@article {pmid39678063,
year = {2024},
author = {Herdi, O and Yildirim, F},
title = {Erratum: Sex-Specific Correlations Between Misophonia Symptoms and ADHD, OCD, and Autism-Related Traits in Adolescent Outpatients.},
journal = {Noro psikiyatri arsivi},
volume = {61},
number = {4},
pages = {384},
doi = {10.29399/npa.29005},
pmid = {39678063},
issn = {1300-0667},
abstract = {[This corrects the article on p. 248 in vol. 61.].},
}

@article {pmid39658570,
year = {2024},
author = {Mahzouni, G and Welch, MM and Young, M and Reddy, V and Samermit, P and Davidenko, N},
title = {Positive Attributable Visual Sources Attenuate the Impact of Trigger Sounds in Misophonia.},
journal = {Multisensory research},
volume = {37},
number = {6-8},
pages = {475-498},
doi = {10.1163/22134808-bja10137},
pmid = {39658570},
issn = {2213-4808},
mesh = {Humans ; Female ; Male ; Adult ; Young Adult ; *Visual Perception/physiology ; Sound ; Photic Stimulation ; Auditory Perception/physiology ; Acoustic Stimulation ; },
abstract = {Misophonia is characterized by strong negative reactions to everyday sounds, such as chewing, slurping or breathing, that can have negative consequences for daily life. Here, we investigated the role of visual stimuli in modulating misophonic reactions. We recruited 26 misophonics and 31 healthy controls and presented them with 26 sound-swapped videos: 13 trigger sounds paired with the 13 Original Video Sources (OVS) and with 13 Positive Attributable Visual Sources (PAVS). Our results show that PAVS stimuli significantly increase the pleasantness and reduce the intensity of bodily sensations associated with trigger sounds in both the misophonia and control groups. Importantly, people with misophonia experienced a larger reduction of bodily sensations compared to the control participants. An analysis of self-reported bodily sensation descriptions revealed that PAVS-paired sounds led participants to use significantly fewer words pertaining to body parts compared to the OVS-paired sounds. We also found that participants who scored higher on the Duke Misophonia Questionnaire (DMQ) symptom severity scale had higher auditory imagery scores, yet visual imagery was not associated with the DMQ. Overall, our results show that the negative impact of misophonic trigger sounds can be attenuated by presenting them alongside PAVSs.},
}

Humans
Female
Male
Adult
Young Adult
*Visual Perception/physiology
Sound
Photic Stimulation
Auditory Perception/physiology
Acoustic Stimulation

@article {pmid39654622,
year = {2024},
author = {Zhang, Z and Yao, Y and Zhu, L},
title = {Assessing real-world safety of plecanatide: a pharmacovigilance study based on the FDA adverse event reporting system.},
journal = {Frontiers in pharmacology},
volume = {15},
number = {},
pages = {1500810},
pmid = {39654622},
issn = {1663-9812},
abstract = {BACKGROUND: Plecanatide is a selective gastrointestinal peptide used for the treatment of chronic idiopathic constipation (CIC) and irritable bowel syndrome with constipation (IBS-C). Given its widespread use, understanding the long-term safety of plecanatide in real-world settings is essential.

METHODS: Data for this study were sourced from the United States Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) from the first quarter of 2017 to the second quarter of 2024. Disproportionality analysis methods were employed to quantify adverse event signals associated with plecanatide. Additionally, a Weibull distribution analysis was conducted to assess changes in adverse events over time. Sensitivity analyses were performed to enhance the robustness of the findings.

RESULTS: A total of 861 cases associated with plecanatide were identified, including 2057 adverse event reports. Common positive adverse events included diarrhea, constipation, abdominal distension, dissatisfaction with treatment, rectal tenesmus, increased fecal volume, abnormal gastrointestinal sounds, and gastrointestinal motility disorders. The majority of adverse events related to plecanatide occurred within the first 7 days of treatment. Findings were consistent across sensitivity analyses.

CONCLUSION: This study preliminarily explores the safety of plecanatide in real-world applications, revealing significant new adverse event signals. These findings provide important safety references for clinicians prescribing plecanatide for CIC and IBS-C.},
}

@article {pmid38286425,
year = {2024},
author = {Aazh, H and Hayes, C and Erfanian, M and Moore, BCJ and Vitoratou, S},
title = {Confirmatory Factor Analysis of the Hyperacusis Impact Questionnaire, Sound Sensitivity Symptoms Questionnaire, and Screening for Anxiety and Depression in Tinnitus, Including Preliminary Analyses of the Parent Versions for Use with Children.},
journal = {Journal of the American Academy of Audiology},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2255-7643},
pmid = {38286425},
issn = {2157-3107},
abstract = {BACKGROUND: We previously reported the results of exploratory factor analysis (EFA) of the Hyperacusis Impact Questionnaire (HIQ), the Sound Sensitivity Symptoms Questionnaire (SSSD), and the Screening for Anxiety and Depression in Tinnitus (SAD-T). Confirmatory factor analysis (CFA) is necessary to confirm the latent constructs determined using EFA. CFA should use different samples but with similar characteristics to those used for EFA.

PURPOSE:  The aim was to use CFA to confirm latent constructs derived using EFA of the HIQ, SSSQ, and SAD-T. We further evaluated the psychometric properties of parent versions of these questionnaires (indicated by -P), which are intended for use with children.

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

STUDY SAMPLE:  Data for 323 consecutive adults and 49 children who attended a Tinnitus and Hyperacusis Therapy Clinic in the United Kingdom within a 6-month period were included.

DATA COLLECTION AND ANALYSIS:  Data were collected retrospectively from the records of patients held at the Audiology Department. CFA with the weighted least-squares mean and variance-adjusted estimator was applied to assess the previously proposed factor structures of the HIQ, SSSQ, and SAD-T. The internal consistency of the scales was assessed via Cronbach's α (α). The items of the HIQ, SSSQ, and SAD-T were tested for measurement invariance regarding age and gender using the multiple indicator multiple cause (MIMIC) model.

