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Jaswal SM, Handy TC. Is misokinesia sensitivity explained by visual attentional orienting? ERP evidence from an emotional oddball task suggests no. PLoS One 2024; 19:e0306464. [PMID: 39074092 DOI: 10.1371/journal.pone.0306464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 06/18/2024] [Indexed: 07/31/2024] Open
Abstract
Misokinesia is a prevalent condition characterized by strong, negative emotional reactions to the sight of repetitive fidgeting movements in others. Here we present the results of a study designed to explore the relationship between misokinesia sensitivity (MKS) and attentional sensitivity to affectively-valenced visual stimuli. In particular, we asked participants with either high or low levels of MKS to perform an emotional oddball task that included responding to faces that had either angry or happy expressions, while we recorded event-related potentials. We found that there were no significant differences between the two MKS groups in attentional sensitivity to these faces, as indexed by the amplitude of the P300 ERP component they elicited. Importantly, we could not ascribe this null ERP finding to either low statistical power or the idiosyncrasies of our ERP analysis parameters. As such, our findings add to growing evidence that MKS may not be the simple result of heightened attentional orienting responses to visual events, but rather, it may be associated with other aspects of cognitive-affective processing.
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Affiliation(s)
- Sumeet M Jaswal
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
| | - Todd C Handy
- Department of Psychology, University of British Columbia, Vancouver, BC, Canada
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2
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Lewin AB, Milgram L, Cepeda SL, Dickinson S, Bolen M, Kudryk K, Bolton C, Karlovich AR, Grassie HL, Kangavary A, Harmon SL, Guzick A, Ehrenreich-May J. Clinical characteristics of treatment-seeking youth with misophonia. J Clin Psychol 2024; 80:1405-1419. [PMID: 38430053 DOI: 10.1002/jclp.23672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation. METHODS The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed. RESULTS Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8-13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably. CONCLUSION Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.
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Affiliation(s)
- Adam B Lewin
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Lauren Milgram
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sandra L Cepeda
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sarah Dickinson
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Morgan Bolen
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Kelly Kudryk
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Cassidy Bolton
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Ashley R Karlovich
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Hannah L Grassie
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Aileen Kangavary
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Sherelle L Harmon
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Andrew Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Storch EA, Guzick AG, D'Souza J, Clinger J, Ayton D, Kook M, Rork C, Smith EE, Draper IA, Khalfe N, Rast CE, Murphy N, Lijfijjt M, Goodman WK, Cervin M. Family Accommodation in Children and Adolescents With Misophonia. Behav Ther 2024; 55:595-604. [PMID: 38670671 PMCID: PMC11055978 DOI: 10.1016/j.beth.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 09/05/2023] [Accepted: 09/12/2023] [Indexed: 04/28/2024]
Abstract
Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life.
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Affiliation(s)
| | - Andrew G Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Baylor College of Medicine
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Gregory J, Graham T, Hayes B. Targeting beliefs and behaviours in misophonia: a case series from a UK specialist psychology service. Behav Cogn Psychother 2024; 52:33-48. [PMID: 37855114 PMCID: PMC7615577 DOI: 10.1017/s1352465823000462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND Misophonia, a disorder of decreased sound tolerance, can cause significant distress and impairment. Cognitive behavioural therapy (CBT) may be helpful for improving symptoms of misophonia, but the key mechanisms of the disorder are not yet known. AIMS This case series aimed to evaluate individual, formulation-driven CBT for patients with misophonia in a UK psychology service. METHOD A service evaluation of one-to-one therapy for patients with misophonia (n=19) was conducted in a specialist psychology service. Patients completed an average of 13 hours of therapy with a focus on the meaning applied to their reactions to sounds and associated behaviours. Primary outcome measures were the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Scale (A-MISO-S). Repeated measures t-tests were used to compare scores from pre-treatment to follow-up, and reliable and clinically significant change on the MQ was calculated. RESULTS Scores significantly improved on both misophonia measures, with an average of 38% change on the MQ and 40% change on the A-MISO-S. From pre-treatment to follow-up, 78% of patients showed reliable improvement on the MQ and 61% made clinically significant change. CONCLUSIONS Limitations included a lack of control group, small sample size, and the use of an outcome measure that had not been thoroughly validated for a treatment-seeking sample. These results suggest that one-to-one, formulation-driven CBT for misophonia is worth exploring further using experimental design. Potential mechanisms to explore further include feared consequences of escalating reactions, the role of safety-seeking behaviours and the impact of early memories associated with reactions to sounds.
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Affiliation(s)
- Jane Gregory
- Department of Experimental Psychology, University of Oxford
- Oxford Health NHS Foundation Trust
- South London and Maudsley NHS Foundation Trust
| | - Tom Graham
- Oxford Health NHS Foundation Trust
- South London and Maudsley NHS Foundation Trust
| | - Brett Hayes
- South London and Maudsley NHS Foundation Trust
- Salomons Institute for Applied Psychology, Canterbury Christ Church University
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Simner J, Rinaldi LJ. Misophonia, self-harm and suicidal ideation. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e142. [PMID: 38868724 PMCID: PMC11114359 DOI: 10.1002/pcn5.142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/03/2023] [Accepted: 08/23/2023] [Indexed: 06/14/2024]
Abstract
Aim Misophonia is a sound sensitivity disorder characterized by an unusually strong aversion to a specific class of sounds-often human bodily sounds (e.g., chewing). These sounds can cause intense negative emotions which can cause profound difficulties in everyday life. The condition is linked with higher rates of anxiety and depression, and here we ask whether it co-occurs with elevated self-harm and suicidal thinking. Methods We measured self-harm and misophonia in the general population by examining a birth cohort sample from the Avon Longitudinal Study of Parents and Children (ALSPAC). We screened them for misophonia as adults, then analyzed their earlier data on well-being, self-harm, and suicidal thinking. Results Adults with misophonia had significantly higher rates of self-harm and suicidal ideation, as well as poorer well-being in a number of different measures at ages 16-17 and 23-24 years. Female misophonics were particularly at risk, from as early as their teenage years, though males, too, show elevated self-harm at 24 years compared to nonmisophonic peers. Conclusion Our data provide evidence of elevated risks of self-harm associated with misophonia and suggest the need for greater recognition and treatment pathways.
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Affiliation(s)
- Julia Simner
- School of PsychologyUniversity of SussexBrightonUK
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Siepsiak M, Turek A, Michałowska M, Gambin M, Dragan WŁ. Misophonia in Children and Adolescents: Age Differences, Risk Factors, Psychiatric and Psychological Correlates. A Pilot Study with Mothers' Involvement. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01593-y. [PMID: 37684420 DOI: 10.1007/s10578-023-01593-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/14/2023] [Indexed: 09/10/2023]
Abstract
Misophonia is a type of disorder characterized by decreased sound tolerance. While it typically begins in childhood, research on its characteristics in this population is limited. We assessed 90 children aged 7-18 with and without misophonia, along with their mothers, using interviews, questionnaires, and performance-based tests. Younger children with misophonia were more likely to use aggression in response to triggers than older, while adolescents largely reported self-harm during triggers. Children with misophonia did not differ from their peers in terms of ADHD, ODD, ASD, dyslexia, social and emotional competencies, head injuries, epilepsy, tinnitus, being prematurely born, or delivered via cesarean sections. However, they had significantly higher symptoms of anxiety and depression, more frequent occurrences of OCD, migraines, and psychosomatic complaints. Their mothers self-reported postpartum depression significantly more frequently than mothers in the control group. There is a need for further research on pediatric misophonia, with the involvement and assessment of parents.
