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Chan KH, Baker A, Gilbert D, Tong S, Rinaldi J, Cypers S, Zhu A, Schoenborn A. The Impact of Mental Health Symptoms in Children With Tinnitus and Misophonia: A Multi-disciplinary Approach. Clin Pediatr (Phila) 2024; 63:1146-1153. [PMID: 37932925 DOI: 10.1177/00099228231211155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
Tinnitus and misophonia are important "sound annoyance" disorders in pediatric otolaryngology and audiology practices. There is scant published literature to suggest increased anxiety and depression symptoms in these disorders. This study aimed at assessing the clinical characteristics of these 2 disorders and their prevalence in mental health-related symptoms in a 2-year retrospective chart review of a multi-disciplinary (otolaryngology, audiology, and psychology) clinic cohort. Analyses were based on 54 (tinnitus = 33 and misophonia = 21) children consisting of 19 males and 35 females with a mean age (standard deviation) of 14.3 (3.0) years. The entire cohort was negatively affected by diagnosis-based symptom severity instruments as assessed by Tinnitus Functional Index and Amsterdam Misophonia Scale. Both subgroups exhibited elevated anxiety and depression symptoms in psychometric instruments as assessed by Screen for Child Anxiety Related Emotional Disorders and Short Mood and Feelings Questionnaire. Evidence-based management of these disorders is lacking, and clinical trials are needed.
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Affiliation(s)
- Kenny H Chan
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Amanda Baker
- Department of Audiology, Speech and Learning, Children's Hospital Colorado, Aurora, CO, USA
| | - Deborah Gilbert
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Suhong Tong
- Research Institute, Children's Hospital Colorado, Aurora, CO, USA
| | - Julie Rinaldi
- Department of Psychiatry, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Scott Cypers
- Department of Psychiatry, School of Medicine, University of Colorado, Aurora, CO, USA
| | - Austin Zhu
- Department of Otolaryngology, School of Medicine, University of Colorado, Aurora, CO, USA
- Department of Otolaryngology, Children's Hospital Colorado, Aurora, CO, USA
| | - Alyssa Schoenborn
- Department of Audiology, Speech and Learning, Children's Hospital Colorado, Aurora, CO, USA
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Mednicoff SD, Barashy S, Vollweiler DJ, Benning SD, Snyder JS, Hannon EE. Misophonia reactions in the general population are correlated with strong emotional reactions to other everyday sensory-emotional experiences. Philos Trans R Soc Lond B Biol Sci 2024; 379:20230253. [PMID: 39005036 DOI: 10.1098/rstb.2023.0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/26/2024] [Indexed: 07/16/2024] Open
Abstract
Misophonic experiences are common in the general population, and they may shed light on everyday emotional reactions to multi-modal stimuli. We performed an online study of a non-clinical sample to understand the extent to which adults who have misophonic reactions are generally reactive to a range of audio-visual emotion-inducing stimuli. We also hypothesized that musicality might be predictive of one's emotional reactions to these stimuli because music is an activity that involves strong connections between sensory processing and meaningful emotional experiences. Participants completed self-report scales of misophonia and musicality. They also watched videos meant to induce misophonia, autonomous sensory meridian response (ASMR) and musical chills, and were asked to click a button whenever they had any emotional reaction to the video. They also rated the emotional valence and arousal of each video. Reactions to misophonia videos were predicted by reactions to ASMR and chills videos, which could indicate that the frequency with which individuals experience emotional responses varies similarly across both negative and positive emotional contexts. Musicality scores were not correlated with measures of misophonia. These findings could reflect a general phenotype of stronger emotional reactivity to meaningful sensory inputs. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.
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Affiliation(s)
- Solena D Mednicoff
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
| | - Sivan Barashy
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
| | - David J Vollweiler
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
| | - Stephen D Benning
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
| | - Joel S Snyder
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
| | - Erin E Hannon
- Department of Psychology, University of Nevada, Las Vegas, NV 89154-9900, USA
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Lewin AB, Milgram L, Cepeda SL, Dickinson S, Bolen M, Kudryk K, Bolton C, Karlovich AR, Grassie HL, Kangavary A, Harmon SL, Guzick A, Ehrenreich-May J. Clinical characteristics of treatment-seeking youth with misophonia. J Clin Psychol 2024; 80:1405-1419. [PMID: 38430053 DOI: 10.1002/jclp.23672] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 02/06/2024] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVE Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation. METHODS The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed. RESULTS Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8-13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably. CONCLUSION Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.
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Affiliation(s)
- Adam B Lewin
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Lauren Milgram
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sandra L Cepeda
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Sarah Dickinson
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Morgan Bolen
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Kelly Kudryk
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Cassidy Bolton
- Department of Pediatrics, Rothman Center for Neuropsychiatry, University of South Florida, Tampa, Florida, USA
| | - Ashley R Karlovich
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Hannah L Grassie
- Department of Psychology, University of Miami, Coral Gables, Florida, USA
| | - Aileen Kangavary
- Department of Educational and Psychological Studies, University of South Florida, Tampa, Florida, USA
| | - Sherelle L Harmon
- Department of Psychology, Florida State University, Tallahassee, Florida, USA
| | - Andrew Guzick
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Neacsiu AD, Beynel L, Gerlus N, LaBar KS, Bukhari-Parlakturk N, Rosenthal MZ. An experimental examination of neurostimulation and cognitive restructuring as potential components for Misophonia interventions. J Affect Disord 2024; 350:274-285. [PMID: 38228276 DOI: 10.1016/j.jad.2024.01.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/08/2023] [Accepted: 01/10/2024] [Indexed: 01/18/2024]
Abstract
Misophonia is a disorder of decreased tolerance to certain aversive, repetitive common sounds, or to stimuli associated with these sounds. Two matched groups of adults (29 participants with misophonia and 30 clinical controls with high emotion dysregulation) received inhibitory neurostimulation (1 Hz) over a personalized medial prefrontal cortex (mPFC) target functionally connected to the left insula; excitatory neurostimulation (10 Hz) over a personalized dorsolateral PFC (dlPFC) target; and sham stimulation over either target. Stimulations were applied while participants were either listening or cognitively downregulating emotions associated with personalized aversive, misophonic, or neutral sounds. Subjective units of distress (SUDS) and psychophysiological measurements (e.g., skin conductance response [SCR] and level [SCL]) were collected. Compared to controls, participants with misophonia reported higher distress (∆SUDS = 1.91-1.93, ps < 0.001) when listening to and when downregulating misophonic distress. Both types of neurostimulation reduced distress significantly more than sham, with excitatory rTMS providing the most benefit (Cohen's dSUDS = 0.53; dSCL = 0.14). Excitatory rTMS also enhanced the regulation of emotions associated with misophonic sounds in both groups when measured by SUDS (dcontrol = 1.28; dMisophonia = 0.94), and in the misophonia group alone when measured with SCL (d = 0.20). Both types of neurostimulation were well tolerated. Engaging in cognitive restructuring enhanced with high-frequency neurostimulation led to the lowest misophonic distress, highlighting the best path forward for misophonia interventions.
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Affiliation(s)
- Andrada D Neacsiu
- Duke University School of Medicine, Durham, NC, USA; Center for Misophonia and Emotional Dysregulation, Durham, NC, USA; Brain Stimulation Research Center, Durham, NC, USA.
| | - Lysianne Beynel
- National Institute for Mental Health, Bethesta, DC, USA; Duke University School of Medicine, Durham, NC, USA.
| | | | - Kevin S LaBar
- Duke University, Durham, NC, USA; Duke Institute for Brain Sciences, Durham, NC, USA.
| | - Noreen Bukhari-Parlakturk
- Duke University, Durham, NC, USA; Duke University School of Medicine, Durham, NC, USA; Duke Institute for Brain Sciences, Durham, NC, USA.
| | - M Zachary Rosenthal
- Duke University, Durham, NC, USA; Duke University School of Medicine, Durham, NC, USA; Center for Misophonia and Emotional Dysregulation, Durham, NC, USA.