RESULTS:  All questionnaires showed good to excellent internal consistency, with α = 0.93 for the HIQ, 0.87 for the SSSQ, and 0.91 for the SAD-T. The parent versions showed acceptable to good internal consistency, with α = 0.88 for the HIQ-P, 0.71 for the SSSQ-P, and 0.86 for the SAD-T-P. CFA showed that the HIQ, SSSQ, and SAD-T were all one-factor questionnaires and the factors generally were similar to those obtained for the EFA. The MIMIC model showed that all three questionnaires can be considered as measurement invariant, with scores similar across genders and ages.

CONCLUSION: The HIQ, SSSQ, and SAD-T are internally consistent one-factor questionnaires that can be used in clinical and research settings to assess the impact of hyperacusis, the severity of sound sensitivity symptoms, and to screen for anxiety and depression symptoms. Future studies should further explore the psychometric properties of the parent versions of the HIQ, SSSQ, and SAD-T.},
}

@article {pmid39552096,
year = {2024},
author = {Poulsen, R and Williams, Z and Dwyer, P and Pellicano, E and Sowman, PF and McAlpine, D},
title = {How auditory processing influences the autistic profile: A review.},
journal = {Autism research : official journal of the International Society for Autism Research},
volume = {},
number = {},
pages = {},
doi = {10.1002/aur.3259},
pmid = {39552096},
issn = {1939-3806},
support = {//Simons Foundation/ ; /DC/NIDCD NIH HHS/United States ; },
abstract = {We need to combine sensory data from various sources to make sense of the world around us. This sensory data helps us understand our surroundings, influencing our experiences and interactions within our everyday environments. Recent interest in sensory-focused approaches to supporting autistic people has fixed on auditory processing-the sense of hearing and the act of listening-and its crucial role in language, communications, and social domains, as well as non-social autism-specific attributes, to understand better how sensory processing might differ in autistic people. In this narrative review, we synthesize published research into auditory processing in autistic people and the relationship between auditory processing and autistic attributes in a contextually novel way. The purpose is to understand the relationship between these domains more fully, drawing on evidence gleaned from experiential perspectives through to neurological investigations. We also examine the relationship between auditory processing and diagnosable auditory conditions, such as hyperacusis, misophonia, phonophobia, and intolerance to loud sounds, as well as its relation to sleep, anxiety, and sensory overload. Through reviewing experiential, behavioral and neurological literature, we demonstrate that auditory processes interact with and shape the broader autistic profile-something not previously considered. Through a better understanding of the potential impact of auditory experiences, our review aims to inform future research on investigating the relationship between auditory processing and autistic traits through quantitative measures or using qualitative experiential inquiry to examine this relationship more holistically.},
}

@article {pmid39540976,
year = {2024},
author = {Rappoldt, LR and Kan, KJ and Dalmeijer, L and Rutten, SA and van Horen, R and van der Pol, MM and de Wit, C and Denys, D and Vulink, NCC and Utens, EMWJ},
title = {Psychometric Validation of the New Misophonia Screening List-Child and Youth and AMISOS-Y (Dutch Child- and Parent-Report Versions) for Assessing Misophonia in Youth.},
journal = {Child psychiatry and human development},
volume = {},
number = {},
pages = {},
pmid = {39540976},
issn = {1573-3327},
support = {2020353//Fonds Stichting Gezondheidszorg Spaarneland/ ; 2020353//Fonds Stichting Gezondheidszorg Spaarneland/ ; 2020353//Fonds Stichting Gezondheidszorg Spaarneland/ ; 2020353//Fonds Stichting Gezondheidszorg Spaarneland/ ; },
abstract = {Misophonia is a recently identified disorder of decreased sound tolerance that often originates in childhood. Currently, there is a lack of validated questionnaires for screening and assessing misophonia severity in children/adolescents. This paper presents an iterative validation process of two innovative (parallel child-/parent-reported) questionnaires: the Misophonia Screening List-Child and Youth for screening, and the Amsterdam Misophonia Scale-Youth (AMISOS-Y) for assessing misophonia severity in youth. After instrument refinement, we performed ROC curve, reliability, and principal component analyses, and assessed concurrent, convergent and divergent validity, on a combined sample (aged 8-18; clinical sample N = 94 youth, 95 parents; control group screening N = 197 youth, 56 parents; control group AMISOS-Y N = 192 youth, 55 parents). Both questionnaires were unidimensional and displayed excellent psychometric properties (α = 0.95-0.96). Future replication studies are needed in community and clinical samples to contribute to a unified diagnostic framework. Trial registered 09/2021: NL-OMON20775.},
}

@article {pmid39482886,
year = {2024},
author = {Smees, R and Simner, J and Hoare, DJ and Ward, J},
title = {Dissociable effects of hyperacusis and misophonia severity imply different mechanisms of decreased sound tolerance.},
journal = {International journal of audiology},
volume = {},
number = {},
pages = {1-8},
doi = {10.1080/14992027.2024.2419558},
pmid = {39482886},
issn = {1708-8186},
abstract = {OBJECTIVE: It is thought that decreased sound tolerance can be subdivided into distinct types including misophonia (involving specific trigger sounds) and hyperacusis (broader in profile). However, there are few established methods for differentially assessing these disorders and this is complicated by the fact that some measures (e.g. the HQ Hyperacusis Questionnaire) were developed before the concept of misophonia was accepted.

DESIGN/STUDY SAMPLE: We took a group of N = 119 participants with misophonia (varying in severity) and asked them about the presence of hyperacusis (based on a scoping review definition).

RESULTS: Scores for some items on the HQ were correlated with scores for misophonia severity (e.g. social impact of sound) and others with scores for hyperacusis (e.g. ability to concentrate in noise). Similarly, some trigger sounds were more indicative of hyperacusis (e.g. dishes being stacked) and others were more indicative of misophonia in the absence of hyperacusis (e.g. chewing).

