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Bibliography on: Misophonia — Cannot Stand the Sound of Chewing

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ESP: PubMed Auto Bibliography 29 Sep 2023 at 01:55 Created: 

Misophonia — Cannot Stand the Sound of Chewing

Wikipedia: Misophonia, literally "hatred of sound," was proposed in 2000 as a condition in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "select sound sensitivity syndrome" and "sound-rage." Misophonia has no classification as an auditory, neurological, or psychiatric condition, there are no standard diagnostic criteria, it is not recognized in the DSM-IV or the ICD-10, and there is little research on its prevalence or treatment. Proponents suggest misophonia can adversely affect ability to achieve life goals and to enjoy social situations. Treatment consists of developing coping strategies such as cognitive behavioral therapy and exposure therapy. As of 2016 the literature on misophonia was very limited (see below). Some small studies show that people with misophonia generally have strong negative feelings, thoughts, and physical reactions to specific sounds, which the literature calls "trigger sounds." One study found that around 80% of the sounds were related to the mouth (eating, yawning, etc.), and around 60% were repetitive.

Created with PubMed® Query: ( misophonia OR "sound rage" OR "select sound sensitivity syndrome" ) NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)


RevDate: 2023-09-11

Armstrong GM, Greenberg RL, Smárason O, et al (2023)

Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia.

Journal of obsessive-compulsive and related disorders, 39:.

Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8-17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.

RevDate: 2023-09-08

Siepsiak M, Turek A, Michałowska M, et al (2023)

Misophonia in Children and Adolescents: Age Differences, Risk Factors, Psychiatric and Psychological Correlates. A Pilot Study with Mothers' Involvement.

Child psychiatry and human development [Epub ahead of print].

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.

RevDate: 2023-09-01

Abramovitch A, Herrera TA, JL Etherton (2023)

A neuropsychological study of misophonia.

Journal of behavior therapy and experimental psychiatry pii:S0005-7916(23)00064-2 [Epub ahead of print].

BACKGROUND AND OBJECTIVES: Misophonia is a recently identified condition characterized by negative emotional responsivity to certain types of sounds. Although progress has been made in understanding of neuronal, psychophysiological, and psychopathological mechanisms, important gaps in research remain, particularly insight into cognitive function. Accordingly, we conducted the first neuropsychological examination of misophonia, including clinical, diagnostic, and functional correlates.

METHODS: A misophonia group (n = 32) and a control group (n = 64) were screened for comorbidities using a formal semi-structured interview and completed a comprehensive neuropsychological battery and self-report measures of depression, anxiety, stress, impulsivity, and functional impairment.

RESULTS: The misophonia group significantly underperformed the control group on only 2 neuropsychological outcomes involving verbal memory retrieval. Subscales of the Misophonia Questionaaire (MQ) were inversely correlated only with measures of attention. The misophonia group reported significantly higher anxiety symptoms, behavioral impulsivity, and functional impairments, and had numerically higher rates of ADHD and OCD.

LIMITATIONS: To facilitate comparability, in lieu of a formal diagnostic algorithm for misophonia, we used a commonly used empirical definition for group allocation that has been utilized in numerous previous studies.

CONCLUSIONS: Misophonia was associated with a reduction in performance on a minority of cognitive tasks and a modest increase in some psychological symptoms and comorbid conditions. Correlational data suggest that difficulties with attention regulation and impulsivity may play a role in misophonia, albeit attention functions were intact. Results should be interpreted with caution given the variability in diagnostic definitions, and more research is needed to understand cognitive functioning under 'cold' conditions in misophonia.

RevDate: 2023-08-23

Spencer SD, Guzick AG, Cervin M, et al (2023)

Mindfulness and cognitive emotion regulation in pediatric misophonia.

Journal of contextual behavioral science, 29:182-191.

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.

RevDate: 2023-07-27

Rinaldi LJ, J Simner (2023)

Mental Health Difficulties in Children who Develop Misophonia: An Examination of ADHD, Depression & Anxiety.

Child psychiatry and human development [Epub ahead of print].

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.

RevDate: 2023-07-28

Aryal S, P Prabhu (2023)

Auditory brainstem functioning in individuals with misophonia.

Journal of otology, 18(3):139-145.

PURPOSE: Misophonia is not investigated much from an audiological perspective. Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia.

METHODS: A cross-sectional study was conducted among university students who had misophonia. The revised Amsterdam Misophonia Scale was used to determine the severity of misophonia. Participants were divided into mild and moderate-severe misophonia and compared with the healthy control group. Auditory Brainstem Response testing was recorded from all the individuals with misophonia. The absolute latency, amplitude, inter-peak latency difference, and inter-rate latency difference were compared between the groups.

RESULTS: One-way ANOVA result showed no significant difference in all the parameters of auditory brainstem response between the groups. These results are suggestive of normal brainstem processing in individuals with misophonia.

CONCLUSIONS: The study concludes that the auditory pathway up to brainstem areas is intact in individuals with misophonia. Further studies are essential on a larger population for generalizing the results.

RevDate: 2023-07-26

Eberhart L, Seegan P, McGuire J, et al (2023)

Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019-2021.

Psychiatric services (Washington, D.C.) [Epub ahead of print].

OBJECTIVE: This article describes trends and attributes associated with digital mental health application (DMHA) referrals from December 2019 through December 2021.

METHODS: In total, 43,842 DMHA referrals for 25,213 unique patients were extracted from the electronic health record of a large, diverse, integrated health system. DMHAs were aggregated by type (cognitive-behavioral therapy [CBT] or mindfulness and meditation [MM]). Monthly referral patterns were described and categorized into mutually exclusive clusters (MM, CBT, or MM and CBT). Multinomial logistic regression and post hoc predicted probabilities were used to profile patient, clinical, and encounter attributes among referral clusters.

RESULTS: DMHA referrals increased, reached equilibrium, and then began to decline over the 25-month observation period. Compared with the referral cluster average, MM-alone referrals were more likely to occur for patients who were ages ≥65, who were Hispanic or Asian, whose reason for visit concerned mental health, and who had a primary diagnosis of other anxiety disorders. CBT-alone referrals were more likely to occur for patients with a primary diagnosis of depression and less likely to occur for Hispanic patients. Combined MM and CBT referrals were more likely to occur for patients who were ages 18-30, whose reason for visit was "other," and who had a primary diagnosis of depression and were less likely to occur for Hispanic patients and those ages ≥65.

CONCLUSIONS: Although this study demonstrates readiness to integrate DMHA referral into clinical workflows, observed variations in attributes of referral clusters support the need to further investigate provider decision making and whether referral patterns are optimal and sustainable.

RevDate: 2023-07-18

Holohan D, Marfilius K, CJ Smith (2023)

Misophonia: A Review of the Literature and Its Implications for the Social Work Profession.

Social work pii:7226156 [Epub ahead of print].

Misophonia is a chronic condition that describes aversion to specific auditory stimuli. Misophonia is characterized by physiological responsivity and negative emotional reactivity. Specific sounds, commonly referred to as "triggers," are often commonplace and sometimes repetitive. They include chewing, coughing, slurping, keyboard tapping, and pen clicking. Common emotional responses include rage, disgust, anxiety, and panic while physical responses include muscle constriction and increased heart rate. This literature review identifies research priorities, limitations, and new directions, examining the implications of misophonia for the social work profession. Misophonia is largely absent from the social work literature. However, the profession is uniquely equipped to understand, screen for, and effectively treat misophonia in direct practice or within interprofessional treatment teams. By conceptualizing misophonia as idiosyncratic and contextual, social workers would enhance the existing body of research by applying an ecological perspective which captures the interaction of individuals and environments in producing human experience. Such an approach would assist clients and clinicians in developing treatment plans that consider the roles of social and physical environments in the development and course of misophonia. A discussion of current limitations within the misophonia literature further emphasizes the need for new perspectives.

RevDate: 2023-07-18
CmpDate: 2023-07-17

Barahmand U, Stalias-Mantzikos ME, Xiang Y, et al (2023)

The New York Misophonia Scale (NYMS): A New Instrument to Identify Misophonia in the General Population.

Journal of psychiatric practice, 29(4):269-281.

Misophonia is a condition in which certain sounds and behaviors elicit distress that ranges from mild annoyance to disgust or anger. The aim of this research was to develop and validate an instrument to screen for misophonia in the general population. Study 1 developed and explored the factor structure and item quality of the New York Misophonia Scale (NYMS), which originally included 42 triggers and 13 behavioral reactions. A sample of 441 American adults responded to the instrument via social media platforms. Of the original 42 triggers, 25 clustered into 4 factors: repetitive actions, mouth sounds, ambient object sounds, and ambient people sounds. The 13 behavioral reactions loaded on to 2 factors, aggressive and nonaggressive reactions. Study 2 evaluated the psychometric properties of the final version of the NYMS using a sample of 200 American adults. The results supported the validity of the factor structure and the reliability of the final version of the NYMS from Study 1. Finally, Study 3 explored the concurrent and convergent validity of the final version of the NYMS with the Misophonia Questionnaire (MQ) and the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF). A sample of 171 adult participants completed all of the scales. Good concurrent validity was found with the MQ and good convergent validity was found with the DERS-SF. Overall, the NYMS appears to be a useful and promising instrument for assessing misophonia triggers, severity of distress elicited, and behavioral reactions to the distress in the general population.

RevDate: 2023-07-10

Campbell J (2023)

Misophonia: A Need for audiologic diagnostic guidelines.

Journal of the American Academy of Audiology [Epub ahead of print].

PURPOSE: The goal of this commentary is to present to audiologists the recent consensus definition of misophonia along with current clinical measures useful for audiologists in the diagnosis of misophonia. Up and coming behavioral methods that may be sensitive to misophonia are highlighted. Finally, a call is put out for translational audiologic research with the goal of developing diagnostic criteria for misophonia.

METHOD: The approach to the consensus definition is described, as well as the main characteristics of misophonia agreed upon by the expert panel. Next, available clinical measures that may be useful to audiologists for the diagnosis of misophonia are presented, followed by a brief review of current behavioral assessment methodology that still requires research to determine sensitivity and specificity to misophonia symptomatology. This discussion leads to the need for establishment of audiologic diagnostic criteria in misophonia, especially when differentiating from hyperacusis.

CONCLUSIONS: While the consensus definition for misophonia is an excellent first step in obtaining expert agreement on the descriptors of misophonic triggers, reactions, and behavior, clinical research is critical in developing criteria for misophonia as a specific sound tolerance disorder.

RevDate: 2023-07-20
CmpDate: 2023-07-19

Seegan PL, Miller MJ, Heliste JL, et al (2023)

Efficacy of stand-alone digital mental health applications for anxiety and depression: A meta-analysis of randomized controlled trials.

Journal of psychiatric research, 164:171-183.

BACKGROUND: Anxiety and depressive disorders affect 20% of the population, cause functional impairment, and represent a leading cause of disability. Although evidence-based treatments exist, the shortage of trained clinicians and high demand for mental health services have resulted in limited access to evidence-based care. Digital mental health applications (DMHA) present innovative, scalable, and sustainable solutions to address disparities in mental health care.

METHODS: The present study used meta-analytic techniques to evaluate the therapeutic effect of DMHAs in randomized controlled trials (RCTs) for individuals experiencing anxiety and/or depressive symptoms. Search terms were selected based on concepts related to digital mental health applications, mental health/wellness, intervention type, trial design, and anxiety and/or depression symptoms/diagnosis outcomes to capture all potentially eligible results. Potential demographic, DMHA, and trial design characteristics were examined as moderators of therapeutic effects.

RESULTS: Random effects meta-analyses found that stand-alone DMHAs produced a modest reduction in anxiety (g = 0.31) and depressive (g = 0.35) symptom severity. Several moderators influenced the therapeutic effects of DMHAs for anxiety and/or depressive symptoms including treatment duration, participant inclusion criteria, and outcome measures.

LIMITATIONS: Minimal information was available on DMHA usability and participant engagement with DMHAs within RCTs.

CONCLUSIONS: While DMHAs have the potential to be scalable and sustainable solutions to improve access and availability of evidence-based mental healthcare, moderator analyses highlight the considerations for implementation of DMHAs in practice. Further research is needed to understand factors that influence therapeutic effects of DMHAs and investigate strategies to optimize its implementation and overcome the extant research-to-practice gap.

RevDate: 2023-06-21

Andermane N, Bauer M, Simner J, et al (2023)

A symptom network model of misophonia: From heightened sensory sensitivity to clinical comorbidity.

Journal of clinical psychology [Epub ahead of print].

OBJECTIVES: Misophonia-an unusually strong intolerance of certain sounds-can cause significant distress and disruption to those who have it but is an enigma in terms of our scientific understanding. A key challenge for explaining misophonia is that, as with other disorders, it is likely to emerge from an interaction of traits that also occur in the general population (e.g., sensory sensitivity and anxiety) and that are transdiagnostic in nature (i.e., shared with other disorders).

METHODS: In this preregistered study with a large sample of participants (N = 1430), we performed a cluster analysis (based on responses to questions relating to misophonia) and identified two misophonia subgroups differing in severity, as well as a third group without misophonia. A subset of this sample (N = 419) then completed a battery of measures designed to assess sensory sensitivity and clinical comorbidities.

RESULTS: Clinical symptoms were limited to the most severe group of misophonics (including autistic traits, migraine with visual aura, anxiety sensitivity, obsessive-compulsive traits). Both the moderate and severe groups showed elevated attention-to-detail and hypersensitivity (across multiple senses). A novel symptom network model of the data shows the presence of a central hub linking misophonia to sensory sensitivity which, in turn, connects to other symptoms in the network (relating to autism, anxiety, etc.).

CONCLUSION: The core features of misophonia are sensory-attentional in nature with severity linked strongly to comorbidities.

RevDate: 2023-07-03

Mattson SA, D'Souza J, Wojcik KD, et al (2023)

A systematic review of treatments for misophonia.

Personalized medicine in psychiatry, 39-40:.

Research into misophonia treatments has been limited and it is unclear what treatment approaches may be effective. This systematic review extracted and synthesized relevant treatment research on misophonia to examine the efficacy of various intervention modalities and identify current trends in order to guide future treatment research. PubMed, PsycINFO, Google Scholar, and Cochrane Central were searched 4using the keywords "misophonia," "decreased sound tolerance," "selective sound sensitivity," or "decreased sound sensitivity." Of the 169 records available for initial screening, 33 studied misophonia treatment specifically. Data were available for one randomized controlled trial, one open label trial, and 31 case studies. Treatments included various forms of psychotherapy, medication, and combinations of the two. Cognitive-behavioral therapy (CBT) incorporating various components has been the most often utilized and effective treatment for reduction of misophonia symptoms in one randomized trial and several case studies/series. Beyond CBT, various case studies suggested possible benefit from other treatment approaches depending on the patient's symptom profile, although methodological rigor was limited. Given the limitations in the literature to date, including overall lack of rigor, lack of comparative studies, limited replication, and small sample size, the field would benefit from the development of mechanism-informed treatments, rigorous randomized trials, and treatment development with an eye towards dissemination and implementation.

RevDate: 2023-06-17

Perez VW, A Friedman (2023)

Misophonia matters: A case study of the role of brain imaging in debates over new diagnoses.

Sociology of health & illness [Epub ahead of print].

Misophonia has gained attention in scientific circles that utilise brain imaging to validate diagnoses. The condition is promoted as not merely a symptom of other psychiatric diagnoses but as a discrete clinical entity. We illustrate the social construction of the diagnostic category of misophonia through examining prominent claims in research studies that use brain imaging to substantiate the diagnosis. We show that brain images are insufficient to establish the 'brain basis for misophonia' due to both technical and logical limitations of imaging data. Often misunderstood as providing direct access to the matter of the body, brain images are mediated and manipulated numerical data (Joyce, 2005, Social Studies of Science 35(3), p. 437). Interpretations of brain scans are further shaped by social expectations and attributes considered salient to the data. Causal inferences drawn from these studies are problematic because 'misophonics' are clinically pre-diagnosed before participating. We argue that imaging cannot replace the social process of diagnosis in the case of misophonia, nor validate diagnostic measures or otherwise substantiate the condition. More broadly, we highlight both the cultural authority and inherent limitations of brain imaging in the social construction of contested diagnoses while also illustrating its role in the disaggregation of symptoms into new diagnoses.