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Perez VW, Friedman A. Misophonia matters: A case study of the role of brain imaging in debates over new diagnoses. SOCIOLOGY OF HEALTH & ILLNESS 2024; 46:92-109. [PMID: 37329250 DOI: 10.1111/1467-9566.13679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 05/08/2023] [Indexed: 06/18/2023]
Abstract
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.
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Brennan CR, Lindberg RR, Kim G, Castro AA, Khan RA, Berenbaum H, Husain FT. Misophonia and Hearing Comorbidities in a Collegiate Population. Ear Hear 2024; 45:390-399. [PMID: 37789522 DOI: 10.1097/aud.0000000000001435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/05/2023]
Abstract
OBJECTIVES Misophonia is a little-understood disorder in which certain sounds cause a strong emotional response in those who experience it. People who are affected by misophonia may find that noises like loud chewing, pen clicking, and/or sniffing trigger intense frustration, anger, or discomfort. The relationship of misophonia with other auditory disorders including loudness hyperacusis, tinnitus, and hearing loss is largely underexplored. This project aimed to investigate the prevalence and hearing-health comorbidities of misophonia in a college-aged population by using an online survey. DESIGN A total of 12,131 undergraduate and graduate students between the ages of 18 and 25 were given the opportunity to answer an in-depth online survey. These students were sampled in a roughly 50 of 50 sex distribution. The survey was created using Qualtrics and included the following components: electronic consent, demographics questionnaire, Misophonia Questionnaire (MQ), Khalfa's Hyperacusis Questionnaire (HQ), Tinnitus and Hearing Survey, and Tinnitus Functional Index (TFI). To be eligible for compensation, answers for each of the above components were required, with the exception of the TFI, which was only presented to students who indicated that they experienced tinnitus. Respondents were determined to have high or possible likelihood of having misophonia if they gave specific answers to the MQ's Emotion and Behavior Scale or the MQ Severity Scale. RESULTS After excluding duplicate responses and age-related outliers, 1,084 responses were included in the analysis. Just over 20% (n = 217) of the sample was determined to have a high or probable likelihood of having misophonia. The sample was primarily White, female, and of mid-to-high socioeconomic status. There was a strong positive correlation between MQ total scores and HQ total scores. High likelihood misophonia status showed a significant relationship with self-reported hearing loss and tinnitus. No statistically significant relationship was found between misophonia and age, ethnicity, or socioeconomic status. MQ total scores differed significantly when separating respondents by sex, self-reported tinnitus, and loudness hyperacusis. White respondents had significantly higher MQ total scores than Asian/Asian American respondents. CONCLUSIONS The estimated prevalence of misophonia was about 8% to 20% of the sample, which agrees with most of the currently published research examining misophonia symptoms in collegiate populations. Results of data analysis suggest that misophonia severity may be related to loudness hyperacusis, sex, and possibly tinnitus. Future studies are needed to further examine the characteristics of these relationships, possibly in populations more optimized to reflect the general population or those with hearing-health disorders.
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Affiliation(s)
- Caroline R Brennan
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Ragnar R Lindberg
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Gibbeum Kim
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Ariana A Castro
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Rafay A Khan
- The Neuroscience Program, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Howard Berenbaum
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL, USA
| | - Fatima T Husain
- Department of Speech and Hearing Science, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Neuroscience Program, University of Illinois Urbana-Champaign, Champaign, IL, USA
- The Beckman Institute for Advanced Science and Technology, University of Illinois Urbana-Champaign, Champaign, IL, USA
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Abramovitch A, Herrera TA, Etherton JL. A neuropsychological study of misophonia. J Behav Ther Exp Psychiatry 2024; 82:101897. [PMID: 37657963 DOI: 10.1016/j.jbtep.2023.101897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 07/09/2023] [Accepted: 08/16/2023] [Indexed: 09/03/2023]
Abstract
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.
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Affiliation(s)
| | - Tanya A Herrera
- Department of Psychology, Texas State University, San Marcos, TX, USA
| | - Joseph L Etherton
- Department of Psychology, Texas State University, San Marcos, TX, USA
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Hayes C, Gregory J, Aziz R, Cerejeira J, Cruz M, Simões JA, Vitoratou S. Psychometric Evaluation and Misophonic Experience in a Portuguese-Speaking Sample. Behav Sci (Basel) 2024; 14:107. [PMID: 38392460 PMCID: PMC10886306 DOI: 10.3390/bs14020107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 01/25/2024] [Accepted: 01/26/2024] [Indexed: 02/24/2024] Open
Abstract
Misophonia, a disorder characterised by an extreme sensitivity to certain sounds, is increasingly being studied in cross-cultural settings. The S-Five scale is a multidimensional psychometric tool initially developed to measure the severity of misophonia in English-speaking populations. The scale has been validated in several languages, and the present study aimed to validate the European Portuguese S-Five scale in a Portuguese-speaking sample. The scale was translated into Portuguese using a forward-backwards translation method. The psychometric properties of the S-Five scale were evaluated in a sample of 491 Portuguese-speaking adults. Confirmatory factor analysis supported a five-factor structure consistent with previous versions of the S-Five scale. The five factors were as follows: (1) internalising appraisals, (2) externalising appraisals, (3) perceived threat and avoidance behaviour, (4) outbursts, and (5) impact on functioning. The satisfactory psychometric properties of the S-Five scale further indicated its cross-cultural stability. As a psychometrically robust tool, the S-Five can measure misophonia in Portuguese-speaking populations, allowing future studies to explore and compare misophonia in this population.
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Affiliation(s)
- Chloe Hayes
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK
| | - Jane Gregory
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
- Oxford Health Specialist Psychological Interventions Centre, Oxford Health NHS Foundation Trust, Oxford OX3 7JX, UK
| | - Rahima Aziz
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK
| | - Joaquim Cerejeira
- Faculty of Medicine, University of Coimbra, 3000-270 Coimbra, Portugal
| | - Marina Cruz
- Department of Psychiatry, Hospital do Divino Espírito Santo de Ponta Delgada, 9500-370 Ponta Delgada, Portugal
| | - José Augusto Simões
- Department of Medical Sciences, University of Beira Interior, 6201-001 Covilhã, Portugal
- Center for Health Technology and Services Research (CINTESIS), 4200-450 Porto, Portugal
| | - Silia Vitoratou
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AB, UK
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Carson TB, Qiu Y, Liang L, Medina AM, Ortiz A, Condon CA, Ryan N, Ambrosio J, Carcamo K, Miranda D, Palacio-Raine A. Development and validation of a paediatric version of the Khalfa Hyperacusis Questionnaire for children with and without autism. Int J Audiol 2023; 62:1187-1195. [PMID: 36053255 DOI: 10.1080/14992027.2022.2113827] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 08/11/2022] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Hyperacusis is reported to occur in 3.2-17.1% of the general paediatric population with higher rates in clinical populations such as autism spectrum disorders (ASD). Although hyperacusis is a relatively common form of decreased sound tolerance (DST), no valid paediatric hyperacusis measures are currently available. The purpose of the present study was to develop and validate a paediatric version of the Khalfa Hyperacusis Questionnaire (HQ) as a first step towards filling this measurement gap. DESIGN A cross-sectional design was used to evaluate therapist opinions of the paediatric version (P-HQ) and to field test the P-HQ in parents of children with and without ASD. Total scores were compared between ASD and non-ASD groups. STUDY SAMPLE Eleven paediatric occupational and speech therapists with expertise in ASD, 64 parents of children with ASD and 37 parents of children without ASD completed online questionnaires. Psychometric analyses were conducted. RESULTS A unidimensional construct was found underlying P-HQ and all items displayed sufficient theoretical relevance to hyperacusis and adequate psychometric properties. CONCLUSIONS The P-HQ demonstrates good internal consistency and shows promise as a potential screening tool for identifying DST in ASD. Further research is warranted to establish normative data and validate cut-off scores.
