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Suggestions for future research into misophonia
Source publication
Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the co...
Contexts in source publication
Context 1
... into the neurobiological underpinnings of miso- phonia is still in its infancy, and there are still a number of unanswered questions regarding the clinical characterization of this condition (Table 1) ...
Context 2
... is general awareness that further research needs to be conducted before firm conclusions can be drawn with regard to both the pathophysiology and treatment of miso- phonia. Ideally, a comprehensive research agenda should also encompass epidemiological, phenomenological, and genetic aspects (Table 1). It is hoped that by combining qualitative and quantitative data from large populations, it will become possible to fully elucidate the hidden nature of this intrusive condition and alleviate the distress that it can cause. ...
Similar publications
General information about tinnitus and decreased sound tolerance, hyperacusis, misophonia, with outline of the neurophysiological model of tinnitus and Tinnitus Retraining Therapy
Citations
... Another study presented deviant neural activation in the auditory processing system, although the EEG methodology used only allowed for recordings of activity in the cortical areas, having limited anatomical specificity, whereas the misophonic response is likely to involve multiple limbic structures [20,21]. ...
Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic–pituitary–adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.
... Unfavorably evaluated properties may be, for example, the gender of the voice (Parson et al., 2013). In addition, undesirable reactions in some recipients may also include (a) the grammatical form of messages (including plurals in utterances) and the use of the imperative mood (Wicklund, 1974), (b) an inappropriate (too fast/slow) speaking rate (Boone et al., 2019), (c) low volume of the spoken message, especially whispering (Murry, 1988), and (d) numerous and audible artifacts (e.g., saliva swallowing, gurgling, breathing) (Cavanna & Seri, 2015). ...
... Conversely, when the speaker's voice was male, recordings with numerous artifacts were also less favored, but instructions with no or some artifacts received similarly high ratings. Thus, the removal procedure appears unnecessary to satisfy practitioners when instructions are given by a man (Cavanna & Seri, 2015). Instructions with many artifacts were rated lower when spoken by a male voice compared to a female voice. ...
Objectives
Despite its numerous benefits, practicing mindfulness involves certain challenges. This study investigates the impact of various characteristics of recorded mindfulness practice instructions on recipients’ evaluations, focusing on elements that may evoke negative reactions and hinder mindfulness practice.
Method
A total of 138 participants evaluated 24 recordings of mindfulness practice excerpts. The recordings differed in terms of the speaker’s gender, the form and pace of the message, the presence of whispering, and the number of artifacts. Respondents rated each recording using a scale and provided open-ended responses about their subjective perception of the recordings. The study employed hierarchical multilevel modeling to analyze the collected data.
Results
The results indicated that recipient gender did not influence preferences for male or female-voiced recordings. However, properties such as form, pace, whispering, and artifacts did affect evaluations. Least favored instruction elements included plural pronouns, slow pacing, primarily whispered speech, and a high number of artifacts. Some differences in evaluations were observed between female and male recording conditions. Additionally, qualitative data revealed participants’ subjective reactions to recordings with varying characteristics, and the study identified the most favorable characteristics of the recordings.
Conclusions
The study results identified which qualities of recorded mindfulness instructions are least preferred and may present obstacles to initiating or continuing the practice. Therefore, this study may help create more optimal instructions and improve the design of apps and platforms offering mindfulness practice recordings, enhancing the quality and accessibility of practice for a broader audience.
Preregistration
This study is not preregistered.
... It is characterized by an aversive emotional response to specific audio stimuli. Scholars researching Misophonia have conceptualized it as a new "medical entity," and it emerges when "an abnormally strong reaction occurs to a sound with a specific pattern and/or meaning to an individual, where the context is also as relevant as the sound" (Cavanna & Seri, 2015). A similar response is also observed towards specific visual stimuli, known as Misokinesia, and is usually coexistent with Misophonia. ...
... A similar response is also observed towards specific visual stimuli, known as Misokinesia, and is usually coexistent with Misophonia. People experiencing Misophonia have reported that the stimuli evokes a strong emotional response, such as anxiety and aggression, and autonomic arousal (Cavanna & Seri, 2015). ...