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Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, Warsaw, Poland.
| | - Anna Turek
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Rinaldi LJ, Simner J. Mental Health Difficulties in Children who Develop Misophonia: An Examination of ADHD, Depression & Anxiety. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01569-y. [PMID: 37501042 DOI: 10.1007/s10578-023-01569-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 07/29/2023]
Abstract
Misophonia is a sound sensitivity disorder characterized by unusually strong aversions to a specific class of sounds (e.g., eating sounds). Here we demonstrate the mental health profile in children who develop misophonia, examining depression, anxiety and ADHD. Our participants were members of the birth cohort ALSPAC (Avon Longitudinal Study of Parents and Children). We screened them for misophonia as adults, then analysed their retrospective mental health data from ages 7 to 16 years inclusive, reported from both children and parents. Data from their Development and Wellbeing Assessments (7-15 years) and their Short Mood and Feelings Questionnaires (9-16 years) show that our misophonia group had a greater likelihood of childhood anxiety disorder and depression in childhood (but not ADHD). Our data provide the first evidence from a large general population sample of the types of mental health co-morbidities found in children who develop misophonia.
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Affiliation(s)
| | - Julia Simner
- School of Psychology, University of Sussex, Brighton, UK.
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Spencer SD, Guzick AG, Cervin M, Storch EA. Mindfulness and cognitive emotion regulation in pediatric misophonia. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2023; 29:182-191. [PMID: 37593659 PMCID: PMC10430875 DOI: 10.1016/j.jcbs.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Misophonia is characterized by decreased tolerance of ordinary human-generated trigger sounds and associated visual stimuli (e.g., chewing, sniffing, lip smacking), coupled with intense affective reactions. The disorder often begins during childhood or adolescence and is associated with impairment and distress in numerous life domains. Research has begun to examine the underlying psychological mechanisms of misophonia in adults, but studies in youth are limited. Trait mindfulness (i.e., nonjudgmental and nonavoidant present-moment awareness) and cognitive emotion regulation (i.e., cognitive processing, or responding to, emotionally arousing situations) are two proposed mechanisms that may underpin pediatric misophonia and associated functional impairment. In the present exploratory cross-sectional study, we examined trait mindfulness and cognitive emotion regulation and their relations with misophonia features and adaptive functioning in 102 youth with misophonia (Mage = 13.7; SD = 2.5; range = 8-17). More severe misophonia was significantly associated with decreased levels of both trait mindfulness and adaptive functioning across domains, in addition to deficits in certain facets of cognitive emotion regulation, particularly self-blame. Neither trait mindfulness nor facets of cognitive emotion regulation moderated the association between misophonia severity and adaptive functioning across domains, with the notable exception that difficulties with adaptive functioning in peer relationships was attenuated in those high in mindfulness. Findings suggest that trait mindfulness- and to a lesser extent cognitive emotion regulation- may be potentially relevant processes in pediatric misophonia. However, more research is needed to uncover the precise nature of these processes to aid future characterization and intervention efforts, especially in light of equivocal findings in the present study.
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Affiliation(s)
- Samuel D. Spencer
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Andrew G. Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
| | - Matti Cervin
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
- Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA
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Vitoratou S, Hayes C, Uglik-Marucha N, Pearson O, Graham T, Gregory J. Misophonia in the UK: Prevalence and norms from the S-Five in a UK representative sample. PLoS One 2023; 18:e0282777. [PMID: 36947525 PMCID: PMC10032546 DOI: 10.1371/journal.pone.0282777] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 02/22/2023] [Indexed: 03/23/2023] Open
Abstract
What is the reality of the misophonic experience in the general population? This is a study on misophonia in a large sample, representative of the UK general population. The study utilises a multidimensional psychometric tool, the S-Five, to study the intensity of the triggering misophonic sounds in everyday activities, the emotions/feelings related to them, and the norms of the key components of the misophonic experience: internalising and externalising appraisals, perceived threat and avoidance behaviours, outbursts, and the impact on functioning. Based on the S-Five scores and a semi-structured interview delivered by clinicians who specialise in misophonia, the estimated prevalence of people for whom symptoms of misophonia cause a significant burden in their life in the UK was estimated to be 18%. The psychometric properties of the S-Five in the UK general population were also evaluated and differences across gender and age were explored. Our results show that the five-factor structure is reproduced, and that the S-Five is a reliable and valid scale for the measurement of the severity of the misophonic experience in the general UK population.
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Affiliation(s)
- Silia Vitoratou
- Biostatistics and Health Informatics Department, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Chloe Hayes
- Biostatistics and Health Informatics Department, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Nora Uglik-Marucha
- Biostatistics and Health Informatics Department, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Oliver Pearson
- Biostatistics and Health Informatics Department, Psychometrics and Measurement Lab, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Tom Graham
- Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London, United Kingdom
| | - Jane Gregory
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Oxford Health Specialist Psychological Interventions Centre, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Siepsiak M, Vrana SR, Rynkiewicz A, Rosenthal MZ, Dragan WŁ. Does context matter in misophonia? A multi-method experimental investigation. Front Neurosci 2023; 16:880853. [PMID: 36685219 PMCID: PMC9847240 DOI: 10.3389/fnins.2022.880853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 11/30/2022] [Indexed: 01/05/2023] Open
Abstract
Introduction Misophonia is a recently defined disorder in which certain aversive repetitive sounds and associated stimuli elicit distressing and impairing affective, behavioral, and physiological responses. The responses in misophonia may be stronger when the sound is produced by close friends and family, suggesting that the context in which a triggering cue occurs may have an important role in misophonia. As such, the goal of this study was to test experimentally whether the context of the sound source influences affective and psychophysiological responses to triggering stimuli in misophonia. Methods Sixty one adults with misophonia and 45 controls listened to audio recordings (8 s) of human eating, animals eating, and human mouth smacking sounds (without eating). After a break, the same audio recordings were presented embedded within videos of human eating (congruent stimuli), animals eating (congruent stimuli), and, in the mouth smacking condition, with visually incongruent stimuli (hands playing in mud or in a bowl with a watery dough). Psychophysiological responses-skin conductance response (SCR) and heart rate (HR), and self-reported affective responses (valence, arousal, dominance) were gathered during the experiment in a laboratory. Results Participants with misophonia assessed all the stimuli as more negative and arousing than the controls, and reported feeling less dominant with respect to the sounds. Animal and mouth smacking sounds were assessed by all the participants as less negative and arousing than human eating sounds, but only in the audio-video conditions. SCR data partially confirmed increased psychophysiological arousal in misophonia participants during an exposure to mouth sounds, but did not reflect the self-report changes in response to different contexts. Misophonia participants had deeper deceleration of HR than controls during human eating sound with congruent video stimuli, while there was no group difference during human mouth smacking with incongruent video stimuli. Conclusion Results suggest that the context of mouth sounds influences affective experiences in adults with misophonia, but also in participants without misophonia. Presentation of animal eating sounds with congruent visual stimuli, or human mouth smacking sounds with incongruent stimuli, decreased self-report reaction to common misophonic triggers.