RevDate: 2023-06-07

Patel NM, Fameen R, Shafeek N, et al (2023)

Prevalence of Misophonia in College Going Students of India: A Preliminary Survey.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 75(2):374-378.

Misophonia, meaning "hatred of sound", is a proposed neurological condition in which certain sounds trigger emotional or physiological responses others may deem unreasonable. The studies on prevalence of misophonia show that almost 20% of college going students exhibit experience misophonia like symptoms worldwide. These studies help us understand that decreased tolerance towards certain sounds has a high prevalence rate. In a country like India, the diversity in terms of exposure to various levels of noise and traditional habits spans across different age groups, locations, socio-economic statuses, and communities. This study aims to establish the prevalence rate and severity of misophonia in college going-students of India and also an attempt to determine gender dominance. The total participants were 328 undergraduate students all over India, with diverse cultural, linguistic, and economic backgrounds. An online survey was conducted through Google forms, wherein the participants filled the self-rating Amsterdam Misophonia Scale and Misophonia Questionnaire. The results of the study showed that the prevalence of misophonia was approximately 15.85%, with a moderate to severe degree of misophonia. The results indicate that misophonia is highly prevalent in India and there is no gender dominance in experiencing misophonia.

RevDate: 2023-07-18
CmpDate: 2023-07-17

Cervin M, Guzick AG, Clinger J, et al (2023)

Measuring misophonia in youth: A psychometric evaluation of child and parent measures.

Journal of affective disorders, 338:180-186.

BACKGROUND: Misophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist.

METHODS: In a sample of 102 youth meeting the proposed diagnostic criteria of misophonia, we evaluated the child and parent-proxy versions of the self-reported Misophonia Assessment Questionnaire (MAQ; assessing broad aspects of misophonia) and the child version of the Amsterdam Misophonia Scale (A-MISO-S; assessing misophonia severity). Confirmatory and exploratory factor analysis were used to examine factor structures of the measures. Further, child-parent agreement on the MAQ and associations between both measures and misophonia-related impairment, quality of life, and misophonia-related school interference were examined to evaluate aspects of convergent validity.

RESULTS: For both youth- and parent-ratings, four MAQ factors emerged: pessimism, distress, interference, and non-recognition. A-MISO-S showed a unidimensional structure, but the item 'effort to resist' did not load significantly onto the unidimensional factor. Good child-parent agreement on the MAQ scales were found and both MAQ and A-MISO-S were moderately to strongly associated with misophonia-related impairment, quality of life (inverse association), and misophonia-related school interference.

LIMITATIONS: MAQ and A-MISO-S assess sensitivity to auditory but not visual stimuli, the sample size was modest, and repeated assessments were not conducted.

CONCLUSIONS: The combination of MAQ and A-MISO-S shows promise as a multidimensional assessment approach for pediatric misophonia. Future evaluations should include known-groups validity, screening performance, and sensitivity to change in symptom severity.

RevDate: 2023-05-09

Aryal S, P Prabhu (2023)

Awareness and perspectives of audiologists on assessment and management of misophonia in India.

Journal of otology, 18(2):104-110.

BACKGROUND: The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia.

PURPOSE: The main aim of our study is to document the present level of awareness and knowledge about misophonia assessment and management among audiologists in India.

METHODS: A descriptive cross-sectional study was carried out among audiologists from all over India. Descriptive statistical procedures were measured based on the type of questions being addressed, and a non-parametric chi-square test was done to see the association among variables.

RESULTS: The results show a lack of knowledge about misophonia even among audiologists, as only 15.3% of the audiologist reported being confident in handling cases with misophonia.

CONCLUSION: Although the exact assessment and management of misophonia is still the topic of debate, it is clear that audiologists are the team's key members. However, the results clearly show a lack of confidence in handling cases of misophonia among audiologists in India. This result shows the future need for Research in misophonia from an audiological perspective.

RevDate: 2023-05-09

Andermane N, Bauer M, Sohoglu E, et al (2023)

A phenomenological cartography of misophonia and other forms of sound intolerance.

iScience, 26(4):106299.

People with misophonia have strong aversive reactions to specific "trigger" sounds. Here we challenge this key idea of specificity. Machine learning was used to identify a misophonic profile from a multivariate sound-response pattern. Misophonia could be classified from most sounds (traditional triggers and non-triggers) and, moreover, cross-classification showed that the profile was largely transferable across sounds (rather than idiosyncratic for each sound). By splitting our participants in other ways, we were able to show-using the same approach-a differential diagnostic profile factoring in potential co-morbidities (autism, hyperacusis, ASMR). The broad autism phenotype was classified via aversions to repetitive sounds rather than the eating sounds most easily classified in misophonia. Within misophonia, the presence of hyperacusis and sound-induced pain had widespread effects across all sounds. Overall, we show that misophonia is characterized by a distinctive reaction to most sounds that ultimately becomes most noticeable for a sub-set of those sounds.

RevDate: 2023-06-15
CmpDate: 2023-06-15

Banks WA, Hansen KM, Erickson MA, et al (2023)

High-mobility group box 1 (HMGB1) crosses the BBB bidirectionally.

Brain, behavior, and immunity, 111:386-394.

High-mobility group box 1 (HMGB1) is a ubiquitous protein that regulates transcription in the nucleus, and is an endogenous damage-associated molecular pattern molecule that activates the innate immune system. HMGB1 activates the TLR4 and RAGE recepto, inducing downstream signals reminiscent of cytokines that have been found to cross the blood-brain barrier (BBB). Blood HMGB1 increases in stroke, sepsis, senescence, alcohol binge drinking and other conditions. Here, we examined the ability of HMGB1 radioactively labeled with iodine (I-HMGB1) to cross the BBB. We found that I-HMGB1 readily entered into mouse brain from the circulation with a unidirectional influx rate of 0.654 μl/g-min. All brain regions tested took up I-HMGB1; uptake was greatest by the olfactory bulb and least in the striatum. Transport was not reliably inhibited by unlabeled HMGB1 nor by inhibitors of TLR4, TLR2, RAGE, or CXCR4. Uptake was enhanced by co-injection of wheatgerm agglutinin, suggestive of involvement of absorptive transcytosis as a mechanism of transport. Induction of inflammation/neuroinflammation with lipopolysaccharide is known to increase blood HMGB1; we report here that brain transport is also increased by LPS-induced inflammation. Finally, we found that I-HMGB1 was also transported in the brain-to-blood direction, with both unlabeled HMGB1 or lipopolysaccharide increasing the transport rate. These results show that HMGB1 can bidirectionally cross the BBB and that those transport rates are enhanced by inflammation. Such transport provides a mechanism by which HMGB1 levels would impact neuroimmune signaling in both the brain and periphery.

RevDate: 2023-05-05

Aazh H, Taylor L, Danesh AA, et al (2023)

The Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Tinnitus for Patients with Tinnitus Alone or Combined with Hyperacusis and/or Misophonia: A Preliminary Analysis.

Journal of the American Academy of Audiology [Epub ahead of print].

BACKGROUND: In the UK, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus.

PURPOSE: The aim was to perform a preliminary assessment of the effect of a specific program of non-guided internet-based CBT for tinnitus, denoted iCBT(T), in alleviating the problems caused by tinnitus alone or tinnitus combined with hyperacusis.

RESEARCH DESIGN: This was a retrospective cross-sectional study.

STUDY SAMPLE: The data for 28 people with tinnitus who completed the iCBT(T) program and answered a series of questions about their tinnitus and hearing status were included in the study. Twelve patients reported also having hyperacusis (including five also with misophonia).

DATA COLLECTION AND ANALYSIS: The iCBT(T) program has seven self-help modules. Anonymous data were collected retrospectively from patients' answers to the questions in the iCBT(T) initial and final assessment modules. Questionnaires administered within the iCBT(T) program were: 4C Tinnitus Management Questionnaire (4C), Screening for Anxiety and Depression in Tinnitus (SAD-T), and the CBT Effectiveness Questionnaire (CBT-EQ).

RESULTS: Responses to the 4C showed a significant improvement from pre- to post-treatment, with a medium effect size. The mean improvement was similar for those with and without hyperacusis. Responses to the SAD-T questionnaire also showed a significant improvement from pre- to post-treatment with a medium effect size. The improvement was significantly greater for participants with tinnitus alone than for participants who also had hyperacusis. For both the 4C and the SAD-T, the improvements were not significantly related to age or gender. Participants' views of the effectiveness of the iCBT(T) program were assessed using the CBT-EQ. The mean score was 50 out of a maximum of 80, indicating moderately high effectiveness. CBT-EQ scores did not differ for those with and without hyperacusis.

CONCLUSIONS: Based on this preliminary analysis, the iCBT(T) program showed promising result in improving the ability to manage tinnitus and decreasing symptoms of anxiety and depression. Future studies with larger samples and control group(s) are required to further assess various aspects of this program.

RevDate: 2023-05-02

Aazh H, Stevens J, L Jacquemin (2023)

Exploding Head Syndrome among patients seeking help for tinnitus and/or hyperacusis at an Audiology Department in the UK: A preliminary study.

Journal of the American Academy of Audiology [Epub ahead of print].

BACKGROUND: Exploding Head Syndrome (EHS) is characterised by hearing a sudden loud noise or experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep. The experience of EHS shares similarities with tinnitus, where an individual perceives a sound without any sound source. To the authors' knowledge, the possible relationship between EHS and tinnitus has not been explored.

PURPOSE: Preliminary assessment of prevalence of EHS and its related factors among patients seeking help for tinnitus and/or hyperacusis.

RESEARCH DESIGN: Retrospective cross sectional study Study sample: 148 consecutive patients who sought help for tinnitus and/or hyperacusis at an audiology clinic in the UK.

DATA COLLECTION AND ANALYSIS: The data regarding demographics, medical history, audiological measures and self-report questionnaires were collected retrospectively from the patients' records. Audiological measures comprised of pure tone audiometry and uncomfortable loudness levels. The self-report questionnaires which were administered as a part of standard care comprised of the tinnitus handicap inventory (THI), numeric rating scale (NRS) of tinnitus loudness, annoyance and effect on life, Hyperacusis Questionnaire (HQ), Insomnia Severity Index (ISI), Generalized Anxiety Disorder (GAD-7), and Patient Health Questionnaire (PHQ-9). To establish presence of EHS, participants were asked "Do you ever hear a sudden, loud noise or feel a sense of explosion in your head at night?".

RESULTS: EHS was reported by 8.1% of patients with tinnitus and/or hyperacusis (n = 12 out of 148). The patients with and without EHS were compared, but no significant relationships were found, between the presence of EHS and age, gender, tinnitus/hyperacusis distress, symptoms of anxiety or depression, sleep difficulties, or audiological measures.

CONCLUSIONS: The prevalence of EHS in a tinnitus and hyperacusis population is similar to that in the general population. While there does not seem to be any association with sleep or mental factors, this might be due to the limited variability in our clinical sample (i.e., most patients exhibited high level of distress regardless of EHS). Replication of the results in a larger sample with more variety of symptom severity is warranted.

RevDate: 2023-04-15

Möllmann A, Heinrichs N, Illies L, et al (2023)

The central role of symptom severity and associated characteristics for functional impairment in misophonia.

Frontiers in psychiatry, 14:1112472.

Misophonia is characterized by a preoccupation with and strong emotional and behavioral reactions to certain triggers, mostly sounds related to eating and breathing. We applied functional impairment due to misophonic symptoms as a central criterion to investigate differences between clinical misophonia and normative decreased sound tolerance in a large non-random sample of n = 1,881 individuals from an online survey. We assessed the frequency of self-reported misophonia symptoms across various symptom measures, compared severity, triggers and emotional reactions, general psychopathology, interpersonal emotion regulation, and quality of life between both groups with and without functional impairing misophonia. Individuals with functional impairment due to misophonia (n = 839) revealed significantly higher general psychopathology symptoms, lower interpersonal emotion regulation skills, and lower quality of life than individuals without impairment (n = 1,042). Anxious/distressed and annoyed reactions to triggers were experienced more frequently compared to emotional reactions of disgust and sadness or depression in both groups. Overall, the group differences were primarily quantitative in nature. We discuss practical implications regarding classification and treatment and provide cutoffs for each symptom measure derived from group assignment for functional impairment.

RevDate: 2023-04-11

Jastreboff PJ, MM Jastreboff (2023)

The neurophysiological approach to misophonia: Theory and treatment.

Frontiers in neuroscience, 17:895574.

Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when negative reactions to a sound depend only on its physical characteristics. In the majority of these patients, the physical characteristics of bothersome sounds were secondary, and patients were able to tolerate other sounds with levels higher than sounds bothersome for them. The dominant feature determining the presence and strength of negative reactions are specific to a given patient's patterns and meaning of bothersome sounds. Moreover, negative reactions frequently depend on the situation in which the offensive sound is presented or by whom it is produced. Importantly, physiological and emotional reactions to bothersome sounds are very similar (even identical) for both hyperacusis and misophonia, so reactions cannot be used to diagnose and differentiate them. To label this non-reported phenomenon, we coined the term misophonia in 2001. Incorporating clinical observations into the framework of knowledge of brain functions allowed us to propose a neurophysiological model for misophonia. The observation that the physical characterization of misophonic trigger was secondary and frequently irrelevant suggested that the auditory pathways are working in identical manner in people with as in without misophonia. Descriptions of negative reactions indicated that the limbic and sympathetic parts of the autonomic nervous systems are involved but without manifestations of general malfunction of these systems. Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them) suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia. Consequently, the strength of functional connections between various systems in the brain plays a dominant role in misophonia, and the functional properties of the individual systems may be perfectly within the norms. Based on the postulated model, we proposed a treatment for misophonia, focused on the extinction of conditioned reflexes linking the auditory system with other systems in the brain. Treatment consists of specific counseling and sound therapy. It has been used for over 20 years with a published success rate of 83%.

RevDate: 2023-08-23
CmpDate: 2023-08-07

Trent ES, Viana AG, Raines EM, et al (2023)

Childhood exposure to parental threatening behaviors and anxiety in emerging adulthood: Indirect effects of perceived stress.

Journal of clinical psychology, 79(9):1984-2008.

BACKGROUND: Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults.

METHODS: Participants (N = 855; Mage  = 18.75 years, SD = 1.05, range 18-24; 70.8% female) were recruited from a large state university and administered a battery of self-report questionnaires assessing constructs of interest.

RESULTS: Structural equation modeling (SEM) analyses indicated that only greater childhood exposure to maternal threatening behaviors was directly associated with greater feelings of helplessness and lower self-efficacy. Furthermore, only childhood exposure to maternal threatening behaviors was indirectly associated with anxiety severity through greater feelings of helplessness and lower self-efficacy. In contrast, childhood exposure to paternal threatening behaviors was neither directly nor indirectly associated with anxiety severity.

LIMITATIONS: Limitations include a cross-sectional design, use of self-report measures, and a nonclinical sample. Replicating these findings in a clinical sample and testing the hypothesized model in a longitudinal design is necessary.

CONCLUSIONS: Findings underscore the need for intervention efforts that screen for and target perceived stress in emerging adults exposed to negative maternal parenting behaviors.

RevDate: 2023-03-24

Rappoldt LR, van der Pol MM, de Wit C, et al (2023)

Effectiveness of an innovative treatment protocol for misophonia in children and adolescents: Design of a randomized controlled trial.

Contemporary clinical trials communications, 33:101105.

BACKGROUND: Misophonia is a recently identified disorder in which individuals experience intense, uncontrollable and disproportional irritation, anger or disgust when confronted with specific sounds or stimuli associated with these sounds. Prevalence rates in children and adolescents are currently still to be investigated. The reported average age of onset is around 13 years, in clinical practice children from 8 years old are referred.Misophonia is associated with avoidance and anticipation anxiety, possibly leading to serious educational and social consequences for children and families. Worldwide, no evidence-based treatment exists specifically for children and adolescents with misophonia.This article presents the design of a randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) combined with psychomotor therapy (PMT) for misophonia in children and adolescents (aged 8-18).

METHODS: In total, 82 patients will be randomly assigned to a treatment condition or waiting list condition of 3 months (WCG). Treatment consists of 7 weekly group therapy sessions (1.5 h CBT plus 1.5 h PMT) and a follow-up after 3 weeks. Pre and post treatment assessments will be conducted during a baseline assessment, after 3 and 6 months. The primary outcome will be assessed by the Amsterdam Misophonia Scale - Youth (AMISOS-Y) and secondary outcomes (e.g. quality of life) and putative predictors (e.g. parenting burden) will be studied.

