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Herdi O, Yıldırım F. Sex-Specific Correlations Between Misophonia Symptoms and ADHD, OCD, and Autism-Related Traits in Adolescent Outpatients. Noro Psikiyatr Ars 2024; 67:248-254. [PMID: 39258129 PMCID: PMC11382567 DOI: 10.29399/npa.28630] [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: 09/26/2023] [Accepted: 12/06/2023] [Indexed: 09/12/2024] Open
Abstract
Introduction Misophonia, not yet classified within diagnostic manuals, triggers strong emotional, physiological, and behavioural reactions to specific sounds. This study examines its correlations with attention deficient/hyperactivity disorder (ADHD) traits, obsessive-compulsive traits, and autism-related traits in adolescent outpatients with non-psychotic disorders. We hypothesize a positive association between misophonic symptoms and these psychological traits. Methods This study was conducted at a Turkish psychiatric centre from January to July 2023 in adolescents aged 12-18. Parents completed the Autism Spectrum Quotient-Adolescent (AQ-Adolescent), and Conner's ADHD Parent Rating Scale-48 (CPRS-48), while the adolescent filled out the Misophonic Symptom Checklist (MCL) and Maudsley Obsessive-Compulsive Inventory (MOCI). Using non-parametric statistical tests, the research found associations between the scales, with a total sample size of 348. Results Females had higher scores on MCL. There is a negative correlation between AQ-Adolescent and MCL, positive correlations between MCL-MOCI and MCL-CPRS-48. In gender specific correlation analysis found that AQ-Adolescent and MCL were negatively correlated, MCL and MOCI were positively correlated in males. MCL, CPRS-48 and MOCI were positively correlated in females. In regression AQ-Adolescent, MOCI and CPRS-48 significantly predicted the levels of MCL. Conclusions Our study unveils a link between ADHD, obsessive-compulsive symptoms, autistic traits, and misophonic symptoms in adolescent psychiatric outpatients, highlighting sex differences.
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Affiliation(s)
- Oğuzhan Herdi
- Antalya Bilim University, Department of Psychology, Antalya, Turkey
| | - Fatma Yıldırım
- Antalya City Hospital, Child and Adolescent Psychiatry, Antalya, Turkey
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Bodo CR, Salcudean A, Nirestean A, Lukacs E, Lica MM, Muntean DL, Anculia RC, Popovici RA, Neda Stepan O, Enătescu VR, Strete EG. Association between Chronic Misophonia-Induced Stress and Gastrointestinal Pathology in Children-A Hypothesis. CHILDREN (BASEL, SWITZERLAND) 2024; 11:699. [PMID: 38929278 PMCID: PMC11201990 DOI: 10.3390/children11060699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 05/30/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024]
Abstract
Misophonia is a neurophysiological disorder with behavioral implications, is complex and multifactorial in origin, and is characterized by an atypical and disproportionate emotional response to specific sounds or associated visual stimuli. Triggers include human-generated sounds, mainly sounds related to feeding and breathing processes, and repetitive mechanical sounds. In response to the triggering stimulus, the patient experiences immediate, high-intensity, disproportionate physical and emotional reactions that affect their quality of life and social functioning. The symptoms of misophonia can occur at any age, but onset in childhood or adolescence is most common. Affected children live in a constant state of anxiety, suffer continuous physical and emotional discomfort, and are thus exposed to significant chronic stress. Chronic stress, especially during childhood, has consequences on the main biological systems through the dysregulation of the hypothalamic-pituitary-adrenal axis, including the gastrointestinal tract. Here, we provide arguments for a positive correlation between misophonic pathology and gastrointestinal symptoms, and this hypothesis may be the starting point for further longitudinal studies that could investigate the correlations between these childhood vulnerabilities caused by misophonia and their effect on the gastrointestinal system. Further research to study this hypothesis is essential to ensure correct and timely diagnosis and optimal psychological and pharmacological support.
