Hyperacusis Questionnaire as a Tool for Measuring Hypersensitivity to Sound in a Tinnitus Research Population
Open accessAbstract
Hypersensitivity to external sounds is often comorbid with tinnitus and may be significant for adherence to certain types of tinnitus management. Therefore, a clear measure of sensitivity to sound is important. The aim of this study was to evaluate the validity and reliability of the Hyperacusis Questionnaire (HQ) for use as a measurement tool using data from a sample of 264 adults who took part in tinnitus research. We evaluated the HQ factor structure, internal consistency, convergent and discriminant validity, and floor and ceiling effects. Internal consistency was high (Cronbach’s alpha = 0.88) and moderate correlations were observed between the HQ, uncomfortable loudness levels, and other health questionnaires. Confirmatory factor analysis revealed that the original HQ three-factor solution and a one-factor solution were both a poor fit to the data. Four problematic items were removed and exploratory factor analysis identified a two-factor (attentional and social) solution. The original three-factor structure of the HQ was not confirmed. All fourteen items do not accurately assess hypersensitivity to sound in a tinnitus population. We propose a 10-item (2-factor) version of the HQ, which will need to be confirmed using a new tinnitus and perhaps nontinnitus population.
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There is a reasonable body of evidence on the development and reliability of the HQ as a diagnostic tool.
“There is reasonable body of evidence on the development and reliability of the HQ as a diagnostic tool [63, 68]”
From Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research (2017) · cites this paper as [68]
The Results (§3.3) report high internal consistency for the HQ, and the Introduction (§1) describes its development and use as a screening tool. But the Introduction says its original structure had not been confirmed in a UK population, while the Discussion (§4) questions the proposed diagnostic cutoff. The paper therefore supports evidence on the HQ’s development and some reliability, but not an unqualified characterization of it as a reliable diagnostic tool. (LLM, conf=0.86)
Experimental — accuracy not yet measuredQuestions have been raised on the appropriateness of the items in the HQ and the need for validation in a population with a primary complaint of hyperacusis.
“Questions have been raised on the appropriateness of the items in the questionnaire and the need of validation in a population with a primary complaint of hyperacusis is known [68].”
From Clinical Interventions for Hyperacusis in Adults: A Scoping Review to Assess the Current Position and Determine Priorities for Research (2017) · cites this paper as [68]
The Discussion identifies problematic HQ items in the tinnitus research sample, and the Conclusions/Recommendations call for further validation. However, the paper recommends validation in general populations, including UK populations; it does not specifically call for validation among people whose primary complaint is hyperacusis. The indexed passages provide section labels but no page numbers. (LLM, conf=0.84)
Experimental — accuracy not yet measured
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“The validity and reliability of the HQ have been questioned by a number of authors (Meeus et al. 2010; Wallén et al. 2012; Fackrell et al. 2015; Fackrell & Hoare 2018).”
BackgroundHyperacusis in children: a scoping review
Potgieter, I., Fackrell, K., Kennedy, V., Crunkhorn, R., & Hoare, D. J. (2020) · BMC Pediatrics · doi:10.1186/s12887-020-02223-5 · Cited by 33 · see citing works
“These findings reflect the recent suggestions that ULLs are not a reliable measure in adults or children [58, 59].”
BackgroundSelf-citationHyperacusis: Loudness intolerance, fear, annoyance and pain
Salvi, R., Chen, G., & Manohar, S. (2022) · Hearing Research · doi:10.1016/j.heares.2022.108648 · Cited by 32 · see citing works
Han, Q., Zhang, Y., Liu, D., Wang, Y., Feng, Y., Yin, X., & Wang, J. (2018) · Neuroradiology · doi:10.1007/s00234-018-2087-0 · Cited by 31 · see citing works
Oishi, N., Yamada, H., Kanzaki, S., Kurita, A., Takiguchi, Y., Yuge, I., Asama, Y., Masuda, M., & Ogawa, K. (2017) · Acta Oto-Laryngologica · doi:10.1080/00016489.2017.1306654 · Cited by 29 · see citing works
“Very recently, the validity and reliability of the HQ were not confirmed in the tinnitus population and a new version of the HQ is proposed [16].”