Magical belief and related behaviours are universal phenomena. However, it has been widely explored in relation with obsessive- compulsive disorder and psychosis. It is a much-researched topic of west but Asian data on the same is meagre. Aim- present study aims to explore magical thinking in Indian sample and its relation with OC features and perceived stress. The study also explores age and gender related difference in the sample. Methods- a sample of 246 participants (144 male and 102 female) from community was recruited. For this purpose, illusory belief scale was used to measure magical thinking, perceived stress scale was used to measure perceived stress and obsessive- compulsive inventory- revised was used to measure OC features in the sample.
Results- group difference for females was found to be high on magical thinking measure whereas group difference for males was found to be high on OCI-r. Age-related variability was not observed in the study. Significant positive correlation was found between magical thinking, perceived stress, and OC features
... (1) BACKGROUND Misophonia is a disorder of decreased tolerance to specific sounds or stimuli associated with those sounds (Swedo et al., 2022). Although often thought of as an aversion to oral/nasal sounds in particular (Jager et al., 2020;Kumar et al., 2021;Schröder et al., 2013), large-scale surveys and experimental investigations of misophonia have revealed a wide variety of reported triggers: chewing, sniffling, keyboard typing, rustling plastic/paper, cutlery noises, etc. (Cavanna & Seri, 2015;Hansen et al., 2021;. Misophonia is a prevalent disorder -population studies estimate 5-20% of the general population is affected (Vitoratou et al., 2023;Kılıç et al., 2021;Jakubovski et al., 2022) and leads to significant impairment in daily life activities for sufferers (Rouw & Erfanian, 2017;Swedo et al., 2022). ...
Misophonia is a disorder of decreased tolerance to certain “trigger” sounds (e.g., chewing, tapping, clicking). While misophonia research is scant in general, studies presenting sounds are especially rare and methodologically variable, likely due to the labor and time required to create stimuli. Thus, we introduce FOAMS: Free Open-Access Misophonia Stimuli, a sound bank publicly available on Zenodo, accompanied by pilot discomfort ratings for 32 of these sounds (4 exemplars of 8 classes). The FOAMS database aims to decrease the burden on researchers, facilitating reproducibility and the pursuit of nuanced research questions to better understand this perplexing disorder.
... Mizofoni terimi 2000'li yılların başında, azalmış ses tolerans problemi açısından diğer hastalardan farklı özellik gösteren bir grup hastayı tanımlamak amacıyla Yunanca "miso" (nefret) ve "phonia" (ses) kelimeleri birleştirilerek oluşturulmuştur (Jastreboff ve Jastreboff, 2001;2014). Mizofonisi olan bireyler sıklıkla insanların çıkardığı sakız patlatma, yemek çiğneme ve çatırdatma sesleri, nefes alıp verme, ıslık sesi, dudak şapırdatma, kalem tıkırtısı gibi diğer insanlar tarafından önemsiz olarak nitelendirilen seslere karşı hassastırlar (Cavanna ve Seri, 2015). Bireyler seslere karşı geliştirdikleri aşırı hassasiyet sonucunda tiksinme, kaygı ve hafif düzeyde kızgınlık gibi farklı duygular hissedebilmekte ve bazen öfke nöbetleri yaşayabilmektedir. ...