CONCLUSIONS: These double dissociations provide compelling evidence for separable forms of sound intolerance. Moreover, our research suggests that a single-item question about hyperacusis is associated with other characteristics of hyperacusis, even when assessed 18 months later.},
}

@article {pmid39470473,
year = {2024},
author = {Almadani, AH and Alabdulkarim, IM and Akresh, MI and Alassaf, MI and Alkathiri, MA and Alkublan, KM and Aldoghmani, RA and Alghtani, YA and Alwaily, SA},
title = {Prevalence of misophonia and its association with depression and obsessive-compulsive disorder among medical students.},
journal = {Medicine},
volume = {103},
number = {43},
pages = {e40217},
pmid = {39470473},
issn = {1536-5964},
mesh = {Humans ; *Obsessive-Compulsive Disorder/epidemiology ; Male ; Female ; *Students, Medical/psychology/statistics & numerical data ; Cross-Sectional Studies ; Prevalence ; *Depression/epidemiology ; Saudi Arabia/epidemiology ; Young Adult ; Adult ; Surveys and Questionnaires ; },
abstract = {Misophonia, a neurobehavioral syndrome, reduces tolerance to specific stimuli and impacts various domains of life. It is also strongly correlated with obsessive-compulsive disorder (OCD) and depression. This study aimed to investigate the prevalence of misophonia among medical students at King Saud University (KSU), Saudi Arabia, identify related sociodemographic factors, and assess misophonia association with OCD and depression. This cross-sectional study included 371 participants. The study tool was distributed electronically between November 19 and December 07, 2023. It consisted of 4 sections: a questionnaire developed by the research team, the Amsterdam Misophonia Scale (A-MISO-S), the Obsessive-Compulsive Inventory-Revised (OCI-R), and the Patient Health Questionnaire-9 (PHQ-9). The results indicated that 42.32% of the participants had previously experienced misophonia, with symptoms developing suddenly in 28.66%. The majority of participants had subclinical misophonia (71.16%) and minimal depression (37.47%), with a significant proportion experiencing mild-to-severe misophonia (28.84%) and varying degrees of depression (33.15%). Approximately 31.00% of the students exhibited likely OCD. The PHQ-9 and A-MISO-S scores showed weak positive correlations, whereas the OCI-R and A-MISO-S scores showed a moderate positive correlation. Furthermore, a moderate positive correlation was observed between the OCI-R and PHQ-9 scores. Multiple logistic regression analysis revealed that sex, family history of misophonia, depression severity, and OCD were significantly associated with clinical misophonia. This study underscores the significance of recognizing misophonia among medical students and its associated factors, such as OCD and depression. Further multicenter studies using more rigorous research methodologies are warranted.},
}

Humans
*Obsessive-Compulsive Disorder/epidemiology
Male
Female
*Students, Medical/psychology/statistics & numerical data
Cross-Sectional Studies
Prevalence
*Depression/epidemiology
Saudi Arabia/epidemiology
Young Adult
Adult
Surveys and Questionnaires

@article {pmid39467402,
year = {2024},
author = {Dixon, LJ and Sevier, CJ and Freshley, AM},
title = {Emotion dysregulation in misophonia: Findings from a nationally representative sample.},
journal = {Journal of psychiatric research},
volume = {180},
number = {},
pages = {266-272},
doi = {10.1016/j.jpsychires.2024.10.022},
pmid = {39467402},
issn = {1879-1379},
abstract = {A core feature of misophonia is the emotional distress that occurs in response to specific sounds (e.g., slurping, pen clicking). Despite the theorized connection between emotion dysregulation and misophonia, there is very little research on this topic. Examining emotion dysregulation and identifying the specific emotion regulation deficits that are associated with worse misophonia symptoms would advance our understanding of potential transdiagnostic factors central to misophonia symptoms; thereby informing the development of more targeted interventions. The current study sought to: 1) characterize emotion dysregulation among individuals with misophonia, 2) compare emotion dysregulation between individuals with clinical and subclinical misophonia, and 3) examine the unique role of emotion dysregulation across three domains of misophonia symptoms. This study included a large, nationally representative sample of U.S. adults (N = 4005; 51.5% female; 62.5% White, non-Hispanic). Participants completed self-report questionnaires to assess misophonia symptoms (i.e., misophonia sounds, emotional and behavioral reactions to misophonia sounds, and misophonia-related impairment), stress, and emotion dysregulation. The results revealed participants with misophonia reported significantly worse emotion regulation abilities compared to individuals with subclinical levels of misophonia. In addition, emotion dysregulation was significantly associated with sensitivity to misophonia sounds, reactions to misophonia sounds, and misophonia-related impairment, even after accounting for covariates. Results support emotion dysregulation as an important element in misophonia and suggest certain dimensions of emotion dysregulation should be considered in future research and in the evaluation of treatment strategies used to reduce misophonia symptoms.},
}

@article {pmid39461373,
year = {2024},
author = {Shan, Y and Siepsiak, M and McMahon, K and Guetta, R and Kelley, L and Chen, T and Rosenthal, MZ},
title = {Network analysis of misophonia symptoms using the Duke Misophonia Questionnaire.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jad.2024.10.105},
pmid = {39461373},
issn = {1573-2517},
abstract = {BACKGROUND: Misophonia is a complex disorder characterized by a strong aversion to specific sounds, leading to significant distress and impairment. While the Duke Misophonia Questionnaire (DMQ) is one of the most comprehensive and validated measures for assessing misophonia, the relative importance of specific subscales and items within the DMQ remains unclear. Network analysis enables an understanding of the interconnections among subscales, providing insights into which parts of the measure are most central to the others. This study employed network analysis to examine the interconnections among DMQ subscales and identify the most central components of misophonia symptomatology.

METHODS: Network analysis was conducted on DMQ data from 144 adults with varying levels of misophonia symptoms. Four network models were examined: overall misophonia, symptoms, beliefs, and impairment. Sex differences were also explored.

RESULTS: The Impairment subscale emerged as the most central in the overall network for both males and females. Key items included cognitive reactions ("I need to get away from the sound," "I thought about physically hurting the person making the sound") as well as affective reactions (panic, anger) in the symptom sub-network, non-acceptance of misophonia beliefs ("I hate being like this") in the belief sub-network, and deterioration of self-esteem due to misophonia in the impairment sub-network. Females reported more severe cognitive and physiological symptoms than males.