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Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, Warsaw, Poland,*Correspondence: Marta Siepsiak,
| | - Scott R. Vrana
- Virginia Commonwealth University, Richmond, VA, United States
| | | | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, NC, United States
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Hansen HA, Stefancin P, Leber AB, Saygin ZM. Neural evidence for non-orofacial triggers in mild misophonia. Front Neurosci 2022; 16:880759. [PMID: 36017175 PMCID: PMC9397125 DOI: 10.3389/fnins.2022.880759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Misophonia, an extreme aversion to certain environmental sounds, is a highly prevalent yet understudied condition plaguing roughly 20% of the general population. Although neuroimaging research on misophonia is scant, recent work showing higher resting-state functional connectivity (rs-fMRI) between auditory cortex and orofacial motor cortex in misophonia vs. controls has led researchers to speculate that misophonia is caused by orofacial mirror neurons. Since orofacial motor cortex was defined using rs-fMRI, we attempted to theoretically replicate these findings using orofacial cortex defined by task-based fMRI instead. Further, given our recent work showing that a wide variety of sounds can be triggering (i.e., not just oral/nasal sounds), we investigated whether there is any neural evidence for misophonic aversion to non-orofacial stimuli. Sampling 19 adults with varying misophonia from the community, we collected resting state data and an fMRI task involving phoneme articulation and finger-tapping. We first defined “orofacial” cortex in each participant using rs-fMRI as done previously, producing what we call resting-state regions of interest (rsROIs). Additionally, we functionally defined regions (fROIs) representing “orofacial” or “finger” cortex using phoneme or finger-tapping activation from the fMRI task, respectively. To investigate the motor specificity of connectivity differences, we subdivided the rsROIs and fROIs into separate sensorimotor areas based on their overlap with two common atlases. We then calculated rs-fMRI between each rsROI/fROI and a priori non-sensorimotor ROIs. We found increased connectivity in mild misophonia between rsROIs and both auditory cortex and insula, theoretically replicating previous results, with differences extending across multiple sensorimotor regions. However, the orofacial task-based fROIs did not show this pattern, suggesting the “orofacial” cortex described previously was not capturing true orofacial cortex; in fact, using task-based fMRI evidence, we find no selectivity to orofacial action in these previously described “orofacial” regions. Instead, we observed higher connectivity between finger fROIs and insula in mild misophonia, demonstrating neural evidence for non-orofacial triggers. These results provide support for a neural representation of misophonia beyond merely an orofacial/motor origin, leading to important implications for the conceptualization and treatment of misophonia.
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Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, Kaplan Neeman R, Bar-Shalita T. Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain. Front Neurosci 2022; 16:907585. [PMID: 35992931 PMCID: PMC9381840 DOI: 10.3389/fnins.2022.907585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 07/18/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Misophonia and sensory over-responsiveness (SOR) share physiological and psychological symptoms. While individuals with SOR demonstrate pain perception alterations, these were not explored in misophonia. Methods This exploratory study comprised thirty healthy adults with (n = 15; based on the Misophonia Questionnaire) and without misophonia. The Sensory Responsiveness Questionnaire (SRQ) was used for evaluating sensory responsiveness. In addition, psychophysical tests were applied for quantification of: (i) stimulus-response function of painful stimuli, (ii) the individual perceived pain intensity, (iii) pain modulation efficiency, (iv) auditory intensity discrimination capability, and (v) painful and unpleasantness responses to six ecological daily sounds using the Battery of Aversiveness to Sounds (BAS). Results Individuals with misophonia reported higher scores in the SRQ-Aversive (p = 0.022) and SRQ-Hedonic (p = 0.029) scales as well as in auditory (p = 0.042) and smell (p = 0.006) sub-scales, indicating higher sensory responsiveness. Yet they were not identified with the SOR type of sensory modulation dysfunction. Groups did not differ in the pain psychophysical tests, and in auditory discrimination test scores (p > 0.05). However, in the misophonia group the BAS evoked higher pain intensity (p = 0.046) and unpleasantness (p <0.001) ratings in the apple biting sound, and higher unpleasantness rating in the scraping a dish sound (p = 0.007), compared to the comparison group. Conclusion Findings indicate increased sensory responsiveness in individuals with misophonia, yet not defined as SOR. Thus, this suggests that misophonia and SOR are two distinct conditions, differing in their behavioral responses to painful and non-painful stimuli.
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Affiliation(s)
- Adi Efraim Kaufman
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Irit Weissman-Fogel
- Physical Therapy Department, Faculty of Social Welfare and Health Sciences, University of Haifa, Haifa, Israel
| | - M. Zachary Rosenthal
- Department of Psychiatry and Behavioral Sciences, Center for Misophonia and Emotion Regulation, Duke University Medical Center, Durham, NC, United States
| | - Ricky Kaplan Neeman
- Department of Communication Disorders, School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tami Bar-Shalita
- Department of Occupational Therapy, School of Health Professions, Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Vitoratou S, Wang J, Hayes C, Wang Q, Stefanatou P, Gregory J. Evidence of Cross-Cultural Consistency of the S-Five Model for Misophonia: Psychometric Conclusions Emerging From the Mandarin Version. Front Psychol 2022; 13:879881. [PMID: 35959032 PMCID: PMC9361842 DOI: 10.3389/fpsyg.2022.879881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Accepted: 06/17/2022] [Indexed: 11/21/2022] Open
Abstract
Misophonia is a disorder generally characterised by a decreased tolerance to everyday sounds. Although research is increasing in misophonia, a cross-cultural validation of a psychometric tool for measuring misophonia has not been evaluated. This study investigated the validity of the S-Five multidimensional model of the misophonic experience in a sample of Chinese participants. The S-Five was translated in a forward-backward method to Mandarin to establish a satisfactory translation. The translation was also independently back translated to English, with no significant differences when compared to the original S-Five. Through exploratory factor analysis, using responses from 256 Chinese individuals, the five dimensions (internalising appraisals, externalising appraisals, perceived threat and avoidance behaviour, outbursts, and impact on functioning) were replicated, indicating the cross-cultural uniformity of the experience of misophonia as captured by the S-Five. That is, current results point to the stability of the manifestation of misophonia across cultures, seen here for the first time in the literature. By design, the S-Five items were developed to reflect sound sensitivities in a manner that is not specific or matching to individuals of a certain age, gender, ethnicity, nationality, socio-economic status, and educational level. Testimonial to this fact is not only the replication of the five factors, but also the replication of the evidence towards satisfactory psychometric properties (reliability and validity) of the scale. Based on the results of this study, the S-Five is a psychometrically robust tool to be used within the Chinese population.
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Affiliation(s)
- Silia Vitoratou
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
- *Correspondence: Silia Vitoratou,
| | - Jingxin Wang
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Chloe Hayes
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Qiaochu Wang
- Psychometrics and Measurement Lab, Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, United Kingdom
| | - Pentagiotissa Stefanatou
- First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Jane Gregory
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
- Oxford Health Specialist Psychological Interventions Centre, Oxford Health NHS Foundation Trust, Oxford, United Kingdom
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Pfeiffer E, Allroggen M, Sachser C. [Misophonia in Childhood and Adolescence: A Narrative Review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 51:222-232. [PMID: 35856746 DOI: 10.1024/1422-4917/a000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Misophonia in Childhood and Adolescence: A Narrative Review Abstract. Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.
