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Sound intolerance: characteristics, psychosocial work factors and reactions to exposure
Umeå University, Faculty of Social Sciences, Department of Psychology.ORCID iD: 0000-0003-1464-693x
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Sound intolerance refers to an adverse reaction to sounds at sound pressure levels most people do not find bothersome. It is sometimes associated with hearing loss and tinnitus, but neither conditions are a prerequisite for being intolerant to sounds. The processes underlying the heightened reactions to sound, or how sound intolerance is related to other afflictions is not fully known, and research in this area can still be described as being in an early stage. This thesis aims to broaden the knowledge about sound intolerance and the sub-category of hyperacusis by using cross-sectional epidemiological and quasi-experimental methods of inquiry.

The thesis consists of three studies, each approaching the subject from a different perspective with the aim to better understand various characteristics of sound intolerance in general, its relation to psychosocial factors in the work environment, and its effects during noise exposure. Studies I & II are cross-sectional studies using two different data sets with similar design. Study I was based on data from a stratified sample in the Västerbotten Environmental Health Study. It examined the characteristics, background descriptions and comorbidities of self-reported and physician diagnosed individuals with hyperacusis, and compared them to a healthy referent group. Analyses revealed that a majority of both hyperacusis groups actively tried to avoid sound sources, and experienced that they for the most part could affect the environment to make it less noisy. There were significantly increased risks for other diagnosed illnesses in the hyperacusis groups compared to the healthy referent group, with large odds ratios (ORs) for the psychiatric illnesses anxiety, depression, post-traumatic stress disorder and exhaustion syndrome. Other common illnesses were tinnitus, hearing impairment and musculoskeletal disorders. Study II used data from the Österbotten Environmental Health Study and focused on the psychosocial work environment for people with hyperacusis. Working participants with hyperacusis who were employed/on leave of absence/paternal leave/long-term sick listed were compared to a working sample without hyperacusis on measures of effort-reward imbalance, work over commitment, emotional and social support and worry at work. The hyperacusis group scored significantly higher on worry, social support, and reward, whereas the groups did not differ significantly with respect to emotional support, over commitment or effort. In the final study, a quasi-experimental design was employed to investigate how individuals with sound intolerance react to noise exposure over time, in terms of perceived sound intensity, unpleasantness, rated distractibility, symptoms, heart rate variability and cognitive performance. Participants were divided into three groups of equal size based on their self-rated sound intolerance, which resulted in low, medium, and high sound intolerance groups. Results revealed large variations across individuals in several outcome variables. Compared to the other two groups, the high sound intolerance group perceived the noise as more unpleasant, stronger, and more distracting. They further rated the symptoms as higher in intensity, showed deviations in heart rate variability, and performed poorer on a cognitive task selected to measure inhibition.

In conclusion, the results suggest that persons with sound intolerance have relatively poor general health and hearing as well as high odds of comorbidity with various symptoms, including psychiatric diagnoses and functional somatic syndromes. In a working population, the sound intolerant show high odds for worrying about things at work, perceiving low social support at work and not feeling rewarded at work. Finally, the results suggest that persons with high sound intolerance have increased distractibility, sound unpleasantness, symptoms over time as well as lowered heart rate variability and cognitive performance when exposed to sounds.

Abstract [sv]

