Sensory and affective dimensions in loudness perception: Insights from young adults.

Traditional psychoacoustic measures often lack accuracy in diagnosing hyperacusis and other sound tolerance disorders, possibly due to their reliance on artificial stimuli and unidimensional scales. The aim of this study was to assess loudness across sensory and affective dimensions using natural sounds, drawing on pain research wherein intensity and unpleasantness are assessed separately. We hypothesized that similar distinctions apply to loudness perception. A total of 102 young adults with normal to mild hearing loss rated 32 sound stimuli (pleasant, unpleasant, neutral, and artificial) at 10 intensities (40 to 100 dBA) on sensory and affective scales. They also completed the Hyperacusis Questionnaire, the Noise Sensitivity Scale, and the Hospital Anxiety and Depression Scale. Mixed linear models indicated both correlations and dissociations between scales that varied according to intensity and valence. Louder stimuli were rated as more unpleasant, but only at high intensities. On the sensory scale, sounds were perceived as louder with increasing intensity; however, at low to moderate intensities, pleasant and neutral sounds were rated as louder, whereas at higher intensities, artificial and unpleasant stimuli were rated as louder. On the affective scale, the perception of unpleasantness also increased with intensity, but less steeply. At high intensities, artificial stimuli were rated similarly to unpleasant stimuli. Noise sensitivity scores predicted louder and more unpleasant ratings, whereas depression scores were associated with softer and less pleasant perceptions. This study highlights the need for multidimensional approaches in audiology and suggests that the integration of sensory and affective scales with natural stimuli may improve the diagnosis and treatment of sound tolerance disorders.