A Trans-Diagnostic Investigation of Attention and Diverse Phenotypes of “Auditory Hyperreactivity” in Autism, ADHD, and the General Population

Patrick Dwyer; Zachary J. Williams; Wenn Lawson; Susan M. Rivera

doi:10.1177/10870547251361226

Une investigation transdiagnostique de l’attention et des divers phénotypes d’« hyperréactivité auditive » dans l’autisme, le TDAH et la population générale

Titre original en anglais : A Trans-Diagnostic Investigation of Attention and Diverse Phenotypes of “Auditory Hyperreactivity” in Autism, ADHD, and the General Population

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Dwyer, P., Williams, Z. J., Lawson, W., & Rivera, S. M. (2025). A Trans-Diagnostic Investigation of Attention and Diverse Phenotypes of “Auditory Hyperreactivity” in Autism, ADHD, and the General Population. Journal of Attention Disorders, 30(1), 57-81. https://doi.org/10.1177/10870547251361226

Date de publication: 18/09/2025 Ajout dans AutiHub: 05/07/2026 Type: Article Langue de l’article: Anglais

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4

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3 / 4 (75,0 %)

Résumé

Objectif : Les expériences d’« hyperréactivité auditive » et de tolérance réduite aux sons, qui peuvent être distinguées en phénotypes tels que l’hyperacousie et la misophonie, sont fréquentes dans l’autisme et le TDAH et ont un impact sur la qualité de vie et le bien-être. En outre, des profils atypiques de régulation de l’attention, y compris l’hyperfocalisation et l’inattention, sont fréquents à la fois dans l’autisme et le TDAH. Des recherches antérieures suggèrent également que l’hyperréactivité sensorielle peut provoquer de l’anxiété, et que l’anxiété peut être associée à l’hypervigilance. On ne sait actuellement pas si l’hyperfocalisation sur des stimuli, le fait d’avoir son attention captée par eux, ou le fait d’être hypervigilant à leur égard pourrait conduire à une hyperréactivité sensorielle. Par conséquent, cette étude examine les relations entre l’hyperfocalisation, l’inattention, l’hypervigilance, l’hyperréactivité auditive et l’anxiété. Méthode : Quatre cent quatre-vingt-douze adultes (122 TDAH uniquement, 130 autisme uniquement, 141 autisme + TDAH et 99 participants de comparaison) ont rempli des questionnaires évaluant l’hyperfocalisation, l’inattention et diverses formes d’hyperréactivité auditive ; les participants ont également réalisé une mesure psychoacoustique en évaluant le caractère agréable de sons déclencheurs misophoniques. Résultat : Selon les questionnaires, l’hyperréactivité auditive était nettement plus élevée chez les participants autistes et les participants avec TDAH que chez les participants de comparaison (.46 ≤ δ de Cliff ≤ .84), tandis que les différences entre l’autisme seul et le TDAH seul étaient faibles (.05 ≤ |δ de Cliff| ≤ .21) et non constantes dans les analyses de sensibilité. L’analyse de trajectoire a suggéré que l’hypervigilance, l’hyperfocalisation et l’inattention étaient liées à l’hyperréactivité auditive, laquelle était liée à l’anxiété, elle-même liée à l’hypervigilance, reflétant potentiellement une relation cyclique. Cependant, la misophonie psychoacoustique n’était que modestement liée aux scores de misophonie autoévalués (.22 ≤ ρ de Spearman ≤ .31) et contribuait peu au composite d’hyperréactivité auditive inclus dans l’analyse de trajectoire. Conclusion : Ces résultats soutiennent généralement l’idée que l’attention pourrait être liée à l’hyperréactivité auditive de nombreuses personnes neurodivergentes, mais soulignent également la nécessité d’améliorer la mesure des expériences sensorielles.