BackgroundAlterations in auditory brain stem response distinguish occasional and constant tinnitus
Edvall, N. K., Mehraei, G., Claeson, M., Lazar, A., Bulla, J., Leineweber, C., Uhlén, I., Canlon, B., & Cederroth, C. R. (2022) · Journal of Clinical Investigation · doi:10.1172/jci155094 · Cited by 28 · see citing works
“Since the LDLs showed limitations in being determined at high frequencies (>12.5 kHz), we instead used the HQ, which has excellent reliability (25– 27), to control for hyperacusis.”
InfluentialVisualization of Global Disease Burden for the Optimization of Patient Management and Treatment
Schlee, W., Hall, D. A., Edvall, N. K., Langguth, B., Canlon, B., & Cederroth, C. R. (2017) · Frontiers in Medicine · doi:10.3389/fmed.2017.00086 · Cited by 27 · see citing works
“Again there is no consensus about the factor structure of the HQ (36, 37) and so here we used the global score, not any subscale scores.”
MethodMisophonia and Hearing Comorbidities in a Collegiate Population
Brennan, C., Lindberg, R. R., Kim, G., Castro, A. A., Khan, R. A., Berenbaum, H., & Husain, F. T. (2023) · Ear and Hearing · doi:10.1097/aud.0000000000001435 · Cited by 27 · see citing works
Minimally Invasive Surgery for the Treatment of Hyperacusis
Silverstein, H., Ojo, R. B., Daugherty, J., Nazarian, R., & Wazen, J. J. (2016) · Otology & Neurotology · doi:10.1097/mao.0000000000001214 · Cited by 23 · see citing works
“Further, their quality of life is often diminished, because of anxiety and avoidance of noise related activities (2,3).”
BackgroundTurkish Adaptation of Khalfa Hyperacusis Questionnaire
Erinç, M., & Derinsu, U. (2020) · Medeniyet Medical Journal · doi:10.5222/mmj.2020.97947 · Cited by 21 · see citing works
“In the study by Fackrell et al. 17 , there were only 19 patients with hyperacusis among 264 patients with tinnitus according to 28-point criterion.”
Fournier, P., Paleressompoulle, D., Esteve Fraysse, M.-J., Paolino, F., Devèze, A., Venail, F., & Noreña, A. (2022) · Hearing Research · doi:10.1016/j.heares.2022.108519 · Cited by 20 · see citing works
Clinical and investigational tools for monitoring noise-induced hyperacusis
Jahn, K. N. (2022) · The Journal of the Acoustical Society of America · doi:10.1121/10.0012684 · Cited by 20 · see citing works
Decreased Sound Tolerance in Tinnitus Patients
Raj-Koziak, D., Gos, E., Kutyba, J. J., Skarżyńśki, H., & Skarzynski, P. H. (2021) · Life · doi:10.3390/life11020087 · Cited by 20 · see citing works
“[30] comprised 264 persons with tinnitus and their mean HQ score was 14.”
BackgroundHoof, L. V., Kleinjung, T., Cardon, E., Rompaey, V. V., & Peter, N. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.969978 · Cited by 20 · see citing works
Meulemeester, K. D., Meeus, M., Pauw, R. D., Cagnie, B. J., Keppler, H., & Lenoir, D. (2023) · PLoS ONE · doi:10.1371/journal.pone.0290116 · Cited by 20 · see citing works
Trivedi, M., Dumkrieger, G. M., Chong, C. D., Dodick, D. W., & Schwedt, T. J. (2021) · Headache The Journal of Head and Face Pain · doi:10.1111/head.14100 · Cited by 18 · see citing works
Aazh, H., Hayes, C., Erfanian, M., Moore, B. C. J., & Vitoratou, S. (2024) · Journal of the American Academy of Audiology · doi:10.1055/a-2255-7643 · Cited by 17 · see citing works
“45 Thus, the HIQ may be more appropriate than the HQ for assessing the impact of hyperacusis.”