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Affiliation(s)
- Tana B Carson
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Yuxi Qiu
- Department of Department of Counseling, Recreation and School Psychology, College of Arts, Sciences and Education, Florida International University, Miami, FL, USA
| | - Lu Liang
- Department of Psychology, College of Arts, Sciences and Education, Florida International University, Miami, FL, USA
| | - Angela M Medina
- Department of Communication Sciences and Disorders, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Annie Ortiz
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Courtney A Condon
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Nicaela Ryan
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Jenna Ambrosio
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Karina Carcamo
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Dana Miranda
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
| | - Alexandra Palacio-Raine
- Department of Occupational Therapy, Nicole Wertheim College of Nursing & Health Sciences, Florida International University, Miami, FL, USA
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Dozier T, Mitchell N. Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder. F1000Res 2023; 12:808. [PMID: 37881332 PMCID: PMC10594049 DOI: 10.12688/f1000research.133506.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2023] [Indexed: 10/27/2023] Open
Abstract
Background: Misophonia is a recently identified condition in which a person perceives a subtle stimulus (e.g., eating sounds, hair twirling) and has an intense, negative emotional response. Misophonia cannot be classified with established nosological systems. Methods: We present a novel five-phase model of misophonia from a cognitive-behavioral framework. This model identifies a learned reflex of the autonomic nervous system as the primary etiology and maintenance of misophonia. Phase one is anticipatory anxiety and avoidance. Phase two is a conditioned physical reflex (for example, the tensing of calf muscles) that develops through stimulus-response Pavlovian conditioning. Phase three includes intense negative emotional responses and accompanying physiological distress, thoughts, urges, and emotion-driven behavior. Phase four is the individual's coping responses to emotional distress, and phase five is the environmental response and resulting internal and external consequences of the coping behaviors. Each phase helps explain the maintenance of the response and the individual's impairment. Results: Anticipatory anxiety and avoidance of phase one contributes to an increased arousal and awareness of triggers, resulting in increased severity of the trigger experience. Both the Pavlovian-conditioned physical reflex of phase two and the emotion-driven behavior caused by the conditioned emotional response of phase three increase with in vivo exposure to triggers. Phase four includes internal and external coping behaviors to the intense emotions and distress, and phase five includes the consequences of those behaviors. Internal consequences include beliefs fiveand new emotions based on environmental responses to anger and panic. For example, the development of emotions such as shame and guilt, and beliefs regarding how 'intolerable' the trigger is. Conclusions: We assert misophonia is a multi-sensory condition and includes anticipatory anxiety, conditioned physical reflexes, intense emotional and physical distress, subsequent internal and external responses, and environmental consequences.
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Holohan D, Marfilius K, Smith CJ. Misophonia: A Review of the Literature and Its Implications for the Social Work Profession. SOCIAL WORK 2023; 68:341-348. [PMID: 37463856 DOI: 10.1093/sw/swad029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/07/2022] [Accepted: 12/19/2022] [Indexed: 07/20/2023]
Abstract
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.
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Affiliation(s)
- Daniel Holohan
- BA, is a student, School of Social Work, Syracuse University, 150 Crouse Dr., Syracuse, NY 13244, USA
| | - Kenneth Marfilius
- DSW, LCSW, is assistant dean of online and distance education, Falk College, and associate teaching professor, School of Social Work, Syracuse University, Syracuse, NY, USA
| | - Carrie J Smith
- MSW, DSW, is department chair and professor, School of Social Work, Syracuse University, Syracuse, NY, USA
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Norena AJ. The Analogy between Tinnitus and Chronic Pain: A Phenomenological Approach. Brain Sci 2023; 13:1129. [PMID: 37626486 PMCID: PMC10452332 DOI: 10.3390/brainsci13081129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/22/2023] [Accepted: 07/25/2023] [Indexed: 08/27/2023] Open
Abstract
Tinnitus is an auditory sensation without external acoustic stimulation or significance, which may be lived as an unpleasant experience and impact the subject's quality of life. Tinnitus loudness, which is generally low, bears no relation to distress. Factors other than psychoacoustic (such as psychological factors) are therefore implicated in the way tinnitus is experienced. The aim of this article is to attempt to understand how tinnitus can, like chronic pain, generate a 'crisis' in the process of existence, which may go as far as the collapse of the subject. The main idea put forward in the present article is that tinnitus may be compared to the phenomenon of pain from the point of view of the way it is experienced. Although the analogy between tinnitus and pain has often been made in the literature, it has been limited to a parallel concerning putative physiopathological mechanisms and has never really been explored in depth from the phenomenological point of view. Tinnitus is comparable to pain inasmuch as it is felt, not perceived: it springs up (without intention or exploration), abolishes the distance between the subject and the sensation (there is only a subject and no object), and has nothing to say about the world. Like pain, tinnitus is formless and abnormal and can alter the normal order of the world with maximum intensity. Finally, tinnitus and pain enclose the subject within the limits of the body, which then becomes in excess. Tinnitus may be a source of suffering, which affects not only the body but a person's very existence and, in particular, its deployment in time. Plans are thus abolished, so time is no longer 'secreted', it is enclosed in an eternal present. If the crisis triggered by tinnitus is not resolved, the subject may buckle and collapse (depression) when their resources for resisting are depleted. The path may be long and winding from the moment when tinnitus emerges to when it assaults existence and its eventual integration into a new existential norm where tinnitus is no longer a source of disturbance.
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Affiliation(s)
- Arnaud J Norena
- Laboratoire de Neurosciences Sensorielles et Cognitives, CNRS, Aix-Marseille University, 13003 Marseille, France
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13
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Mattson SA, D’Souza J, Wojcik KD, Guzick AG, Goodman WK, Storch EA. A systematic review of treatments for misophonia. PERSONALIZED MEDICINE IN PSYCHIATRY 2023; 39-40:100104. [PMID: 37333720 PMCID: PMC10276561 DOI: 10.1016/j.pmip.2023.100104] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
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.
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Affiliation(s)
- Seth A. Mattson
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Johann D’Souza
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Katharine D. Wojcik
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Andrew G. Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Wayne K. Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
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14
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Aryal S, Prabhu P. Understanding misophonia from an audiological perspective: a systematic review. Eur Arch Otorhinolaryngol 2023; 280:1529-1545. [PMID: 36484853 DOI: 10.1007/s00405-022-07774-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/01/2022] [Indexed: 12/13/2022]
Abstract
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.
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Affiliation(s)
- Sajana Aryal
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, 570006, India.
| | - Prashanth Prabhu
- Department of Audiology, All India Institute of Speech and Hearing, Mysore, 570006, India
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15
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Guzick AG, Cervin M, Smith EEA, Clinger J, Draper I, Goodman WK, Lijffijt M, Murphy N, Lewin AB, Schneider SC, Storch EA. Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia. J Affect Disord 2023; 324:395-402. [PMID: 36584703 PMCID: PMC9878468 DOI: 10.1016/j.jad.2022.12.083] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 11/25/2022] [Accepted: 12/18/2022] [Indexed: 12/29/2022]
Abstract
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.