Objective: Experiences of “auditory hyper-reactivity” and decreased sound tolerance, which can be separated into phenotypes such as hyperacusis and misophonia, are prevalent in autism and ADHD and impact quality of life and wellbeing. Furthermore, atypical patterns of attention regulations—including hyper-focus and inattention—are common in both autism and ADHD. Prior research also suggests sensory hyper-reactivity can cause anxiety, and anxiety can be associated with hyper-vigilance. It is currently unclear whether hyper-focusing on stimuli, having one’s attention captured by them, or being hyper-vigilant toward them could lead to sensory hyper-reactivity. Therefore, this study investigates relationships among hyper-focus, inattention, hyper-vigilance, auditory hyper-reactivity, and anxiety. Method: Four hundred ninety-two adults (122 ADHD-only, 130 autistic-only, 141 autistic + ADHD, and 99 comparison) completed questionnaires indexing hyper-focus, inattention, and various forms of auditory hyper-reactivity; participants also completed a psychoacoustic measure by rating the pleasantness of misophonic trigger sounds. Result: Per questionnaires, auditory hyper-reactivity was markedly elevated in both autistic and ADHD participants relative to comparison participants (.46 ≤ Cliff’s δ ≤.84), whereas differences between autism and ADHD alone were small (.05 ≤ |Cliff’s δ| ≤.21) and not consistent in sensitivity analyses. Path analysis suggested hyper-vigilance, hyper-focus, and inattention were related to auditory hyper-reactivity, which was related to anxiety, which was related to hyper-vigilance, potentially reflecting a cyclic relationship. However, psychoacoustic misophonia was only modestly related to self-reported misophonia scores (.22 ≤ Spearman’s ρ ≤.31), and contributed little to the auditory hyper-reactivity composite included in the path analysis. Conclusion: These findings generally support the idea that attention may be connected to many neurodivergent people’s auditory hyper-reactivity, but also emphasize the need for improved measurement of sensory experiences.

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Ces indicateurs décrivent la bibliographie citée importée pour cette publication. Les métriques de références citées utilisent le total des références citées comme dénominateur. Les métriques d’auteurices cité·es indiquent si elles utilisent toutes les occurrences d’auteurices cité·es ou seulement les occurrences rattachées à des auteurices déjà intégré·es à la base de données AutiHub. Ils utilisent les rattachements mis en cache entre les auteurices cité·es et les auteurices intégré·es à la base de données AutiHub. Dernier calcul : 16/08/2026 11:30.

Références citées

128

Nombre total de références citées intégrées pour cette publication.

Références citées avec un·e auteur·ice identifié·e comme autiste

13 / 128 (10,2 %)

Occurrences d’auteur·ices cité·es identifié·es comme autistes

27 / 772 (3,5 %)

Parmi les occurrences rattachées à des auteurices intégré·es à la base de données AutiHub : 27 / 174 (15,5 %). Auteurices cité·es distinct·es identifié·es comme autistes : 18 / 706 (2,5 %).

Occurrences citées rattachées à la base AutiHub

174 / 772 (22,5 %)

Auteurices cité·es distinct·es rattaché·es : 129 / 706 (18,3 %)

Occurrences rattachées, non identifiées comme autistes

147 / 174 (84,5 %)

Parmi les seules occurrences rattachées. Sur l’ensemble des occurrences d’auteurices cité·es : 147 / 772 (19,0 %). Auteurices cité·es distinct·es rattaché·es, non identifié·es comme autistes : 111 / 129 (86,0 %).

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(s. d.). Williams Z. J. (2022 May 3). Decreased sound tolerance in autism: Understanding and distinguishing between hyperacusis misophonia and phonophobia. ENT & Audiology News. https://www.entandaudiologynews.com/features/audiology-features/post/decreased-sound-tolerance-in-autism-understanding-and-distinguishing-between-hyperacusis-misophonia-and-phonophobia

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Williams Z. J. (2024). Investigating the nature of decreased sound tolerance in autistic and non-autistic adults. Vanderbilt University. https://ir.vanderbilt.edu/items/a9e54a3e-61db-467b-b2cf-2eb0e9f8b977

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(s. d.). Williams Z. J. Cascio C. J. Woynaroski T. G. (2021 May). Multidimensional inventory of sound tolerance in adults (MIST-A). ResearchGate. https://dx.doi.org/10 . 13140/RG. 2. 2. 10492. 28802/1

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