CONCLUSION: This trial is the first study worldwide testing the effectiveness of a combined CBT plus PMT protocol for misophonia in children and adolescents. If proven effective, this protocol provides an innovation to improve care for youth with misophonia.

RevDate: 2023-04-20
CmpDate: 2023-03-24

Vitoratou S, Hayes C, Uglik-Marucha N, et al (2023)

Misophonia in the UK: Prevalence and norms from the S-Five in a UK representative sample.

PloS one, 18(3):e0282777.

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.

RevDate: 2023-06-06
CmpDate: 2023-03-13

Trager RJ, Daniels CJ, Meyer KW, et al (2023)

Clinician approaches to spinal manipulation for persistent spinal pain after lumbar surgery: systematic review and meta-analysis of individual patient data.

Chiropractic & manual therapies, 31(1):10.

BACKGROUND: This review aimed to identify variables influencing clinicians' application of spinal manipulative therapy (SMT) for persistent spine pain after lumbar surgery (PSPS-2). We hypothesized markers of reduced clinical/surgical complexity would be associated with greater odds of applying SMT to the lumbar region, use of manual-thrust lumbar SMT, and SMT within 1-year post-surgery as primary outcomes; and chiropractors would have increased odds of using lumbar manual-thrust-SMT compared to other practitioners.

METHODS: Per our published protocol, observational studies describing adults receiving SMT for PSPS-2 were included. PubMed, Web of Science, Scopus, OVID, PEDro, and Index to Chiropractic Literature were searched from inception to January 6, 2022. Individual patient data (IPD) were requested from contact authors when needed for selection criteria. Data extraction and a customized risk-of-bias rubric were completed in duplicate. Odds ratios (ORs) for primary outcomes were calculated using binary logistic regressions, with covariates including age, sex, symptom distribution, provider, motion segments, spinal implant, and surgery-to-SMT interval.

RESULTS: 71 articles were included describing 103 patients (mean age 52 ± 15, 55% male). The most common surgeries were laminectomy (40%), fusion (34%), and discectomy (29%). Lumbar SMT was used in 85% of patients; and of these patients was non-manual-thrust in 59%, manual-thrust in 33%, and unclear in 8%. Clinicians were most often chiropractors (68%). SMT was used > 1-year post-surgery in 66% of cases. While no primary outcomes reached significance, non-reduced motion segments approached significance for predicting use of lumbar-manual-thrust SMT (OR 9.07 [0.97-84.64], P = 0.053). Chiropractors were significantly more likely to use lumbar-manual-thrust SMT (OR 32.26 [3.17-327.98], P = 0.003). A sensitivity analysis omitting high risk-of-bias cases (missing ≥ 25% IPD) revealed similar results.

CONCLUSIONS: Clinicians using SMT for PSPS-2 most often apply non-manual-thrust SMT to the lumbar spine, while chiropractors are more likely to use lumbar-manual-thrust SMT relative to other providers. As non-manual-thrust SMT may be gentler, the proclivity towards this technique suggests providers are cautious when applying SMT after lumbar surgery. Unmeasured variables such as patient or clinician preferences, or limited sample size may have influenced our findings. Large observational studies and/or international surveys are needed for an improved understanding of SMT use for PSPS-2. Systematic review registration PROSPERO (CRD42021250039).

RevDate: 2023-04-06
CmpDate: 2023-03-10

Mahady A, Takac M, A De Foe (2023)

What is autonomous sensory meridian response (ASMR)? A narrative review and comparative analysis of related phenomena.

Consciousness and cognition, 109:103477.

A narrative review of autonomous sensory meridian response (ASMR) was carried out. Definitional factors relevant to ASMR were canvassed. Related, but distinctly unique, sensorial phenomena, including frisson, synaesthesia, and misophonia were considered. Finally, the status of literature with respect to clinical outcomes, individual differences, and current research applications was evaluated. ASMR is a nascent phenomenon that has rapidly progressed in scope and depth of study throughout the past decade; a notable shift from brief-form studies to an increase in formalised trials is noted. Yet, critical questions remain unaddressed, including expectancy and placebo effects, that future research should interrogate.

RevDate: 2023-03-08

Smit DJA, Bakker M, Abdellaoui A, et al (2022)

A genome-wide association study of a rage-related misophonia symptom and the genetic link with audiological traits, psychiatric disorders, and personality.

Frontiers in neuroscience, 16:971752.

INTRODUCTION: People with misophonia experience strong negative emotional responses to sounds and associated stimuli-mostly human produced-to an extent that it may cause impairment in social functioning. The exact nature of the disorder remains a matter of ongoing research and debate. Here, we investigated the genetic etiology of misophonia to understand contributing genetic factors and shed light on individual differences in characteristics that are related to the disorder.

METHODS: For misophonia, we used an unpublished genome-wide association study (GWAS) from genetic service provider 23andMe, Inc., on a self-report item probing a single common misophonic symptom: the occurrence of rage when others produce eating sounds. First, we used gene-based and functional annotation analyses to explore neurobiological determinants of the rage-related misophonia symptom. Next, we calculated genetic correlations (r G) of this rage-related misophonia symptom GWAS with a wide range of traits and disorders from audiology (tinnitus, hearing performance, and hearing trauma), psychiatry, neurology, and personality traits.

RESULTS: The rage-related misophonia symptom was significantly correlated with tinnitus, major depression disorder (MDD), post-traumatic stress disorder (PTSD), and generalized anxiety disorder (GAD; 0.12 < r G < 0.22). Stronger genetic correlations (0.21 < r G < 0.42) were observed for two clusters of personality traits: a guilt/neuroticism and an irritability/sensitivity cluster. Our results showed no genetic correlation with attention deficit and hyperactivity disorder, obsessive-compulsive disorder, and psychotic disorders. A negative correlation with autism spectrum disorder (ASD) was found, which may be surprising given the previously reported comorbidities and the sensory sensitivity reported in ASD. Clustering algorithms showed that rage-related misophonia consistently clustered with MDD, generalized anxiety, PTSD, and related personality traits.

DISCUSSION: We conclude that-based on the genetics of a common misophonia symptom-misophonia most strongly clusters with psychiatric disorders and a personality profile consistent with anxiety and PTSD.

RevDate: 2023-02-21

Larsen BS, Winther S, Nissen L, et al (2022)

Improved pre-test likelihood estimation of coronary artery disease using phonocardiography.

European heart journal. Digital health, 3(4):600-609.

AIMS: Current early risk stratification of coronary artery disease (CAD) consists of pre-test probability scoring such as the 2019 ESC guidelines on chronic coronary syndromes (ESC2019), which has low specificity and thus rule-out capacity. A newer clinical risk factor model (risk factor-weighted clinical likelihood, RF-CL) showed significantly improved rule-out capacity over the ESC2019 model. The aim of the current study was to investigate if the addition of acoustic features to the RF-CL model could improve the rule-out potential of the best performing clinical risk factor models.

METHODS AND RESULTS: Four studies with heart sound recordings from 2222 patients were pooled and distributed into two data sets: training and test. From a feature bank of 40 acoustic features, a forward-selection technique was used to select three features that were added to the RF-CL model. Using a cutoff of 5% predicted risk of CAD, the developed acoustic-weighted clinical likelihood (A-CL) model showed significantly (P < 0.05) higher specificity of 48.6% than the RF-CL model (specificity of 41.5%) and ESC 2019 model (specificity of 6.9%) while having the same sensitivity of 84.9% as the RF-CL model. Area under the curve of the receiver operating characteristic for the three models was 72.5% for ESC2019, 76.7% for RF-CL, and 79.5% for A-CL.

CONCLUSION: The proposed A-CL model offers significantly improved rule-out capacity over the ESC2019 model and showed better overall performance than the RF-CL model. The addition of acoustic features to the RF-CL model was shown to significantly improve early risk stratification of symptomatic patients suspected of having stable CAD.

RevDate: 2023-01-23

Aazh H, McFerran D, Danesh AA, et al (2023)

A comparison of interaural asymmetry, audiogram slope, and psychometric measures of tinnitus, hyperacusis, anxiety and depression for patients with unilateral and bilateral tinnitus.

International journal of audiology [Epub ahead of print].

OBJECTIVE: To evaluate differences in tinnitus impact, hyperacusis and hearing threshold level (HTL) between patients with unilateral and bilateral tinnitus. For patients with unilateral tinnitus, to compare audiological variables for the tinnitus ear and the non-tinnitus ear. To assess whether the presence of unilateral tinnitus increases the likelihood of interaural hearing asymmetry (relative to bilateral tinnitus) that warrants referral for an MRI scan.

DESIGN: Retrospective cross-sectional.

STUDY SAMPLE: Data regarding HTLs and responses to self-report questionnaires were collected from the records of 311 patients attending a tinnitus clinic.

RESULTS: 38.5% had unilateral tinnitus and the ears with tinnitus had higher HTLs and greater HTL slopes than the ears without tinnitus. There was no significant difference in tinnitus impact and hyperacusis between patients with unilateral and bilateral tinnitus. 40% of patients with unilateral tinnitus and 13% of patients with bilateral tinnitus had a between-ear difference in HTL ≥15 dB at two adjacent frequencies (2AF15 asymmetry). Unilateral tinnitus increased the risk of 2AF15 asymmetry by a factor of 4.4.

CONCLUSIONS: Unilateral tinnitus increases the risk of having interaural asymmetry in HTLs that warrants referral for an MRI scan.

RevDate: 2023-02-01

Siepsiak M, Vrana SR, Rynkiewicz A, et al (2022)

Does context matter in misophonia? A multi-method experimental investigation.

Frontiers in neuroscience, 16:880853.

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.

RevDate: 2023-02-02

Aazh H (2022)

Commentary: Consensus definition of misophonia.

Frontiers in neuroscience, 16:1077097.

RevDate: 2023-01-11

Remmert N, Jebens A, Gruzman R, et al (2022)

A nomological network for misophonia in two German samples using the S-Five model for misophonia.

Frontiers in psychology, 13:902807.

The Selective Sound Sensitivity Syndrome Scale (S-Five) is a contemporary and multidimensional self-report instrument measuring different aspects of misophonia. The five-factor scale consists of 25 items measuring the severity of the misophonic experience. The items capture misophonia in relation to internalising and externalising appraisals, perceived threat, aggressive behavior (outbursts), and adverse impact on individuals' lives. It is complemented by a trigger checklist (S-Five-T), measuring the emotional nature and intensity of reactions to sensory triggers. In this work, we administered the S-Five in two German samples with a majority of individuals with significant misophonia. The S-Five and the supplementary S-Five-T were both translated into German using a rigorous translation procedure (i.e., TRAPD) and were separately tested in large German community samples. Psychometric analyses included the evaluation of the factor structure, measurement invariance with respect to age and gender, reliability (internal consistency and stability over time), and an extensive examination of the construct validity in a proposed nomological network. The nomological network we explore in this work consists of several constructs including different misophonic manifestations, anger and aggression, disgust propensity, anxiety sensitivity, depression, obsessive-compulsive traits, and functional impairment in different life domains. Results indicate evidence in line with the nomological network as demonstrated by strong correlations between the S-Five dimensions and convergent measures. All S-Five dimensions strongly correlated with overall misophonic symptoms (r ≥ 0.53). Internalising appraisals were highly associated with insight into excessive or disproportionate reactions to sounds (r ≥ 0.59), externalising appraisals with anger and irritability (r ≥ 0.46), threat with trait anxiety and dysregulation facets (r ≥ 0.62), aggressive behavior (outbursts) with anger and behavioral dysregulation (r ≥ 0.70), and impact with distress and functional impairment (r ≥ 0.64). The results demonstrate that the S-Five has a robust five-factor structure and allows to draw reliable and valid conclusions about misophonic experiences in German samples. The proposed nomological network gives an initial insight into the nature of misophonia and provides a formalized fundament to develop and test further hypotheses about misophonia in a more sophisticated and symptom-oriented way.

RevDate: 2023-04-17
CmpDate: 2023-01-23

Guzick AG, Cervin M, Smith EEA, et al (2023)

Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia.

Journal of affective disorders, 324:395-402.

BACKGROUND: There is little information on the clinical presentation, functional impact, and psychiatric characteristics of misophonia in youth, an increasingly recognized syndrome characterized by high emotional reactivity to certain sounds and associated visual stimuli.

METHOD: One-hundred-two youth (8-17 years-old) with misophonia and their parents were recruited and compared with 94 youth with anxiety disorders. Participants completed validated assessments of misophonia severity, quality of life, as well as psychiatric symptoms and diagnoses.

RESULTS: The most common misophonia triggers included eating (96 %), breathing (84 %), throat sounds (66 %), and tapping (54 %). Annoyance/irritation, verbal aggression, avoidance behavior, and family impact were nearly universal. Misophonia severity was associated with internalizing symptoms, child-reported externalizing behaviors, and poorer quality of life. High rates of comorbidity with internalizing and neurodevelopmental disorders were found. Quality of life and externalizing behaviors were not significantly different between misophonia and anxiety samples; internalizing symptoms and autism characteristics were significantly higher among youth with anxiety disorders.

LIMITATIONS: This self-selected sample was characterized by limited multicultural diversity.

CONCLUSIONS: This study presents misophonia as a highly impairing psychiatric syndrome. Future interdisciplinary work should clarify the mechanisms of misophonia, establish evidence-based treatments, and extend these findings to randomly sampled and more culturally diverse populations.

RevDate: 2023-04-05
CmpDate: 2023-04-03

Bertolín S, Alonso P, Martínez-Zalacaín I, et al (2023)

Right Prefrontal Cortical Thickness Is Associated With Response to Cognitive-Behavioral Therapy in Children With Obsessive-Compulsive Disorder.

Journal of the American Academy of Child and Adolescent Psychiatry, 62(4):403-414.

OBJECTIVE: Cognitive-behavioral therapy (CBT) is considered a first-line treatment for obsessive-compulsive disorder (OCD) in pediatric and adult populations. Nevertheless, some patients show partial or null response. The identification of predictors of CBT response may improve clinical management of patients with OCD. Here, we aimed to identify structural magnetic resonance imaging (MRI) predictors of CBT response in 2 large series of children and adults with OCD from the worldwide ENIGMA-OCD consortium.

METHOD: Data from 16 datasets from 13 international sites were included in the study. We assessed which variations in baseline cortical thickness, cortical surface area, and subcortical volume predicted response to CBT (percentage of baseline to post-treatment symptom reduction) in 2 samples totaling 168 children and adolescents (age range 5-17.5 years) and 318 adult patients (age range 18-63 years) with OCD. Mixed linear models with random intercept were used to account for potential cross-site differences in imaging values.

RESULTS: Significant results were observed exclusively in the pediatric sample. Right prefrontal cortex thickness was positively associated with the percentage of CBT response. In a post hoc analysis, we observed that the specific changes accounting for this relationship were a higher thickness of the frontal pole and the rostral middle frontal gyrus. We observed no significant effects of age, sex, or medication on our findings.

CONCLUSION: Higher cortical thickness in specific right prefrontal cortex regions may be important for CBT response in children with OCD. Our findings suggest that the right prefrontal cortex plays a relevant role in the mechanisms of action of CBT in children.

RevDate: 2023-03-08
CmpDate: 2023-03-08

Aryal S, P Prabhu (2023)

Understanding misophonia from an audiological perspective: a systematic review.

European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 280(4):1529-1545.

PURPOSE: Misophonia is a neurophysiological disorder in which certain sounds trigger an intensely emotional or physiological response caused by an increased autonomic nervous system reaction to the triggers. Misophonia is a relatively new condition, and the neurophysiological mechanism behind this condition is not known yet. The assessment and management of misophonia need a team approach. Audiologists are vital members of the team. However, their roles in this condition are not well-understood. The study aims to review the neurophysiological mechanism of misophonia, highlighting the mechanism involved in the audiological pathway and directing the discussion toward applications of findings in the assessment and management of misophonia from the audiological perspective.

METHODS: We reviewed 12 articles from different databases to understand the neurophysiological mechanisms of misophonia. Most of the studies selected were experimental designs involving individuals with misophonia.

RESULTS: The result of the review revealed abnormal activation and connection among the different higher cortical structures in participants with misophonia. By signifying various neurophysiological and neuroradiological findings, the review confirms that misophonia is a neurophysiological disorder that may border between audiology, neurology, and psychiatry. Assessment of study quality reported an overall low risk of bias.