CONCLUSIONS: The DMQ Impairment subscale and specific items identified as most central in each network may represent key aspects of misophonia symptomatology. Prioritizing these components in assessment and intervention efforts may be beneficial when appropriate.},
}

@article {pmid39454324,
year = {2024},
author = {Dewan, M and Campbell Daniels, E and Hunt, JE and Bryant, EA and Trikeriotis, SI and Kelly, DL and Adams, HA and Hare, SM and Waltz, JA},
title = {Aberrant salience signaling in auditory processing in schizophrenia: Evidence for abnormalities in both sensory processing and emotional reactivity.},
journal = {Schizophrenia research},
volume = {274},
number = {},
pages = {329-336},
doi = {10.1016/j.schres.2024.09.026},
pmid = {39454324},
issn = {1573-2509},
abstract = {It has been long known that people with schizophrenia (SZ) have deficits in perceptual processing, including in the auditory domain. Furthermore, they often experience increased emotional responsivity and dysregulation, which further impacts overall functioning. Increased emotional responsivity to auditory stimuli is also seen in people with misophonia, a condition in which specific sounds elicit robust negative emotional responses. Given the role of emotional reactivity and dysregulation in the pathogenesis of SZ, our study investigated whether misophonia symptoms were elevated in SZ, or if people with SZ have a generalized increase in reactivity to sensory information. To explore the link between emotional reactivity to sound and more general aspects emotional reactivity and salience signaling in SZ, we used the Misophonia Questionnaire, the Sensory Processing Scale (SPS), and Aberrant Salience Inventory (ASI) in 30 people with SZ and 28 demographically-matched healthy volunteers (HVs). We found that people with SZ exhibited more emotional behavior associated with misophonia symptoms (specifically, distress in relation to sound) than HVs (t56 = 4.889, p < 0.001), but did not have elevated rates of misophonia overall. Also, sensory processing abnormalities and heightened emotional responses in people with SZ were not limited to the auditory domain but, rather, extended to all sensory modalities. Our results support the idea that SZ involves dysfunction in salience signaling, regarding auditory stimuli, but that abnormalities in salience signaling in SZ are more domain-general. These results highlight the importance of interventions designed to enhance emotion regulation in patients with SZ regarding stimuli in multiple modalities.},
}

@article {pmid39442925,
year = {2024},
author = {Wang, R and Ma, T and Jin, Q and Xu, C and Yang, X and Wang, K and Wang, X},
title = {Waveguide-Based Microwave Nitric Oxide Sensor for COVID-19 Screening: Mass Transfer Modulation Effect on Hollow Confined WO3 Structures.},
journal = {ACS sensors},
volume = {},
number = {},
pages = {},
doi = {10.1021/acssensors.4c01889},
pmid = {39442925},
issn = {2379-3694},
abstract = {Serious acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a tremendous threat to global public health. Recently, the Food and Drug Administration approved the emergency use of volatile organic components as detection biomarkers for COVID-19, ushering in a new era of portable, simple, and rapid epidemiological screening based on breath diagnosis. Nitric oxide (NO) is an important biomarker indicating the degree of inflammation in the respiratory tract. In this study, a hollow multishelled structured WO3 (HoMSs-WO3)-based waveguide microwave gas sensor (MGS) was fabricated to detect trace levels of NO in exhaled breath for the preliminary diagnosis of COVID-19. The sensor showed excellent reusability and selectivity and efficiently detected NO in the 10-100 ppb, with a sensitivity of 39.27 dB/ppm and a detection limit of 2.52 ppb. In addition, a sound correlation was observed in the measurement results between the MGS and the Sunvou detector for detecting NO from the exhaled breath of clinical COVID-19 patients. The difference between the two measurements was within 1.96 standard bias, and the consistency range was -12 to 17 ppb, thus fully demonstrating the significant potential of the sensor in COVID-19 screening.},
}

@article {pmid39426015,
year = {2024},
author = {Bagrowska, P and Siepsiak, M and Nalberczak-Skóra, M and Gawęda, Ł},
title = {Exacerbation of paranoia-like thoughts following exposure to common misophonia trigger sounds.},
journal = {Schizophrenia research},
volume = {274},
number = {},
pages = {290-298},
doi = {10.1016/j.schres.2024.10.005},
pmid = {39426015},
issn = {1573-2509},
abstract = {Paranoia-like thoughts refer to heightened suspicions and unfounded beliefs about being watched or persecuted by others. Recent research has found a significant correlation between misophonia symptoms, a form of decreased sound tolerance, and paranoia-like thoughts, both of which are linked to heightened negative emotions in clinical and non-clinical populations. Notably, it has been observed that misophonia may also be associated with the tendency to attribute hostile intent to those producing triggering sounds, a feature consistent with paranoid ideation (i.e., perceptions of intentional harm). However, existing research is based on correlational data, limiting causal inference. Therefore, an online study involving a non-clinical sample (N = 487) employed an experimental approach to examine the relationship between misophonia symptoms, negative emotional response, and paranoia-like thoughts. Participants were randomly assigned to one of four task conditions, each related to exposure to different stimulus types: orofacial human-produced sounds, non-human sounds, sounds without visual context, or visuals devoid of sound. The results of mixed model ANOVA and mediation analysis revealed that exposure to common misophonia trigger sounds with a human-related visual context slightly, but not significantly, raised the levels of paranoia-like thoughts. However, it did lead to a significant increase in negative emotions, which, in turn, proved to be a significant mediator of an increase in paranoia-like thoughts. Conversely, exposure to non-human sounds or to only audio/visual stimuli either decreased both negative emotions and paranoia-like thoughts or showed no significant change. This emphasized the role of context and the involvement of negative emotional response to human-made sounds in amplifying paranoia-like thoughts. Importantly, this effect was observed in individuals who do not meet the provisional diagnostic criteria for misophonia, suggesting that symptoms of misophonia may extend beyond clinical diagnoses, with milder manifestations potentially being present within the general population.},
}