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Affiliation(s)
- Elisa Pfeiffer
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
| | - Marc Allroggen
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
| | - Cedric Sachser
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
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15
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Rinaldi LJ, Smees R, Ward J, Simner J. Poorer Well-Being in Children With Misophonia: Evidence From the Sussex Misophonia Scale for Adolescents. Front Psychol 2022; 13:808379. [PMID: 35465571 PMCID: PMC9019493 DOI: 10.3389/fpsyg.2022.808379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/11/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Misophonia is an unusually strong aversion to a specific class of sounds - most often human bodily sounds such as chewing, crunching, or breathing. A number of studies have emerged in the last 10 years examining misophonia in adults, but little is known about the impact of the condition in children. Here we set out to investigate the well-being profile of children with misophonia, while also presenting the first validated misophonia questionnaire for children. Materials and Methods We screened 142 children (10-14 years; Mean 11.72 SD 1.12; 65 female, 77 male) using our novel diagnostic [the Sussex Misophonia Scale for Adolescents (SMS-Adolescent)]. This allowed us to identify a group of children already manifesting misophonia at that age - the first population-sampled cohort of child misophonics examined to date. Children and their parents also completed measures of well-being (for convergent validation of our SMS-Adolescent) and creative self-construct (for discriminant validation). Results Data show that children with misophonia have significantly elevated levels of anxiety and obsessive compulsive traits. Additionally children with misophonia have significantly poorer life-satisfaction, and health-related quality of life. As predicted, they show no differences in creative self-construct. Conclusion Together our data suggest the first evidence in population sampling of poorer life outcomes for children with misophonia, and provide preliminary convergent and discriminant validation for our novel misophonia instrument. Our data suggest a need for greater recognition and therapeutic outlets for adolescents with misophonia.
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Affiliation(s)
- Louisa J Rinaldi
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Rebecca Smees
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Jamie Ward
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Julia Simner
- School of Psychology, University of Sussex, Brighton, United Kingdom
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16
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Swonke ML, Neve L, Rossi NA, McKinnon B, Daram S, Pine HS. Misophonia: An Underrecognized Disease in Pediatric Patients. EAR, NOSE & THROAT JOURNAL 2022:1455613221095606. [PMID: 35414290 DOI: 10.1177/01455613221095606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Misophonia is a chronic condition in which patients experience a strong negative, emotional, or psychologic reaction to specific sounds. These sounds cause the individual to have a sudden, uncontrolled, and disproportionate negative reaction affecting their daily activities. The literature describes several cases of misophonia in the adult population; however, only 2 pediatric case studies are reported. Herein, we present 2 additional cases. An exaggerated response to an auditory stimulus is observed in other disorders such as tinnitus, hyperacusis, migraines, and many psychiatric disorders. Sound aversion has a broad differential diagnosis and may require visits to numerous specialists, placing strain on the patient and the healthcare system. Furthermore, misophonia is underdiagnosed in the pediatric population as it requires self-reporting of symptoms. The pathophysiology, prevalence, and treatment of misophonia continue to be relatively unknown. We attempt to highlight this rarely reported pediatric diagnosis and elaborate on its clinical presentation to increase awareness among otolaryngologists.
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Affiliation(s)
- Megan L Swonke
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Luis Neve
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Nicholas A Rossi
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Brian McKinnon
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Shiva Daram
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
| | - Harold S Pine
- Department of Otolaryngology-Head and Neck Surgery, 12338University of Texas Medical Branch, Galveston, TX, USA
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17
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Swedo SE, Baguley DM, Denys D, Dixon LJ, Erfanian M, Fioretti A, Jastreboff PJ, Kumar S, Rosenthal MZ, Rouw R, Schiller D, Simner J, Storch EA, Taylor S, Werff KRV, Altimus CM, Raver SM. Consensus Definition of Misophonia: A Delphi Study. Front Neurosci 2022; 16:841816. [PMID: 35368272 PMCID: PMC8969743 DOI: 10.3389/fnins.2022.841816] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/07/2022] [Indexed: 01/24/2023] Open
Abstract
Misophonia is a disorder of decreased tolerance to specific sounds or their associated stimuli that has been characterized using different language and methodologies. The absence of a common understanding or foundational definition of misophonia hinders progress in research to understand the disorder and develop effective treatments for individuals suffering from misophonia. From June 2020 through January 2021, the authors conducted a study to determine whether a committee of experts with diverse expertise related to misophonia could develop a consensus definition of misophonia. An expert committee used a modified Delphi method to evaluate candidate definitional statements that were identified through a systematic review of the published literature. Over four rounds of iterative voting, revision, and exclusion, the committee made decisions to include, exclude, or revise these statements in the definition based on the currently available scientific and clinical evidence. A definitional statement was included in the final definition only after reaching consensus at 80% or more of the committee agreeing with its premise and phrasing. The results of this rigorous consensus-building process were compiled into a final definition of misophonia that is presented here. This definition will serve as an important step to bring cohesion to the growing field of researchers and clinicians who seek to better understand and support individuals experiencing misophonia.
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Affiliation(s)
- Susan E. Swedo
- PANDAS Physicians Network, Mooresville, NC, United States,Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - David M. Baguley
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom,NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom,Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Laura J. Dixon
- Department of Psychology, University of Mississippi, Oxford, MS, United States
| | - Mercede Erfanian
- UCL Institute for Environmental Design and Engineering, University College London, London, United Kingdom
| | | | - Pawel J. Jastreboff
- Jastreboff Hearing Disorders Foundation, Columbia, MD, United States,Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, United States
| | - Sukhbinder Kumar
- Auditory Group, Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - M. Zachary Rosenthal
- Center for Misophonia and Emotion Regulation, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States,Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Romke Rouw
- Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Daniela Schiller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Julia Simner
- School of Psychology, Pevensey Building, University of Sussex, Brighton, United Kingdom,Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Steven Taylor
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Kathy R. Vander Werff
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, United States
| | - Cara M. Altimus
- Center for Strategic Philanthropy, Milken Institute, Washington, DC, United States
| | - Sylvina M. Raver
- Center for Strategic Philanthropy, Milken Institute, Washington, DC, United States,*Correspondence: Sylvina M. Raver,
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18
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Listening to People with Misophonia: Exploring the Multiple Dimensions of Sound Intolerance Using a New Psychometric Tool, the S-Five, in a Large Sample of Individuals Identifying with the Condition. PSYCH 2021. [DOI: 10.3390/psych3040041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Misophonia involves a strong emotional response to certain sounds and can cause significant distress and functional impairment. The aim of this study was to present and psychometrically evaluate a new, multidimensional measure of misophonia, the S-Five. The study also aimed to present and test a supplementary tool, a checklist of triggers that measure the nature and intensity of reactions. The stages of development for the measure are described. Psychometric testing on the final version of the tool was conducted using a sample of 828 individuals who identified with having misophonia. Analyses included factor structure assessment, measurement invariance testing, reliability (test–retest and internal consistency), and (concurrent) convergent validity assessment. Five factors emerged in the S-Five as dimensions of the experience of misophonia: internalising appraisals, externalising appraisals, sense of emotional threat, outbursts, and impact. No measurement bias was identified with respect to gender and age. All reliability and validity indices were satisfactory. The S-Five is a multidimensional measurement scale with satisfactory psychometric properties and will be a valuable tool for improving understanding of misophonia in research and clinical settings.