Z Mizofoni, şiddetli duygusal veya fizyolojik tepkileri tetikleyen belirli seslere karşı azalmış bir ses tolerans bozukluğu durumudur. Mizofonisi olan bireyler yemek çiğneme, dudak şapırdatma, nefes alıp verme gibi diğer insanlar tarafından önemsiz olarak bulunan spesifik seslere karşı tiksinme, kaygı, kızgınlık hissedebilmekte ve bazen öfke nöbetleri yaşayabilmektedir. Mizofoninin prevalansı, değerlendirme ve yönetimi konusunda fikir birliği yoktur. Mizofoni araştırmalarının önündeki en büyük engellerden biri psikometrik açıdan güçlü değerlendirme araçlarının azlığıdır. Bu çalışmanın amacı Mizofoni Ölçeği'nin (Misophonia Questionnaire; Wu ve ark., 2014) Türkçe uyarlamasını yaparak mizofoniye yönelik klinik ve populasyon temelli değerlendirmeler için ölçüm aracı ihtiyacını gidermektir. Araştırma, yaşları 18-26 arasında değişen Başkent Üniversitesinde lisans düzeyinde öğrenim gören 638 öğrenci ile gerçekleştirilmiştir. Yapı geçerliği kapsamında açımlayıcı (N = 420) ve doğrulayıcı faktör analizi (N = 218) uygulanmış, içtutarlılık ve ayırt edici geçerlik sınamaları gerçekleştirilmiştir. Güvenirlik için ise iç tutarlılık, yarıya bölüm ve test-tekrar test yöntemleri kullanılmıştır. Açımlayıcı faktör analizinde ölçeğin mizofoni semptomları, mizofoni duygu ve davranışlar-kaçınma ve içselleştirme, mizofoni duygular ve davranışlar-saldırganlık ve dışsallaştırma olmak üzere üç faktörlü bir yapıya sahip olduğu gözlenmiştir. Doğrulayıcı faktör analizinde söz konusu üç faktörlü yapı için uyum indeksleri kabul edilebilir sınırlar içinde bulunmuştur. Ayırt edici geçerlik sonucunda, klinik olarak mizofonisi olanların olmayanlara göre tüm faktörlerde daha yüksek ortalamaya sahip olduğu görülmüştür. Ölçeğin bütünü için Cronbach Alfa iç tutarlılık katsayısının .89 (faktörler için sırasıyla .79, .85 ve .83), yarıya bölüm güvenirlik katsayısının .83 (faktörler için sırasıyla .86, .87 ve .81) ve test-tekrar test güvenirlik katsayısının .78 olduğu bulunmuştur. Bu çalışma ile genel örneklemde mizofoniyi değerlendirme amacı ile kullanılabilecek Mizofoni Ölçeği Türkçeye kazandırılmıştır. Yapılan psikometrik analizler sonucunda Mizofoni Ölçeği'nin geçerliğini ve güvenirliğini destekleyen verilere ulaşılmıştır.
... Mizofoni terimi 2000'li yılların başında, azalmış ses tolerans problemi açısından diğer hastalardan farklı özellik gösteren bir grup hastayı tanımlamak amacıyla Yunanca "miso" (nefret) ve "phonia" (ses) kelimeleri birleştirilerek oluşturulmuştur (Jastreboff ve Jastreboff, 2001;2014). Mizofonisi olan bireyler sıklıkla insanların çıkardığı sakız patlatma, yemek çiğneme ve çatırdatma sesleri, nefes alıp verme, ıslık sesi, dudak şapırdatma, kalem tıkırtısı gibi diğer insanlar tarafından önemsiz olarak nitelendirilen seslere karşı hassastırlar (Cavanna ve Seri, 2015). Bireyler seslere karşı geliştirdikleri aşırı hassasiyet sonucunda tiksinme, kaygı ve hafif düzeyde kızgınlık gibi farklı duygular hissedebilmekte ve bazen öfke nöbetleri yaşayabilmektedir. ...