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Affiliation(s)
- Andrew G Guzick
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States.
| | - Matti Cervin
- Department of Clinical Sciences Lund, Lund University, Sweden
| | - Eleanor E A Smith
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Jane Clinger
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Isabel Draper
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Wayne K Goodman
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Marijn Lijffijt
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Nicholas Murphy
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Adam B Lewin
- Department of Pediatrics, University of South Florida, United States
| | - Sophie C Schneider
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
| | - Eric A Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, United States
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16
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Remmert N, Jebens A, Gruzman R, Gregory J, Vitoratou S. A nomological network for misophonia in two German samples using the S-Five model for misophonia. Front Psychol 2022; 13:902807. [PMID: 36619047 PMCID: PMC9811822 DOI: 10.3389/fpsyg.2022.902807] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 11/28/2022] [Indexed: 12/24/2022] Open
Abstract
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.
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Affiliation(s)
- Nico Remmert
- Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
| | - Antonia Jebens
- Department of Psychometrics and Measurement Lab, Biostatistics and Health Informatics King’s College London, Institute of Psychiatry, Psychology and Neurosciences, London, United Kingdom
| | - Rebecca Gruzman
- Department of Psychology, Medical School Berlin, Berlin, Germany
| | - Jane Gregory
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom
| | - Silia Vitoratou
- Department of Psychometrics and Measurement Lab, Biostatistics and Health Informatics King’s College London, Institute of Psychiatry, Psychology and Neurosciences, London, United Kingdom
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Antoniadou M, Tziovara P, Antoniadou C. The Effect of Sound in the Dental Office: Practices and Recommendations for Quality Assurance-A Narrative Review. Dent J (Basel) 2022; 10:dj10120228. [PMID: 36547044 PMCID: PMC9776681 DOI: 10.3390/dj10120228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Sound is inextricably linked to the human senses and is therefore directly related to the general health of the individual. The aim of the present study is to collect data on the effect of two dimensions of sound, music, and noise from an emotional and functional point of view in the dental office and to perform a thorough review of the relevant literature. We collected articles from the databases PubMed and Google Scholar through keywords that were related to noise and music in healthcare. Important information was also extracted from articles on the web and official websites. Screening of the relevant literature was performed according to accuracy and reliability of the methodology tested. A total of 261 articles were associated to sound and music in healthcare. Ninety-six of them were the most well documented and were thus included in our article. Most of the articles associate noise with negative emotions and a negative impact on performance, while music is associated with positive emotions ranging from emotional state to therapeutic approaches. Few results were found regarding ways to reduce noise in a health facility. If there is a difficulty to find effective methods of reducing the daily noise-inducing sounds in the dental office, we must focus on ways to incorporate music into it as a means of relaxation and therapy.
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Affiliation(s)
- Maria Antoniadou
- Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Correspondence: ; Tel.: +30-69-4434-2546
| | - Panagiota Tziovara
- Dental School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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18
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Bagrowska P, Pionke-Ubych R, Gawęda Ł. 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. Schizophr Res 2022; 250:137-142. [PMID: 36410290 DOI: 10.1016/j.schres.2022.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/28/2022] [Accepted: 11/05/2022] [Indexed: 11/19/2022]
Abstract
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.
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Affiliation(s)
- Paulina Bagrowska
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Stefana Jaracza 1, 00-378 Warsaw, Poland.
| | - Renata Pionke-Ubych
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Stefana Jaracza 1, 00-378 Warsaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Stefana Jaracza 1, 00-378 Warsaw, Poland
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Imgart H, Zanko A, Lorek S, Schlichterle PS, Zeiler M. Exploring the link between eating disorders and persistent genital arousal disorder/genito-pelvic dysesthesia: first description and a systematic review of the literature. J Eat Disord 2022; 10:159. [PMID: 36357896 PMCID: PMC9650894 DOI: 10.1186/s40337-022-00687-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Accepted: 10/10/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) characterized by recurrent physiological genital without corresponding psychological arousal is a poorly understood and researched condition. Based on the first two case descriptions of eating disorders directly linked to PGAD/GPD the aim of this paper was to systematically review the literature on possible associations between eating disorders and PGAD/GPD. METHOD A systematic literature search on eating disorders and PGAD/GPD was conducted in PubMed, PsycINFO, and Scopus, complemented by Google Scholar. We included case reports, case series, cross-sectional studies and review articles published in peer-reviewed journals written in English or German-language. RESULTS The included original papers described a total of 2078 cases with PGAD/GPD symptomatology. Of these, 892 participants fulfilled all five PGAD/GPD core criteria. The aetiology of PGAD/GPD is unknown. Multifactorial genesis of PGAD/GPD is presumed including neurological, pharmacological, hormonal, vascular and psychological causes. A high degree of psychological comorbidity is reported. No study was found that drew a direct link between eating disorders and PGAD/GPD. Although PGAD/GPD symptoms also occur in adolescents, there are no findings in this regard. However, we found a gap in data collection: eating disorders as potential psychiatric comorbidities were systematically recorded in only a few studies. CONCLUSION The existing literature have not yet considered a possible link between eating disorders and PGAD/GPD so far. According to the authors' knowledge, this work is the first review to systematically explore the associations. We suspect underreporting of PGAD/GPD cases in eating disorders and particularly during adolescence. We argue that there are several common factors that appear to be important in the etiology, course, and treatment of both disorders (e.g. hormonal dysregulation or sensory sensitivity and avoidance), warranting future research on the possible comorbidity of these disorders.
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Affiliation(s)
- Hartmut Imgart
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany.
| | - Annika Zanko
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Sandra Lorek
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Patti-Sue Schlichterle
- Competence Center for Eating Disorders, Parkland Clinic, Im Kreuzfeld 6, 34537, Bad Wildungen, Germany
| | - Michael Zeiler
- Eating Disorder Unit, Department for Child and Adolescent Psychiatry, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria
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20
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Smith EEA, Guzick AG, Draper IA, Clinger J, Schneider SC, Goodman WK, Brout JJ, Lijffijt M, Storch EA. Perceptions of various treatment approaches for adults and children with misophonia. J Affect Disord 2022; 316:76-82. [PMID: 35970326 PMCID: PMC9884516 DOI: 10.1016/j.jad.2022.08.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 08/01/2022] [Accepted: 08/09/2022] [Indexed: 01/31/2023]
Abstract
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.
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Affiliation(s)
- Eleanor E A Smith
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Andrew G Guzick
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Isabel A Draper
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Jane Clinger
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Sophie C Schneider
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Wayne K Goodman
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | | | - Marjin Lijffijt
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA
| | - Eric A Storch
- Department of Psychiatry and Behavior Sciences, Baylor College of Medicine, 1977 Butler Blvd., Suite 4-100, Houston, TX 77030, USA.
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21
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Rosenthal MZ, McMahon K, Greenleaf AS, Cassiello-Robbins C, Guetta R, Trumbull J, Anand D, Frazer-Abel ES, Kelley L. Phenotyping misophonia: Psychiatric disorders and medical health correlates. Front Psychol 2022; 13:941898. [PMID: 36275232 PMCID: PMC9583952 DOI: 10.3389/fpsyg.2022.941898] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- M. Zachary Rosenthal
- Department of Psychiatry and Behavior, Duke University Medical Center, Durham, NC, United States
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
- *Correspondence: M. Zachary Rosenthal,
| | - Kibby McMahon
- Department of Psychiatry and Behavior, Duke University Medical Center, Durham, NC, United States
| | - Anna S. Greenleaf
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | | | - Rachel Guetta
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Jacqueline Trumbull
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | | | - Emily S. Frazer-Abel
- Department of Psychiatry and Behavior, Duke University Medical Center, Durham, NC, United States
| | - Lisalynn Kelley
- Department of Psychiatry and Behavior, Duke University Medical Center, Durham, NC, United States
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22
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Treatment of Misophonia with Risperidone in a Patient with Autism Spectrum Disorder. Case Rep Psychiatry 2022; 2022:3169834. [PMID: 36247223 PMCID: PMC9553690 DOI: 10.1155/2022/3169834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/20/2022] [Indexed: 11/18/2022] Open
Abstract
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.