CONCLUSIONS: This review highlights the need to include an audiologist as a team member in the evaluation and management of misophonia.

RevDate: 2022-12-10

Jakubovski E, Müller A, Kley H, et al (2022)

Prevalence and clinical correlates of misophonia symptoms in the general population of Germany.

Frontiers in psychiatry, 13:1012424.

INTRODUCTION: Misophonia refers to a phenomenon in which affected individuals have a selective intolerance to sounds of mostly oral or nasal origin. This intolerance is typically associated with strong emotional reactions such as anger, irritation, and disgust. The aim of this study was to conduct the first large epidemiological survey to determine the prevalence of misophonia symptoms in the adult population in Germany.

METHODS: We conducted a large-scale representative population survey between December 2020 and March 2021. For this purpose, a sample of 2,519 people were visited in their households and assessed with the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Questionnaire (AMISOS-R) to document misophonic symptoms. The primary estimate of clinical misophonia symptoms prevalence was based on the MQ Severity Scale and a secondary estimate was based on the AMISOS-R. The survey further included self-ratings to measure perfectionism, not-just-right experience (NJRE), autonomous sensory meridian response (ASMR) and general health as well as demographic data.

RESULTS: Five percent of the sample scored equal or above the MQ Severity Scale threshold for clinical misophonia symptoms (5.9% based on AMISOS-R). Individuals with clinical misophonia symptoms had a higher rate of perfectionism, a higher occurrence of NJRE, higher susceptibility to ASMR, and a worse general health status than those scoring below the cut-off-score. All those factors also independently predicted the severity of misophonia symptoms in a multiple regression model.

CONCLUSION: Misophonia is a frequent condition and should further be examined as an independent diagnostic entity.

RevDate: 2022-11-29

Webb J, S Keane (2022)

MDMA for the treatment of misophonia, a proposal.

Frontiers in psychiatry, 13:983285.

Misophonia is a disorder characterized by negative physical and emotional reactions to certain trigger sounds, such as chewing food. Up to 50% of population samples endorse some symptoms of misophonia, with about 20% having symptoms that impair normal life functioning. Most misophonia patients exhibit intense negative emotions and autonomic arousal (the fight-flight-freeze response) in response to a trigger, similarly to how someone with post-traumatic stress disorder (PTSD) might respond to a trauma trigger. Curiously, misophonia trigger sounds are often most distressing when coming from a specific person, suggesting the disorder may be responsive to interpersonal relationship factors. Treatment of misophonia is currently limited to the use of hearing modifications (e.g., earplugs or headphones) and psychotherapy, but many patients continue to suffer despite these best efforts. Phase 3 clinical trials suggest that MDMA is efficacious at treating the symptoms of autonomic arousal, negative emotions, and interpersonal suffering found in PTSD. As such, we propose that MDMA may represent an ideal treatment for some suffering from severe misophonia. In this perspective article, we review the symptoms of misophonia, and outline how MDMA may be uniquely suited for treating it, perhaps using a protocol analogous to the MAPS Phase 3 studies for PTSD.

RevDate: 2022-12-21
CmpDate: 2022-12-16

Bagrowska P, Pionke-Ubych R, Ł Gawęda (2022)

Do they make these sounds to hurt me? The mediating role of emotion regulation, anxiety and hostile attributions in the relationship between misophonia and paranoia-like thoughts.

Schizophrenia research, 250:137-142.

Misophonia is a complex syndrome in which selective auditory stimuli, such as sounds of breathing, sniffing or eating, trigger an intense, negative emotional response. Previous studies have shown that the symptoms of misophonia coexist with a number of mental disorders, such as OCD, depression and anxiety. However, still little is known about other mental states that may be present in this context. A total of 312 people from the non-clinical sample participated in an online correlational study, which aimed at investigating whether there is a significant association between misophonia symptoms and paranoia-like thoughts, as well as to examine what factors might underlie this potential relationship. The results revealed that misophonia positively correlates with paranoia-like thoughts. A serial mediation analysis showed that difficulties in regulating emotions, anxiety and hostile attributions are significant mediators in the relationship between misophonia and paranoia-like thoughts. Importantly, these mediators, above all, form a potential coherent explanatory mechanism underlying this association. Hence, our results highlight the important role of socio-cognitive factors in the conceptualization of misophonia and its relation to paranoia-like thoughts.

RevDate: 2022-11-17

Malaty IA, Anderson S, Bennett SM, et al (2022)

Diagnosis and Management of Functional Tic-Like Phenomena.

Journal of clinical medicine, 11(21):.

Over the past 3 years, a global phenomenon has emerged characterized by the sudden onset and frequently rapid escalation of tics and tic-like movements and phonations. These symptoms have occurred not only in youth known to have tics or Tourette syndrome (TS), but also, and more notably, in youth with no prior history of tics. The Tourette Association of America (TAA) convened an international, multidisciplinary working group to better understand this apparent presentation of functional neurological disorder (FND) and its relationship to TS. Here, we review and summarize the literature relevant to distinguish the two, with recommendations to clinicians for diagnosis and management. Finally, we highlight areas for future emphasis and research.

RevDate: 2022-10-25

Rosenthal MZ, McMahon K, Greenleaf AS, et al (2022)

Phenotyping misophonia: Psychiatric disorders and medical health correlates.

Frontiers in psychology, 13:941898.

Misophonia is characterized by decreased tolerance to specific sounds and associated stimuli that causes significant psychological distress and impairment in daily functioning (Swedo et al., 2022). Aversive stimuli (often called "triggers") are commonly repetitive facial (e.g., nose whistling, sniffling, and throat clearing) or oral (e.g., eating, drinking, and mouth breathing) sounds produced by other humans. Few empirical studies examining the nature and features of misophonia have used clinician-rated structured diagnostic interviews, and none have examined the relationship between misophonia and psychiatric disorders in the Diagnostic and Statistical Manual-5th version (DSM-5; American Psychiatric Association, 2013). In addition, little is known about whether there are any medical health problems associated with misophonia. Accordingly, the purpose of the present study was to improve the phenotypic characterization of misophonia by investigating the psychiatric and medical health correlates of this newly defined disorder. Structured diagnostic interviews were used to assess rates of lifetime and current DSM-5 psychiatric disorders in a community sample of 207 adults. The three most commonly diagnosed current psychiatric disorders were: (1) social anxiety disorder, (2) generalized anxiety disorder, and (3) specific phobia. The three most common lifetime psychiatric disorders were major depressive disorder, social anxiety disorder, and generalized anxiety disorder. A series of multiple regression analyses indicated that, among psychiatric disorders that were correlated with misophonia, those that remained significant predictors of misophonia severity after controlling for age and sex were borderline personality disorder, obsessive compulsive disorder, and panic disorder. No medical health problems were significantly positively correlated with misophonia severity.

RevDate: 2022-11-17
CmpDate: 2022-10-25

Yektatalab S, Mohammadi A, L Zarshenas (2022)

The Prevalence of Misophonia and Its Relationship with Obsessive-compulsive Disorder, Anxiety, and Depression in Undergraduate Students of Shiraz University of Medical Sciences: A Cross-Sectional Study.

International journal of community based nursing and midwifery, 10(4):259-268.

BACKGROUND: Misophonia is a severe emotional response to repetitive sounds. This disorder may limit a person's communication, reduce his/her ability, or disrupt his/her social and personal life. This study aimed to determine the prevalence of Misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of Shiraz University of Medical Sciences.

METHODS: The present study is an analytical descriptive study conducted in October 2020. The study samples consisted of 390 undergraduate students of Shiraz University of Medical Sciences. A relative and systematic sampling method was used. In this study, demographic questionnaire, misophonia questionnaire (A score of 7 or higher is considered as misophonia), Beck anxiety questionnaire, Beck depression questionnaire, and Maudsley obsessive-compulsive inventory questionnaire were used, and the data were analyzed using SPSS 24 software. In this study, chi-square test was used to examine the relationship between the variables. Due to the non-normality of the data, the Spearman correlation coefficient was used for data analysis. The significance level was considered equal to and less than 0.05.

RESULTS: Of the 390 participants in the study, 93 (23.8%) had experienced misophonia. Among these 93 students, 37 (39.8%) had obsessive-compulsive disorder, 8 (8.6%) suffered anxiety, and 9 (9.7%) were depressed. There was a significant and direct relationship between misophonia and obsessive-compulsive disorder,anxiety and depression respectively(P<0.001).

CONCLUSION: Due to the prevalence of misophonia among students and its direct relationship with obsessive-compulsive disorder, anxiety and depression, we recommend that future studies should be conducted to find the ways to prevent and reduce the incidence of misophonia.

RevDate: 2022-10-19

Pan EJ, Weleff J, Anand A, et al (2022)

Treatment of Misophonia with Risperidone in a Patient with Autism Spectrum Disorder.

Case reports in psychiatry, 2022:3169834.

We report the case of a 32-year-old male with autism spectrum disorder (ASD) suffering from severe misophonia. After titrating risperidone to 2 mg twice a day, the patient reported a significant reduction in his symptoms and his Amsterdam misophonia scale-revised (AMISOS-R) score dropped by from 31 to 5. Upon discharge, the patient was noted to have decreased irritability and overall improved behavior and effect. This significant symptomatic improvement was likely not explained by inpatient admission alone or other simultaneous pharmacologic treatments, as the effect was seen during an isolated titration of risperidone with other treatments remaining constant. Although, unfortunately, follow-up findings indicated that the treatment was not curative for the patient, risperidone's potential for treating misophonia may warrant systematic investigation.

RevDate: 2022-10-11

Mednicoff SD, Barashy S, Gonzales D, et al (2022)

Auditory affective processing, musicality, and the development of misophonic reactions.

Frontiers in neuroscience, 16:924806.

Misophonia can be characterized both as a condition and as a negative affective experience. Misophonia is described as feeling irritation or disgust in response to hearing certain sounds, such as eating, drinking, gulping, and breathing. Although the earliest misophonic experiences are often described as occurring during childhood, relatively little is known about the developmental pathways that lead to individual variation in these experiences. This literature review discusses evidence of misophonic reactions during childhood and explores the possibility that early heightened sensitivities to both positive and negative sounds, such as to music, might indicate a vulnerability for misophonia and misophonic reactions. We will review when misophonia may develop, how it is distinguished from other auditory conditions (e.g., hyperacusis, phonophobia, or tinnitus), and how it relates to developmental disorders (e.g., autism spectrum disorder or Williams syndrome). Finally, we explore the possibility that children with heightened musicality could be more likely to experience misophonic reactions and develop misophonia.

RevDate: 2022-10-13
CmpDate: 2022-10-04

Zai G, Dembo J, Levitsky N, et al (2022)

Misophonia: A Detailed Case Series and Literature Review.

The primary care companion for CNS disorders, 24(5): pii:21cr03124.

RevDate: 2022-10-13
CmpDate: 2022-09-13

Castillo-Escario Y, Werthen-Brabants L, Groenendaal W, et al (2022)

Convolutional Neural Networks for Apnea Detection from Smartphone Audio Signals: Effect of Window Size.

Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference, 2022:666-669.

Although sleep apnea is one of the most prevalent sleep disorders, most patients remain undiagnosed and untreated. The gold standard for sleep apnea diagnosis, polysomnography, has important limitations such as its high cost and complexity. This leads to a growing need for novel cost-effective systems. Mobile health tools and deep learning algorithms are nowadays being proposed as innovative solutions for automatic apnea detection. In this work, a convolutional neural network (CNN) is trained for the identification of apnea events from the spectrograms of audio signals recorded with a smartphone. A systematic comparison of the effect of different window sizes on the model performance is provided. According to the results, the best models are obtained with 60 s windows (sensitivity-0.72, specilicity-0.89, AUROC = 0.88), For smaller windows, the model performance can be negatively impacted, because the windows become shorter than most apnea events, by which sound reductions can no longer be appreciated. On the other hand, longer windows tend to include multiple or mixed events, that will confound the model. This careful trade-off demonstrates the importance of selecting a proper window size to obtain models with adequate predictive power. This paper shows that CNNs applied to smartphone audio signals can facilitate sleep apnea detection in a realistic setting and is a first step towards an automated method to assist sleep technicians. Clinical Relevance- The results show the effect of the window size on the predictive power of CNNs for apnea detection. Furthermore, the potential of smartphones, audio signals, and deep neural networks for automatic sleep apnea screening is demonstrated.

RevDate: 2022-08-30

Grossini E, Stecco A, Gramaglia C, et al (2022)

Misophonia: Analysis of the neuroanatomic patterns at the basis of psychiatric symptoms and changes of the orthosympathetic/ parasympathetic balance.

Frontiers in neuroscience, 16:827998.

BACKGROUND/AIM: Misophonia is a disorder characterized by reduced tolerance to specific sounds or stimuli known as "triggers," which tend to evoke negative emotional, physiological, and behavioral responses. In this study, we aimed to better characterize participants with misophonia through the evaluation of the response of the autonomic nervous system to "trigger sounds," a psychometric assessment, and the analysis of the neurological pathways.

MATERIALS AND METHODS: Participants included 11 adults presenting with misophonic disturbance and 44 sex-matched healthy controls (HCs). Following recently proposed diagnostic criteria, the participants listened to six "trigger sounds" and a "general annoyance" sound (baby crying) during a series of physiological tests. The effects were examined through functional magnetic resonance imaging (fMRI), the analysis of heart rate variability (HRV), and of galvanic skin conductance (GSC). The fMRI was performed on a 3T Scanner. The HRV was obtained through the analysis of electrocardiogram, whereas the GSC was examined through the positioning of silver-chloride electrodes on fingers. Furthermore, the psychometric assessment included questionnaires focused on misophonia, psychopathology, resilience, anger, and motivation.

RESULTS: Participants with misophonia showed patterns of increased sympathetic activation in response to trigger sounds and a general annoyance sound, the low frequency (LF) component of HRV, the sympathetic index, and the number of significant GSC over the threshold, where the amplitude/phasic response of GSC was higher. The fMRI analysis provided evidence for the activation of the temporal cortex, the limbic area, the ventromedial prefrontal/premotor/cingulate cortex, and the cerebellum in participants with misophonia. In addition, the psychometric assessment seemed to differentiate misophonia as a construct independent from general psychopathology.

CONCLUSION: These results suggest the activation of a specific auditory-insula-limbic pathway at the basis of the sympathetic activation observed in participants with misophonia in response to "trigger and general annoyance sounds." Further studies should disentangle the complex issue of whether misophonia represents a new clinical disorder or a non-pathological condition. These results could help to build diagnostic tests to recognize and better classify this disorder. The relevance of this question goes beyond purely theoretical issues, as in the first case, participants with misophonia should receive a diagnosis and a targeted treatment, while in the second case, they should not.

RevDate: 2022-08-27

Hansen HA, Stefancin P, Leber AB, et al (2022)

Neural evidence for non-orofacial triggers in mild misophonia.

Frontiers in neuroscience, 16:880759.

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.

RevDate: 2022-08-23

Efraim Kaufman A, Weissman-Fogel I, Rosenthal MZ, et al (2022)

Opening a window into the riddle of misophonia, sensory over-responsiveness, and pain.

Frontiers in neuroscience, 16:907585.

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.

RevDate: 2022-08-19

Larsen EA, Hovland T, Nielsen GE, et al (2022)

Preliminary validation of the Norwegian version of misophonia questionnaire (MQ-NOR).

International journal of audiology [Epub ahead of print].

OBJECTIVE: To perform a psychometric validation of a Norwegian version of the Misophonia Questionnaire (MQ-NOR) and to test the link between the personality trait neuroticism and misophonia assessed with the MQ-NOR.

DESIGN: Participants completed online versions of the MQ-NOR on two occasions about two weeks apart and the neuroticism scale from BFI-20.

STUDY SAMPLE: Two-hundred and twenty-seven (T1) and 173 (T2) participants with self-reported misophonia.

RESULTS: The MQ-NOR was found to comprise two factors: Symptom Scale and Emotions and Behaviours Scale. Overall, the MQ-NOR evidenced good internal consistency and test-retest reliability. Regression analyses supported a positive relationship between misophonia and neuroticism that was moderated by participant age, but not gender.

CONCLUSION: The MQ-NOR demonstrates good psychometric properties, but until more extensively validated, it is cautiously recommended for use by clinicians in Norway to assessing misophonia. Future validation studies should be carried out.