Mizofoni, şiddetli duygusal veya fizyolojik tepkileri tetikleyen belirli seslere karşı azalmış bir ses tolerans bozukluğu durumudur. Mizofonisi olan bireyler yemek çiğneme, dudak şapırdatma, nefes alıp verme gibi diğer insanlar tarafından önemsiz olarak bulunan spesifik seslere karşı tiksinme, kaygı, kızgınlık hissedebilmekte ve bazen öfke nöbetleri yaşayabilmektedir. Mizofoninin prevalansı, değerlendirme ve yönetimi konusunda fikir birliği yoktur. Mizofoni araştırmalarının önündeki en büyük engellerden biri psikometrik açıdan güçlü değerlendirme araçlarının azlığıdır. Bu çalışmanın amacı Mizofoni Ölçeği'nin (Misophonia Questionnaire; Wu ve ark., 2014) Türkçe uyarlamasını yaparak mizofoniye yönelik klinik ve populasyon temelli değerlendirmeler için ölçüm aracı ihtiyacını gidermektir. Araştırma, yaşları 18-26 arasında değişen Başkent Üniversitesinde lisans düzeyinde öğrenim gören 638 öğrenci ile gerçekleştirilmiştir. Yapı geçerliği kapsamında açımlayıcı (N = 420) ve doğrulayıcı faktör analizi (N = 218) uygulanmış, içtutarlılık ve ayırt edici geçerlik sınamaları gerçekleştirilmiştir. Güvenirlik için ise iç tutarlılık, yarıya bölüm ve test-tekrar test yöntemleri kullanılmıştır. Açımlayıcı faktör analizinde ölçeğin mizofoni semptomları, mizofoni duygu ve davranışlar-kaçınma ve içselleştirme, mizofoni duygular ve davranışlar-saldırganlık ve dışsallaştırma olmak üzere üç faktörlü bir yapıya sahip olduğu gözlenmiştir. Doğrulayıcı faktör analizinde söz konusu üç faktörlü yapı için uyum indeksleri kabul edilebilir sınırlar içinde bulunmuştur. Ayırt edici geçerlik sonucunda, klinik olarak mizofonisi olanların olmayanlara göre tüm faktörlerde daha yüksek ortalamaya sahip olduğu görülmüştür. Ölçeğin bütünü için Cronbach Alfa iç tutarlılık katsayısının .89 (faktörler için sırasıyla .79, .85 ve .83), yarıya bölüm güvenirlik katsayısının .83 (faktörler için sırasıyla .86, .87 ve .81) ve test-tekrar test güvenirlik katsayısının .78 olduğu bulunmuştur. Bu çalışma ile genel örneklemde mizofoniyi değerlendirme amacı ile kullanılabilecek Mizofoni Ölçeği Türkçeye kazandırılmıştır. Yapılan psikometrik analizler sonucunda Mizofoni Ölçeği'nin geçerliğini ve güvenirliğini destekleyen verilere ulaşılmıştır.
... It is characterized by an aversive emotional response to specific audio stimuli. Scholars researching Misophonia have conceptualized it as a new "medical entity," and it emerges when "an abnormally strong reaction occurs to a sound with a specific pattern and/or meaning to an individual, where the context is also as relevant as the sound" (Cavanna & Seri, 2015). A similar response is also observed towards specific visual stimuli, known as Misokinesia, and is usually coexistent with Misophonia. ...
... A similar response is also observed towards specific visual stimuli, known as Misokinesia, and is usually coexistent with Misophonia. People experiencing Misophonia have reported that the stimuli evokes a strong emotional response, such as anxiety and aggression, and autonomic arousal (Cavanna & Seri, 2015). ...
Objective: Misophonia is a chronic condition in which a person reports intense emotional response and autonomic arousal to specific sounds. It is not a categorized disorder or has a set of symptoms, though a diagnostic criterion has been suggested. The present study aimed at understanding the role of social relationships in the development and maintenance of Misophonia. Design: Using MisoQuest, a tool for assessing Misophonic tendencies, eleven participants were shortlisted for a phenomenological inquiry of their Misophonia experiences. With the Bio-psycho-social model as a reference point, the research was conceptualized and analyzed thematically. Results: The experience of Misophonia across the participants showed similar patterns in terms of heightened auditory reception of the trigger and intense emotional response. The study found two main classifications: Person-Specific Triggers (PST) and non-Person-Specific Triggers (n-PST). With PSTs, which were mainly the family members of the participants, the response to Misophonia was more intense, and the relationship with them was found to be conflictual, emotionally distant, and unsupportive. On the other hand, n-PSTs did not elicit an intense response. Conclusions: The impact of Misophonia was found in the social setting in the form of withdrawal, poor relationships, less social belongingness, and lack of awareness leading to invalidation. The present study implicates healthcare professionals to be more informed about the psychosocial experience of Misophonia. Simultaneously, understanding the role of attachment patterns and social belongingness creates a possibility of developing holistic therapy approaches, intervention programs, and community awareness.