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23
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Mednicoff SD, Barashy S, Gonzales D, Benning SD, Snyder JS, Hannon EE. Auditory affective processing, musicality, and the development of misophonic reactions. Front Neurosci 2022; 16:924806. [PMID: 36213735 PMCID: PMC9537735 DOI: 10.3389/fnins.2022.924806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/02/2022] [Indexed: 11/13/2022] Open
Abstract
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.
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Grossini E, Stecco A, Gramaglia C, De Zanet D, Cantello R, Gori B, Negroni D, Azzolina D, Ferrante D, Feggi A, Carriero A, Zeppegno P. Misophonia: Analysis of the neuroanatomic patterns at the basis of psychiatric symptoms and changes of the orthosympathetic/ parasympathetic balance. Front Neurosci 2022; 16:827998. [PMID: 36033627 PMCID: PMC9406292 DOI: 10.3389/fnins.2022.827998] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/14/2022] [Indexed: 11/16/2022] Open
Abstract
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.
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Affiliation(s)
- Elena Grossini
- Laboratory of Physiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
- *Correspondence: Elena Grossini,
| | - Alessandro Stecco
- Radiology Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Carla Gramaglia
- Psychiatry Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Daniel De Zanet
- Laboratory of Physiology, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Roberto Cantello
- Neurology Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Benedetta Gori
- Neurology Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Davide Negroni
- Radiology Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Danila Azzolina
- Statistic Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Daniela Ferrante
- Statistic Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Feggi
- Psychiatry Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Alessandro Carriero
- Radiology Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
| | - Patrizia Zeppegno
- Psychiatry Unit, Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
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Williams ZJ, Cascio CJ, Woynaroski TG. Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire. Front Psychol 2022; 13:897901. [PMID: 35936331 PMCID: PMC9355318 DOI: 10.3389/fpsyg.2022.897901] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
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.
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Affiliation(s)
- Zachary J. Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, Nashville, TN, United States
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Carissa J. Cascio
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
| | - Tiffany G. Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, TN, United States
- Vanderbilt Brain Institute, Vanderbilt University, Nashville, TN, United States
- Frist Center for Autism and Innovation, Vanderbilt University, Nashville, TN, United States
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, TN, United States
- Department of Communication Sciences and Disorders, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, United States
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Pfeiffer E, Allroggen M, Sachser C. [Misophonia in Childhood and Adolescence: A Narrative Review]. ZEITSCHRIFT FUR KINDER-UND JUGENDPSYCHIATRIE UND PSYCHOTHERAPIE 2022; 51:222-232. [PMID: 35856746 DOI: 10.1024/1422-4917/a000885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Misophonia in Childhood and Adolescence: A Narrative Review Abstract. Misophonia describes a phenomenon in which the affected children and adolescents show a strong negative physiological and emotional reaction when confronted with specific (misophonic) auditory stimuli (most commonly eating or breathing sounds). Several studies with adults yielded prevalence rates between 6 % and 20 % in various (clinical) samples, but the representativeness of samples was largely limited. More than 80 % of the first manifestation of symptoms occurs during childhood and adolescence. Regarding comorbid disorders, studies show great heterogeneity, with estimates ranging from 28-76 % of comorbid mental disorders and approximately 25 % with comorbid physical disorders. The exact etiology is currently not well studied. Initial neurophysiological explanations and imaging studies point to a specific physiological response in misophonia patients. Although many case reports are now available, and diagnostic criteria and measurement tools have been developed, misophonia currently does not represent a distinct neurological, audiological, or psychiatric disorder in the DSM-5 or ICD-11.
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Affiliation(s)
- Elisa Pfeiffer
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
| | - Marc Allroggen
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
| | - Cedric Sachser
- Klinik für Kinder- und Jugendpsychiatrie/Psychotherapie, Universität Ulm, Deutschland
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27
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Heller LM, Smith JM. Identification of Everyday Sounds Affects Their Pleasantness. Front Psychol 2022; 13:894034. [PMID: 35936236 PMCID: PMC9347306 DOI: 10.3389/fpsyg.2022.894034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/20/2022] [Indexed: 11/19/2022] Open
Abstract
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.
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Ward RT, Gilbert FE, Pouliot J, Chiasson P, McIlvanie S, Traiser C, Riels K, Mears R, Keil A. The Relationship Between Self-Reported Misophonia Symptoms and Auditory Aversive Generalization Leaning: A Preliminary Report. Front Neurosci 2022; 16:899476. [PMID: 35812229 PMCID: PMC9260228 DOI: 10.3389/fnins.2022.899476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/02/2022] [Indexed: 01/29/2023] Open
Abstract
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.
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Affiliation(s)
- Richard T. Ward
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Faith E. Gilbert
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Jourdan Pouliot
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Payton Chiasson
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Skylar McIlvanie
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Caitlin Traiser
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Kierstin Riels
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
| | - Ryan Mears
- Department of Psychology, University of Florida, Gainesville, FL, United States
| | - Andreas Keil
- Center for the Study of Emotion and Attention, University of Florida, Gainesville, FL, United States
- Department of Psychology, University of Florida, Gainesville, FL, United States
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Remmert N, Schmidt KMB, Mussel P, Hagel ML, Eid M. The Berlin Misophonia Questionnaire Revised (BMQ-R): Development and validation of a symptom-oriented diagnostical instrument for the measurement of misophonia. PLoS One 2022; 17:e0269428. [PMID: 35727794 PMCID: PMC9212156 DOI: 10.1371/journal.pone.0269428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 05/22/2022] [Indexed: 11/17/2022] Open
Abstract
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.
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Affiliation(s)
- Nico Remmert
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
- * E-mail:
| | | | - Patrick Mussel
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
| | | | - Michael Eid
- Department of Psychology, Freie Universität Berlin, Berlin, Germany
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Ferrer-Torres A, Giménez-Llort L. Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6790. [PMID: 35682372 PMCID: PMC9180704 DOI: 10.3390/ijerph19116790] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 02/01/2023]
Abstract
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.
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Affiliation(s)
- Antonia Ferrer-Torres
- L’Alfatier-Centro Médico Psicológico, 08025 Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
| | - Lydia Giménez-Llort
- Department of Psychiatry and Forensic Medicine, School of Medicine, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain;
- Institut de Neurociències, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
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Cakiroglu S, Cosgun S, Gormez V. The prevalence and severity of misophonia in the Turkish population and validation of the Amsterdam Misophonia Scale-Revised. Bull Menninger Clin 2022; 86:159-180. [DOI: 10.1521/bumc.2022.86.2.159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
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.