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Affiliation(s)
- Cristina Raluca Bodo
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (C.R.B.); (M.M.L.)
| | - Andreea Salcudean
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (C.R.B.); (M.M.L.)
| | - Aurel Nirestean
- Department of Psychiatry, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (A.N.); (E.L.); (E.G.S.)
| | - Emese Lukacs
- Department of Psychiatry, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (A.N.); (E.L.); (E.G.S.)
| | - Maria Melania Lica
- Department of Ethics and Social Sciences, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (C.R.B.); (M.M.L.)
| | - Daniela Lucia Muntean
- Department of Analytical Chemistry and Drug Analysis, Faculty of Pharmacy, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania;
| | | | - Ramona Amina Popovici
- Department of Dental Preventive Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania;
| | - Oana Neda Stepan
- Department VIII-Neurosciences, Discipline of Psychiatry, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.N.S.); (V.R.E.)
| | - Virgil Radu Enătescu
- Department VIII-Neurosciences, Discipline of Psychiatry, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania; (O.N.S.); (V.R.E.)
| | - Elena Gabriela Strete
- Department of Psychiatry, George Emil Palade University of Medicine and Pharmacy, Sciences and Technology of Târgu Mureș, 540136 Târgu Mureș, Romania; (A.N.); (E.L.); (E.G.S.)
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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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Patel NM, Fameen R, Shafeek N, Prabhu P. Prevalence of Misophonia in College Going Students of India: A Preliminary Survey. Indian J Otolaryngol Head Neck Surg 2023; 75:374-378. [PMID: 37275093 PMCID: PMC10235297 DOI: 10.1007/s12070-022-03266-z] [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: 02/17/2021] [Accepted: 10/26/2022] [Indexed: 11/10/2022] Open
Abstract
Misophonia, meaning "hatred of sound", is a proposed neurological condition in which certain sounds trigger emotional or physiological responses others may deem unreasonable. The studies on prevalence of misophonia show that almost 20% of college going students exhibit experience misophonia like symptoms worldwide. These studies help us understand that decreased tolerance towards certain sounds has a high prevalence rate. In a country like India, the diversity in terms of exposure to various levels of noise and traditional habits spans across different age groups, locations, socio-economic statuses, and communities. This study aims to establish the prevalence rate and severity of misophonia in college going-students of India and also an attempt to determine gender dominance. The total participants were 328 undergraduate students all over India, with diverse cultural, linguistic, and economic backgrounds. An online survey was conducted through Google forms, wherein the participants filled the self-rating Amsterdam Misophonia Scale and Misophonia Questionnaire. The results of the study showed that the prevalence of misophonia was approximately 15.85%, with a moderate to severe degree of misophonia. The results indicate that misophonia is highly prevalent in India and there is no gender dominance in experiencing misophonia.
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Affiliation(s)
| | - Ridha Fameen
- All India Institute of Speech and Hearing, Mysore, Karnataka 570006 India
| | - Neha Shafeek
- All India Institute of Speech and Hearing, Mysore, Karnataka 570006 India
| | - Prashanth Prabhu
- All India Institute of Speech and Hearing, Mysore, Karnataka 570006 India
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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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Hyperacusis: Loudness Intolerance, Fear, Annoyance and Pain. Hear Res 2022; 426:108648. [DOI: 10.1016/j.heares.2022.108648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/10/2022]
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Yektatalab S, Mohammadi A, Zarshenas L. The Prevalence of Misophonia and Its Relationship with Obsessive-compulsive Disorder, Anxiety, and Depression in Undergraduate Students of Shiraz University of Medical Sciences: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF COMMUNITY BASED NURSING AND MIDWIFERY 2022; 10:259-268. [PMID: 36274664 PMCID: PMC9579453 DOI: 10.30476/ijcbnm.2022.92902.1888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Revised: 09/03/2022] [Accepted: 09/13/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Misophonia is a severe emotional response to repetitive sounds. This disorder may limit a person's communication, reduce his/her ability, or disrupt his/her social and personal life. This study aimed to determine the prevalence of Misophonia and its relationship with obsessive-compulsive disorder, anxiety, and depression in undergraduate students of Shiraz University of Medical Sciences. METHODS The present study is an analytical descriptive study conducted in October 2020. The study samples consisted of 390 undergraduate students of Shiraz University of Medical Sciences. A relative and systematic sampling method was used. In this study, demographic questionnaire, misophonia questionnaire (A score of 7 or higher is considered as misophonia), Beck anxiety questionnaire, Beck depression questionnaire, and Maudsley obsessive-compulsive inventory questionnaire were used, and the data were analyzed using SPSS 24 software. In this study, chi-square test was used to examine the relationship between the variables. Due to the non-normality of the data, the Spearman correlation coefficient was used for data analysis. The significance level was considered equal to and less than 0.05. RESULTS Of the 390 participants in the study, 93 (23.8%) had experienced misophonia. Among these 93 students, 37 (39.8%) had obsessive-compulsive disorder, 8 (8.6%) suffered anxiety, and 9 (9.7%) were depressed. There was a significant and direct relationship between misophonia and obsessive-compulsive disorder,anxiety and depression respectively(P<0.001). CONCLUSION Due to the prevalence of misophonia among students and its direct relationship with obsessive-compulsive disorder, anxiety and depression, we recommend that future studies should be conducted to find the ways to prevent and reduce the incidence of misophonia.