@article {pmid39376325,
year = {2024},
author = {Gowda, V and Prabhu, P},
title = {Prevalence of Misophonia in Adolescents and Adults Across the Globe: A Systematic Review.},
journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India},
volume = {76},
number = {5},
pages = {4614-4622},
pmid = {39376325},
issn = {2231-3796},
abstract = {misophonia is a sound tolerance disorder which disturbs the emotions of people when exposed to specific triggers. Studies have shown that visual triggers alone can cause misophonia in affected individuals in the absence of auditory triggers. It is also said to affect people's quality of lives affecting social life, work life and personal relationships. Different studies on misophonia indicate that it is prevalent between 5% and 34.67%. These studies help us understand the existence of misophonia across different parts of the world. Studies report factors like gender, age, socioeconomic status, etc. play significant roles in impacting the prevalence of disorder. This study aims to review 12 such English articles available online, to get a comprehensive set of data to make it easy for readers and researchers. Results of the review indicate that not many countries have their prevalence rates established which could be indicating the lack of awareness. In countries that have carried out the study, clinically significant misophonia exists in many individuals with various degrees with multiple factors affecting it.},
}

@article {pmid39369709,
year = {2024},
author = {Guzick, AG and Rast, CE and Maddox, BB and Rodriguez Barajas, S and Clinger, J and McGuire, J and Storch, EA},
title = {"How Can I Get Out of This?": A Qualitative Study of the Phenomenology and Functional Impact of Misophonia in Youth and Families.},
journal = {Psychopathology},
volume = {},
number = {},
pages = {1-11},
doi = {10.1159/000535044},
pmid = {39369709},
issn = {1423-033X},
abstract = {INTRODUCTION: Misophonia is an increasingly recognized disorder characterized by negative emotional and sensory reactions to specific noises. Although misophonia most often begins in childhood, there has been minimal research on its clinical presentation in youth. This qualitative study explored cognitive behavioral processes that are involved in misophonia and its associated functional impairment in young people and their families.

METHODS: Focused interviews were conducted with 20 youth with misophonia (ages 10-17) and their parents. Thematic analyses of these interviews using a cognitive behavioral theoretical framework were conducted.

RESULTS: A number of themes were identified, which included internalizing and externalizing cognitive behavioral processes at the individual level (e.g., hypervigilance, anticipatory anxiety, escape, automatic negative attributions), secondary emotional and functional consequences (e.g., negative perception of self, guilt, anxiety, depression, emotional exhaustion, concentration difficulties at school), as well as significant impacts to school, social life, and particularly to family life (e.g., conflict/tension, anger and resentment, family accommodation). These themes are integrated in a proposed theoretical model.

DISCUSSION: Misophonia is characterized by several transdiagnostic cognitive behavioral processes, including avoidance, maladaptive cognitions, emotional reactivity, and family communication difficulties, as well as significant functional impairment. Developing treatments that target these processes has the potential to help youth overcome misophonia and improve the quality of life of youth and their families.},
}

@article {pmid39368459,
year = {2024},
author = {Guzick, AG and Schneider, SC and Kook, M and Greenberg, R and Perozo-Garcia, A and Lee, MP and Garcia, J and Onyeka, OC and Riddle, DB and Storch, EA},
title = {Internet-based, parent-led cognitive behavioral therapy for autistic youth with anxiety-related disorders: A randomized trial comparing email vs. telehealth support.},
journal = {Behaviour research and therapy},
volume = {183},
number = {},
pages = {104639},
doi = {10.1016/j.brat.2024.104639},
pmid = {39368459},
issn = {1873-622X},
abstract = {This study tested two versions of parent-led, Internet-delivered cognitive behavioral therapy for anxiety among autistic youth; one that provided weekly email support (iCBT-Email), and one that provided alternating bi-weekly emails and video calls (iCBT-Video) across 12 weeks. It was expected that those in the iCBT-Video condition would complete more treatment content, which in turn would lead to more anxiety improvement. Fifty-seven autistic youth (7-15 years-old) with anxiety disorders were randomized to iCBT-Email or iCBT-Video. There were no significant differences in improvement in clinician-rated, child-reported, or parent-reported anxiety severity or functional impairment. Posttreatment response rates were 55% in iCBT-Email and 67% in iCBT-Video. Module completion predicted improved treatment outcome, though there was no difference in module completion across groups. Therapists spent an average of 16.29 min/family/week (SD = 7.11) in the iCBT-Email condition and 24.13 min/family/week (SD = 6.84) in the iCBT-Video condition. Email and telehealth-supported, parent-led iCBT both appear to be effective treatments for autistic youth with anxiety disorders that require reduced therapist effort. Future research should seek novel methods to enhance engagement with iCBT content. CLINICALTRIALS.GOV IDENTIFIER: NCT05284435.},
}

@article {pmid39357020,
year = {2024},
author = {Spencer, SD and Mangen, KH and Omar, Y and Storch, EA},
title = {Acceptance and Commitment Therapy for an Emerging Adult Female With Misophonia: A Case Study.},
journal = {Journal of psychiatric practice},
volume = {30},
number = {5},
pages = {374-378},
pmid = {39357020},
issn = {1538-1145},
mesh = {Humans ; Female ; *Acceptance and Commitment Therapy/methods ; Young Adult ; Adult ; },
abstract = {Misophonia is characterized by decreased tolerance to idiosyncratic and repetitive human-generated sounds (ie, triggers), coupled with affective-based reactions that result in impairment and distress. Often having its onset in youth, misophonia can become especially prominent during key developmental periods, including emerging adulthood. While efforts to develop interventions for misophonia remain ongoing, a consensus has not yet been reached concerning recommended first-line treatments. Acceptance and commitment therapy (ACT), which has demonstrated efficacy in treating various psychiatric disorders via targeting psychological flexibility processes, represents one potentially feasible approach for addressing misophonia. This case study describes the application of an individually delivered, 12-session ACT intervention for a black female in her early 20s with misophonia. Descriptive data collected at 4 time points (pretreatment, mid-treatment, posttreatment, and at 2-month follow-up) suggested the potential promise of ACT as a treatment for misophonia, improving psychological flexibility processes and reducing secondary depression and anxiety symptoms. Findings are discussed in the context of the possible mechanisms of ACT most likely responsible for misophonia-related clinical improvement. More rigorous studies (eg, clinical trials) are needed to confirm promising findings from existing case studies.},
}