RevDate: 2023-01-30
CmpDate: 2022-09-08

Smith EEA, Guzick AG, Draper IA, et al (2022)

Perceptions of various treatment approaches for adults and children with misophonia.

Journal of affective disorders, 316:76-82.

OBJECTIVE: Misophonia is a complex disorder characterized by a heightened reaction to certain sounds and associated stimuli. While there is no uniformly accepted treatment to date, different intervention approaches are being investigated. Individual's perceptions of different misophonia treatment methods may affect compliance and satisfaction with treatment options. We sought to gather data on patient perceptions of currently available misophonia treatments.

METHODS: Using an online survey, we collected data about treatment preferences, treatment usage, and diagnosis history from parents of children with misophonia (N = 141) and adults with misophonia (N = 252).

RESULTS: Most respondents were not satisfied with misophonia treatments that they or their children had previously received. Audiologic interventions including active and passive noise cancelling and lifestyle modifications were rated as most appropriate for treatment of misophonia by both parent and adult respondents.

LIMITATIONS: Because of the descriptive nature of this study, we chose to use a completer-only approach to ensure the data reflect the true responses of participants, though this did result in a meaningful proportion of missing data. Participants were selected through convenience sampling and responses were self-reported. Individuals with more severe misophonia symptoms may be more likely to participate and complete a research survey.

CONCLUSIONS: Most interventions are considered inappropriate by parents of youth with misophonia and by adults with misophonia. This should be interpreted in the light of a general lack of misophonia-specific interventions. Findings suggest dissatisfaction with currently available treatments and an opportunity for development of effective treatment strategies corresponding to participants' preferences. Deeper understanding of treatment preferences has the potential to guide future treatment development.

RevDate: 2022-08-13

Vitoratou S, Wang J, Hayes C, et al (2022)

Evidence of Cross-Cultural Consistency of the S-Five Model for Misophonia: Psychometric Conclusions Emerging From the Mandarin Version.

Frontiers in psychology, 13:879881.

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.

RevDate: 2022-08-13

Neacsiu AD, Szymkiewicz V, Galla JT, et al (2022)

The neurobiology of misophonia and implications for novel, neuroscience-driven interventions.

Frontiers in neuroscience, 16:893903.

Decreased tolerance in response to specific every-day sounds (misophonia) is a serious, debilitating disorder that is gaining rapid recognition within the mental health community. Emerging research findings suggest that misophonia may have a unique neural signature. Specifically, when examining responses to misophonic trigger sounds, differences emerge at a physiological and neural level from potentially overlapping psychopathologies. While these findings are preliminary and in need of replication, they support the hypothesis that misophonia is a unique disorder. In this theoretical paper, we begin by reviewing the candidate networks that may be at play in this complex disorder (e.g., regulatory, sensory, and auditory). We then summarize current neuroimaging findings in misophonia and present areas of overlap and divergence from other mental health disorders that are hypothesized to co-occur with misophonia (e.g., obsessive compulsive disorder). Future studies needed to further our understanding of the neuroscience of misophonia will also be discussed. Next, we introduce the potential of neurostimulation as a tool to treat neural dysfunction in misophonia. We describe how neurostimulation research has led to novel interventions in psychiatric disorders, targeting regions that may also be relevant to misophonia. The paper is concluded by presenting several options for how neurostimulation interventions for misophonia could be crafted.

RevDate: 2022-08-09

Dibb B, SE Golding (2022)

A longitudinal investigation of quality of life and negative emotions in misophonia.

Frontiers in neuroscience, 16:900474.

AIMS: This longitudinal study examined the role of anger, disgust, and anxiety in the experience of misophonia, the quality of life of those with self-reported misophonia in comparison to those without misophonia, and the association of misophonia and quality of life over time.

METHODS: An online longitudinal survey was conducted, with misophonia, anger, disgust, anxiety, depression, self-esteem, and quality of life measured at two time points (6-months apart) in two groups of people (those with self-reported misophonia and those without misophonia).

RESULTS: Anger and disgust emerged as the primary predictors of misophonic responses. Anxiety and depression were not significantly associated with misophonia over time. Differences in quality of life were observed between those with and without self-reported misophonia in the current study, with lower scores across the SF-36 domains of role limitations due to emotional problems, energy/fatigue, emotional wellbeing, social functioning, and general health for those with misophonia compared to those without misophonia. Compared with other studies, scores for those with self-reported misophonia were lower than those with long-term physical conditions, similar to those with tinnitus, but higher than those with obsessive compulsive disorder. Misophonia was predictive of quality of life over time but only on two domains: role limitations due to emotional problems (predictors: avoidance, emotional responses, and impact on participation in life) and pain (predictor: impact on participation in life). Depression remained a strong predictor of quality of life over time.

CONCLUSION: Anger and disgust are more strongly associated with the experience of misophonia than anxiety. Quality of life in people with self-reported misophonia is lower than in the general population and may be similar to those with tinnitus. Depression, avoiding triggers, the extent of the emotional response, and perceived impact on participation in life are associated with perceptions of lower quality of life over time for people with self-reported misophonia.

RevDate: 2023-04-24

Williams ZJ, Cascio CJ, TG Woynaroski (2022)

Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire.

Frontiers in psychology, 13:897901.

Misophonia is a newly described disorder of sound tolerance characterized by strong negative emotional reactions to specific "trigger" sounds, resulting in significant distress, pathological avoidance, and impairment in daily life. Research on misophonia is still in its infancy, and most existing psychometric tools for assessing misophonia symptoms have not been extensively validated. The purpose of the current study was to introduce and psychometrically validate the duke-vanderbilt Misophonia Screening Questionnaire (DVMSQ), a novel self-report measure of misophonia symptoms that can be used to determine misophonia "caseness" in clinical and research settings. Employing large online samples of general population adults (n = 1403) and adults on the autism spectrum (n = 936), we rigorously evaluated the internal structure, reliability, validity, and measurement invariance of the DVMSQ. Results indicated that 17 of the 20 original DVMSQ items fit well to a bifactor structure with one "general misophonia" factor and four specific factors (anger/aggression, distress/avoidance, impairment, and global impact). DVMSQ total and subscale scores were highly reliable in both general population and autistic adult samples, and the measure was found to be approximately invariant across age, sex, education level, and autism status. DVMSQ total scores also correlated strongly with another measure of misophonia symptoms (Duke Misophonia Questionnaire-Symptom Scale), with correlations between these two measures being significantly stronger than correlations between the DVMSQ and scales measuring other types of sound intolerance (Inventory of Hyperacusis Symptoms [General Loudness subscale] and DSM-5 Severity Measure for Specific Phobia [modified for phonophobia]). Additionally, DVMSQ items were used to operationalize diagnostic criteria for misophonia derived from the Revised Amsterdam Criteria, which were further updated to reflect a recent consensus definition of misophonia (published after the development of the DVMSQ). Using the new DVMSQ algorithm, 7.3% of general population adults and 35.5% of autistic adults met criteria for clinically significant misophonia. Although additional work is needed to further investigate the psychometric properties of the DVMSQ and validate its theory-based screening algorithm using best-estimate clinical diagnoses, this novel measure represents a potentially useful tool to screen for misophonia and quantify symptom severity and impairment in both autistic adults and the general population.

RevDate: 2022-08-09

Samermit P, Young M, Allen AK, et al (2022)

Development and Evaluation of a Sound-Swapped Video Database for Misophonia.

Frontiers in psychology, 13:890829.

Misophonia has been characterized as intense negative reactions to specific trigger sounds (often orofacial sounds like chewing, sniffling, or slurping). However, recent research suggests high-level, contextual, and multisensory factors are also involved. We recently demonstrated that neurotypicals' negative reactions to aversive sounds (e.g., nails scratching a chalkboard) are attenuated when the sounds are synced with positive attributable video sources (PAVS; e.g., tearing a piece of paper). To assess whether this effect generalizes to misophonic triggers, we developed a Sound-Swapped Video (SSV) database for use in misophonia research. In Study 1, we created a set of 39 video clips depicting common trigger sounds (original video sources, OVS) and a corresponding set of 39 PAVS temporally synchronized with the OVS videos. In Study 2, participants (N = 34) rated the 39 PAVS videos for their audiovisual match and pleasantness. We selected the 20 PAVS videos with best match scores for use in Study 3. In Study 3, a new group of participants (n = 102) observed the 20 selected PAVS and 20 corresponding OVS and judged the pleasantness or unpleasantness of each sound in the two contexts accompanying each video. Afterward, participants completed the Misophonia Questionnaire (MQ). The results of Study 3 show a robust attenuating effect of PAVS videos on the reported unpleasantness of trigger sounds: trigger sounds were rated as significantly less unpleasant when paired with PAVS with than OVS. Moreover, this attenuating effect was present in nearly every participant (99 out of 102) regardless of their score on the MQ. In fact, we found a moderate positive correlation between the PAVS-OVS difference and misophonia severity scores. Overall our results provide validation that the SSV database is a useful stimulus database to study how misophonic responses can be modulated by visual contexts. Here, we release the SSV database with the best 18 PAVS and 18 OVS videos used in Study 3 along with aggregate ratings of audio-video match and pleasantness ( We also provide detailed instructions on how to produce these videos, with the hope that this database grows and improves through collaborations with the community of misophonia researchers.

RevDate: 2022-08-09

Heller LM, JM Smith (2022)

Identification of Everyday Sounds Affects Their Pleasantness.

Frontiers in psychology, 13:894034.

This study examines the role of source identification in the emotional response to everyday sounds. Although it is widely acknowledged that sound identification modulates the unpleasantness of sounds, this assumption is based on sparse evidence on a select few sounds. We gathered more robust evidence by having listeners judge the causal properties of sounds, such as actions, materials, and causal agents. Participants also identified and rated the pleasantness of the sounds. We included sounds from a variety of emotional categories, such as Neutral, Misophonic, Unpleasant, and Pleasant. The Misophonic category consists of everyday sounds that are uniquely distressing to a subset of listeners who suffer from Misophonia. Sounds from different emotional categories were paired together based on similar causal properties. This enabled us to test the prediction that a sound's pleasantness should increase or decrease if it is misheard as being in a more or less pleasant emotional category, respectively. Furthermore, we were able to induce more misidentifications by imposing spectral degradation in the form of envelope vocoding. Several instances of misidentification were obtained, all of which showed pleasantness changes that agreed with our predictions.

RevDate: 2022-11-30
CmpDate: 2022-08-01

Paunovic KŽ, SM Milenković (2022)

The proposed criteria for high perceived misophonia in young healthy adults and the association between Misophonia symptoms and noise sensitivity.

Noise & health, 24(113):40-48.

CONTEXT: The association between noise sensitivity and misophonia has not been explored in any population, according to the available literature.

AIMS: To assess the proportion of misophonia symptoms among young healthy adults, to propose the criteria for high perceived misophonia, and to explore the association between misophonia with noise sensitivity with adjustment for sex, age, perceived anxiety, and depression.

SETTINGS AND DESIGN: A cross-sectional study on 1132 medical students, aged 21.4 ± 2.1 years.

METHODS AND MATERIAL: Misophonia symptoms were self-reported using the Amsterdam Misophonia Scale. Nine criteria for high perceived misophonia are proposed. Noise sensitivity was measured with Weinstein scale. Perceived anxiety and depression were measured using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, respectively.

STATISTICAL ANALYSIS USED: Multiple logistic regression.

RESULTS: Almost half of the students reported the feeling of irritation against people making provoking sounds. Only one in 10 claimed the feeling of loss of self-control when exposed to provoking sounds. High noise sensitivity and high depression were associated with higher odds of meeting the criteria for high perceived misophonia.

CONCLUSION: Noise-sensitive students are at higher risk of reporting misophonia symptoms and of being classified with high perceived misophonia. The combination of at least four or more symptoms, which classifies every 10th student with high perceived misophonia, is proposed as a self-assessment tool for epidemiological studies among young healthy adults.

RevDate: 2022-07-26

Brout JJ (2022)

A Brief Commentary on the Consensus Definition of Misophonia.

Frontiers in neuroscience, 16:879070.

RevDate: 2022-07-23

Aazh H, Erfanian M, Danesh AA, et al (2022)

Audiological and Other Factors Predicting the Presence of Misophonia Symptoms Among a Clinical Population Seeking Help for Tinnitus and/or Hyperacusis.

Frontiers in neuroscience, 16:900065.

This paper evaluates the proportion and the audiological and other characteristics of patients with symptoms of misophonia among a population seeking help for tinnitus and/or hyperacusis at an audiology clinic (n = 257). To assess such symptoms, patients were asked "over the last 2 weeks, how often have you been bothered by any of the following problems? Feeling angry or anxious when hearing certain sounds related to eating noises, lip-smacking, sniffling, breathing, clicking sounds, tapping?". The results of routine audiological tests and self-report questionnaires were gathered retrospectively from the records of the patients. Measures included: pure tone audiometry, uncomfortable loudness levels (ULLs), and responses to the tinnitus impact questionnaire (TIQ), the hyperacusis impact questionnaire (HIQ), and the screening for anxiety and depression in tinnitus (SAD-T) questionnaire. The mean age of the patients was 53 years (SD = 16) (age range 17 to 97 years). Fifty four percent were female. Twenty-three percent of patients were classified as having misophonia. The presence and frequency of reporting misophonia symptoms were not related to audiometric thresholds, except that a steeply sloping audiogram reduced the likelihood of frequent misophonia symptoms. Those with more frequent misophonia symptoms had lower values of ULLmin (the across-frequency average of ULLs for the ear with lower average ULLs) than those with less frequent or no reported symptoms. The reported frequency of experiencing misophonia symptoms increased with increasing impact of tinnitus (TIQ score ≥9), increasing impact of hyperacusis (HIQ score >11), and symptoms of anxiety and depression (SAD-T score ≥4). It is concluded that, when assessing individuals with tinnitus and hyperacusis, it is important to screen for misophonia, particularly when ULLmin is abnormally low or the TIQ, HIQ or SAD-T score is high. This will help clinicians to distinguish patients with misophonia, guiding the choice of therapeutic strategies.

RevDate: 2022-07-22

Wang Q, Vitoratou S, Uglik-Marucha N, et al (2022)

Emotion Processes Predicting Outbursts and Functional Impact in Misophonia.

Frontiers in psychology, 13:903142.

Misophonia involves a decreased tolerance to certain sounds and is associated with a range of emotions and emotion processes. In addition to the distress caused by misophonia, some individuals report having aggressive outbursts and significant impact on doing things they would like to be able to do. This study aimed to examine whether misophonia-specific cognitive and emotional processes were associated with misophonic outbursts and impact, and whether these relationships could be explained in part by emotion processes not specific to misophonia. A sample of 703 individuals, 315 of whom identified with having misophonia, completed measures of misophonia, depression and anxiety symptoms, anxiety and disgust sensitivity, interoception and beliefs about emotions. Exploratory correlation and regression analyses were used to build mediation models, which were tested using multiple linear regression. Externalising appraisals (blaming others for causing one's reaction to sounds) were positively associated with misophonic outbursts, and this relationship was partially explained by anxiety symptoms and disgust sensitivity. Sense of emotional threat in misophonia predicted functional impact of misophonia, and this was partially explained by depression symptoms and negative beliefs about emotions. Anxiety sensitivity and interoception were not significant independent predictors of misophonic outbursts or functional impact. These results provide support for the relevance of emotion processes in misophonia and highlight the importance of using multi-dimensional measures of misophonia to improve our understanding of the condition.

RevDate: 2022-09-09
CmpDate: 2022-09-07

Henry JA, Theodoroff SM, Edmonds C, et al (2022)

Sound Tolerance Conditions (Hyperacusis, Misophonia, Noise Sensitivity, and Phonophobia): Definitions and Clinical Management.

American journal of audiology, 31(3):513-527.

UNLABELLED: Purpose: For some people, exposure to everyday sounds presents a significant problem. The purpose of this tutorial was to define and differentiate between the various sound tolerance conditions and to review some options for their clinical management.

METHOD: We informally reviewed the literature regarding sound tolerance conditions. The terminology and definitions provided are mostly consistent with how these terms are defined. However, many inconsistencies are noted. Methods of assessment and treatment also differ, and different methodologies are briefly described.