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Affiliation(s)
- Shahrzad Yektatalab
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Agrin Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ladan Zarshenas
- Community Based Psychiatric Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,
Department of Mental Health and Psychiatric Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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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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Neacsiu AD, Szymkiewicz V, Galla JT, Li B, Kulkarni Y, Spector CW. The neurobiology of misophonia and implications for novel, neuroscience-driven interventions. Front Neurosci 2022; 16:893903. [PMID: 35958984 PMCID: PMC9359080 DOI: 10.3389/fnins.2022.893903] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 06/28/2022] [Indexed: 11/25/2022] Open
Abstract
Decreased tolerance in response to specific every-day sounds (misophonia) is a serious, debilitating disorder that is gaining rapid recognition within the mental health community. Emerging research findings suggest that misophonia may have a unique neural signature. Specifically, when examining responses to misophonic trigger sounds, differences emerge at a physiological and neural level from potentially overlapping psychopathologies. While these findings are preliminary and in need of replication, they support the hypothesis that misophonia is a unique disorder. In this theoretical paper, we begin by reviewing the candidate networks that may be at play in this complex disorder (e.g., regulatory, sensory, and auditory). We then summarize current neuroimaging findings in misophonia and present areas of overlap and divergence from other mental health disorders that are hypothesized to co-occur with misophonia (e.g., obsessive compulsive disorder). Future studies needed to further our understanding of the neuroscience of misophonia will also be discussed. Next, we introduce the potential of neurostimulation as a tool to treat neural dysfunction in misophonia. We describe how neurostimulation research has led to novel interventions in psychiatric disorders, targeting regions that may also be relevant to misophonia. The paper is concluded by presenting several options for how neurostimulation interventions for misophonia could be crafted.
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Affiliation(s)
- Andrada D. Neacsiu
- Duke Center for Misophonia and Emotion Regulation, Duke Brain Stimulation Research Center, Department of Psychiatry and Behavioral Neuroscience, School of Medicine, Duke University, Durham, NC, United States
| | - Victoria Szymkiewicz
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Jeffrey T. Galla
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Brenden Li
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Yashaswini Kulkarni
- Department of Psychology and Neuroscience, Duke University, Durham, NC, United States
| | - Cade W. Spector
- Department of Philosophy, Duke University, Durham, NC, United States
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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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Paunović KŽ, Milenković SM. The proposed criteria for high perceived misophonia in young healthy adults and the association between Misophonia symptoms and noise sensitivity. Noise Health 2022; 24:40-48. [PMID: 35900389 PMCID: PMC9703820 DOI: 10.4103/nah.nah_40_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
CONTEXT The association between noise sensitivity and misophonia has not been explored in any population, according to the available literature. AIMS To assess the proportion of misophonia symptoms among young healthy adults, to propose the criteria for high perceived misophonia, and to explore the association between misophonia with noise sensitivity with adjustment for sex, age, perceived anxiety, and depression. SETTINGS AND DESIGN A cross-sectional study on 1132 medical students, aged 21.4 ± 2.1 years. METHODS AND MATERIAL Misophonia symptoms were self-reported using the Amsterdam Misophonia Scale. Nine criteria for high perceived misophonia are proposed. Noise sensitivity was measured with Weinstein scale. Perceived anxiety and depression were measured using the Hamilton Anxiety Rating Scale and the Hamilton Depression Rating Scale, respectively. STATISTICAL ANALYSIS USED Multiple logistic regression. RESULTS Almost half of the students reported the feeling of irritation against people making provoking sounds. Only one in 10 claimed the feeling of loss of self-control when exposed to provoking sounds. High noise sensitivity and high depression were associated with higher odds of meeting the criteria for high perceived misophonia. CONCLUSION Noise-sensitive students are at higher risk of reporting misophonia symptoms and of being classified with high perceived misophonia. The combination of at least four or more symptoms, which classifies every 10th student with high perceived misophonia, is proposed as a self-assessment tool for epidemiological studies among young healthy adults.