Manta, O., Sarafidis, M., Schlee, W., Mazurek, B., Matsopoulos, G. K., & Koutsouris, D. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12113843 · Cited by 16 · see citing works
“…[79], the Tinnitus Severity (TS) [80], the Mini-Tinnitus Questionnaire (Mini-TQ) [81,82], the Questionnaire on Hypersensitivity to Sound (GUF) [83,84], the Patient Health Questionnaire (PHQ-9) [85], the WHO Quality of Life Questionnaire (WHOQOL-BREF) [86], and the European School of…”
MethodPrabhu, P., & Nagaraj, M. K. (2020) · Journal of Otology · doi:10.1016/j.joto.2019.12.004 · Cited by 16 · see citing works
“Hypersensitivity to external sounds is often co-morbid with tinnitus and may be significant for adherence to certain types of tinnitus management (Fackrell et al., 2015).”
BackgroundLong-Term Effects of COVID-19 and the Pandemic on Tinnitus Patients
Erinç, M., Mutlu, A., Çelik, S., Kalcioglu, M. T., & Szczepek, A. J. (2022) · Frontiers in Neurology · doi:10.3389/fneur.2022.921173 · Cited by 15 · see citing works
Hyperacusis and Misophonia: A Systematic Review of Psychometric Measures
Kula, F. B., Cropley, M., & Aazh, H. (2022) · Journal of the American Academy of Audiology · doi:10.1055/a-1896-5032 · Cited by 14 · see citing works
“Approximately 20% of the studies were conducted in the U.K. 9,15,28 and 13% in the U.S. 10,29 and Italy.”
Carson, T. B., Qiu, Y., Lu, L., Medina, A. M., Ortiz, A., Condon, C. A., Ryan, N., Ambrosio, J., Carcamo, K., Miranda, D., et al. (2022) · International Journal of Audiology · doi:10.1080/14992027.2022.2113827 · Cited by 14 · see citing works
“The maximum score is 42 and a cut-off score of 28 is recommended as indicative of auditory hypersensitivity (Khalfa et al. 2002), although some researchers have suggested alternative cut-off scores be used to improve identification (Fackrell et al. 2015; Meeus et al. 2010).”
MethodHyperacusis Assessment Questionnaire—A New Tool Assessing Hyperacusis in Subjects with Tinnitus
Raj-Koziak, D., Gos, E., Kutyba, J. J., Skarzynski, P. H., & Skarżyńśki, H. (2023) · Journal of Clinical Medicine · doi:10.3390/jcm12206622 · Cited by 15 · see citing works
“The most popular seems to be the Hyperacusis Questionnaire (HQ) developed by Khalfa et al. [37], but the independent validation of HQ done by Fackrell et al. [38] suggests that it does not provide a valid overall measure of hypersensitivity.”
BackgroundMethodInfluentialvan der Wal, A., de Heyning, P. V., Gilles, A., Jacquemin, L., Topsakal, V., Rompaey, V. V., Braem, M. J. A., Visscher, C. M., Truijen, S., Michiels, S., et al. (2020) · Frontiers in Neuroscience · doi:10.3389/fnins.2020.561038 · Cited by 13 · see citing works
Assessment of Reduced Tolerance to Sound (Hyperacusis) in University Students.
Yılmaz, Ş., Taş, M., Bulut, E., & Nurçin, E. (2017) · Europe PMC (PubMed Central) · doi:10.4103/nah.nah_54_16 · Cited by 13 · see citing works
“lished by Wolters Kluwer - Medknow reactions to specific “trigger” sounds) are sometimes used in the place of hyperacusis, both these conditions describe aversive emotional responses to sounds.([2,4]) Tyler et al.”
BackgroundMethodResultInfluentialLuyten, T., Jacquemin, L., Looveren, N. V., Declau, F., Fransén, E., Cardon, E., Bodt, M. S. D., Topsakal, V., de Heyning, P. V., Rompaey, V. V., et al. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.02048 · Cited by 13 · see citing works
The electrophysiological markers of hyperacusis: a scoping review
Bigras, C., Villatte, B., Duda, V., & Hébert, S. (2022) · International Journal of Audiology · doi:10.1080/14992027.2022.2070083 · Cited by 11 · see citing works
“This could be due to its low reliability and validity (Fackrell et al. 2015).”