Ljudintolerans syftar på en negativ reaktion på ljud vid ljudtrycksnivåer som de flesta människor inte finner obehagligt. Vilka processer som ligger bakom de förhöjda reaktionerna eller relationerna till andra åkommor är ännu oklart. Syftet med den här avhandlingen är att bredda kunskapen om ljudintolerans och dess underkategori hyperakusi, genom bruket av tvärsektionella och kvasi-experimentella metoder.           Avhandlingen består av tre studier som angriper ämnet från olika perspektiv, med syfte att bättre förstå generella egenskaper hos ljudintolerans; relationen till psykosociala arbetsmiljöfaktorer; samt effekterna av en ljudexponering i kontrollerad laboratoriemiljö. Studie I bestod av tvärsnittsdata från Miljöhälsostudien i Västerbotten och avhandlade egenskaper, bakgrundsdata och komorbiditeter för självrapporterade och läkardiagnostiserade individer med hyperakusi, jämfört med en referensgrupp utan dessa besvär. Resultaten visade att en majoritet av båda hyperakusi-grupperna försökte undvika ljudkällor, och upplevde att de för det mesta kunde påverka miljön för att göra den mindre bullrig. Det var en signifikant ökad risk för flera samsjukligheter för den självrapporterade gruppen jämfört med referenterna, med stora oddskvoter för såväl psykiatriska, muskuloskeletala och otorinolaryngologiska diagnoser, som funktionella somatiska syndrom. Studie II var även den en tvärsnittsstudie, den här gången med data från Miljöhälsostudien i Österbotten. Fokus för denna studie var kopplingen mellan ljudintolerans och psykosociala arbetsmiljöfaktorer. Personer med hyperakusi som arbetade, var tjänstlediga, föräldralediga eller långtidssjukskrivna, jämfördes med motsvarande grupp utan hyperakusi. Resultaten visade signifikant högre risk att skatta högt på enkätinstrument som mätte oro, brist på socialt stöd och brist på belöning. Ingen signifikant skillnad fanns för variablerna lågt känslomässigt stöd, överengagemang på arbetsplatsen och ansträngning. Den tredje och sista studien var en kvasi-experimentell laboratoriestudie. Syftet var att studera hur personer med ljudintolerans reagerade på ljudstimuli över en längre tidsperiod, med avseende på upplevd intensitet, obehag, distraktionsgrad, symptom, hjärtslagsvariabilitet och kognitiv prestation. Deltagarna delades upp i tre grupper baserat på deras egenskattade ljudintolerans. Resultaten visade på signifikanta skillnader; gruppen med hög ljudintolerans upplevde ljudet som mer obehagligt, distraherande och starkare. De rapporterade även kraftigare symptom, lägre hjärtslagsvariabilitet och sämre prestation på inhibitionsuppgiften jämfört med grupperna med låg och medelhög ljudintolerans. Sammantaget föreslår resultaten från studierna i den här avhandlingen att personer med ljudintolerans använder undvikande beteende, har generell sämre hälsa och större samsjuklighet än normalt. Yrkesarbetande med ljudintolerans löper större risk för att oroa sig för saker på jobbet, upplever lägre socialt stöd och känner sig inte så belönade på arbetsplatsen. Slutligen föreslår resultaten att personer med hög ljudintolerans upplever hög distraktion, obehag, och symptom över tid samt sänkt hjärtslagsvariabilitet och presterar relativt dåligt på kognitiva uppgifter vid exponering för ljud.

Place, publisher, year, edition, pages
Umeå: Umeå universitet , 2019. , p. 61
Keywords [en]
Sound intolerance, hyperacusis, psychosocial work environment, Noise sensitivity scale, white noise
Keywords [sv]
Ljudintolerans, hyperakusi, psykosocial arbetsmiljö, vitt brus, ljudöverkänslighet
National Category
Psychology (excluding Applied Psychology)
Research subject
Psychology
Identifiers
URN: urn:nbn:se:umu:diva-166112ISBN: 978-91-7855-160-6 (print)OAI: oai:DiVA.org:umu-166112DiVA, id: diva2:1377396
Public defence
2020-01-17, Hörsal F, Humanisthuset, Umeå, 09:00 (English)
Opponent
Supervisors
Available from: 2019-12-18 Created: 2019-12-11 Last updated: 2019-12-18Bibliographically approved
List of papers
1. Characteristics of hyperacusis in the general population
Open this publication in new window or tab >>Characteristics of hyperacusis in the general population
2016 (English)In: Noise & Health, ISSN 1463-1741, E-ISSN 1998-4030, Vol. 18, no 83, p. 178-184Article in journal (Refereed) Published
Abstract [en]