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Affiliation(s)
- Katarina Ž. Paunović
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Address for correspondence: Katarina Ž. Paunović, Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Dr Subotica 8, 11000 Belgrade, Serbia. E-mail:
| | - Sanja M. Milenković
- Institute of Hygiene and Medical Ecology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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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: 65] [Impact Index Per Article: 32.5] [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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14
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Jager I, Vulink N, van Loon A, van der Pol M, Schröder A, Slaghekke S, Denys D. Synopsis and Qualitative Evaluation of a Treatment Protocol to Guide Systemic Group-Cognitive Behavioral Therapy for Misophonia. Front Psychiatry 2022; 13:794343. [PMID: 35836662 PMCID: PMC9275669 DOI: 10.3389/fpsyt.2022.794343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/08/2022] [Indexed: 11/19/2022] Open
Abstract
Misophonia is a disorder in which patients suffer from anger or disgust when confronted with specific sounds such as those associated with eating or breathing, causing avoidance of cue related situations resulting in significant functional impairment. Functional magnetic resonance imaging studies suggest misophonia is associated with increased activity in the auditory cortex and salience network, which might reflect increased vigilance toward specific misophonia triggers. New treatments have been developed and investigated in the last years in which this vigilance plays an important role. This is a synopsis of the first group protocol for systemic Cognitive Behavioral Therapy (G-CBT) for misophonia. We discuss the model of CBT for misophonia, provide a detailed guide to the treatment illustrated with a case study, discuss advantages, limitations, and possible pitfalls by a qualitative evaluation of the protocol, and review evidence for the protocol.
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Affiliation(s)
- Inge Jager
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands.,GGZ inGeest, Amsterdam, Netherlands
| | - Nienke Vulink
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Arnoud van Loon
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Marthe van der Pol
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | | | - Simone Slaghekke
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands
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15
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Vitoratou S, Uglik-Marucha N, Hayes C, Erfanian M, Pearson O, Gregory J. Item Response Theory Investigation of Misophonia Auditory Triggers. Audiol Res 2021; 11:567-581. [PMID: 34698077 PMCID: PMC8544191 DOI: 10.3390/audiolres11040051] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/06/2021] [Accepted: 10/08/2021] [Indexed: 11/16/2022] Open
Abstract
Misophonia is characterised by a low tolerance for day-to-day sounds, causing intense negative affect. This study conducts an in-depth investigation of 35 misophonia triggers. A sample of 613 individuals who identify as experiencing misophonia and 202 individuals from the general population completed self-report measures. Using contemporary psychometric methods, we studied the triggers in terms of internal consistency, stability in time, precision, severity, discrimination ability, and information. Three dimensions of sensitivity were identified, namely, to eating sounds, to nose/throat sounds, and to general environmental sounds. The most informative and discriminative triggers belonged to the eating sounds. Participants identifying with having misophonia had also significantly increased odds to endorse eating sounds as auditory triggers than others. This study highlights the central role of eating sounds in this phenomenon and finds that different triggers are endorsed by those with more severe sound sensitivities than those with low sensitivity.
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Affiliation(s)
- 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; (S.V.); (N.U.-M.); (C.H.); (O.P.)
| | - Nora Uglik-Marucha
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK; (S.V.); (N.U.-M.); (C.H.); (O.P.)
| | - 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; (S.V.); (N.U.-M.); (C.H.); (O.P.)
| | - Mercede Erfanian
- UCL Institute for Environmental Design and Engineering, The Bartlett, University College London, London WC1H 0NN, UK;
| | - Oliver Pearson
- Psychometrics and Measurement Lab, Biostatistics and Health Informatics Department, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 8AB, UK; (S.V.); (N.U.-M.); (C.H.); (O.P.)