BackgroundJacquemin, L., Cardon, E., Michiels, S., Luyten, T., van der Wal, A., Hertogh, W. D., Vanderveken, O. M., de Heyning, P. V., Lammers, M. J. W., Rompaey, V. V., et al. (2022) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-022-07336-4 · Cited by 11 · see citing works
“Even though some authors have discussed whether the original cut-off score of the HQ is too high [43], this original cut-off was used in the current study to ensure that only the patients with clinically significant hyperacusis were identified as having hyperacusis.”
MethodAazh, H., Hayes, C., Moore, B. C. J., & Vitoratou, S. (2022) · International Journal of Audiology · doi:10.1080/14992027.2022.2101027 · Cited by 11 · see citing works
Meis, M., Hüber, R., Fischer, R.-L., Schulte, M., Spilski, J., & Meister, H. (2016) · International Journal of Audiology · doi:10.1080/14992027.2016.1248795 · Cited by 10 · see citing works
“With regard to the profiling the user’s aversions towards sounds, one promising questionnaire might be the Hyperacusis Questionnaire (HQ) from Fackrell et al (2015).”
BackgroundMethodHyperacusis and social media trends
Deshpande, A. K., Deshpande, S. B., & O'Brien, C. (2019) · Hearing Balance and Communication · doi:10.1080/21695717.2018.1539321 · Cited by 10 · see citing works
“The reduced tolerance to sound is also associated with other conditions, including migraines, autism, post-traumatic stress disorder, Lyme disease, Bell’s palsy and Meniere’s disease [1,3].”
BackgroundMethodInfluentialAhmmed, A. U., & Mukherjee, D. (2020) · Hearing Balance and Communication · doi:10.1080/21695717.2020.1727216 · Cited by 11 · see citing works
Hyperacusis is associated with smaller gray matter volumes in the supplementary motor area
Makani, P., Koops, E. A., Pyott, S. J., van Dijk, P., & Thioux, M. (2023) · NeuroImage Clinical · doi:10.1016/j.nicl.2023.103425 · Cited by 9 · see citing works
“Such an investigation would, however, require a more complete assessment of individuals with hyperacusis than afforded by the instruments available in this study (Baguley & Hoare, 2018; Enzler et al., 2021; Fackrell et al., 2015).”
MethodBigras, C., Theodoroff, S. M., Thielman, E. J., & Hébert, S. (2024) · Hearing Research · doi:10.1016/j.heares.2024.108992 · Cited by 9 · see citing works
“However, Fackrell et al. (2015) deemed this solution a poor fit when applied to a tinnitus population.”
InfluentialEfficacy of different clinical assessment measures of hyperacusis: a systematic review
Parmar, A., & Prabhu, P. (2022) · European Archives of Oto-Rhino-Laryngology · doi:10.1007/s00405-022-07724-w · Cited by 9 · see citing works
“There is even a gender difference present, where females score more on the HQ than males and are hypothesized to be more sensitive to sounds as well as experience more distress related to hormone and emotional rate changes [24, 37].”
BackgroundInfluentialHyperacusis: Focus on Gender Differences: A Systematic Review
Musumano, L. B., Stavros Hatzopoulos, A., Fancello, V., Bianchini, C., Bellini, T., Pelucchi, S., Skarzynski, P. H., Skarzynska, M. B., & Ciorba, A. (2023) · Life · doi:10.3390/life13102092 · Cited by 8 · see citing works
“Magalhaes et al. [12], assessed nine subjects (eight females and one male) and by administering a questionnaire on hyperacusis found that all eight female patients were affected.”
BackgroundMethodCut-off score of the Khalfa Hyperacusis Questionnaire with 10 selected items
Yamada, H., Ishikawa, T., Oishi, N., & Ogawa, K. (2021) · International Journal of Audiology · doi:10.1080/14992027.2021.1894491 · Cited by 8 · see citing works
“a general population that did not necessarily complain of sensitivity to sound (Fackrell et al. 2015).”
