sample of autistic adults who self-reported DST. Across the entire sample, misophonia symptoms were associated with more autistic traits and higher anxiety, whereas hyperacusis symptom severity was associated with more autistic traits, higher anxiety and depression symptoms, and poorer quality of life. Conclusion: Although clinical cases of misophonia and hyperacusis were more prevalent in our sample of autistic adults who self-reported DST, 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 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. Community Brief: