Sensory hyperacusis as a predictor of anxiety in adolescence

An increasing number of children report anxiety in early to mid-adolescence. Early identification of risk during the transition from primary to secondary schools (age 11) could enhance family- or school-based interventions. While known predictors of adolescent anxiety provide some insight, there is a need to identify and understand additional risk factors. Hyperacusis (aversive sensitivity to sound) is correlated with anxiety in children and adults and thus a candidate risk factor longitudinally.

We explored the predictive potential of auditory hyperacusis using data from the Avon Longitudinal Study of Parents and Children (ALSPAC, n = 6,621). Hyperacusis at age 11 was assessed with a single question, while anxiety and related emotional problems were captured by the emotional subscale of the Strength and Difficulties Questionnaire (SDQ-E) at ages 13, 16 and through longitudinal trajectories (4-16 years).

Hyperacusis significantly predicted anxiety at ages 13 and 16. This predictive effect remained for age 13 even when accounting for pre-existing anxiety/emotional problems, autism traits and other neurodiversity characteristics (ADHD, dyslexia, dyspraxia). Similar, though less pronounced, patterns emerged at age 16. When testing the four previously identified childhood trajectories of emotional problems, hyperacusis predicted persistent versus decreasing trajectories (the two cases when preschool anxiety is already high) more reliably than increasing from low trajectories (the two cases when preschool anxiety is low). Additional exploratory analyses found that hyperacusis was most strongly associated with SDQ-E items related to fear, worry, and nervousness; still predicted SDQ-E scores at age 25, but not adult generalised anxiety disorder, major depressive disorder or suicidal self-harm.

Taken together, our findings suggest that assessing hyperacusis at age 11 can provide additional predictive insights into the exacerbation and maintenance of anxiety in adolescence.