| | - Jane Gregory
- Centre for Anxiety Disorders and Trauma, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
- Correspondence:
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16
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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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17
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Abstract
Die Misophonie ist eine Intoleranz auf bestimmte Alltagsgeräusche. Hierbei fungieren als „Trigger“ „menschliche Körpergeräusche“, z. B. Schlucken/Schmatzen/Atemgeräusche oder Geräusche, die von Menschen, aber nicht vom menschlichen Körper erzeugt werden (z. B. Klicken Kugelschreiberknopf), ferner Tier‑/Maschinengeräusche. Die Betroffenen verspüren sofort eine negativ-emotionale Reaktion wie Wut, Aggression, Ekel u.a. Objektivierbare Veränderungen sind Herzfrequenzerhöhung und Blutdruckveränderungen. Die emotionale Reaktion ist individuell und hängt z. B. von Geräuschart, persönlicher Vorerfahrung, sozialem Kontext oder psychologischem Profil ab. Die Misophonie ist bisher als Krankheit nicht definiert und keinem offiziellen Diagnosesystem zugeordnet, sie scheint eine eigenständige Störung zu sein: Assoziationen bestehen u. a. mit Aufmerksamkeits‑/Zwangsstörungen, Tinnitus, Hyperakusis, Autismus-Spektrum-Krankheiten. Definitionskriterien wurden 2013 veröffentlicht; verschiedene, validierte Fragebögen wurden bisher zur Misophonieausprägung entwickelt. Studien mit funktionellen MRT-Untersuchungen des Kopfes zeigten eine übermäßige Aktivierung des anterioren Inselkortex (AIC) und seiner benachbarten Regionen, die für Emotionsverarbeitung/-regulation verantwortlich sind. Bisher gibt es keine randomisierten kontrollierten Studien zur Therapie. Einzelne Publikationen beschreiben kognitive Verhaltensinterventionen, Retrainingtherapien und Schallmaskierungssysteme. Zur Triggerreduktion werden Ohrstöpsel/Musikkopfhörer verwendet. Auch HNO-Ärzte können mit Misophoniepatienten konfrontiert werden, z. B. zur Klärung des Hörvermögens oder Beratung von Therapiemöglichkeiten. Der Bericht stellt eine Übersicht des aktuellen Wissensstands zur Misophonie sowie ihrer Diagnostik und Therapie dar.
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Affiliation(s)
- C Schwemmle
- Arbeitsbereich Phoniatrie, Pädaudiologie, klinische Audiologie, Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland.
| | - C Arens
- Arbeitsbereich Phoniatrie, Pädaudiologie, klinische Audiologie, Universitätsklinik für Hals‑, Nasen- und Ohrenheilkunde, Otto-von-Guericke-Universität Magdeburg, Leipziger Straße 44, 39120, Magdeburg, Deutschland
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18
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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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19
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Jager IJ, Vulink NCC, Bergfeld IO, van Loon AJJM, Denys DAJP. Cognitive behavioral therapy for misophonia: A randomized clinical trial. Depress Anxiety 2020; 38:708-718. [PMID: 33336858 PMCID: PMC8359510 DOI: 10.1002/da.23127] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 10/15/2020] [Accepted: 12/02/2020] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND Patients with misophonia suffer from anger or disgust confronted with specific sounds such as smacking or breathing. Avoidance of cue-related situations results in social isolation and significant functional impairment. This is the first randomized, controlled cognitive behavioral therapy (CBT) trial for misophonia, evaluating the short- and long-term efficacy. METHODS The evaluator-blinded, randomized clinical trial was conducted from May 2017 until December 2018 at an academic outpatient clinic. Misophonia patients were randomly assigned to 3 months of weekly group-CBT or a waiting list and tested at baseline, 3 months (following CBT or waiting list), 6 months (after cross-over), and 15/18 months (1-year follow-up). CBT consisted of task concentration and arousal reduction, positive affect labeling, and stimulus manipulation. Co-primary outcomes were symptom severity assessed by the Amsterdam Misophonia Scale-Revised (AMISOS-R) and improvement on the Clinical Global Impression-Improvement (CGI-I). Secondary outcomes were self-assessed ratings of general psychopathology (Symptom Checklist-90-Revised [SCL-90-R]) and quality of life (five-dimensional EuroQol [EQ5-D], Sheehan Disability Scale [SDS], WHO Quality of Life-BREF [WHOQoL-BREF]). RESULTS In all, 54 out of 71 patients were included (mean age, 33.06 [SD, 14.13] years; 38 women [70.4%]) and 46 (85%) completed the study. In the randomized phase, CBT resulted in statistically significant less misophonia symptoms in the short-term (-9.7 AMISOS-R; 95% CI, -12.0 to -7.4; p < .001, d = 1.97). The CBT group had an observed clinical improvement (CGI-I < 3) in 37% compared to 0% in the waiting list group (p < .001). The effect of CBT was maintained at 1-year follow-up on primary and secondary outcomes. CONCLUSIONS This first randomized control trial shows both short-term and long-term efficacy of CBT for misophonia.