RESULTS: Hyperacusis describes physical discomfort or pain when any sound reaches a certain level of loudness that would be tolerable for most people. Misophonia refers to intense emotional reactions to certain sounds (often body sounds such as chewing and sniffing) that are not influenced by the perceived loudness of those sounds. Noise sensitivity refers to increased reactivity to sounds that may include general discomfort (annoyance or feeling overwhelmed) due to a perceived noisy environment, regardless of its loudness. Phonophobia, as addressed in the audiology profession, describes anticipatory fear of sound. Phonophobia is an emotional response such as anxiety and avoidance of sound due to the "fear" that sound(s) may occur that will cause a comorbid condition to get worse (e.g., tinnitus) or the sound itself will result in discomfort or pain. (Note that phonophobia is a term used by neurologists to describe "migraineur phonophobia"-a different condition not addressed herein.) Conclusions: The literature addresses sound tolerance conditions but reveals many inconsistencies, indicating lack of consensus in the field. When doing an assessment for decreased sound tolerance, it is important to define any terms used so that the patient and all health care professionals involved in the care of the patient are aligned with the goals of the treatment plan. Treatment generally involves gradual and systematic sound desensitization and counseling.


RevDate: 2023-05-18
CmpDate: 2023-05-18

Pfeiffer E, Allroggen M, C Sachser (2023)

[Misophonia in Childhood and Adolescence: A Narrative Review].

Zeitschrift fur Kinder- und Jugendpsychiatrie und Psychotherapie, 51(3):222-232.

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.

RevDate: 2022-07-16

Jager I, Vulink N, van Loon A, et al (2022)

Synopsis and Qualitative Evaluation of a Treatment Protocol to Guide Systemic Group-Cognitive Behavioral Therapy for Misophonia.

Frontiers in psychiatry, 13:794343.

Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as those associated with eating or breathing, causing avoidance of cue related situations resulting in significant functional impairment. Functional magnetic resonance imaging studies suggest misophonia is associated with increased activity in the auditory cortex and salience network, which might reflect increased vigilance toward specific misophonia triggers. New treatments have been developed and investigated in the last years in which this vigilance plays an important role. This is a synopsis of the first group protocol for systemic Cognitive Behavioral Therapy (G-CBT) for misophonia. We discuss the model of CBT for misophonia, provide a detailed guide to the treatment illustrated with a case study, discuss advantages, limitations, and possible pitfalls by a qualitative evaluation of the protocol, and review evidence for the protocol.

RevDate: 2023-02-22

Kula FB, Cropley M, H Aazh (2023)

Hyperacusis and Misophonia: A Systematic Review of Psychometric Measures.

Journal of the American Academy of Audiology [Epub ahead of print].

BACKGROUND: Hyperacusis can be defined as an intolerance of certain everyday sounds, which are perceived as too loud or uncomfortable and which cause significant distress and impairment in the individual's day-to-day activities. Misophonia is defined as a high magnitude of emotional and behavioral reaction to certain sounds produced by human beings, such as eating sounds and breathing sounds. Several psychometric instruments have been developed to assess symptoms and the impact of hyperacusis and misophonia; however, to the authors' knowledge, no study has evaluated and compared the methodological quality of the studies on psychometric properties of the existing instruments.

PURPOSE:  This article systematically reviews the research studies assessing the psychometric properties of the instruments used for hyperacusis and misophonia and assesses the quality and appropriateness of the methodologies used.

RESEARCH DESIGN:  Systematic review.

DATA COLLECTION AND ANALYSIS:  A systematic literature search was performed using five electronic literature databases (PubMed, Scopus, PsycINFO, Google Scholar, and Web of Science). Studies were included if they were written in English and reported information about the psychometric properties of instruments measuring hyperacusis or misophonia symptoms or their impact. The quality of the studies and that of the psychometric instruments were evaluated using the consensus-based standards for the selection of health-measurement instruments (COSMIN) tool.

RESULTS:  The title and abstracts of 916 articles were screened and 39 articles were selected for full-text evaluation, with 14 articles meeting the inclusion criteria. From these 14 articles, 8 different instruments (5 for hyperacusis and 3 for misophonia) were identified and reviewed comprising: (1) Hyperacusis Questionnaire (HQ), (2) Inventory of Hyperacusis Symptoms, (3) questionnaire on hypersensitivity to sound, (4) Hyperacusis Handicap Questionnaire, (5) short HQ, (6) Amsterdam Misophonia Scale, (7) MisoQuest, and (8) the Misophonia Questionnaire.

CONCLUSION:  None of the papers reviewed reported all the information required to meet the COSMIN standards. The studies' methodological quality varied between "very good" and "inadequate" depending on their grade on the COSMIN tool. There is a need for further research on the psychometric properties of the instruments included in this review.

RevDate: 2023-01-28

Ward RT, Gilbert FE, Pouliot J, et al (2022)

The Relationship Between Self-Reported Misophonia Symptoms and Auditory Aversive Generalization Leaning: A Preliminary Report.

Frontiers in neuroscience, 16:899476.

Misophonia is characterized by excessive aversive reactions to specific "trigger" sounds. Although this disorder is increasingly recognized in the literature, its etiological mechanisms and maintaining factors are currently unclear. Several etiological models propose a role of Pavlovian conditioning, an associative learning process heavily researched in similar fear and anxiety-related disorders. In addition, generalization of learned associations has been noted as a potential causal or contributory factor. Building upon this framework, we hypothesized that Misophonia symptoms arise as a consequence of overgeneralized associative learning, in which aversive responses to a noxious event also occur in response to similar events. Alternatively, heightened discrimination between conditioned threat and safety cues may be present in participants high in Misophonia symptoms, as predicted by associative learning models of Misophonia. This preliminary report (n = 34) examines auditory generalization learning using self-reported behavioral (i.e., valence and arousal ratings) and EEG alpha power reduction. Participants listened to three sine tones differing in pitch, with one pitch (i.e., CS+) paired with an aversive loud white noise blast, prompting aversive Pavlovian generalization learning. We assessed the extent to which overgeneralization versus heightened discrimination learning is associated with self-reported Misophonia symptoms, by comparing aversive responses to the CS+ and other tones similar in pitch. Behaviorally, all participants learned the contingencies between CS+ and noxious noise, with individuals endorsing elevated Misophonia showing heightened aversive sensitivity to all stimuli, regardless of conditioning and independent of hyperacusis status. Across participants, parieto-occipital EEG alpha-band power reduction was most pronounced in response to the CS+ tone, and this difference was greater in those with self-reported Misophonia symptoms. The current preliminary findings do not support the notion that overgeneralization is a feature of self-reported emotional experience in Misophonia, but that heightened sensitivity and discrimination learning may be present at the neural level.

RevDate: 2022-07-16

Banker SM, Na S, Beltrán J, et al (2022)

Disrupted computations of social control in individuals with obsessive-compulsive and misophonia symptoms.

iScience, 25(7):104617.

Misophonia is a disorder in which certain sounds produced by other people lead to intense negative reactions. It remains unknown how misophonia relates to other psychiatric conditions or impairments. To identify latent constructs underlying symptoms, we conducted a factor analysis consisting of items from questionnaires assessing symptoms of misophonia and other psychiatric conditions. One thousand forty-two participants completed the questionnaires and a social exchange task in which they either could ("controllable") or could not ("uncontrollable") influence future monetary offers from other people. Misophonia and obsessive-compulsive (OC) symptoms loaded onto the same factor. Compared with individuals with low Miso-OC factor scores, individuals with high scores reported higher perceived controllability of their social interactions during the uncontrollable condition and stronger aversion to social norm violations in the uncontrollable compared with the controllable condition. Together, these results suggest misophonia, and OC symptoms share a latent psychiatric dimension characterized by aberrant computations of social controllability.

RevDate: 2023-05-15
CmpDate: 2023-03-07

Rinaldi LJ, Simner J, Koursarou S, et al (2023)

Autistic traits, emotion regulation, and sensory sensitivities in children and adults with Misophonia.

Journal of autism and developmental disorders, 53(3):1162-1174.

Misophonia is an unusually strong aversion to everyday sounds such as chewing, crunching, or breathing. Previous studies have suggested that rates of autism might be elevated in misophonia, and here we examine this claim in detail. We present a comprehensive review of the relevant literature, and two empirical studies examining children and adults with misophonia. We tested 142 children and 379 adults for traits associated with autism (i.e., attention-to-detail, attention-switching, social processing, communication, imagination, emotion regulation, and sensory sensitivity across multiple domains). Our data show that autistic traits are indeed elevated in misophonics compared to controls. We discuss our findings in relation to models of the interface between autism, sensory sensitivities, and the specific features of misophonia.

RevDate: 2022-07-16
CmpDate: 2022-06-23

Remmert N, Schmidt KMB, Mussel P, et al (2022)

The Berlin Misophonia Questionnaire Revised (BMQ-R): Development and validation of a symptom-oriented diagnostical instrument for the measurement of misophonia.

PloS one, 17(6):e0269428.

Misophonia is a clinical syndrome which is characterized by intense emotional and physical reactions to idiosyncratic sounds. However, its psychometric measurement is still in the early stages. This study describes the optimization of a self-report instrument, the Berlin Misophonia Questionnaire (BMQ), and addresses its strengths in comparison to existing psychometric measures. This new measure integrates contemporary empirical findings and is based on the latest criteria of misophonia. A cross-sectional online study was conducted using data of 952 affected as well as non-affected individuals. The final BMQ-R consists of 77 items in 21 scales, which were selected using a probabilistic item selection algorithm (Ant Colony Optimization). The results of confirmatory factor analyses, the assessment of reliability, and an extensive construct validation procedure supported the reliability and validity of the developed scales. One outstanding strength of the BMQ-R is its comprehensive measurement of misophonic emotional and physical responses. The instrument further allows for distinguishing between behavioral, cognitive, and emotional dysregulation; the measurement of clinical insight and significance; as well as discerning reactive and anticipating avoidance strategies. Our work offers several improvements to the measurement of misophonia by providing a reliable and valid multidimensional diagnostical instrument. In line with the scientific consensus on defining misophonia, the BMQ-R allows to formally recognize individuals with misophonia and so to compare findings of future studies. Undoubtedly, this measure fills a research gap, which we hope will facilitate the investigation of causes and treatment of misophonia.

RevDate: 2022-07-16

Savard MA, Sares AG, Coffey EBJ, et al (2022)

Specificity of Affective Responses in Misophonia Depends on Trigger Identification.

Frontiers in neuroscience, 16:879583.

Individuals with misophonia, a disorder involving extreme sound sensitivity, report significant anger, disgust, and anxiety in response to select but usually common sounds. While estimates of prevalence within certain populations such as college students have approached 20%, it is currently unknown what percentage of people experience misophonic responses to such "trigger" sounds. Furthermore, there is little understanding of the fundamental processes involved. In this study, we aimed to characterize the distribution of misophonic symptoms in a general population, as well as clarify whether the aversive emotional responses to trigger sounds are partly caused by acoustic salience of the sound itself, or by recognition of the sound. Using multi-talker babble as masking noise to decrease participants' ability to identify sounds, we assessed how identification of common trigger sounds related to subjective emotional responses in 300 adults who participated in an online study. Participants were asked to listen to and identify neutral, unpleasant and trigger sounds embedded in different levels of the masking noise (signal-to-noise ratios: -30, -20, -10, 0, +10 dB), and then to evaluate their subjective judgment of the sounds (pleasantness) and emotional reactions to them (anxiety, anger, and disgust). Using participants' scores on a scale quantifying misophonia sensitivity, we selected the top and bottom 20% scorers from the distribution to form a Most-Misophonic subgroup (N = 66) and Least-Misophonic subgroup (N = 68). Both groups were better at identifying triggers than unpleasant sounds, which themselves were identified better than neutral sounds. Both groups also recognized the aversiveness of the unpleasant and trigger sounds, yet for the Most-Misophonic group, there was a greater increase in subjective ratings of negative emotions once the sounds became identifiable, especially for trigger sounds. These results highlight the heightened salience of trigger sounds, but furthermore suggest that learning and higher-order evaluation of sounds play an important role in misophonia.

RevDate: 2022-07-16
CmpDate: 2022-06-13

Ferrer-Torres A, L Giménez-Llort (2022)

Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field.

International journal of environmental research and public health, 19(11):.

Misophonia is a scarcely known disorder. This systematic review (1) offers a quantitative and qualitative analysis of the literature since 2001, (2) identifies the most relevant aspects but also controversies, (3) identifies the theoretical and methodological approaches, and (4) highlights the outstanding advances until May 2022 as well as aspects that remain unknown and deserve future research efforts. Misophonia is characterized by strong physiological, emotional, and behavioral reactions to auditory, visual, and/or kinesthetic stimuli of different nature regardless of their physical characteristics. These misophonic responses include anger, general discomfort, disgust, anxiety, and avoidance and escape behaviors, and decrease the quality of life of the people with the disorder and their relatives. There is no consensus on the diagnostic criteria yet. High comorbidity between misophonia and other psychiatric and auditory disorders is reported. Importantly, the confusion with other disorders contributes to its underdiagnosis. In recent years, assessment systems with good psychometric properties have increased considerably, as have treatment proposals. Although misophonia is not yet included in international classification systems, it is an emerging field of growing scientific and clinical interest.

RevDate: 2022-06-03
CmpDate: 2022-06-03

Cakiroglu S, Cosgun S, V Gormez (2022)

The prevalence and severity of misophonia in the Turkish population and validation of the Amsterdam Misophonia Scale-Revised.

Bulletin of the Menninger Clinic, 86(2):159-180.

The Amsterdam Misophonia Scale-Revised (AMISOS-R) is a self-report scale that measures the presence and severity of symptoms experienced in response to specific auditory stimuli. This cross-sectional, descriptive study aims to evaluate psychometric properties of the AMISOS-R in the Turkish language and to examine psychosocial factors associated with misophonia. A total of 374 individuals (female/male: 154/220) between 15 and 45 years of age were included in the study. Confirmatory factor analysis showed that the fit indices were at a good level, and they supported the single-factor structure. Test-retest results and Cronbach's alpha coefficient showed that the scale had high reliability. Misophonia scores were also found to be moderately correlated with obsessive-compulsive disorder and neuroticism. The AMISOS-R was found to be a valid and reliable tool to evaluate misophonia in the Turkish language.

RevDate: 2022-07-16

Bendowska A, Malak R, Zok A, et al (2022)

The Ethics of Translational Audiology.

Audiology research, 12(3):273-280.

Translational research moves promising primary research results from the laboratory to practical application. The transition from basic science to clinical research and from clinical research to routine healthcare applications presents many challenges, including ethical. This paper addresses issues in the ethics of translational audiology and discusses the ethical principles that should guide research involving people with hearing loss. Four major ethical principles are defined and explained, which are as follows: beneficence, nonmaleficence, autonomy, and justice. In addition, the authors discuss issues of discrimination and equal access to medical services among people with hearing loss. Despite audiology's broad field of interest, which includes evaluation and treatment of auditory disorders (e.g., deafness, tinnitus, misophonia, or hyperacusis) and balance disorders, this study focuses primarily on deafness and its therapies.

RevDate: 2022-07-16

Rinaldi LJ, Smees R, Ward J, et al (2022)

Poorer Well-Being in Children With Misophonia: Evidence From the Sussex Misophonia Scale for Adolescents.

Frontiers in psychology, 13:808379.

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.

RevDate: 2022-11-02
CmpDate: 2022-05-12

Lee JP, Binger C, Harrington N, et al (2022)

Aided Language Measures: Establishing Observer Agreement for Communicators in Early Language Phases.

American journal of speech-language pathology, 31(3):1394-1411.

PURPOSE: Although many valid, reliable, and developmentally sensitive measures exist to monitor the language gains of children who rely on spoken language to communicate, the same is not true for graphic symbol communicators. This study is a first step in developing such measures by examining the interobserver agreement (IOA) and within-observer agreement of 13 measures designed to monitor the language progress of children who use aided augmentative and alternative communication (AAC). These measures are based on the Graphic Symbol Utterance and Sentence Development Framework (Binger et al., 2020) and are hypothesized to capture various phases of graphic symbol communication.

METHOD: Four graduate student observers coded 13 measures across 57 different play-based sessions of children with Down syndrome ages 3;0-5;11 (years;months). For IOA, sessions were coded by two different observers. For within-observer agreement, all sessions were recoded by the same coders. Corpus-level analyses were completed to characterize the nature of the samples (e.g., average mean length of utterance for the samples). IOA and within-observer agreement were examined for each utterance.