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Affiliation(s)
- Suleyman Cakiroglu
- Child and adolescent psychiatrist, Istanbul Göztepe Prof. Dr. Süleyman Yalçin City Hospital, Istanbul, Turkey
| | - Sefa Cosgun
- Child and adolescent psychiatrist, Van Training and Research Hospital, Van, Turkey
| | - Vahdet Gormez
- Associate professor and child and adolescent psychiatrist, Istanbul Medeniyet University, Medicine Faculty, Istanbul, Turkey
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32
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Rinaldi LJ, Smees R, Ward J, Simner J. Poorer Well-Being in Children With Misophonia: Evidence From the Sussex Misophonia Scale for Adolescents. Front Psychol 2022; 13:808379. [PMID: 35465571 PMCID: PMC9019493 DOI: 10.3389/fpsyg.2022.808379] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/11/2022] [Indexed: 01/07/2023] Open
Abstract
Objective Misophonia is an unusually strong aversion to a specific class of sounds - most often human bodily sounds such as chewing, crunching, or breathing. A number of studies have emerged in the last 10 years examining misophonia in adults, but little is known about the impact of the condition in children. Here we set out to investigate the well-being profile of children with misophonia, while also presenting the first validated misophonia questionnaire for children. Materials and Methods We screened 142 children (10-14 years; Mean 11.72 SD 1.12; 65 female, 77 male) using our novel diagnostic [the Sussex Misophonia Scale for Adolescents (SMS-Adolescent)]. This allowed us to identify a group of children already manifesting misophonia at that age - the first population-sampled cohort of child misophonics examined to date. Children and their parents also completed measures of well-being (for convergent validation of our SMS-Adolescent) and creative self-construct (for discriminant validation). Results Data show that children with misophonia have significantly elevated levels of anxiety and obsessive compulsive traits. Additionally children with misophonia have significantly poorer life-satisfaction, and health-related quality of life. As predicted, they show no differences in creative self-construct. Conclusion Together our data suggest the first evidence in population sampling of poorer life outcomes for children with misophonia, and provide preliminary convergent and discriminant validation for our novel misophonia instrument. Our data suggest a need for greater recognition and therapeutic outlets for adolescents with misophonia.
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Affiliation(s)
- Louisa J. Rinaldi
- School of Psychology, University of Sussex, Brighton, United Kingdom
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33
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Norris JE, Kimball SH, Nemri DC, Ethridge LE. Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping. Front Neurosci 2022; 16:832516. [PMID: 35418830 PMCID: PMC8995706 DOI: 10.3389/fnins.2022.832516] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 03/03/2022] [Indexed: 12/18/2022] Open
Abstract
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.
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Affiliation(s)
- Jordan E. Norris
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Suzanne H. Kimball
- Department of Communication Sciences and Disorders, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
| | - Danna C. Nemri
- Department of Psychology, University of Oklahoma, Norman, OK, United States
| | - Lauren E. Ethridge
- Department of Psychology, University of Oklahoma, Norman, OK, United States
- Section on Developmental and Behavioral Pediatrics, Department of Pediatrics, University of Oklahoma Health Sciences Center, Oklahoma City, OK, United States
- *Correspondence: Lauren E. Ethridge,
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34
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Swedo SE, Baguley DM, Denys D, Dixon LJ, Erfanian M, Fioretti A, Jastreboff PJ, Kumar S, Rosenthal MZ, Rouw R, Schiller D, Simner J, Storch EA, Taylor S, Werff KRV, Altimus CM, Raver SM. Consensus Definition of Misophonia: A Delphi Study. Front Neurosci 2022; 16:841816. [PMID: 35368272 PMCID: PMC8969743 DOI: 10.3389/fnins.2022.841816] [Citation(s) in RCA: 67] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/07/2022] [Indexed: 01/24/2023] Open
Abstract
Misophonia is a disorder of decreased tolerance to specific sounds or their associated stimuli that has been characterized using different language and methodologies. The absence of a common understanding or foundational definition of misophonia hinders progress in research to understand the disorder and develop effective treatments for individuals suffering from misophonia. From June 2020 through January 2021, the authors conducted a study to determine whether a committee of experts with diverse expertise related to misophonia could develop a consensus definition of misophonia. An expert committee used a modified Delphi method to evaluate candidate definitional statements that were identified through a systematic review of the published literature. Over four rounds of iterative voting, revision, and exclusion, the committee made decisions to include, exclude, or revise these statements in the definition based on the currently available scientific and clinical evidence. A definitional statement was included in the final definition only after reaching consensus at 80% or more of the committee agreeing with its premise and phrasing. The results of this rigorous consensus-building process were compiled into a final definition of misophonia that is presented here. This definition will serve as an important step to bring cohesion to the growing field of researchers and clinicians who seek to better understand and support individuals experiencing misophonia.
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Affiliation(s)
- Susan E. Swedo
- PANDAS Physicians Network, Mooresville, NC, United States,Pediatrics and Developmental Neuroscience Branch, National Institute of Mental Health, National Institutes of Health, Bethesda, MD, United States
| | - David M. Baguley
- Hearing Sciences, Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, United Kingdom,NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, United Kingdom,Nottingham Audiology Services, Nottingham University Hospitals, Nottingham, United Kingdom
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Laura J. Dixon
- Department of Psychology, University of Mississippi, Oxford, MS, United States
| | - Mercede Erfanian
- UCL Institute for Environmental Design and Engineering, University College London, London, United Kingdom
| | | | - Pawel J. Jastreboff
- Jastreboff Hearing Disorders Foundation, Columbia, MD, United States,Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, United States
| | - Sukhbinder Kumar
- Auditory Group, Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - M. Zachary Rosenthal
- Center for Misophonia and Emotion Regulation, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States,Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Romke Rouw
- Brain and Cognition, Department of Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Daniela Schiller
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States,Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Julia Simner
- School of Psychology, Pevensey Building, University of Sussex, Brighton, United Kingdom,Department of Psychology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Eric A. Storch
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, United States
| | - Steven Taylor
- Department of Psychiatry, The University of British Columbia, Vancouver, BC, Canada
| | - Kathy R. Vander Werff
- Department of Communication Sciences and Disorders, Syracuse University, Syracuse, NY, United States
| | - Cara M. Altimus
- Center for Strategic Philanthropy, Milken Institute, Washington, DC, United States
| | - Sylvina M. Raver
- Center for Strategic Philanthropy, Milken Institute, Washington, DC, United States,*Correspondence: Sylvina M. Raver,
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Eijsker N, Schröder A, Liebrand LC, Smit DJA, van Wingen G, Denys D. White matter abnormalities in misophonia. Neuroimage Clin 2022; 32:102787. [PMID: 34461433 PMCID: PMC8405911 DOI: 10.1016/j.nicl.2021.102787] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 08/02/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022]
Abstract
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.
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Affiliation(s)
- Nadine Eijsker
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands
| | - Arjan Schröder
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands
| | - Luka C Liebrand
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands; Amsterdam University Medical Centers, University of Amsterdam, Department of Biomedical Engineering and Physics, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands
| | - Dirk J A Smit
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands
| | - Guido van Wingen
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands
| | - Damiaan Denys
- Amsterdam University Medical Centers, University of Amsterdam, Department of Psychiatry, Amsterdam Neuroscience, Meibergdreef 9, Amsterdam 1105 AZ, the Netherlands; Amsterdam Brain and Cognition, University of Amsterdam, Nieuwe Achtergracht 129, Amsterdam 1001 NK, the Netherlands.
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Listening to People with Misophonia: Exploring the Multiple Dimensions of Sound Intolerance Using a New Psychometric Tool, the S-Five, in a Large Sample of Individuals Identifying with the Condition. PSYCH 2021. [DOI: 10.3390/psych3040041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Misophonia involves a strong emotional response to certain sounds and can cause significant distress and functional impairment. The aim of this study was to present and psychometrically evaluate a new, multidimensional measure of misophonia, the S-Five. The study also aimed to present and test a supplementary tool, a checklist of triggers that measure the nature and intensity of reactions. The stages of development for the measure are described. Psychometric testing on the final version of the tool was conducted using a sample of 828 individuals who identified with having misophonia. Analyses included factor structure assessment, measurement invariance testing, reliability (test–retest and internal consistency), and (concurrent) convergent validity assessment. Five factors emerged in the S-Five as dimensions of the experience of misophonia: internalising appraisals, externalising appraisals, sense of emotional threat, outbursts, and impact. No measurement bias was identified with respect to gender and age. All reliability and validity indices were satisfactory. The S-Five is a multidimensional measurement scale with satisfactory psychometric properties and will be a valuable tool for improving understanding of misophonia in research and clinical settings.