... Both sensory phenomena and misophonia are highly correlated with perfectionism, which is a phenotypic component of OCD (22,50). Additionally, a report published by the International College of Obsessive-Compulsive Disorders (ICOCS) suggested a transition between OCD, TS, and misophonia (51,52). Although the rates of comorbidity with tic disorders were lower in our study compared to the literature, patients diagnosed with tic disorders were found in the misophonia group (53). ...
... Although the rates of comorbidity with tic disorders were lower in our study compared to the literature, patients diagnosed with tic disorders were found in the misophonia group (53). Some authors have documented concurrent misophonia in pediatric OCD and tic disorders and proposed that misophonia may be associated with neurodevelopmental conditions, particularly in the context of sensory sensitivity syndrome (52). In our study, the earlier onset of OCD and the higher frequency of sensory phenomena in the misophonia patient group may suggest a relationship between the presence of misophonia and a neurodevelopmental condition. ...
Objective: The objective of this study was to compare patients with obsessive-compulsive disorder (OCD) with and without misophonia in terms of sociodemographic data, clinical features, and executive functions. Method: This study included 39 patients with obsessive-compulsive disorder and misophonia, as well as 38 patients with obsessive-compulsive disorder without misophonia. A sociodemographic data form, the Yale-Brown Obsessive-Compulsive Scale, the Yale-Brown Obsessive-Compulsive Scale Symptom Checklist, a structured interview form for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Disorders, and the Hamilton Depression Rating Scale were administered to all patients. The executive functions of the patients were evaluated using the Digit Span Test, the Stroop Test, the Trail Making Test, the Verbal Fluency Test, the Wisconsin Card Sorting Test, and the Tower of London test. Results: The obsessive-compulsive disorder group with misophonia had a higher rate of dirtiness obsession/cleaning compulsion, other compulsions, agoraphobia, and eating disorder comorbidities compared to the group without misophonia (p<0.05). Additionally, patients with misophonia had significantly higher Yale-Brown Obsessive-Compulsive Scale obsession scores (p=0.016). However, no difference was found between the groups in terms of executive functions (p>0.05). Conclusion: The presence of high dirtiness obsessions, other compulsions, and agoraphobia comorbidity in in patients with obsessive-compulsive disorder and misophonia suggests an association with disgust sensitivity, sensory phenomena, and anxiety sensitivity, respectively, in obsessive-compulsive disorder. Contrary to expectations, the preservation of executive functions in misophonia can be interpreted as misophonia diverging from the OCD category. How to cite this article: Gokovali Begenen A, Pirdogan Aydin E, Demirci H, Ozer OA. A comparison of clinical features and executive functions between patients with obsessive compulsive disorder with and without misophonia. Dusunen Adam J Psychiatr Neurol Sci 2023;36:90-102.
... Unfortunately, this danger is clearly visible in misophonia when professionals from various fields impose criteria for identifying misophonic subjects based on presumed etiology. Currently, there are two, contrasting approaches to misophonia as highlighted in Swedo's study (Swedo et al., 2022): first, "medical" Jastreboff, 2002, 2015;Edelstein et al., 2013;Cavanna and Seri, 2015) and second, "psychiatric" (Schroder et al., 2013). The consensus committee concluded that at the moment, there is no sufficient evidence to select one of these approaches over the other, but "that underlying organic etiology of the disorder cannot be ruled out" (Swedo et al., 2022). ...
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%.
... The misophonic response can range from mild irritation to anger and distress and can result in impairment to social and occupational functioning [3,4]. Common manifestations of misophonia include feelings of anger, disgust, and anxiety [4][5][6][7][8]; muscle tension [3,9]; avoidance of triggering stimuli [3,[10][11][12], withdrawal from social situations [10][11][12][13][14][15] and, in some cases, verbal and physical aggression [6,10,13,16]. Secondary emotional responses have also been reported, for example shame, guilt [5,17] and anticipatory anxiety [10]. ...
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.