BackgroundResultInfluentialHusain, F. T., Chappell, J., & Tai, Y. (2021) · International Journal of Audiology · doi:10.1080/14992027.2021.1953712 · Cited by 9 · see citing works
“…found to occur with a prevalence rate between 7.2 to 88.8% within the tinnitus population (Dauman and Bouscau-Faure 2005; de Magalhaes et al. 2003; Fackrell et al. 2015; Fioretti, Fusetti, and Eibenstein 2013; Guimaraes et al. 2014; Kojima et al. 2017; Ralli et al. 2017), but affects only between…”
BackgroundInfluentialMiller, R. M., Dunn, J. A., O’Beirne, G. A., Whitney, S. L., & Snell, D. L. (2024) · Brain Injury · doi:10.1080/02699052.2024.2337905 · Cited by 7 · see citing works
“…or activities conducted) of any individual which increase their degree of reactivity to noise in general’ (p59), or hyperacusis as defined by Fackrell and colleagues (50) which is ‘increased sensitivity to ordinary environmental sounds that would not usually be bothersome to most individuals’ (p1).”
BackgroundUmashankar, A., Gander, P. E., Alter, K., & Sedley, W. (2025) · Hearing Research · doi:10.1016/j.heares.2025.109299 · Cited by 7 · see citing works
“Thresholds were estimated based on the initial presented level at either 40 dB HL or above depending on the participant ’ s residual hearing (Carhart and Jerger, 1959).”
Schecklmann, M., Jacquemin, L., & Baguley, D. (2024) · Springer eBooks · doi:10.1007/978-3-031-35647-6_41 · Cited by 7 · see citing works
Results of a 6-Month Field Trial of a Transitional Intervention for Debilitating Hyperacusis
Formby, C., Cherri, D., Secor, C. A., Armstrong, S., Juneau, R., Hutchison, P., & Eddins, D. A. (2024) · Journal of Speech Language and Hearing Research · doi:10.1044/2024_jslhr-23-00360 · Cited by 7 · see citing works
Tortorella, F., Pavaci, S., Fioretti, A. B., Masedu, F., Lauriello, M., & Eibenstein, A. (2017) · Audiology Research · doi:10.4081/audiores.2017.182 · Cited by 7 · see citing works
Aazh, H., Langguth, B., & Danesh, A. A. (2018) · International Journal of Audiology · doi:10.1080/14992027.2018.1514470 · Cited by 7 · see citing works
“Cronbach’s alpha for this questionnaire is 0.88 (Fackrell et al. 2015).”
BackgroundInfluentialMakani, P., Thioux, M., Koops, E. A., Pyott, S. J., & van Dijk, P. (2024) · Brain Sciences · doi:10.3390/brainsci14070726 · Cited by 6 · see citing works
“Differentiating the Effects of the Attentional and Social Subscales of the Hyperacusis Questionnaire on SMA Gray Matter Volumes Responses to the Hyperacusis Questionnaire can be classified into two component groups: attentional and social [30].”
BackgroundAazh, H., Kartsonaki, C., & Moore, B. C. J. (2022) · International Journal of Audiology · doi:10.1080/14992027.2022.2143430 · Cited by 6 · see citing works
“Cronbach ’ s alpha for the English version of the HQ is 0.88 (Fackrell et al. 2015).”
InfluentialCommentary: Consensus definition of misophonia
Aazh, H. (2023) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.1077097 · Cited by 7 · see citing works
“Therefore, most research studies in the field of audiology have not distinguished misophonia from hyperacusis (Fackrell et al., 2015; Sheldrake et al., 2015; Zaugg et al., 2016; Aazh et al., 2017).”
BackgroundAlkharabsheh, A., Alshurafa, S., Alhanbali, S., & Garadat, S. N. (2025) · PLoS ONE · doi:10.1371/journal.pone.0319665 · Cited by 5 · see citing works
Demoen, S., Jacquemin, L., Timmermans, A. A. A., Rompaey, V. V., Vanderveken, O. M., Vermeersch, H., Joossen, I., Eetvelde, J. V., Schlee, W., Marneffe, W., et al. (2022) · Trials · doi:10.1186/s13063-022-06378-7 · Cited by 5 · see citing works
“Moderate correlations between the HQ, uncomfortable loudness levels and other health questionnaires and a high internal consistency of the HQ have been demonstrated [57].”