RESULTS: Across all observers and measures, acceptable levels of IOA and within-observer agreement were achieved, with most measures yielding relatively high levels of agreement. Some differences were noted across measures, with the less experienced coders demonstrating less agreement on select measures.

CONCLUSIONS: Results provide initial evidence that many measures based on the Graphic Symbol Utterance and Sentence Development Framework can be reliably coded. These findings are a first step in developing psychometrically sound measures to monitor the expressive language progress of children who use AAC.


RevDate: 2022-04-15

Norris JE, Kimball SH, Nemri DC, et al (2022)

Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping.

Frontiers in neuroscience, 16:832516.

Misophonia is a condition characterized by hypersensitivity and strong emotional reactivity to specific auditory stimuli. Misophonia clinical presentations are relatively complex and reflect individualized experiences across clinical populations. Like some overlapping neurodevelopmental and neuropsychiatric disorders, misophonia is potentially syndromic where symptom patterns rather than any one symptom contribute to diagnosis. The current study conducted an exploratory k-means cluster analysis to evaluate symptom presentation in a non-clinical sample of young adult undergraduate students (N = 343). Individuals participated in a self-report spectrum characteristics survey indexing misophonia, tinnitus severity, sensory hypersensitivity, and social and psychiatric symptoms. Results supported a three-cluster solution that split participants on symptom presentation: cluster 1 presented with more severe misophonia symptoms but few overlapping formally diagnosed psychiatric co-occurring conditions; cluster 3 was characterized by a more nuanced clinical presentation of misophonia with broad-band sensory hypersensitivities, tinnitus, and increased incidence of social processing and psychiatric symptoms, and cluster 2 was relatively unaffected by misophonia or other sensitivities. Clustering results illustrate the spectrum characteristics of misophonia where symptom patterns range from more "pure" form misophonia to presentations that involve more broad-range sensory-related and psychiatric symptoms. Subgroups of individuals with misophonia may characterize differential neuropsychiatric risk patterns and stem from potentially different causative factors, highlighting the importance of exploring misophonia as a multidimensional condition of complex etiology.

RevDate: 2022-04-13

Swonke ML, Neve L, Rossi NA, et al (2022)

Misophonia: An Underrecognized Disease in Pediatric Patients.

Ear, nose, & throat journal [Epub ahead of print].

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.

RevDate: 2023-03-01
CmpDate: 2022-11-18

Weinzimmer SA, Goetz AR, Guzick AG, et al (2022)

Primary Outcomes for Adults Receiving the Unified Protocol after Hurricane Harvey in an Integrated Healthcare Setting.

Community mental health journal, 58(8):1522-1534.

The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) has demonstrated efficacy for treating anxiety and depression. However, there are limited effectiveness data when conducted in real-world settings with diverse populations, including those with trauma. We evaluated treatment outcomes in a naturalistic, community setting among 279 adults who received UP following Hurricane Harvey. We examined change in overall clinical severity, depression and anxiety symptoms, functional impairment, and baseline outcome predictors (i.e., demographic characteristics, impact from Hurricane Harvey, co-occurrence of depression and anxiety symptoms). Global clinical severity, depression and anxiety symptoms, and functional impairment decreased by end-of-treatment. Participants experienced global symptom improvement to a lesser degree than demonstrated in efficacy trials. Participants who experienced greater storm impact reported larger reductions in anxiety symptoms than those less impacted by Harvey. Further studies evaluating the effectiveness of the UP post-disaster and with diverse samples are needed.

RevDate: 2022-04-05

Ashall V (2022)

A Feminist Ethic of Care for the Veterinary Profession.

Frontiers in veterinary science, 9:795628.

I can still see the dog's face as its eyes connected with mine, framed by the black bin bag it had been carried in. I can still hear the clicking sound, louder than the animal's shrill cries, made by a mass of maggots moving against one another beneath the dogs matted fur, moistened by fluids leaking from its damaged flesh. My hands were shaking with panic and rage and I could hardly draw up the euthatal into the syringe quickly enough. I wanted to put an end to this, immediately. As the lethal fluid flowed into the tiny vein the dog's body finally relaxed. At my hand, like so many others, she had ceased to exist. Through the window I could see her owners waiting outside in the sunshine to pay me and I thought about the silky feel of the fur which covered an expensively shaped head. I knew this dog was loved once. This paper develops two neglected areas of veterinary thought; anthropological studies of the veterinary profession and feminist care approaches in veterinary ethics. I argue that the development of veterinary anthropology is crucial to advancing our understanding of veterinary lived experiences, through highlighting the previously under acknowledged emotional, relational and contextual realities of veterinary practice. I further propose that an ethic of care for the veterinary profession, which meaningfully connects with veterinary lived experiences, may provide a valuable approach through which to further develop veterinary ethical thinking. I share an autoethnographic account of a difficult veterinary encounter, which I then analyse using a novel feminist care approach. Through analyses centered on both emotional and relational aspects of veterinary care, I challenge the boundaries of traditional veterinary ethical approaches in terms of the scope, scale and complexity of veterinary ethical decision making. I describe the concept of emotional sponge work in veterinary practice and outline its potential impact for advancing understanding of both veterinary well-being and the profession's societal role. Finally, I propose that a feminist ethic of care might provide a framework for redefining the focus of veterinary professional responsibility, beyond animal health and toward the maintenance of healthy relationships between humans and animals.

RevDate: 2023-01-23

Swedo SE, Baguley DM, Denys D, et al (2022)

Consensus Definition of Misophonia: A Delphi Study.

Frontiers in neuroscience, 16:841816.

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.

RevDate: 2023-02-26
CmpDate: 2022-04-20

Naguy A, Al-Humoud AM, Pridmore S, et al (2022)

Low-Dose Risperidone for an Autistic Child with Comorbid ARFID and Misophonia.

Psychopharmacology bulletin, 52(1):91-94.

Avoidant/Restrictive Food Intake Disorder and misophonia seem to be overrepresented in autism spectrum disorder. Literature is mute on psychopharmacotherapy in these complex presentations. Here, authors report on a challenging case of low-functioning ASD child with comorbid ARFID and misophonia that responded favorably to a low-dose risperidone. This is followed by a brief discussion of purported pharmacodynamic mechanisms and relevant literature.

RevDate: 2022-06-07
CmpDate: 2022-04-12

Simner J, Koursarou S, Rinaldi LJ, et al (2021)

Attention, flexibility, and imagery in misophonia: Does attention exacerbate everyday disliking of sound?.

Journal of clinical and experimental neuropsychology, 43(10):1006-1017.

INTRODUCTION: Misophonia is an unusually strong aversion to everyday sounds, such as chewing, crunching, or breathing. Here, we ask whether misophonia might be tied to an unusual profile of attention (and related traits), which serves to substantially heighten an otherwise everyday disliking of sounds.

METHODS: In Study 1, we tested 136 misophonics and 203 non-misophonics on self-report measures of attention to detail, cognitive inflexibility, and auditory imagery, as well as collecting details about their misophonia. In Study 2, we administered the Embedded Figures task to 20 misophonics and 36 non-misophonics.

RESULTS: We first showed that the degree to which sounds trigger misophonia reflects the pattern by which they are (more mildly) disliked by everyone. This suggests that misophonia is scaffolded onto existing mechanisms rather than qualitatively different ones. Compared to non-misophonics, we also found that misophonics self-reported greater attention to detail, cognitive inflexibility, and auditory imagery. As their symptoms worsen, they also become more accurate in an attentional task (Embedded Figures).

CONCLUSIONS: Our findings provide a better understanding of misophonia and support the hypothesis that dispositional traits of attention to detail may be key to elevating everyday disliking of sound into the more troubling aversions of misophonia.

RevDate: 2022-05-23
CmpDate: 2022-04-05

Siepsiak M, Rosenthal MZ, Raj-Koziak D, et al (2022)

Psychiatric and audiologic features of misophonia: Use of a clinical control group with auditory over-responsivity.

Journal of psychosomatic research, 156:110777.

OBJECTIVE: This cross-sectional study was designed to add to the emerging empirical literature characterizing the psychiatric and audiologic features of misophonia. Because most research to date has not compared misophonia to clinical control groups, the present study used both participants who did not report any sound intolerance problems and a clinical control group of participants with auditory over-responsivity not formally meeting criteria for a diagnosis of misophonia using proposed diagnostic criteria by Schroeder et al. (2013). Severity of misophonia symptoms, frequency of current or lifetime psychiatric disorders, loudness discomfort, and hearing loss were compared across groups.

METHODS: Structured interviews, questionnaires, and objective measures of audiologic functioning were administered to a sample of adult participants (N = 156). Measures included an interviewer-rated diagnostic assessment of misophonia, the MisoQuest, (Siepsiak et al., 2020), M.I.N·I (Sheehan et al., 1998), loudness discomfort level (LDL), and hearing loss (PTA).

RESULTS: Group differences in misophonia symptom severity among all three groups were observed: FWelch (2,50.57) = 149.92, p < .001, n2 = 0.64, validating group assignment. Psychiatric disorders were significantly more frequent in the misophonia group (71%) than in the auditory over-responsivity group (40%) and control group (40%): X[2] (2, N = 142) = 14.3; p = .001; V = 0.317. A wide range of psychiatric disorders were observed in the misophonia group, (e.g., major depressive episode, suicidality and panic disorder were the most common). There were no significant differences between groups with regards to audiologic functioning.

CONCLUSION: Misophonia co-occurs with a variety of psychiatric disorders but does not appear to be associated with loudness discomfort or hearing impairments.

RevDate: 2022-12-21
CmpDate: 2022-12-07

Allusoglu S, S Aksoy (2022)

The reliability and validity of decreased sound tolerance scale-screening.

Brazilian journal of otorhinolaryngology, 88 Suppl 3(Suppl 3):S155-S163.

OBJECTIVES: Decreased Sound Tolerance (DST) is a negative reaction to a sound that does not cause any reaction in an individual with normal hearing. DST's subclasses include hyperacusis, phonophobia, and misophonia, which are distinct and have therapy variations. There is no diagnostic method or scale that distinguishes them in the literature. This study's purpose was to develop a screening scale that distinguishes these three DSTs.

METHODS: The study comprised 257 willing participants with normal hearing. Cronbach alpha coefficient, item-total correlation, and item differentiation of the Decreased Sound Tolerance Scale-Screening (DSTS-S) were evaluated. Structural validity of DSTS-S was performed by Varimax rotation with Kaiser normalization using Explanatory Factor Analysis (EFA), and Confirmatory Factor Analysis (CFA) was performed to assess its structural compatibility. The scale's total scores from each section were compared using the Mann-Whitney U test in symptom (+) and symptom (-) participants.

RESULTS: The Cronbach alpha value for hyperacusis, phonophobia, and misophonia sections of DSTS-S was calculated as 0.881, 0.775, and 0.938, respectively. The difference between the independent samplet-test and the variables was statistically significant (p < 0.01). The Mann-Whitney U test showed a significant difference between the median values of the total groups' scores with and without hyperacusis, phonophobia, and misophonia (HTS, PTS, and MTS, respectively) (p < 0.05). Evaluation by ROC analysis showed that hyperacusis was useful in predicting the presence of hyperacusis, phonophobia was useful in predicting the presence of phonophobia, and misophonia was useful in predicting the presence of misophonia (p < 0.001). Hyperacusis and misophonia sections showed high reliability, and phonophobia section showed a moderately reliable level. The Kappa test showed that the compatibility between test-retest for the total scores was statistically significant (p < 0.001).

CONCLUSION: The study's results indicated that DSTS-S is a valid and reliable scale for identifying subtypes/problems/classes of decreased sound tolerance.

RevDate: 2022-04-18
CmpDate: 2022-02-22

Guetta RE, Cassiello-Robbins C, Trumbull J, et al (2022)

Examining emotional functioning in misophonia: The role of affective instability and difficulties with emotion regulation.

PloS one, 17(2):e0263230.

Misophonia is a newly described condition characterized by sensory and emotional reactivity (e.g., anxiety, anger, disgust) to repetitive, pattern-based sounds (e.g., throat clearing, chewing, slurping). Individuals with misophonia report significant functional impairment and interpersonal distress. Growing research indicates ineffective coping and emotional functioning broadly (e.g., affective lability, difficulties with emotion regulation) are central to the clinical presentation and severity of misophonia. Preliminary evidence suggests an association between negative emotionality and deficits in emotion regulation in misophonia. Still, little is known about (a) the relationships among specific components of emotional functioning (e.g., emotion regulation, affective lability) with misophonia, and (b) which component(s) of misophonia (e.g., noise frequency, emotional and behavioral responses, impairment) are associated with emotional functioning. Further, despite evidence that mood and anxiety disorders co-occur with misophonia, investigation thus far has not controlled for depression and anxiety symptoms. Examination of these relationships will help inform treatment development for misophonia. The present study begins to disambiguate the relationships among affective lability, difficulties with emotion regulation, and components of misophonia. A sample of 297 participants completed questionnaires assessing misophonia, emotional functioning, depression, anxiety, and COVID-19 impact. Findings indicated that misophonia severity was positively associated with each of these constructs with small to medium effect sizes. When controlling for depression, anxiety, and COVID-19 impact, results from this preliminary study suggest that (a) difficulties with emotion regulation may be correlated with misophonia severity, and (b) misophonic responses, not number of triggers or perceived severity, are associated with difficulties with emotion regulation. Overall, these findings begin to suggest that emotion regulation is important to our understanding the risk factors and treatment targets for misophonia.

RevDate: 2022-02-09

Zarotti N, Tuthill A, P Fisher (2022)

Online Emotion Regulation for an Adolescent With Misophonia: A Case Study.

Journal of cognitive psychotherapy pii:JCP-2021-0015 [Epub ahead of print].

Misophonia is a novel diagnosis characterised by extreme and uncontrollable autonomic reactions and emotional responses to selective auditory stimuli, which can significantly impair an individual's daily life. No agreed diagnostic criteria are currently available for misophonia, and any therapeutic guidance is yet to be formalised. In this case study, a tailored psychological intervention based on the cognitive model and developed around emotion regulation principles and techniques was adopted to treat misophonia in a 16-year-old female from the United Kingdom. The treatment lasted for 15 weeks and was delivered online due to the ongoing COVID-19 social distancing regulations. The results showed that the intervention was feasible and acceptable, and effective at reducing levels of misophonic symptoms from severe to moderate/mild while also improving emotion dysregulation and overall anxiety and depression. Particular improvements were observed for specific skills such as acceptance and awareness of emotional responses and increased access to emotion regulation strategies. These findings also translated into a number of reported daily life improvements in the client's psychological and social well-being. As the current evidence base on misophonia continues to develop, more methodologically rigorous research is warranted to build on the present findings and inform the adoption of further psychotherapeutic approaches to treat this new condition.

RevDate: 2022-02-07

Anonymous (2022)

Misophonia Successfully Treated of With Fluoxetine: A Case Report: Erratum.

Clinical neuropharmacology, 45(1):15.

RevDate: 2022-05-31
CmpDate: 2022-01-18

Webb J (2022)

β-Blockers for the Treatment of Misophonia and Misokinesia.

Clinical neuropharmacology, 45(1):13-14.

Misophonia is an adverse physical and emotional reaction to certain repetitive trigger sounds, usually generated by other people. Misokinesia refers to visual triggers that are sometimes (but not always) related to trigger sounds. Despite how common and disabling these conditions can be, medication treatment of misophonia and misokinesia is largely unexplored. We present the first case of using a β-blocker (propranolol) to successfully treat a patient experiencing misophonia and misokinesia. A moderate dose (60 mg) of propranolol completely eliminated multiple auditory and visual trigger symptoms related to other people eating. His trigger response symptoms included overwhelming negative emotions and prominent sympathetic overactivity (fight-or-flight response). These symptoms were so severe that he had avoided most meals with friends and family for the past several years. Propranolol eliminated the emotional and physiological effects of both the auditory and visual triggers, with an Amsterdam Misophonia Scale score reduction from 15 to 2. This enabled him to resume eating meals with family and friends with no distress. The medication was well tolerated. In summary, we report the novel finding that β-blockers were markedly effective at treating the physical and emotional symptoms of a patient with misophonia and misokinesia. This suggests a novel treatment approach for these conditions.

RevDate: 2022-02-25
CmpDate: 2022-02-25

La Buissonnière-Ariza V, Guzik AG, Schneider SC, et al (2022)

Family Accommodation of Symptoms in Adults With Obsessive-Compulsive Disorder: Factor Structure and Usefulness of the Family Accommodation Scale for OCD-Patient Version.