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Abstract
Misophonia, a condition marked by extreme intolerance to certain classes of sounds (e.g., respiratory or gustatory noises), has recently attracted increased research attention. As yet there are no evidence-based treatments, although some promising options are under empirical consideration. This paper presents a stress management and exposure therapy-based treatment protocol for adults with misophonia. The protocol details considerations specific to exposure therapy for misophonia, including unique considerations for developing hierarchies and example misophonia exposure exercises and exposure homework. Stress management approaches employed to facilitate engagement with exposure are also described. Two case examples are included, which illustrate the application of the misophonia treatment protocol. The first case describes treatment for a client whose misophonia symptoms are the primary focus and the second case describes treatment for a client whose misophonia symptoms are secondary to relationship difficulties. This protocol can be used to stimulate further treatment research for misophonia and guide treatment for individuals with misophonia.
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Kılıç C, Öz G, Avanoğlu KB, Aksoy S. The prevalence and characteristics of misophonia in Ankara, Turkey: population-based study. BJPsych Open 2021; 7:e144. [PMID: 34353403 PMCID: PMC8358974 DOI: 10.1192/bjo.2021.978] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Misophonia is defined as significant distress (anger, distress or disgust) when exposed to certain sounds that would not affect most people, such as lip smacking or gum chewing. Although misophonia is common, the aetiology, prevalence and effective treatments are largely unknown. AIMS Based on our proposed diagnostic criteria, we examined the prevalence of misophonia and its relationship with clinical and demographic variables in a large representative population sample. METHOD We used a household sample (N = 541) of all residents aged >15 years, living in 300 homes randomly selected in Ankara city centre, Turkey. All participants were assessed at their homes by trained interviewers, for sociodemographic variables, misophonic sounds and related factors, using a semi-structured interview (the Misophonia Interview Schedule) developed for the current research. RESULTS The current misophonia diagnosis prevalence was 12.8% (n = 69 of 541), although 427 (78.9%) participants reported at least one sound that was distressing. The mean number of misophonic sounds was 8.6 (s.d. 8.9, range 0-44); the figure was 17.6 in those with misophonia compared with 7.3 in those without misophonia. Of those with misophonia, only 5.8% contacted services for their condition. Predictors of misophonia diagnosis included younger age, family history of misophonia and previous contact with mental health services. CONCLUSIONS Our study showed that misophonia is common in the general population, may cause significant disruption in daily life and is undertreated. Although more evidence is needed to classify misophonia as a psychiatric disorder, our findings support others who claim that the condition belongs to the group of mental disorders.
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Affiliation(s)
- Cengiz Kılıç
- Department of Psychiatry, Hacettepe University, Turkey; and Stress Assessment and Research Center, Hacettepe University, Turkey
| | - Gökhan Öz
- Stress Assessment and Research Center, Hacettepe University, Turkey
| | - Kezban Burcu Avanoğlu
- Stress Assessment and Research Center, Hacettepe University, Turkey; and Department of Psychiatry, Hacettepe University, Turkey
| | - Songül Aksoy
- Department of Audiology, Hacettepe University, Turkey
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Family-Based Cognitive Behavioral Therapy for Youth With Misophonia: A Case Report. COGNITIVE AND BEHAVIORAL PRACTICE 2021. [DOI: 10.1016/j.cbpra.2021.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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40
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Naylor J, Caimino C, Scutt P, Hoare DJ, Baguley DM. The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale. Psychiatr Q 2021; 92:609-619. [PMID: 32829440 PMCID: PMC8110492 DOI: 10.1007/s11126-020-09825-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p < 0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.
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Affiliation(s)
- Jay Naylor
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK.
| | - Charlotte Caimino
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Polly Scutt
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - Derek J Hoare
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
| | - David M Baguley
- Hearing Sciences, Division of Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham NIHR Biomedical Research Centre, School of Medicine, University of Nottingham, Nottingham, UK
- Nottingham Audiology Services, Nottingham University Hospitals NHS Trust, Nottingham, UK
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41
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Enzler F, Loriot C, Fournier P, Noreña AJ. A psychoacoustic test for misophonia assessment. Sci Rep 2021; 11:11044. [PMID: 34040061 PMCID: PMC8155015 DOI: 10.1038/s41598-021-90355-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 05/04/2021] [Indexed: 11/09/2022] Open
Abstract
Misophonia is a condition where a strong arousal response is triggered when hearing specific human generated sounds, like chewing, and/or repetitive tapping noises, like pen clicking. It is diagnosed with clinical interviews and questionnaires since no psychoacoustic tools exist to assess its presence. The present study was aimed at developing and testing a new assessment tool for misophonia. The method was inspired by an approach we have recently developed for hyperacusis. It consisted of presenting subjects (n = 253) with misophonic, pleasant, and unpleasant sounds in an online experiment. The task was to rate them on a pleasant to unpleasant visual analog scale. Subjects were labeled as misophonics (n = 78) or controls (n = 55) by using self-report questions and a misophonia questionnaire, the MisoQuest. There was a significant difference between controls and misophonics in the median global rating of misophonic sounds. On the other hand, median global rating of unpleasant, and pleasant sounds did not differ significantly. We selected a subset of the misophonic sounds to form the core discriminant sounds of misophonia (CDSMiso). A metric: the CDS score, was used to quantitatively measure misophonia, both with a global score and with subscores. The latter could specifically quantify aversion towards different sound sources/events, i.e., mouth, breathing/nose, throat, and repetitive sounds. A receiver operating characteristic analysis showed that the method accurately classified subjects with and without misophonia (accuracy = 91%). The present study suggests that the psychoacoustic test we have developed can be used to assess misophonia reliably and quickly.
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Affiliation(s)
- Falco Enzler
- Centre National de la Recherche Scientifique, Aix-Marseille University, Laboratory of Cognitive Neurosciences , 3 Place Victor Hugo, 13003, Marseille, France
| | | | - Philippe Fournier
- Centre National de la Recherche Scientifique, Aix-Marseille University, Laboratory of Cognitive Neurosciences , 3 Place Victor Hugo, 13003, Marseille, France
| | - Arnaud J Noreña
- Centre National de la Recherche Scientifique, Aix-Marseille University, Laboratory of Cognitive Neurosciences , 3 Place Victor Hugo, 13003, Marseille, France.
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42
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Williams ZJ, He JL, Cascio CJ, Woynaroski TG. A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms. Neurosci Biobehav Rev 2021; 121:1-17. [PMID: 33285160 PMCID: PMC7855558 DOI: 10.1016/j.neubiorev.2020.11.030] [Citation(s) in RCA: 55] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 12/23/2022]
Abstract
Atypical behavioral responses to environmental sounds are common in autistic children and adults, with 50-70 % of this population exhibiting decreased sound tolerance (DST) at some point in their lives. This symptom is a source of significant distress and impairment across the lifespan, contributing to anxiety, challenging behaviors, reduced community participation, and school/workplace difficulties. However, relatively little is known about its phenomenology or neurocognitive underpinnings. The present article synthesizes a large body of literature on the phenomenology and pathophysiology of DST-related conditions to generate a comprehensive theoretical account of DST in autism. Notably, we argue against conceptualizing DST as a unified construct, suggesting that it be separated into three phenomenologically distinct conditions: hyperacusis (the perception of everyday sounds as excessively loud or painful), misophonia (an acquired aversive reaction to specific sounds), and phonophobia (a specific phobia of sound), each responsible for a portion of observed DST behaviors. We further elaborate our framework by proposing preliminary neurocognitive models of hyperacusis, misophonia, and phonophobia that incorporate neurophysiologic findings from studies of autism.