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19
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Lewin AB, Dickinson S, Kudryk K, Karlovich AR, Harmon SL, Phillips DA, Tonarely NA, Gruen R, Small B, Ehrenreich-May J. Transdiagnostic cognitive behavioral therapy for misophonia in youth: Methods for a clinical trial and four pilot cases. J Affect Disord 2021; 291:400-408. [PMID: 34001373 DOI: 10.1016/j.jad.2021.04.027] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 04/14/2021] [Accepted: 04/19/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Misophonia is a condition marked by dysregulated emotions and behaviors in response to trigger sounds, often chewing, breathing, or coughing. Evidence suggests that misophonia develops in adolescence and the emotions and behaviors are a conditioned response to distress, resulting in social avoidance, stress, and family conflict. In addition, co-occurrence with other psychiatric illnesses such as anxiety, OCD, and Tourette syndrome is common. A transdiagnostic cognitive behavioral therapeutic (CBT) approach appears appropriate. There are currently no controlled studies of youth with misophonia. The current paper describes the approach to a pilot randomized, blinded family-based treatment study for youth ages 8-16 years. Preliminary results from a pilot open trial also are described. METHODS A 2-phase dual site telehealth treatment study using a transdiagnostic CBT approach, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; Ehrenreich-May et al., 2018), is proposed. Phase 1 consisted of a 4-case pilot of UP-C/A. Phase 2 includes a randomized trial comparing the UP-C/A to a standard relaxation and education protocol. RESULTS Preliminary results from the pilot show modest improvements in evaluator-rated misophonia symptoms on the Clinical Global Impression Severity and Improvement scales. LIMITATIONS There is little research to inform evidence-based practice for youth with misophonia. Study limitations include lack of standardized misophonia assessment instruments and an absence of formal diagnostic criteria. CONCLUSIONS The current paper describes proposed methods for the first randomized controlled trial for youth with misophonia and their families along with results from a 4-case pilot.
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Affiliation(s)
- Adam B Lewin
- Department of Pediatrics, University of South Florida, United States.
| | - Sarah Dickinson
- Department of Pediatrics, University of South Florida, United States
| | - Kelly Kudryk
- Department of Pediatrics, University of South Florida, United States
| | | | | | | | - Niza A Tonarely
- Department of Psychology, University of Miami, United States
| | - Rinatte Gruen
- Department of Psychology, University of Miami, United States
| | - Brent Small
- School of Aging Studies, University of South Florida, United States
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20
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Abstract
Die Misophonie ist eine Intoleranz auf bestimmte Alltagsgeräusche. Hierbei fungieren als „Trigger“ „menschliche Körpergeräusche“, z. B. Schlucken/Schmatzen/Atemgeräusche oder Geräusche, die von Menschen, aber nicht vom menschlichen Körper erzeugt werden (z. B. Klicken Kugelschreiberknopf), ferner Tier‑/Maschinengeräusche. Die Betroffenen verspüren sofort eine negativ-emotionale Reaktion wie Wut, Aggression, Ekel u.a. Objektivierbare Veränderungen sind Herzfrequenzerhöhung und Blutdruckveränderungen. Die emotionale Reaktion ist individuell und hängt z. B. von Geräuschart, persönlicher Vorerfahrung, sozialem Kontext oder psychologischem Profil ab. Die Misophonie ist bisher als Krankheit nicht definiert und keinem offiziellen Diagnosesystem zugeordnet, sie scheint eine eigenständige Störung zu sein: Assoziationen bestehen u. a. mit Aufmerksamkeits‑/Zwangsstörungen, Tinnitus, Hyperakusis, Autismus-Spektrum-Krankheiten. Definitionskriterien wurden 2013 veröffentlicht; verschiedene, validierte Fragebögen wurden bisher zur Misophonieausprägung entwickelt. Studien mit funktionellen MRT-Untersuchungen des Kopfes zeigten eine übermäßige Aktivierung des anterioren Inselkortex (AIC) und seiner benachbarten Regionen, die für Emotionsverarbeitung/-regulation verantwortlich sind. Bisher gibt es keine randomisierten kontrollierten Studien zur Therapie. Einzelne Publikationen beschreiben kognitive Verhaltensinterventionen, Retrainingtherapien und Schallmaskierungssysteme. Zur Triggerreduktion werden Ohrstöpsel/Musikkopfhörer verwendet. Auch HNO-Ärzte können mit Misophoniepatienten konfrontiert werden, z. B. zur Klärung des Hörvermögens oder Beratung von Therapiemöglichkeiten. Der Bericht stellt eine Übersicht des aktuellen Wissensstands zur Misophonie sowie ihrer Diagnostik und Therapie dar.
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Affiliation(s)
- C Schwemmle
- Arbeitsbereich Phoniatrie, Pädaudiologie, klinische Audiologie, Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
| | - C Arens
- Arbeitsbereich Phoniatrie, Pädaudiologie, klinische Audiologie, Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland
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21
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Hansen HA, Leber AB, Saygin ZM. What sound sources trigger misophonia? Not just chewing and breathing. J Clin Psychol 2021; 77:2609-2625. [PMID: 34115383 DOI: 10.1002/jclp.23196] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/14/2021] [Accepted: 05/30/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Misophonia is a highly prevalent yet understudied condition characterized by aversion toward particular environmental sounds. Oral/nasal sounds (e.g., chewing, breathing) have been the focus of research, but variable experiences warrant an objective investigation. Experiment 1 asked whether human-produced oral/nasal sounds were more aversive than human-produced nonoral/nasal sounds and non-human/nature sounds. Experiment 2 additionally asked whether machine-learning algorithms could predict the presence and severity of misophonia. METHOD Sounds were presented to individuals with misophonia (Exp.1: N = 48, Exp.2: N = 45) and members of the general population (Exp.1: N = 39, Exp.2: N = 61). Aversiveness ratings to each sound were self-reported. RESULTS Sounds from all three source categories-not just oral/nasal sounds-were rated as significantly more aversive to individuals with misophonia than controls. Further, modeling all sources classified misophonia with 89% accuracy and significantly predicted misophonia severity (r = 0.75). CONCLUSIONS Misophonia should be conceptualized as more than an aversion to oral/nasal sounds, which has implications for future diagnostics and experimental consistency moving forward.
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Affiliation(s)
- Heather A Hansen
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Andrew B Leber
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
| | - Zeynep M Saygin
- Department of Psychology, The Ohio State University, Columbus, Ohio, USA
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22
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Abstract
BACKGROUND Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as loud chewing or breathing, causing avoidance of cue-related situations resulting in significant functional impairment. Though the first treatment studies with cognitive behavioural therapy (CBT) showed promising results, an average of 50% of the patients has not improved much clinically. OBJECTIVE The aim of this pilot study was to assess the effectiveness of eye movement desensitization and reprocessing (EMDR) therapy as a trauma-focused approach in treating misophonia symptoms. METHOD A sample of 10 adult participants with misophonia was studied at the outpatient clinic of the Academic Medical Center in Amsterdam. Participants were either on the waiting list for CBT or non-responders to CBT. EMDR was focused on misophonia-related emotionally disturbing memories and delivered in a mean of 2.6 sessions of 60-90 minutes. Pre- and post-treatment self-assessed ratings of misophonia symptoms (AMISOS-R, primary outcome), of general psychopathology (SCL-90-R) and of quality of life (SDS) were administered. The co-primary outcome was the Clinical Global Impression Improvement scale (CGI-I). RESULTS A paired t-test (n = 8) showed improvement on the primary outcome (-6.14 [MD], 5.34 [SD]) on the AMISOS-R (P = .023). Three of the eight patients showed clinically significant improvement measured with the CGI-I. No significant effect on secondary outcomes was found. CONCLUSIONS These preliminary results suggest that EMDR therapy focused on emotionally disturbing misophonia-related memories can reduce misophonia symptoms. RCTs with sufficient sample sizes are required to firmly establish the value of EMDR therapy for misophonia.