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Affiliation(s)
- Inge J. Jager
- Department of Psychiatry, Amsterdam UMC, Amsterdam NeuroscienceUniversity of AmsterdamAmsterdamThe Netherlands
| | - Nienke C. C. Vulink
- Department of Psychiatry, Amsterdam UMC, Amsterdam NeuroscienceUniversity of AmsterdamAmsterdamThe Netherlands
| | - Isidoor O. Bergfeld
- Department of Psychiatry, Amsterdam UMC, Amsterdam NeuroscienceUniversity of AmsterdamAmsterdamThe Netherlands
- Amsterdam Brain and CognitionAmsterdamThe Netherlands
| | - Arnoud J. J. M. van Loon
- Department of Psychiatry, Amsterdam UMC, Amsterdam NeuroscienceUniversity of AmsterdamAmsterdamThe Netherlands
| | - Damiaan A. J. P. Denys
- Department of Psychiatry, Amsterdam UMC, Amsterdam NeuroscienceUniversity of AmsterdamAmsterdamThe Netherlands
- Amsterdam Brain and CognitionAmsterdamThe Netherlands
- Netherlands Institute for NeuroscienceInstitute of the Royal Netherlands Academy of Arts and SciencesAmsterdamThe Netherlands
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20
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Abstract
Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.
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Affiliation(s)
- C. S. Vanaja
- School of Audiology and Speech Language, Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
| | - Miriam Soni Abigail
- School of Audiology and Speech Language, Pathology, Bharati Vidyapeeth (Deemed to be University), Pune, Maharashtra, India
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21
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Jager I, de Koning P, Bost T, Denys D, Vulink N. Misophonia: Phenomenology, comorbidity and demographics in a large sample. PLoS One 2020; 15:e0231390. [PMID: 32294104 PMCID: PMC7159231 DOI: 10.1371/journal.pone.0231390] [Citation(s) in RCA: 105] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 03/23/2020] [Indexed: 12/18/2022] Open
Abstract
Objective Analyze a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition. Methods This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centers, location AMC, the Netherlands. We examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g., SCL-90-R, WHOQoL). Results The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. Two percent reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects we performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001). Limitations This was a single site study, leading to possible selection–and confirmation bias, since AMC-criteria were used. Conclusions This study with 575 subjects is the largest misophonia sample ever described. Based on these results we propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.
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Affiliation(s)
- Inge Jager
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
- * E-mail:
| | - Pelle de Koning
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
| | - Tim Bost
- Department of Otorhinolaryngology, Clinical and Experimental Audiology, Amsterdam Public Health, Amsterdam UMC (location AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
| | - Nienke Vulink
- Department of Psychiatry, Amsterdam UMC (location AMC), Amsterdam, The Netherlands
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22
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Potgieter I, MacDonald C, Partridge L, Cima R, Sheldrake J, Hoare DJ. Misophonia: A scoping review of research. J Clin Psychol 2019; 75:1203-1218. [PMID: 30859581 DOI: 10.1002/jclp.22771] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 12/02/2018] [Accepted: 02/16/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To scope the literature describing misophonia populations, management, and research opportunities. METHOD Literature searches for research studies describing patients diagnosed with misophonia, defining a patient profile, or outlining development or testing of an intervention for misophonia. A data extraction form was developed and piloted before data from each article were independently charted by two researchers. Researchers then agreed on a final data set for each article. RESULTS Thirty-one records were included. The misophonia population was described in terms of onset age, triggers, reaction, coping strategies, and comorbid conditions. We identified nine outcome measures. Case studies on treatments included cognitive behavioral therapy, counterconditioning, mindfulness and acceptance, dialectical behavioral therapy, and pharmaceuticals. Future research priorities identified included clarifying the phenomenology and prevalence of misophonia, and randomized controlled trials of treatments. CONCLUSION Misophonia is under-researched but there are strong foundations for future research to finalize diagnostic criteria, validate outcome measures, and trial treatments.
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Affiliation(s)
- Iskra Potgieter
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK.,Otology and Hearing Group, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Carol MacDonald
- Department of Psychology, University of Stirling, Stirling, UK
| | - Lucy Partridge
- Nuffield Hearing & Speech Centre, Royal National Throat Nose and Ear Hospital, London, UK
| | - Rilana Cima
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | | | - Derek J Hoare
- National Institute for Health Research (NIHR) Nottingham Biomedical Research Centre, University of Nottingham, Nottingham, UK
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