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Affiliation(s)
- Zachary J Williams
- Medical Scientist Training Program, Vanderbilt University School of Medicine, 221 Eskind Biomedical Library and Learning Center, 2209 Garland Ave., Nashville, TN, 37240, United States; Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States.
| | - Jason L He
- Department of Forensic and Neurodevelopmental Sciences, Sackler Institute for Translational Neurodevelopment, Institute of Psychiatry, Psychology and Neuroscience, King's College London, Strand Building, Strand Campus, Strand, London, WC2R 2LS, London, United Kingdom.
| | - Carissa J Cascio
- Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, 2254 Village at Vanderbilt, 1500 21st Ave South, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
| | - Tiffany G Woynaroski
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, 1215 21st Avenue South, Medical Center East, Room 8310, Nashville, TN, 37232, United States; Vanderbilt Brain Institute, Vanderbilt University, 7203 Medical Research Building III, 465 21st Avenue South, Nashville, TN, 37232, United States; Frist Center for Autism and Innovation, Vanderbilt University, 2414 Highland Avenue, Suite 115, Nashville, TN, 37212, United States; Vanderbilt Kennedy Center, Vanderbilt University Medical Center, 110 Magnolia Cir, Nashville, TN, 37203, United States.
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Adams B, Sereda M, Casey A, Byrom P, Stockdale D, Hoare DJ. A Delphi survey to determine a definition and description of hyperacusis by clinician consensus. Int J Audiol 2020; 60:607-613. [PMID: 33305628 DOI: 10.1080/14992027.2020.1855370] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE There is currently no singularly accepted definition of hyperacusis. The aim of this study was to determine a definition and description of hyperacusis by clinician consensus. DESIGN A three-round Delphi survey involving hearing healthcare professionals built towards clinical consensus on a definition of hyperacusis. Round 1 involved three open-ended questions about hyperacusis. Seventy-nine statements were generated on descriptions, impact, sounds, and potential features of hyperacusis. Agreement on the relevance of each statement to defining or describing hyperacusis was then measured in Rounds 2 and 3. General consensus was defined a priori as ≥70% agreement, or ≥90 for clinical decision making. STUDY SAMPLE Forty-five hearing healthcare professionals were recruited to take part in this study. Forty-one completed Round 1, 36 completed Round 2, and 33 completed Round 3. RESULTS Consensus was reached on 42/79 statements. From these a consensus definition includes "A reduced tolerance to sound(s) that are perceived as normal to the majority of the population or were perceived as normal to the person before their onset of hyperacusis". A consensus description of hyperacusis was also determined. CONCLUSIONS This consensus definition of hyperacusis will help to determine the scope of clinical practice guidelines and influence needed research on hyperacusis.
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Affiliation(s)
- Bethany Adams
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Magdalena Sereda
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Amanda Casey
- Audiology, Aston University, Aston Triangle, Birmingham, UK
| | - Peter Byrom
- Peter Byrom Audiology Ltd, Thornbury Hospital, Sheffield, UK
| | | | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, Nottingham, UK.,Hearing Sciences, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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44
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McGeoch PD, Rouw R. How everyday sounds can trigger strong emotions: ASMR, misophonia and the feeling of wellbeing. Bioessays 2020; 42:e2000099. [PMID: 33174254 DOI: 10.1002/bies.202000099] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/24/2020] [Indexed: 11/09/2022]
Abstract
We propose that synesthetic cross-activation between the primary auditory cortex and the anatomically adjacent insula may help explain two puzzling conditions-autonomous sensory meridian response (ASMR) and misophonia-in which quotidian sounds involuntarily trigger strong emotional responses. In ASMR the sounds engender relaxation, while in misophonia they trigger an aversive response. The insula both plays an important role in autonomic nervous system control and integrates multiple interoceptive maps representing the physiological state of the body to substantiate a dynamic representation of emotional wellbeing. We propose that in ASMR cross-activation of the map for affective (sensual) touch leads to an increase in subjective wellbeing and parasympathetic activity. Conversely, in misophonia the effect of the cross-activation is to decrease emotional wellbeing and increase sympathetic activity. Our hypothesis also illuminates the connection between hearing and wellbeing more broadly and helps explain why so many people experience decreased wellbeing from modern urban soundscapes.
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Affiliation(s)
- Paul D McGeoch
- Center for Brain and Cognition, University of California, San Diego, California, USA.,School of Medicine, Dentistry and Biomedical Sciences, Queen's University, Belfast, United Kingdom
| | - Romke Rouw
- Brain and Cognition, Dept of Psychology, University of Amsterdam, Amsterdam, Netherlands
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45
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Potgieter I, Fackrell K, Kennedy V, Crunkhorn R, Hoare DJ. Hyperacusis in children: a scoping review. BMC Pediatr 2020; 20:319. [PMID: 32600446 PMCID: PMC7322835 DOI: 10.1186/s12887-020-02223-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 06/22/2020] [Indexed: 12/18/2022] Open
Abstract
Background Hyperacusis is a chronic condition commonly defined as a lowered tolerance or increased sensitivity to everyday environmental sounds. It has been viewed as a paediatric disorder which can cause significant impairment to a child’s normal functioning. Although clinical guidance highlights the importance of identifying whether the child has intolerance to loud sounds and managing this appropriately, there are currently no assessment or treatment methods that have been designed and tested for use with children with hyperacusis. A review is therefore indicated to consider the profile of children with hyperacusis as a basis for future research into their assessment and treatment. Method A scoping review methodology was followed with literature searches conducted in Embase, PsychINFO, PubMed CENTRAL, Scopus, Web of Science and Google Scholar. Research articles were included if they reported on research studies describing children diagnosed with hyperacusis, providing clinical profile information, and/or reporting on an assessment or management method for children with a primary complaint of hyperacusis. Data were charted on Excel and verified by a second researcher. Twenty-one research articles were included. Results Children with hyperacusis are typically described in terms of age at presentation, troublesome sounds, physical sensation, behavioural reactions, coping strategies, comorbid conditions and impact on daily life. Methods of assessing the children include semi-structured interviews, questionnaires, neurological assessment, observation and uncomfortable loudness levels. Management methods include psychological therapy, sound therapy, tinnitus retraining therapy, medication and neuro-rehabilitation. Conclusion The information we catalogued on various elements of clinical profile, assessment and management can serve as a stepping stone in future research developing questionnaires for clinical measurement of the impact of hyperacusis on children, and the measurement of treatment related change in clinic and in trials. Positive outcomes were noted by the authors following all of the above treatments; future research must compare these and specify the parameters for optimal results.
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Affiliation(s)
- Iskra Potgieter
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK. .,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.
| | - Kathryn Fackrell
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK.,National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre (NETSCC), University of Southampton, Southampton, UK
| | - Veronica Kennedy
- 4 Paediatric Audiology Department, Bolton NHS Foundation Trust, Bolton, UK
| | - Rosa Crunkhorn
- 4 Paediatric Audiology Department, Bolton NHS Foundation Trust, Bolton, UK
| | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Ropewalk House, 113 The Ropewalk, Nottingham, NG1 5DU, UK.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
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