Journal of psychiatric practice, 28(1):36-47 pii:00131746-202201000-00005.

For individuals with obsessive-compulsive disorder (OCD), family accommodation of symptoms, such as over-reassurance, participation in rituals, or facilitation of avoidance, is one of the key factors associated with symptom severity, maintenance, and related impairment. Most studies have assessed accommodation behaviors based on reports from family members or other loved ones. Recently, a patient-rated questionnaire, the Family Accommodation Scale for OCD-Patient Version (FAS-PV) was developed to assess family accommodation from the patient's perspective. This study investigated the factor structure of the FAS-PV and clinical variables associated with patient-reported family accommodation in a sample of 151 treatment-seeking adults with OCD. A confirmatory factor analysis suggested that a 4-factor model best characterized the scale, with the following factors: (1) participation in symptoms, (2) avoidance of OCD triggers, (3) taking on responsibilities, and (4) modifying responsibilities. Internal consistency was high for the total score and for scores on the 4 subscales of the FAS-PV. Approximately 87% of the sample reported accommodation behaviors at some level. Family accommodation was positively correlated with OCD symptom severity and functional disability, and partially mediated the associations between these 2 factors, so that greater OCD severity was associated with greater accommodation, which, in turn, was associated with greater disability. Our findings parallel those of studies that have employed other versions of the FAS and suggest that the FAS-PV is a useful tool for assessing family accommodation of OCD symptoms from the patient's perspective.

RevDate: 2021-10-29

Vitoratou S, Uglik-Marucha N, Hayes C, et al (2021)

Item Response Theory Investigation of Misophonia Auditory Triggers.

Audiology research, 11(4):567-581.

Misophonia is characterised by a low tolerance for day-to-day sounds, causing intense negative affect. This study conducts an in-depth investigation of 35 misophonia triggers. A sample of 613 individuals who identify as experiencing misophonia and 202 individuals from the general population completed self-report measures. Using contemporary psychometric methods, we studied the triggers in terms of internal consistency, stability in time, precision, severity, discrimination ability, and information. Three dimensions of sensitivity were identified, namely, to eating sounds, to nose/throat sounds, and to general environmental sounds. The most informative and discriminative triggers belonged to the eating sounds. Participants identifying with having misophonia had also significantly increased odds to endorse eating sounds as auditory triggers than others. This study highlights the central role of eating sounds in this phenomenon and finds that different triggers are endorsed by those with more severe sound sensitivities than those with low sensitivity.

RevDate: 2021-10-29

Danesh AA, Howery S, Aazh H, et al (2021)

Hyperacusis in Autism Spectrum Disorders.

Audiology research, 11(4):547-556.

Hyperacusis is highly prevalent in the autism spectrum disorder (ASD) population. This auditory hypersensitivity can trigger pragmatically atypical reactions that may impact social and academic domains. Objective: The aim of this report is to describe the relationship between decreased sound tolerance disorders and the ASD population. Topics covered: The main topics discussed include (1) assessment and prevalence of hyperacusis in ASD; (2) etiology of hyperacusis in ASD; (3) treatment of hyperacusis in ASD. Conclusions: Knowledge of the assessment and treatment of decreased sound tolerance disorders within the ASD population is growing and changing.

RevDate: 2022-11-10

Rosenthal MZ, Anand D, Cassiello-Robbins C, et al (2021)

Development and Initial Validation of the Duke Misophonia Questionnaire.

Frontiers in psychology, 12:709928.

Misophonia is characterized by decreased tolerance and accompanying defensive motivational system responding to certain aversive sounds and contextual cues associated with such stimuli, typically repetitive oral (e. g., eating sounds) or nasal (e.g., breathing sounds) stimuli. Responses elicit significant psychological distress and impairment in functioning, and include acute increases in (a) negative affect (e.g., anger, anxiety, and disgust), (b) physiological arousal (e.g., sympathetic nervous system activation), and (c) overt behavior (e.g., escape behavior and verbal aggression toward individuals generating triggers). A major barrier to research and treatment of misophonia is the lack of rigorously validated assessment measures. As such, the primary purpose of this study was to develop and psychometrically validate a self-report measure of misophonia, the Duke Misophonia Questionnaire (DMQ). There were two phases of measure development. In Phase 1, items were generated and iteratively refined from a combination of the scientific literature and qualitative feedback from misophonia sufferers, their family members, and professional experts. In Phase 2, a large community sample of adults (n = 424) completed DMQ candidate items and other measures needed for psychometric analyses. A series of iterative analytic procedures (e.g., factor analyses and IRT) were used to derive final DMQ items and scales. The final DMQ has 86 items and includes subscales: (1) Trigger frequency (16 items), (2) Affective Responses (5 items), (3) Physiological Responses (8 items), (4) Cognitive Responses (10 items), (5) Coping Before (6 items), (6) Coping During (10 items), (7) Coping After (5 items), (8) Impairment (12 items), and Beliefs (14 items). Composite scales were derived for overall Symptom Severity (combined Affective, Physiological, and Cognitive subscales) and Coping (combined the three Coping subscales). Depending on the needs of researchers or clinicians, the DMQ may be use in full form, individual subscales, or with the derived composite scales.

RevDate: 2021-11-11

Rodriguez M, Eisenlohr-Moul TA, Weisman J, et al (2021)

The Use of Task Shifting to Improve Treatment Engagement in an Internet-Based Mindfulness Intervention Among Chinese University Students: Randomized Controlled Trial.

JMIR formative research, 5(10):e25772.

BACKGROUND: Traditional in-person psychotherapies are incapable of addressing global mental health needs. Use of computer-based interventions is one promising solution for closing the gap between the amount of global mental health treatment needed and received.

OBJECTIVE: Although many meta-analyses have provided evidence supporting the efficacy of self-guided, computer-based interventions, most report low rates of treatment engagement (eg, high attrition and low adherence). The aim of this study is to investigate the efficacy of an adjunctive treatment component that uses task shifting, wherein mental health care is provided by nonspecialist peer counselors to enhance engagement in an internet-based, self-directed, evidence-based mindfulness intervention among Chinese university students.

METHODS: From 3 universities across China, 54 students who reported at least mild stress, anxiety, or depression were randomly assigned to a 4-week internet-based mindfulness intervention (MIND) or to the intervention plus peer counselor support (MIND+), respectively. Be Mindful delivers all the elements of mindfulness-based cognitive therapy in an internet-based, 4-week course. Participants completed daily monitoring of mindfulness practice and mood, as well as baseline and posttreatment self-reported levels of depression, anxiety, stress, and trait mindfulness. We screened 56 volunteer peer counselor candidates who had no former training in the delivery of mental health services. Of these, 10 were invited to participate in a day-long training, and 4 were selected. Peer counselors were instructed to provide 6 brief (15-20 minute) sessions each week, to help encouraging participants to complete the internet-based intervention. Peer counselors received weekly web-based group supervision.

RESULTS: For both conditions, participation in the internet-based intervention was associated with significant improvements in mindfulness and mental health outcomes. The pre-post effect sizes (Cohen d) for mindfulness, depression, anxiety, and stress were 0.55, 0.95, 0.89, and 1.13, respectively. Participants assigned to the MIND+ (vs MIND) condition demonstrated significantly less attrition and more adherence, as indicated by a greater likelihood of completing posttreatment assessments (16/27, 59% vs 7/27, 26%; χ[2]1=6.1; P=.01) and a higher percentage of course completion (72.6/100, 72.6% vs 50.7/100, 50.7%; t52=2.10; P=.04), respectively. No significant between-group differences in daily frequency and duration of mindfulness practice were observed. Multilevel logistic growth models showed that MIND+ participants reported significantly greater pre-post improvements in daily stress ratings (interaction estimate 0.39, SE 0.18; t317=2.29; P=.02) and depression (interaction estimate 0.38, SE 0.16; t330=2.37; P=.02) than those in the MIND condition.

CONCLUSIONS: This study provides new insights into effective ways of leveraging technology and task shifting to implement large-scale mental health initiatives that are financially feasible, easily transportable, and quickly scalable in low-resource settings. The findings suggest that volunteer peer counselors receiving low-cost, low-intensity training and supervision may significantly improve participants' indices of treatment engagement and mental health outcomes in an internet-based mindfulness intervention among Chinese university students.

RevDate: 2023-04-12
CmpDate: 2021-12-31

Jager I, Vulink N, de Roos C, et al (2021)

EMDR therapy for misophonia: a pilot study of case series.

European journal of psychotraumatology, 12(1):1968613.

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.

RevDate: 2021-09-18

Palm L, Haas M, Pisarenko A, et al (2021)

Validation of the Rage Attack Questionnaire-Revised (RAQ-R) in a Mixed Psychiatric Population.

Frontiers in psychiatry, 12:724802.

Rage Attacks (RA) represent a clinically relevant symptom in patients with different psychiatric disorders. However, only recently the Rage Attack Questionnaire Revised (RAQ-R, 22 items, range, 0-66) has been developed as a new instrument for the assessment of RA. This study aimed to validate the RAQ-R in a large mixed psychiatric and psychosomatic sample. We tested internal consistency, convergent and discriminant validity as well as factor structure. In order to further explore the relationship of RA to other psychiatric symptoms, we calculated Pearson correlations between the RAQ-R and several other self-assessments including measurements for general psychological distress, quality of life, depression, anxiety, attention deficit/hyperactivity disorder (ADHD), impulsivity, and self-regulation abilities. Most relevant predictors of RA were examined in a multiple regression with stepwise elimination. In order to assess the manifestation of RA in different psychiatric disorders, group differences between diagnostic categories and healthy controls were calculated. Additionally, psychiatric patients were compared to patients with Tourette syndrome along RAQ-R scores. Data from healthy subjects and patients with Tourette syndrome were obtained from a previous study of our group. In this study, we included 156 patients with a wide and typical spectrum of psychiatric diseases. The RAQ-R was found to have excellent internal consistency and strong construct validity in this sample (Cronbach's α = 0.97, Average Variance Extracted = 0.58). Thus, the RAQ-R was shown to be a psychometrically sound assessment of RA in patients with different psychiatric disorders. Close constructs to RA were found to be aggression and hostility (r = 0.68) as well as low frustration tolerance and impulse control (r = 0.69). Compared to healthy controls, RA were significantly more common in the psychiatric sample (p < 0.001). More specifically, RAQ-R scores in all diagnostic categories assessed were higher compared to controls. Highest scores and effect sizes were found in patients with ADHD and borderline personality disorder (p < 0.001). Our results suggest that RA are a common and relevant symptom in many psychiatric disorders. As depression and RA showed only a moderate relation, RA should be distinguished from the concept of anger attacks, which are described as a core symptom of depression.

RevDate: 2022-08-05
CmpDate: 2022-08-05

Scheerer NE, Boucher TQ, Bahmei B, et al (2022)

Family Experiences of Decreased Sound Tolerance in ASD.

Journal of autism and developmental disorders, 52(9):4007-4021.

Decreased sound tolerance (DST) is the most common sensory difficulty experienced by autistic individuals. Parents of 88 autistic children and young adults between the ages of 3 and 30 described coping strategies and physical and emotional responses used to deal with distressing sounds, and their impact on daily activities. Loud, sudden, and high-pitched sounds were most commonly endorsed as distressing, most often causing autistic children and young adults to cover their ears or yell, while producing stress, irritation, fear, and anxiety. Parents reported warning their child, providing breaks, or avoiding noisy settings as the most used coping strategies. Overall, findings indicate that DST leads to fewer opportunities for autistic children and young adults to participate at home, at school, and in the community. Further, results suggest hyperacusis, misophonia, and phonophobia, subtypes of DST, are present in autistic children and young adults.

RevDate: 2023-05-05
CmpDate: 2022-01-19

Eijsker N, Schröder A, Liebrand LC, et al (2021)

White matter abnormalities in misophonia.

NeuroImage. Clinical, 32:102787.

Misophonia is a condition in which specific ordinary sounds provoke disproportionately strong negative affect and physiological arousal. Evidence for neurobiological abnormalities underlying misophonia is scarce. Since many psychiatric disorders show white matter (WM) abnormalities, we tested for both macro and micro-structural WM differences between misophonia patients and healthy controls. We collected T1-weighted and diffusion-weighted magnetic resonance images from 24 patients and 25 matched controls. We tested for group differences in WM volume using whole-brain voxel-based morphometry and used the significant voxels from this analysis as seeds for probabilistic tractography. After calculation of diffusion tensors, we compared group means for fractional anisotropy, mean diffusivity, and directional diffusivities, and applied tract-based spatial statistics for voxel-wise comparison. Compared to controls, patients had greater left-hemispheric WM volumes in the inferior fronto-occipital fasciculus, anterior thalamic radiation, and body of the corpus callosum connecting bilateral superior frontal gyri. Patients also had lower averaged radial and mean diffusivities and voxel-wise comparison indicated large and widespread clusters of lower mean diffusivity. We found both macro and microstructural WM abnormalities in our misophonia sample, suggesting misophonia symptomatology is associated with WM alterations. These biological alterations may be related to differences in social-emotional processing, particularly recognition of facial affect, and to attention for affective information.

RevDate: 2021-11-01
CmpDate: 2021-09-10

Tarnowska KA, Dispoto BC, J Conragan (2021)

Explainable AI-based clinical decision support system for hearing disorders.

AMIA Joint Summits on Translational Science proceedings. AMIA Joint Summits on Translational Science, 2021:595-604.

In clinical system design, human-computer interaction and explainability are important topics of research. Clinical systems need to provide users with not only results but also an account of their behaviors. In this research, we propose a knowledge-based clinical decision support system (CDSS) for the diagnosis and therapy of hearing disorders, such as tinnitus, hyperacusis, and misophonia. Our prototype eTRT system offers an explainable output that we expect to increase its trustworthiness and acceptance in the clinical setting. Within this paper, we: (1) present the problem area of tinnitus and its treatment; (2) describe our data-driven approach based on machine learning, such as association- and action rule discovery; (3) present the evaluation results from the inference on the extracted rule-based knowledge and chosen test cases of patients; (4) discuss advantages of explainable output incorporated into a graphical user interface; (5) conclude with the results achieved and directions for future work.

RevDate: 2021-11-24
CmpDate: 2021-11-24

Dibb B, Golding SE, TH Dozier (2021)

The development and validation of the Misophonia response scale.

Journal of psychosomatic research, 149:110587.

OBJECTIVE: Most current Misophonia scales are not validated, do not include both emotional and physiological responses to triggers, and/or focus only on auditory triggers. This research aimed to develop and validate a measure of the magnitude of the Misophonic response that addressed these omissions.

METHOD: Three studies were carried out with individuals with self-diagnosed Misophonia. In study 1, expert opinion and participants commented on initial items to determine both face and content validity. In study 2, scale structure, reliability, and convergent and discriminant validity were determined using correlations, principal component analysis (PCA), and reliability analysis. In study 3, factor structure was confirmed in another sample of participants using confirmatory factor analysis (CFA).

RESULTS: The final 22-item scale assesses the magnitude of responses to triggers across any sensory modality. There are three subscales (emotional, physiological, and participation in life), with three additional items measuring frequency of triggers, avoidance of triggers, and time taken to recover from the triggers. The final scale showed suitable discriminant and convergent validity, with good internal consistency (Cronbach's alphas range 0.77 to 0.89). The three-component solution extracted using PCA explained 53.97% of variance, with all items loading between 0.45 and 0.84. The structure was confirmed with CFA (χ[2] = 269.01, p < .001; CFI = 0.96; TLI = 0.96 and RMSEA = 0.045 (CI 0.037-0.053).

CONCLUSION: The Misophonia Response Scale, which is valid and reliable, will facilitate understanding of Misophonia as it is short and easy to use for self-report in research.


ESP Quick Facts

ESP Origins

In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

ESP Support

In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

ESP Rationale

Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

ESP Goal

In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

ESP Usage

Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

ESP Content

When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

ESP Help

Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

ESP Plans

With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.

Electronic Scholarly Publishing
961 Red Tail Lane
Bellingham, WA 98226

E-mail: RJR8222 @

Papers in Classical Genetics

The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin (and even a collection of poetry — Chicago Poems by Carl Sandburg).


ESP now offers a much improved and expanded collection of timelines, designed to give the user choice over subject matter and dates.


Biographical information about many key scientists.

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are now being automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 07 JUL 2018 )