BackgroundAazh, H., Stevens, J., & Jacquemin, L. (2023) · Journal of the American Academy of Audiology · doi:10.1055/a-2084-4808 · Cited by 5 · see citing works
Evaluation and Management of Misophonia Using a Hybrid Telecare Approach: A Case Report
Zitelli, L. (2021) · Seminars in Hearing · doi:10.1055/s-0041-1731693 · Cited by 4 · see citing works
“The questionnaire recommended by Aazh and Moore,(11) the HQ, was developed in 2002 and has been widely used, although a subsequent study has identified concerns about its validity.(43) The IHS has since been proposed.”
MethodOptimization of the Operant Silent Gap-in-Noise Detection Paradigm in Humans
Negri, L., Oliver, P., Mitchell, R., Sinha, L., Kearney, J., Saad, D., Nodal, F. R., & Bajo, V. M. (2024) · Journal of Integrative Neuroscience · doi:10.31083/j.jin2310183 · Cited by 4 · see citing works
“Exclusion criteria were any major medical or psychiatric condition (other than tinnitus), hearing loss (defined as >25 dB hearing level (HL) in both ears), severe hyperacusis (assessed using the Khalfa hyperacusis questionnaire [23,24]), claustrophobia, or belonging to a vulnerable group.”
Hyperacusis and stapes surgery: An observation in fifty patients after stapedotomy
Santos, M., Rego, Â. R., Lino, J., Coutinho, M. B., & Sousa, C. A. E. (2020) · Journal of Otology · doi:10.1016/j.joto.2020.07.001 · Cited by 4 · see citing works
“It can have a negative impact on the quality of life, as it often compromises concentration, sleep, and emotional status, turning professional, familial and social lives difficult (Moller et al., 2014; Fackrell et al., 2015).”
BackgroundPreliminary Examination of the Incidence of and Factors Related to Hearing Tinnitus in Dreams
Aazh, H., Stevens, J., & Moore, B. C. J. (2020) · Journal of the American Academy of Audiology · doi:10.1055/s-0040-1718929 · Cited by 4 · see citing works
Tinnitus and hyperacusis assessment tools – an overview
Rajchel, J. J., & Skarzynski, P. H. (2020) · Nowa Audiofonologia · doi:10.17431/895267 · Cited by 4 · see citing works
“[72] w populacji osób z szumami usznymi uwidoczniły istotne braki kwestionariusza.”
BackgroundHypersensitivity to noise and light: A multifactorial framework of attention, personality, and mood
Marzolla, M. C., Hurks, P. P. M., Borghans, L., & Heugten, C. M. V. (2026) · Current Psychology · doi:10.1007/s12144-025-08905-6 · Cited by 3 · see citing works
“Specifically, internal consistencies for these questionnaires were 0.88 and 0.87, respectively (Fackrell et al., 2015; Perenboom et al., 2018).”
InfluentialTziridis, K., Neubert, B., Seehaus, A., Krauß, P., Schilling, A., Brüeggemann, P., Mazurek, B., & Schulze, H. (2025) · Frontiers in Neurology · doi:10.3389/fneur.2025.1596274 · Cited by 4 · see citing works
“Exclusion criteria were objective tinnitus, acute auditory diseases (with the exception of hearing loss, independent of its type), or recent surgeries affecting the auditory system, as well as hyperacusis, as assessed by the German version of the hyperacusis questionnaire (37).”
ESTABLISHING RELIABILITY AND VALIDITY OF THE ARABIC VERSION OF THE HYPERACUSIS QUESTIONNAIRE
Alkharabsheh, A., & Alaqrabawi, W. S. (2021) · Journal of Hearing Science · doi:10.17430/jhs.2021.11.1.2 · Cited by 3 · see citing works
“Hyperacusis is defined as an increased sensitivity to normal environmental sounds [1–3].”