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Affiliation(s)
- Inge Jager
- Department of Psychiatry, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands
| | - Nienke Vulink
- Department of Psychiatry, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands
| | - Carlijn de Roos
- Department of Child and Adolescent Psychiatry, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC (Location AMC), Amsterdam, The Netherlands
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23
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Siepsiak M, Sobczak AM, Bohaterewicz B, Cichocki Ł, Dragan WŁ. Prevalence of Misophonia and Correlates of Its Symptoms among Inpatients with Depression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5464. [PMID: 32751203 PMCID: PMC7432123 DOI: 10.3390/ijerph17155464] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 07/09/2020] [Accepted: 07/16/2020] [Indexed: 11/16/2022]
Abstract
Misophonia is an underexplored condition that significantly decreases the quality of life of those who suffer from it. It has neurological and physiological correlates and is associated with a variety of psychiatric symptoms; however, a growing body of data suggests that it is a discrete disorder. While comorbid diagnoses among people with misophonia have been a matter of research interest for many years there is no data on the frequency of misophonia among people with psychiatric disorders. This could be the next step to reveal additional mechanisms underlying misophonia. Until recently, the use of a variety of non-validated questionnaires and the dominance of internet-based studies have been also a major obstacles to a proper definition of misophonia. A total of 94 inpatients diagnosed with depression were assessed for misophonia with face-to-face interviews as well as with MisoQuest-a validated misophonia questionnaire. The prevalence of misophonia among these patients and the congruence of MisoQuest with face-to-face interviews were evaluated. Additionally, the patients filled in a series of questionnaires that measured a variety of psychiatric symptoms and psychological traits. Anxiety, depression, impulsivity, somatic pain, vegetative symptoms, post-traumatic stress disorder (PTSD) symptoms, gender, and age were analyzed in relation to the severity of symptoms of misophonia. Between 8.5 to 12.76% of inpatients with depression were diagnosed with misophonia (depending on measurement and inclusion criteria). MisoQuest accuracy was equal to 92.55%, sensitivity-66.67% and specificity-96.34%. Severity of misophonia symptoms was positively correlated to the greatest extent with anxiety. Moderate positive correlation was also found between severity of misophonia symptoms and depressive symptoms, intrusions, and somatic pain; a weak positive correlation was found between severity of misophonia and non-planning impulsivity, motor impulsivity, avoidance, and vegetative symptoms. There was no relationship between the severity of misophonia symptoms and attentional impulsivity or the age of participants.
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Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, 00-183 Warsaw, Poland;
| | - Anna Maria Sobczak
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Bartosz Bohaterewicz
- Department of Cognitive Neuroscience and Neuroergonomics, Institute of Applied Psychology, Jagiellonian University, 30-348 Cracow, Poland; (A.M.S.); (B.B.)
| | - Łukasz Cichocki
- Department of Psychiatry, Andrzej Frycz Modrzewski Cracow Academy, 30-705 Cracow, Poland;
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24
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Siepsiak M, Śliwerski A, Łukasz Dragan W. Development and Psychometric Properties of MisoQuest-A New Self-Report Questionnaire for Misophonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051797. [PMID: 32164250 PMCID: PMC7084437 DOI: 10.3390/ijerph17051797] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/28/2020] [Accepted: 03/05/2020] [Indexed: 01/12/2023]
Abstract
Background: Misophonia is a condition related to experiencing psychophysiological sensations when exposed to specific sound triggers. In spite of progress in research on the subject, a fully validated questionnaire assessing misophonia has not been published yet. The goal of this study was to create and validate a new questionnaire to measure misophonia. Methods: MisoQuest is based on the diagnostic criteria proposed by Schröder et al. in 2013, with minor changes implemented by the authors of MisoQuest. A total of 705 participants took part in the study, completing the online questionnaires. Exploratory Factor Analysis (EFA) and analyses using the Item Response Theory (IRT) were performed. Internal consistency was evaluated with Cronbach's alpha. Results: The reliability of the MisoQuest was excellent (α = 0.955). The stability at five weeks was strong. There was a significant difference in results between people classified as those with misophonia and those without misophonia. Conclusions: MisoQuest has good psychometric values and can be helpful in the identification of misophonia. A deeper analysis showed that certain triggers might be more specific for people with misophonia. Consideration of violent behavior in response to misophonic triggers as a symptom of misophonia was undermined.
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Affiliation(s)
- Marta Siepsiak
- Faculty of Psychology, University of Warsaw, 00-183 Warsaw, Poland;
- Correspondence:
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Daniels EC, Rodriguez A, Zabelina DL. Severity of misophonia symptoms is associated with worse cognitive control when exposed to misophonia trigger sounds. PLoS One 2020; 15:e0227118. [PMID: 31945068 PMCID: PMC6964854 DOI: 10.1371/journal.pone.0227118] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 12/11/2019] [Indexed: 11/18/2022] Open
Abstract
The present study aimed to investigate the extent to which the severity of misophonia symptoms is linked with cognitive control under misophonia symptom-provocation circumstances in the general population sample. Participants (N = 79) completed a measure of cognitive control–a Stroop color naming task, which consists of congruent and incongruent stimuli, and requires inhibition of a prepotent response (reading a word) in the service of a less predominant response (naming a color), while listening to misophonia symptom-provocation or universally unpleasant sounds. Participants’ misophonia sound sensitivity, and emotional behaviors towards trigger sounds were assessed using the Misophonia Questionnaire. Stronger emotional behavioral reactions to misophonia trigger sounds were significantly associated with the larger Stroop effect when participants were exposed to the misophonia trigger sounds, but not when they were exposed to the universally unpleasant sounds. This effect held when controlling for the personality trait of Neuroticism and for baseline levels of anxiety. Both elevated misophonia sound sensitivity and emotional behaviors towards trigger sounds significantly correlated with higher self-reported anxiety when performing the Stroop task. However, only elevated emotional behaviors towards trigger sounds were linked with higher anxiety levels at baseline, suggesting that people who experience stronger emotions and behavioral reactions to misophonia trigger sounds may have higher anxiety at a trait level. Limitations and future directions are discussed.
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Affiliation(s)
- Emily C. Daniels
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States of America
| | - Andrew Rodriguez
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States of America
| | - Darya L. Zabelina
- Department of Psychological Science, University of Arkansas, Fayetteville, AR, United States of America
- * E-mail:
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Erfanian M, Kartsonaki C, Keshavarz A. Misophonia and comorbid psychiatric symptoms: a preliminary study of clinical findings. Nord J Psychiatry 2019; 73:219-228. [PMID: 31066600 DOI: 10.1080/08039488.2019.1609086] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders' features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.
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Affiliation(s)
- Mercede Erfanian
- a UCL Institute for Environmental Design and Engineering, University College London , London , UK.,b International Misophonia Research Network (IMRN) , New York , CT , USA
| | - Christiana Kartsonaki
- b International Misophonia Research Network (IMRN) , New York , CT , USA.,c Nuffield Department of Population Health , University of Oxford , Oxford , UK.,d MRC Population Health Research Unit , University of Oxford , Oxford , UK
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Houghton DC, Uhde TW, Borckardt JJ, Cortese BM. Exploratory Investigation of a Brief Cognitive Behavioral Intervention and Transcranial Direct Current Stimulation on Odor Sensitivity. Psychosom Med 2019; 81:389-395. [PMID: 30762663 PMCID: PMC6961818 DOI: 10.1097/psy.0000000000000679] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Enhanced odor sensitivity is a phenomenon that potentially underlies conditions such as multiple chemical sensitivity (MCS). Currently, there are no treatments that have been shown to effectively decrease odor sensitivity. Given similarities of odor hypersensitivity/MCS to pain sensitization disorders such as fibromyalgia, there may be a potential for interventions that improve pain tolerance to modulate odor sensitivity. METHODS This exploratory study randomized 72 healthy community adult volunteers to receive one of six treatments in between two assessments of thermal pain tolerance and odor threshold. Participants were randomized to receive either cathodal, anodal, or sham transcranial direct current stimulation (tDCS) aimed at dorsolateral prefrontal cortex. In addition, participants were provided a brief cognitive behavioral intervention (CBI) for pain consisting of task framing, cognitive restructuring, and distraction technique training, or a control intervention consisting of information about pain. RESULTS Persons who received a brief CBI showed significantly increased odor thresholds (reduced sensitivity) during intervention (F (1,62) = 7.29, p = .009, ηp = .11), whereas the control intervention was not associated with altered odor thresholds. Moreover, in those who received brief CBI, more severe anxiety associated with larger reductions in odor sensitivity (ρ = .364, p = .035). There was no effect of tDCS (F (2,62) = .11, p = .90) nor interaction between tDCS and CBI (F (2,62) = .32, p = .73). CONCLUSIONS Given the connection between anxiety and MCS, results suggest that CBT techniques for somatic processes may show promise in treating conditions characterized by increased sensitivity to odors (e.g., MCS).