Humans
Female
*Acceptance and Commitment Therapy/methods
Young Adult
Adult

@article {pmid39348505,
year = {2024},
author = {Muñoz, K and Woolley, MG and Velasquez, D and Ortiz, D and San Miguel, GG and Petersen, JM and Twohig, MP},
title = {Audiological Characteristics of a Sample of Adults With Misophonia.},
journal = {American journal of audiology},
volume = {},
number = {},
pages = {1-10},
doi = {10.1044/2024_AJA-24-00111},
pmid = {39348505},
issn = {1558-9137},
abstract = {PURPOSE: The aim of this study was to describe the audiological test results from a sample of 60 adults with self-reported misophonia.

METHOD: Audiological testing was completed prior to participant randomization in a controlled trial for misophonia treatment. Participants completed the Inventory of Hyperacusis Symptoms Survey (IHS), the Tinnitus and Hearing Survey (THS), the Misophonia Questionnaire (MQ), and behavioral and objective audiometric measures.

RESULTS: Hearing thresholds were less than 25 dBHL for 97% of the participants. Loudness discomfort levels for tonal stimuli suggested hyperacusis in 25% of the sample. Total scores on the IHS indicated that 12% met the clinical cutoff for hyperacusis, and, on the THS, 27% experienced problems with tinnitus, 77% experienced problems with hearing, and 53% experienced problems with sound tolerance. On the MQ, 37% indicated mild levels of misophonia and 58% indicated moderate levels. For speech-in-noise testing, a mild signal-to-noise ratio loss was present for 15% of participants. Most of the participants had present distortion product otoacoustic emissions (DPOAEs).

CONCLUSIONS: Audiological data on individuals with misophonia are lacking. In this article, we present results from audiological testing on 60 adults with self-reported misophonia. Most had normal peripheral hearing sensitivity based on pure-tone audiometry and DPOAE measures; some had difficulties with sound sensitivities and understanding speech-in-noise, self-report indicated problems with hyperacusis, tinnitus, and hearing difficulty.},
}

@article {pmid39341019,
year = {2024},
author = {Ahmmed, A and Vijayakumar, S},
title = {A Retrospective Study Distinguishing between Hyperacusis and Misophonia in children with Auditory Processing Disorder (APD).},
journal = {International journal of pediatric otorhinolaryngology},
volume = {186},
number = {},
pages = {112119},
doi = {10.1016/j.ijporl.2024.112119},
pmid = {39341019},
issn = {1872-8464},
abstract = {OBJECTIVES: Decreased sound tolerance (DST) is common in children with auditory processing disorder (APD). This study aimed to differentiate between hyperacusis and misophonia in children with APD.

DESIGN: A retrospective study evaluating outcomes of structured history and co-morbidity following Research Domain Criteria (RDoC) frame-work. Misophonia was considered as oversensitivity to eating/chewing sounds and hyperacusis as oversensitivity to other sounds.

STUDY SAMPLE: Two hundred and seventy-nine children (160 males; 119 females), 6-16 year-olds with NVIQ ≥80, diagnosed with APD between January 2021 and December 2022.

RESULTS: One hundred and forty-three out of 279 children with APD had DST, of which 107 had hyperacusis (without misophonia) and 36 had misophonia. Misophonia co-existed with hyperacusis in 35 children (97 %), and in one child misophonia occurred without hyperacusis. Misophonia was prevalent in older children, in females, and those with tinnitus. Fear and being upset were predominant emotional responses in hyperacusis (without misophonia) while disgust and verbal abuse were prevalent in misophonia (with or without hyperacusis). Compared to children without DST, the hyperacusis (without misophonia) and misophonia (with or without hyperacusis) groups had significant higher prevalence of ADHD, anxiety, and language impairment. Educational difficulties were similar in APD irrespective of the presence or absence of DST. Despite higher tinnitus prevalence in misophonia (with or without hyperacusis) along with similar co-morbidities and educational difficulties in both hyperacusis (without misophonia) and misophonia (with or without hyperacusis), the misophonia (with or without hyperacusis) group surprisingly had less support at school which was reflected in fewer Education, Health and Care Plan (EHCP).

CONCLUSIONS: In APD misophonia mostly co-exists with hyperacusis, with differences in emotional responses, tinnitus prevalence, and gender distribution when compared to hyperacusis (without misophonia). Increase in awareness about misophonia is needed, as children with misophonia may have unidentified needs. Larger scale prospective study is required to clarify if misophonia evolves from hyperacusis, and to explore the factors underlying 'misophonia with hyperacusis' and 'misophonia without hyperacusis'. For clarity, DST studies need to specify if hyperacusis or misophonia co-existed when referring to hyperacusis or misophonia.},
}