Shared Service Centers and Financial Performance of Panafrican Equipment Group in Kenya
Mogoa, L., & Koori, J. (2021) · International Journal of Current Aspects in Finance Banking and Accounting · doi:10.35942/ijcfa.v3i2.192 · Cited by 3 · see citing works
Hypersensitivity to Noise and Light: A Multifactorial Framework of Attention, Personality, and MoodPreprint
Marzolla, M. C., Hurks, P. P. M., Borghans, L., & Heugten, C. M. V. (2024) · doi:10.31234/osf.io/rt45x · Cited by 3 · see citing works
Bigras, C., Duda, V., & Hébert, S. (2025) · Hearing Research · doi:10.1016/j.heares.2025.109425 · Cited by 2 · see citing works
Fernandez, C., & Isnard, V. (2025) · Hearing Research · doi:10.1016/j.heares.2025.109436 · Cited by 2 · see citing works
Díaz, P. O., Neustadt, N., Anna María Morris, N., & Graciela Gómez, M. (2022) · Revista de otorrinolaringología y cirugía de cabeza y cuello · doi:10.4067/s0718-48162022000100101 · Cited by 2 · see citing works
Aplicabilidade do Tinnitus and Hearing Survey (THS) na diferenciação de queixas auditivas
Scheffer, A. R., Ferreira, M. C., & Mondelli, M. F. C. G. (2021) · CoDAS · doi:10.1590/2317-1782/20202020016 · Cited by 2 · see citing works
“Among the possible etiologies of hyperacusis are conditions involving the peripheral auditory system, such as noise-induced hearing loss, Menière’s disease, as well as central nervous system diseases and syndromes and hormonal and infectious diseases, however, normal hearing thresholds do not necessarily reflect the n…”
BackgroundVijayakumar, S., & Ahmmed, A. U. (2025) · International Journal of Pediatric Otorhinolaryngology · doi:10.1016/j.ijporl.2025.112334 · Cited by 1 · see citing works
Rycek, K., Keppler, H., Deklerck, A., & Dhooge, I. J. M. (2025) · International Journal of Audiology · doi:10.1080/14992027.2025.2508736 · Cited by 1 · see citing works
“Previous reports demonstrate a prevalence of hyperacusis in patients with tinnitus ranging from 7.2% to 13% based on a HQ total score > 28 (Fackrell et al. 2015; Jacquemin et al. 2022).”
InfluentialPerspectives on self-management of noise intrusion in daily living with hyperacusis
Dauman, N., Erlandsson, S., Londero, A., & Fagelson, M. A. (2025) · Hearing Research · doi:10.1016/j.heares.2025.109452 · Cited by 1 · see citing works
LOUDNESS HYPERACUSIS: MECHANISMS OF LOUDNESS PERCEPTION AND THEIR BREAKDOWN
Moore, B. C. J. (2025) · Journal of Hearing Science · doi:10.17430/jhs/204835 · Cited by 1 · see citing works
“Khalfa et al. [8] suggested a cutoff score of 28, Meeus et al. [19] suggested a cutoff score of 26, while Fackrell et al. [20] suggested that the cutoff score of 28 needs to be re-evaluated but did not propose a definite value.”
Yi, C., Yu, H., Li, Q., Wang, Z., Yang, R., Song, H. J., Yang, M., Yao, D., Xu, P., Zhao, Y., et al. (2026) · IEEE Transactions on Neural Systems and Rehabilitation Engineering · doi:10.1109/tnsre.2026.3664180 · Cited by 1 · see citing works
“HQ [27] assesses symptoms of auditory hypersensitivity.”
Structural and functional brain alterations in patients with hyperacusis: MRI systematic review
Alkahtani, R., Elbeltagy, R., Hamd, Z. Y., & Hassan, A. B. A. (2026) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2026.1785826 · Cited by 1 · see citing works
“This feedback loop can explain why hyperacusis patients frequently experience social withdrawal, and reduce quality of life and anxiety (Husain and Schmidt, 2014; Leaver et al., 2016; Fackrell et al., 2015).”