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Affiliation(s)
- David C. Houghton
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
- Psychological and Brain Sciences Department, Texas A&M University, College Station, TX, USA
| | - Thomas W. Uhde
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Jeffrey J. Borckardt
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Bernadette M. Cortese
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
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Potgieter I, MacDonald C, Partridge L, Cima R, Sheldrake J, Hoare DJ. Misophonia: A scoping review of research. J Clin Psychol 2019; 75:1203-1218. [PMID: 30859581 DOI: 10.1002/jclp.22771] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 12/02/2018] [Accepted: 02/16/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To scope the literature describing misophonia populations, management, and research opportunities. METHOD Literature searches for research studies describing patients diagnosed with misophonia, defining a patient profile, or outlining development or testing of an intervention for misophonia. A data extraction form was developed and piloted before data from each article were independently charted by two researchers. Researchers then agreed on a final data set for each article. RESULTS Thirty-one records were included. The misophonia population was described in terms of onset age, triggers, reaction, coping strategies, and comorbid conditions. We identified nine outcome measures. Case studies on treatments included cognitive behavioral therapy, counterconditioning, mindfulness and acceptance, dialectical behavioral therapy, and pharmaceuticals. Future research priorities identified included clarifying the phenomenology and prevalence of misophonia, and randomized controlled trials of treatments. CONCLUSION Misophonia is under-researched but there are strong foundations for future research to finalize diagnostic criteria, validate outcome measures, and trial treatments.
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Affiliation(s)
- Iskra Potgieter
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Carol MacDonald
- Department of Psychology, University of Stirling, Stirling, UK
| | - Lucy Partridge
- Nuffield Hearing & Speech Centre, Royal National Throat Nose and Ear Hospital, London, UK
| | - Rilana Cima
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | | | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
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Janik McErlean AB, Banissy MJ. Increased misophonia in self-reported Autonomous Sensory Meridian Response. PeerJ 2018; 6:e5351. [PMID: 30123700 PMCID: PMC6084287 DOI: 10.7717/peerj.5351] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 07/10/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Autonomous Sensory Meridian Response (ASMR) is a sensory experience elicited by auditory and visual triggers, which so far received little attention from the scientific community. This self-reported phenomenon is described as a relaxing tingling sensation, which typically originates on scalp and spreads through a person's body. Recently it has been suggested that ASMR shares common characteristics with another underreported condition known as misophonia, where sounds trigger negative physiological, emotional and behavioural responses. The purpose of this study was to elucidate whether ASMR is associated with heightened levels of misophonia. METHODS The Misophonia Questionnaire (MQ) was administered to individuals reporting to experience ASMR and to age and gender matched controls. RESULTS Compared to controls ASMR group scored higher on all subscales of MQ including the Misophonia Symptom Scale, the Misophonia Emotions and Behaviors Scale and the Misophonia Severity Scale. DISCUSSION Individuals reporting ASMR experience have elevated levels of misophonia.
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30
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Atagün Mİ, İslamoğlu S, Can SS. Misophonia: a disorder for social world. ANKARA MEDICAL JOURNAL 2018. [DOI: 10.17098/amj.409046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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31
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Brout JJ, Edelstein M, Erfanian M, Mannino M, Miller LJ, Rouw R, Kumar S, Rosenthal MZ. Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda. Front Neurosci 2018; 12:36. [PMID: 29467604 PMCID: PMC5808324 DOI: 10.3389/fnins.2018.00036] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Accepted: 01/15/2018] [Indexed: 02/04/2023] Open
Abstract
Misophonia is a neurobehavioral syndrome phenotypically characterized by heightened autonomic nervous system arousal and negative emotional reactivity (e. g., irritation, anger, anxiety) in response to a decreased tolerance for specific sounds. The aims of this review are to (a) characterize the current state of the field of research on misophonia, (b) highlight what can be inferred from the small research literature to inform treatment of individuals with misophonia, and (c) outline an agenda for research on this topic. We extend previous reviews on this topic by critically reviewing the research investigating mechanisms of misophonia and differences between misophonia and other conditions. In addition, we integrate this small but growing literature with basic and applied research from other literatures in a cross-disciplinary manner.
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Affiliation(s)
- Jennifer J Brout
- International Misophonia Research Network, New York, NY, United States
| | - Miren Edelstein
- International Misophonia Research Network, New York, NY, United States.,Department of Psychology, Center for Brain and Cognition, University of California, San Diego, San Diego, CA, United States
| | - Mercede Erfanian
- International Misophonia Research Network, New York, NY, United States.,Department of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Michael Mannino
- Center for Complex Systems and Brain Sciences, Florida Atlantic University, Boca Raton, FL, United States
| | - Lucy J Miller
- International Misophonia Research Network, New York, NY, United States.,Department of Psychology, Brain and Cognition, Amsterdam University, Amsterdam, Netherlands
| | - Romke Rouw
- Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Sukhbinder Kumar
- International Misophonia Research Network, New York, NY, United States.,Auditory Group, Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - M Zachary Rosenthal
- International Misophonia Research Network, New York, NY, United States.,Department of Psychiatry and Behavioral Science, Duke University Medical Center, Durham, NC, United States.,Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
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Dozier TH, Lopez M, Pearson C. Proposed Diagnostic Criteria for Misophonia: A Multisensory Conditioned Aversive Reflex Disorder. Front Psychol 2017; 8:1975. [PMID: 29184520 PMCID: PMC5694628 DOI: 10.3389/fpsyg.2017.01975] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 10/27/2017] [Indexed: 01/28/2023] Open
Affiliation(s)
| | - Michelle Lopez
- Misophonia Institute, Livermore, CA, United States.,Department of Psychology, Alliant International University, San Diego, CA, United States.,Center for Stress and Anxiety Management, San Diego, CA, United States
| | - Christopher Pearson
- Misophonia Institute, Livermore, CA, United States.,John Cox Health and Physiotherapy, West Yorkshire, United Kingdom
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Affiliation(s)
- Arjan Schröder
- Department of Psychiatry, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands
| | - Guido van Wingen
- Department of Psychiatry, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands
| | - Nienke C Vulink
- Department of Psychiatry, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of AmsterdamAmsterdam, Netherlands.,The Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Academy of Arts and SciencesAmsterdam, Netherlands
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34
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Rouw R, Erfanian M. A Large-Scale Study of Misophonia. J Clin Psychol 2017; 74:453-479. [DOI: 10.1002/jclp.22500] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 02/24/2017] [Accepted: 04/16/2017] [Indexed: 11/07/2022]
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Misophonia: A new mental disorder? Med Hypotheses 2017; 103:109-117. [PMID: 28571795 DOI: 10.1016/j.mehy.2017.05.003] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Revised: 04/24/2017] [Accepted: 05/01/2017] [Indexed: 11/20/2022]
Abstract
Misophonia, a phenomenon first described in the audiology literature, is characterized by intense emotional reactions (e.g., anger, rage, anxiety, disgust) in response to highly specific sounds, particularly sounds of human origin such as oral or nasal noises made by other people (e.g., chewing, sniffing, slurping, lip smacking). Misophonia is not listed in any of the contemporary psychiatric classification systems. Some investigators have argued that misophonia should be regarded as a new mental disorder, falling within the spectrum of obsessive-compulsive related disorders. Other researchers have disputed this claim. The purpose of this article is to critically examine the proposition that misophonia should be classified as a new mental disorder. The clinical and research literature on misophonia was examined and considered in the context of the broader literature on what constitutes a mental disorder. There have been growing concerns that diagnostic systems such as DSM-5 tend to over-pathologize ordinary quirks and eccentricities. Accordingly, solid evidence is required for proposing a new psychiatric disorder. The available evidence suggests that (a) misophonia meets many of the general criteria for a mental disorder and has some evidence of clinical utility as a diagnostic construct, but (b) the nature and boundaries of the syndrome are unclear; for example, in some cases misophonia might be simply one feature of a broader pattern of sensory intolerance, and (c) considerably more research is required, particularly work concerning diagnostic validity, before misophonia, defined as either as a disorder or as a key feature of some broader syndrome of sensory intolerance, should be considered as a diagnostic construct in the psychiatric nomenclature. A research roadmap is proposed for the systematic evaluation as to whether misophonia should be considered for future editions of DSM or ICD.
