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

Abstract

ObjectivesMisophonia—an unusually strong intolerance of certain sounds—can cause significant distress and disruption to those who have it but is an enigma in terms of our scientific understanding. A key challenge for explaining misophonia is that, as with other disorders, it is likely to emerge from an interaction of traits that also occur in the general population (e.g., sensory sensitivity and anxiety) and that are transdiagnostic in nature (i.e., shared with other disorders).MethodsIn this preregistered study with a large sample of participants (N = 1430), we performed a cluster analysis (based on responses to questions relating to misophonia) and identified two misophonia subgroups differing in severity, as well as a third group without misophonia. A subset of this sample (N = 419) then completed a battery of measures designed to assess sensory sensitivity and clinical comorbidities.ResultsClinical symptoms were limited to the most severe group of misophonics (including autistic traits, migraine with visual aura, anxiety sensitivity, obsessive‐compulsive traits). Both the moderate and severe groups showed elevated attention‐to‐detail and hypersensitivity (across multiple senses). A novel symptom network model of the data shows the presence of a central hub linking misophonia to sensory sensitivity which, in turn, connects to other symptoms in the network (relating to autism, anxiety, etc.).ConclusionThe core features of misophonia are sensory‐attentional in nature with severity linked strongly to comorbidities.

Brain circuits in autonomous sensory meridian response and related phenomena

“…Misophonia has been found to be comorbid with various psychiatric conditions, including obsessive-compulsive personality disorder, mood disorders, attention-deficit hyperactivity disorder, autism, tinnitus, hyperacusis, post-traumatic stress disorder (PTSD), eating disorders, migraine with visual aura, anxiety sensitivity, and hypersensitivity [15,109,[120][121][122][123].…”

The unified protocol for transdiagnostic treatment of emotional disorders for misophonia: a pilot trial exploring acceptability and efficacy

“…Recent research has highlighted problematic emotional responses as the mechanism underlying impairment in misophonia. People with misophonia report a range of affective responses to their misophonic triggers, especially anger, anxiety and disgust (Dibb and Golding, 2022;Savard et al, 2022;Andermane et al, 2023;Vitoratou et al, 2023). Studies also have pointed to the relationship between misophonia and problems with emotion regulation, particularly difficulties controlling impulsive behavior while upset (Cassiello-Robbins et al, 2020a;Guetta et al, 2022;Rinaldi et al, 2023).…”