@article {pmid39337229,
year = {2024},
author = {Silva, LA and Noll, M and Siqueira, GC and Barbosa, AKN},
title = {Assessing Misophonia in Young Adults: The Prevalence and Psychometric Validation of the MisoQuest Questionnaire.},
journal = {Healthcare (Basel, Switzerland)},
volume = {12},
number = {18},
pages = {},
doi = {10.3390/healthcare12181888},
pmid = {39337229},
issn = {2227-9032},
abstract = {Background/Objectives: Misophonia, characterized by strong emotional reactions to specific sounds, poses significant challenges, particularly in academic settings. This study aimed to examine the psychometric properties of the Brazilian version of the MisoQuest in a sample of high school and university students. The primary objective was to assess its reliability and structural validity to enhance understanding of misophonia in young adults. Methods: A total of 549 students (Mean age = 23.2 years, SD = 9.3; 285 females, 260 males, 4 individuals who did not disclose their gender) participated. Both exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were employed to evaluate the MisoQuest. Fit indices for unifactorial and trifactorial models were compared. Internal consistency was assessed using Cronbach's alpha. Results: The EFA suggested a dominant single-factor structure with high factor loadings (ranging from 0.60 to 0.79). However, the CFA revealed excellent fit for both unifactorial (CFI and TLI = 1.00, RMSEA close to zero) and trifactorial models (CFI and TLI = 1.00, RMSEA = 0.037). The MisoQuest demonstrated high internal consistency (Cronbach's alpha = 0.93). Additionally, 4.5% of participants were identified as positive for misophonia based on a predefined cutoff score of 61. Conclusions: The Brazilian version of the MisoQuest is a reliable and valid tool for assessing misophonia. These findings suggest that the instrument may capture multiple dimensions of the disorder. Given the observed prevalence of misophonia and its impact on students, early identification and tailored interventions are crucial for providing adequate support. Further research is needed to refine the tool and expand its clinical utility.},
}

@article {pmid39312259,
year = {2024},
author = {Bryant, BR and Sisk, MR and McGuire, JF},
title = {Efficacy of Gamified Digital Mental Health Interventions for Pediatric Mental Health Conditions: A Systematic Review and Meta-Analysis.},
journal = {JAMA pediatrics},
volume = {},
number = {},
pages = {},
pmid = {39312259},
issn = {2168-6211},
abstract = {IMPORTANCE: Anxiety, depression, and attention-deficit/hyperactivity disorder (ADHD) affect up to 20% of children and adolescents. Despite demonstrated efficacy, evidence-based treatments for these conditions are often inaccessible; innovative solutions are essential to meet the demand for pediatric mental health care.

OBJECTIVE: To examine the efficacy and moderators of gamified DMHIs for anxiety, depression, and ADHD in randomized clinical trials (RCTs) for children and adolescents.

DATA SOURCES: A systematic search of PubMed, PsycInfo, and Web of Science was conducted for RCTs published before March 20, 2024.

STUDY SELECTION: RCTs that evaluated the efficacy of gamified DMHIs for treating pediatric ADHD, depression, or anxiety were included. Studies were excluded if they did not use a gamified DMHI, provide sufficient data for effect sizes, or were unavailable in English.

DATA EXTRACTION AND SYNTHESIS: Efficacy data were extracted from rating scales for ADHD, depression, and anxiety. Extracted moderator variables included participant characteristics (eg, age and sex), intervention characteristics (eg, delivery modality and time limit), and trial design characteristics (eg, outcome measure and risk of bias).

MAIN OUTCOMES AND MEASURES: The primary outcome was change in ADHD, depression, or anxiety severity in the treatment group compared to the control group. Hedges g quantified treatment effects.

RESULTS: The search strategy identified 27 RCTs that included 2911 participants across ADHD, depression, and anxiety disorders. There were modest significant effects of gamified DMHIs on ADHD (g, 0.28; 95% CI, 0.09 to 0.48) and depression (g, 0.28; 95% CI, 0.08 to 0.47) but small, nonsignificant effects for anxiety disorders (g, 0.07; 95% CI, -0.02 to 0.17). Moderator analyses revealed that DMHIs for ADHD delivered on a computer and those RCTs that had a greater preponderance of male participants produced larger treatment effects. DMHIs for depressive disorders that used preset time limits for gamified DMHIs also exhibited larger treatment effects.

CONCLUSIONS AND RELEVANCE: The findings suggest a benefit of gamified DMHIs for youth with ADHD or depressive disorder. Pediatricians and other health care professionals have new information about novel, accessible, and efficacious options for pediatric mental health care.},
}

@article {pmid39269531,
year = {2024},
author = {Spencer, SD and Petersen, JM and Schneider, RL and Guzick, AG and McGuire, JF},
title = {Clinical Considerations for Integrating Ethical Principles of Beneficence in the Development of Evidence-Based Interventions: The case of Pediatric Misophonia.},
journal = {Research on child and adolescent psychopathology},
volume = {},
number = {},
pages = {},
pmid = {39269531},
issn = {2730-7174},
abstract = {Misophonia is a condition involving decreased tolerance and intense responses to specific sounds, often those that are human-generated and repetitive in nature. Misophonia frequently onsets during childhood and is associated with significant distress, impairment, and diminished quality of life. While misophonia research remains nascent and no definitive practice guidelines exist at present, extant studies offer several promising potential avenues in intervention development for adults with misophonia. However, such research is comparatively limited for youth. Before widespread adoption of promising treatments, it is important to consider the potential for harm or non-beneficence that may arise from the mis-informed application of such treatments. In this article, we identify several potential pitfalls within intervention development for pediatric misophonia and provide recommendations to circumvent them. To that end, we focus on the following three topic areas: (a) challenges arising when psychological mechanisms are not considered in intervention development, (b) importation of a cognitive-behavior therapy (CBT) framework for obsessive-compulsive spectrum disorders without nuanced tailoring to misophonia, and (c) neglecting to include individuals with lived experience in the process of intervention development research. Considering these key areas within misophonia intervention development will be critical for upholding beneficence and minimizing harm in treatment of misophonia across the lifespan.},
}

@article {pmid39258129,
year = {2024},
author = {Herdi, O and Yıldırım, F},
title = {Sex-Specific Correlations Between Misophonia Symptoms and ADHD, OCD, and Autism-Related Traits in Adolescent Outpatients.},
journal = {Noro psikiyatri arsivi},
volume = {67},
number = {3},
pages = {248-254},
doi = {10.29399/npa.28630},
pmid = {39258129},
issn = {1300-0667},
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.},
}

@article {pmid39182828,
year = {2024},
author = {Bowers, EM and Woolley, MG and Muñoz, K and Petersen, JM and Twohig, MP},
title = {Acceptance and commitment therapy versus progressive relaxation training for misophonia: Randomized controlled trial protocol, interventions, and audiological assessments.},
journal = {Contemporary clinical trials},
volume = {},
number = {},
pages = {107671},
doi = {10.1016/j.cct.2024.107671},
pmid = {39182828},
issn = {1559-2030},
abstract = {BACKGROUND: Misophonia is a disorder characterized by an intense emotional reaction to specific sounds, often leading to significant distress and impairment in daily functioning. Acceptance and commitment therapy (ACT) is a promising psychotherapy for treating misophonia, but has only been previously tested in case studies. This paper presents a protocol for the first randomized controlled trial (RCT) assessing the efficacy and feasibility of ACT supplemented by audiological interventions for misophonia versus progressive relaxation training (PRT).