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36
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Dozier TH. Treating the Initial Physical Reflex of Misophonia With the Neural Repatterning Technique: A Counterconditioning Procedure. PSYCHOLOGICAL THOUGHT 2015. [DOI: 10.5964/psyct.v8i2.138] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Misophonia is a condition in which a person has an acute emotional response of anger or disgust to a commonly occurring innocuous auditory or visual stimulus referred to as a trigger. This case details the effective treatment of misophonia in a young woman that included a counterconditioning treatment called the Neural Repatterning Technique (NRT), which combines a continuous positive stimulus and a reduced intensity, intermittent trigger. The treatment was delivered via the Misophonia Trigger Tamer smartphone app and all treatments were conducted independently by the patient. In this patient, the trigger elicited a physical reflex of contraction of the flexor digitorum profundus, which caused her to clench her fist. To enhance the effect of the NRT treatment, Progressive Muscle Relaxation was incorporated to increase her ability to deliberately relax the affected muscle during treatment. During NRT treatment sessions, the patient experienced a weak physical reflex to the reduced trigger stimulus but no emotional response. Her emotional response of misophonia was not treated, but when the physical reflex extinguished, the emotional response also extinguished. This case indicates that the misophonic response includes a Pavlovian-conditioned physical reflex. It is proposed that the trigger elicited the physical reflex and the physical reflex then elicited the conditioned emotional response that is characteristic of misophonia. Because of the conditioned reflex nature of misophonia, it is proposed that a more appropriate name for this disorder would be Conditioned Aversive Reflex Disorder.
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Webber TA, Storch EA. Toward a theoretical model of misophonia. Gen Hosp Psychiatry 2015; 37:369-70. [PMID: 25886954 DOI: 10.1016/j.genhosppsych.2015.03.019] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Revised: 03/29/2015] [Accepted: 03/30/2015] [Indexed: 10/23/2022]
Affiliation(s)
- Troy A Webber
- Department of Psychology, University of South Florida, Tampa, FL.
| | - Eric A Storch
- Department of Psychology, University of South Florida, Tampa, FL; Department of Pediatrics, University of South Florida Morsani College of Medicine, Tampa, FL; Department of Health Policy and Management, University of South Florida, Tampa, FL; Department of Psychiatry and Behavioral Neurosciences, University of South Florida Morsani College of Medicine, Tampa, FL; Rogers Behavioral Health-Tampa Bay, Tampa, FL; All Children's Hospital-Johns Hopkins Medicine, St. Petersburg, FL
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Taylor S, Conelea CA, McKay D, Crowe KB, Abramowitz JS. Sensory intolerance: latent structure and psychopathologic correlates. Compr Psychiatry 2014; 55:1279-84. [PMID: 24703593 PMCID: PMC4060532 DOI: 10.1016/j.comppsych.2014.03.007] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2014] [Revised: 03/15/2014] [Accepted: 03/18/2014] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Sensory intolerance refers to high levels of distress evoked by everyday sounds (e.g., sounds of people chewing) or commonplace tactile sensations (e.g., sticky or greasy substances). Sensory intolerance may be associated with obsessive-compulsive (OC) symptoms, OC-related phenomena, and other forms of psychopathology. Sensory intolerance is not included as a syndrome in current diagnostic systems, although preliminary research suggests that it might be a distinct syndrome. OBJECTIVES First, to investigate the latent structure of sensory intolerance in adults; that is, to investigate whether it is syndrome-like in nature, in which auditory and tactile sensory intolerance co-occur and are associated with impaired functioning. Second, to investigate the psychopathologic correlates of sensory intolerance. In particular, to investigate whether sensory intolerance is associated with OC-related phenomena, as suggested by previous research. METHOD A sample of 534 community-based participants were recruited via Amazon.com's Mechanical Turk program. Participants completed measures of sensory intolerance, OC-related phenomena, and general psychopathology. RESULTS Latent class analysis revealed two classes of individuals: those who were intolerant of both auditory and tactile stimuli (n=150), and those who were relatively undisturbed by auditory or tactile stimuli (n=384). Sensory-intolerant individuals, compared to those who were comparatively sensory tolerant, had greater scores on indices of general psychopathology, more severe OC symptoms, a higher likelihood of meeting caseness criteria for OC disorder, elevated scores on measures of OC-related dysfunctional beliefs, a greater tendency to report OC-related phenomena (e.g., a greater frequency of tics), and more impairment on indices of social and occupational functioning. Sensory-intolerant individuals had significantly higher scores on OC symptoms even after controlling for general psychopathology. CONCLUSIONS Consistent with recent research, these findings provide further evidence for a sensory intolerance syndrome. The findings provide a rationale for conducting future research for determining whether a sensory intolerance syndrome should be included in the diagnostic nomenclature.
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Affiliation(s)
- Steven Taylor
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada.
| | | | - Dean McKay
- Department of Psychology, Fordham University, New York, NY, USA
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Sensory Over-Responsivity in Pediatric Obsessive Compulsive Disorder. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9442-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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40
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Wu MS, Lewin AB, Murphy TK, Storch EA. Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample. J Clin Psychol 2014; 70:994-1007. [PMID: 24752915 DOI: 10.1002/jclp.22098] [Citation(s) in RCA: 142] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger outbursts. While there has been increasing interest in misophonia, few data have been published to date. METHOD This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self-report measures. RESULTS Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive-compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts. CONCLUSION This investigation contributes to a better understanding of misophonia and indicates potential factors that may co-occur and influence the clinical presentation of a person with misophonia symptoms.
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Affiliation(s)
- Monica S Wu
- University of South Florida Morsani College of Medicine; University of South Florida, Department of Psychology
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