There is a need for better understanding of various characteristics in hyperacusis in the general population. The objectives of the present study were to investigate individuals in the general population with hyperacusis regarding demographics, lifestyle, perceived general health and hearing ability, hyperacusis-specific characteristics and behavior, and comorbidity. Using data from a large-scale population-based questionnaire study, we investigated individuals with physician-diagnosed (n=66) and self-reported (n=313) hyperacusis in comparison to individuals without hyperacusis (n=2995). High age, female sex, and high education were associated with hyperacusis, and that trying to avoid sound sources, being able to affect the sound environment, and having sough medical attention were common reactions and behaviors. Posttraumatic stress disorder, chronic fatigue syndrome, generalized anxiety disorder, depression, exhaustion, fibromyalgia, irritable bowel syndrome, migraine, hearing impairment, tinnitus, and back/joint/muscle disorders were comorbid with hyperacusis. The results provide ground for future study of these characteristic features being risk factors for development of hyperacusis and/or consequences of hyperacusis.

Place, publisher, year, edition, pages
Medknow Publications, 2016
Keywords
Functional somatic syndrome, hyperacusis, noise sensitivity, prevalence, psychiatric disorder, sound intolerance
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychology
Identifiers
urn:nbn:se:umu:diva-126759 (URN)10.4103/1463-1741.189244 (DOI)000383904300002 ()27569405 (PubMedID)
Available from: 2016-10-18 Created: 2016-10-13 Last updated: 2019-12-11Bibliographically approved
2. Associations between hyperacusis and psychosocial work factors in the general population
Open this publication in new window or tab >>Associations between hyperacusis and psychosocial work factors in the general population
2019 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 92, no 1, p. 59-65Article in journal (Refereed) Published
Abstract [en]

Purpose: We investigated the association between hyperacusis and aspects of psychosocial work environment in a general population. The objectives were to investigate (1) prevalence and characteristics (among age, sex, access to social support at home, education, smoking, physical exercise, and perceived general health) of hyperacusis in a general working population and (2) associations between hyperacusis and psychosocial factors in the work environment. The psychosocial work aspects included effort, reward, overcommitment, worry, and social and emotional support.

Methods: Using data from a sample stratified for age and sex from the Österbotten Environmental Health Study in Finland, currently employed participants with self-reported hyperacusis and referents were compared on questionnaire instruments quantifying six aspects of their psychosocial work environment.

Results: Among 856 currently employed participants, 47 constituted a hyperacusis group and 809 a reference group. The hyperacusis group scored significantly higher than the referents on worry at work, social support at work, and reward at work, but not on emotional support at work, work overcommitment, or effort at work. About 40% of the hyperacusis group scored on the upper quartile of the three former work environment factors, with odds ratios ranging from 1.91 to 2.56.

Conclusions: The results suggest that worrying about aspects at work, perceiving low social support, and not perceiving being rewarded at work are associated with hyperacusis.

Place, publisher, year, edition, pages
Springer, 2019
Keywords
Psychosocial work environment, Effort-reward imbalance, Worry at work, Social support, Emotional support
National Category
Applied Psychology Otorhinolaryngology
Identifiers
urn:nbn:se:umu:diva-155771 (URN)10.1007/s00420-018-1356-x (DOI)000455144300005 ()30194539 (PubMedID)
Available from: 2019-01-28 Created: 2019-01-28 Last updated: 2019-12-11Bibliographically approved
3. Reactions to white noise exposure in sound intolerance: Perception, symptoms, cognition and autonomic responses.
Open this publication in new window or tab >>Reactions to white noise exposure in sound intolerance: Perception, symptoms, cognition and autonomic responses.
Show others...
(English)Manuscript (preprint) (Other academic)
National Category
Psychology (excluding Applied Psychology)
Identifiers
urn:nbn:se:umu:diva-166118 (URN)
Available from: 2019-12-11 Created: 2019-12-11 Last updated: 2019-12-12

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