Zhong, H., Pan, C., Zhao, Y., Tang, X., Sun, J., & Liang, Y. (2026) · Neuroscience · doi:10.1016/j.neuroscience.2026.04.035 · Cited by 1 · see citing works
Preclinical Animal Behavioral Models of Hyperacusis and Loudness Recruitment
Radziwon, K. E., Manohar, S., Auerbach, B. D., Liu, X., Chen, G., & Salvi, R. (2020) · Springer eBooks · doi:10.1007/978-3-030-40413-0_6 · Cited by 1 · see citing works
Londero, A., & Bouccara, D. (2019) · EMC - Otorrinolaringología · doi:10.1016/s1632-3475(19)42482-x · Cited by 1 · see citing works
Correlation of Non-Auditory Comorbidities and Hearing Loss in Tinnitus PatientsPreprint
Tziridis, K., Neubert, B., Seehaus, A., Krauß, P., Schilling, A., Brüeggemann, P., Mazurek, B., & Schulze, H. (2024) · Preprints.org · doi:10.20944/preprints202402.1763.v1 · Cited by 1 · see citing works
An investigation of tinnitus using behavioural and functional imaging measures
Davies, J. E. (2016) · Nottingham ePrints (University of Nottingham)
Disturbed auditory perceptions: An Update
Molini, E., Lapenna, R., Cipriani, L., Zompo, M. R. D., Giommetti, G., Ricci, G., & Lapenna, R. (2017) · Archives of Otolaryngology & Rhinology · doi:10.17352/2455-1759.000050
“[68], state: “association between hypersensitivity to sound, tinnitus, and peripheral auditory system damage present in stapedectomy, Menieres’s disease, and sensorineural hearing loss led to hypotheses assuming peripheral contribution to the generation of hypersensitivity to sound” [69].”
BackgroundDecreased sound tolerance – a literature review
Raj-Koziak, D., Świerniak, W., Skarżyńśki, H., & Skarzynski, P. H. (2020) · Nowa Audiofonologia · doi:10.17431/1003163
Londero, A., & Bouccara, D. (2019) · EMC - Otorinolaringoiatria · doi:10.1016/s1639-870x(19)42526-9
(2022) · Thieme Publishers New York eBooks · doi:10.1055/b-0042-191977
Problems of hyperacusis and misophonia occurring in patients with tinnitus
Raj-Koziak, D., Gos, E., Kutyba, J. J., Skarzynski, P. H., & Skarżyńśki, H. (2024) · Nowa Audiofonologia · doi:10.17431/na/173418
Revision of the Turkish Khalfa Hyperacusis Questionnaire: a boosted tool for the tinnitus population
Özdeş, N. Ö., Kır, G., & Tokgöz-Yılmaz, S. (2025) · Acta Oto-Laryngologica · doi:10.1080/00016489.2025.2485438
“Specifically, the study by Fackrell et al. evaluating the English version of the HQ similarly identified items 1 and 11 among four problematic items, highlighting their consistently low factor loadings and issues regarding their interpretability across tinnitus populations [19].”
Londero, A., Trandafir, C. M., & Simeus, E. J. (2025) · Encyclopédie médico-chirurgicale. Oto-rhino-laryngologie · doi:10.1016/s0246-0351(25)48890-4
- Authors
- Fackrell, K., Fearnley, C., Hoare, D. J., & Sereda, M.
- Affiliations
- University of Nottingham (GB)
- Corresponding author
- Sereda, Magdalena
- Venue
- BioMed Research International
- Publisher
- Wiley
- Published
- 2015
- Volume
- 2015
- Pages
- 1-12
- ISSN
- 1110-7243 (ISSN-L)
- 2314-6133
- 2314-6141
- PMC
- PMC4628763
- OpenAlex
- W2116418013
- Cited by
- 110
- References
- 75
- Citations by year
- 2026: 13 · 2025: 11 · 2024: 10 · 2023: 8 · 2022: 19 · 2021: 9 · 2020: 15 · 2019: 5 · 2018: 5 · 2017: 10 · 2016: 4 · 2014: 1
- FWCI
- 4.12
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- BioMed Research International (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Repository@Nottingham (University of Nottingham) (publishedVersion, cc-by)
- Repository@Nottingham (University of Nottingham) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Nottingham ePrints (University of Nottingham) (submittedVersion, cc-by)
- Funders
- National Institute for Health Research Biomedical Research Unit
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Health Sciences › Health Professions › Speech and Hearing › Noise Effects and Management
- Keywords
- hyperacusis, tinnitus, questionnaire validity, reliability statistics, factor structure, factor analysis, convergent and discriminant validity, floor and ceiling effects, uncomfortable loudness level, questionnaire shortening
- MeSH terms
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Psychometrics, Surveys and Questionnaires, Hyperacusis, Tinnitus, Reproducibility of Results, Young Adult
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