METHODS: The outlined protocol is a RCT with 60 adults with misophonia. After undergoing a comprehensive psychological and audiological evaluation, participants were randomly assigned to ACT (n = 30) or PRT (n = 30). All participants completed clinician-administered and self-report assessments at baseline, post-intervention, 3-month follow-up, and 6-month follow-up. The primary outcome was misophonia severity and impairment measured via clinical interview. Secondary outcomes included disgust, anger, sensory sensitivities, well-being, distress, and psychological flexibility.

DISCUSSION: This paper outlines the rationale of using ACT supplemented by audiological methods for misophonia with the novel therapeutic target of enhancing psychological flexibility. The results of this randomized controlled trial will help determine if ACT is an efficacious and acceptable treatment for misophonia. This trial will also help clarify active psychological mechanisms of misophonia, and assess whether this combination of psychological and audiological services can effectively help individuals with misophonia.},
}

@article {pmid39061457,
year = {2024},
author = {Natalini, E and Fioretti, A and Eibenstein, R and Eibenstein, A},
title = {Metacognitive Interpersonal Therapy for Misophonia: A Single-Case Study.},
journal = {Brain sciences},
volume = {14},
number = {7},
pages = {},
doi = {10.3390/brainsci14070717},
pmid = {39061457},
issn = {2076-3425},
abstract = {BACKGROUND: Misophonia is a chronic condition in which the exposure to specific sounds increases the arousal and recurrence of specific intense negative emotions. We hypothesized that misophonia may be strongly related to maladaptive interpersonal schemas that create difficulties in interpersonal relationships. Subjects with maladaptive interpersonal schemas think that other people try to subjugate, criticize, dominate, exploit, deceive, disregard, and humiliate them. Furthermore, these patients typically endorse a representation of self as mistreated, constricted, harmed, damaged, humiliated, impotent, inadequate, or fragile.

METHODS: We describe the course of a treatment of Metacognitive Interpersonal Therapy (MIT) in a young man presenting misophonia and co-occurrent obsessive-compulsive personality disorder (OCPD) and avoidant personality disorder (AvPD), with narcissistic traits and normal hearing. We collected qualitative and quantitative data at the beginning of the intervention and at 2 years follow-up.

RESULTS: The therapy aimed at increasing awareness of maladaptive interpersonal schemas and promoting a healthy self. The results reported a significant decrease in misophonia; behavioural experiments were used to increase the quality of social relationships and tolerance to the trigger sounds.

CONCLUSIONS: MIT can be an effective therapy for the treatment of misophonia.},
}

@article {pmid39025447,
year = {2024},
author = {Seegan, PL and McGuire, JF},
title = {Provider and patient barriers and facilitators to integration of digital mental health applications in routine clinical care.},
journal = {Journal of affective disorders},
volume = {},
number = {},
pages = {},
doi = {10.1016/j.jad.2024.07.089},
pmid = {39025447},
issn = {1573-2517},
abstract = {BACKGROUND: The limited accessibility of mental healthcare providers highlights the need for innovative approaches to provide effective and efficient care. Digital mental health applications (DMHAs) can improve patient access to evidence-based treatments and reduce burden on the healthcare system. Here, we examined the provider and patient barriers and facilitators to integration of DMHAs in a healthcare system.

METHODS: Patients (n = 57) and providers (n = 100) were recruited from a large healthcare system over five months. Participants completed a survey assessing attitudes towards DMHAs, and perceived facilitators and barriers to adoption and utilization of DMHAs in mental healthcare.

RESULTS: DMHA credibility was a key facilitator for provider adoption, while usability and accessibility were identified as key facilitators for patient utilization. Provider barriers included patient cost/provider reimbursement, limited knowledge, perceived limits to credibility, patient outcome enhancement, and personalization of DMHAs for patient needs. Patients identified privacy concerns as the top barrier for using DMHAs.

LIMITATIONS: The self-report survey nature of this study, modest sample size, and majority of sample identifying as White and upper middle class make results subject to biases and limitations. Given the potential of DMHAs to address disparities in access to mental healthcare, more research is needed including populations who are at greatest risk.

CONCLUSIONS: Findings provide new insights to inform the development of intervention strategies to improve the integration of DMHAs within healthcare systems. Additional research examining key stakeholders at different levels of care is critical to address barriers, optimize facilitators, and develop roadmaps for best-practice use in healthcare systems.},
}

@article {pmid39005041,
year = {2024},
author = {Lin, IF and Kondo, HM},
title = {Brain circuits in autonomous sensory meridian response and related phenomena.},
journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences},
volume = {379},
number = {1908},
pages = {20230252},
doi = {10.1098/rstb.2023.0252},
pmid = {39005041},
issn = {1471-2970},
mesh = {Humans ; *Brain/physiology ; Nerve Net/physiology ; Sensation/physiology ; Synesthesia ; },
abstract = {Autonomous sensory meridian response (ASMR) is characterized by a tingling sensation with a feeling of relaxation and a state of flow. We explore the neural underpinnings and comorbidities of ASMR and related phenomena with altered sensory processing. These phenomena include sensory processing sensitivity (SPS), synaesthesia, Alice in Wonderland syndrome and misophonia. The objective of this article is to uncover the shared neural substrates and distinctive features of ASMR and its counterparts. ASMR, SPS and misophonia exhibit common activations in the brain regions associated with social cognition, emotion regulation and empathy. Nevertheless, ASMR responders display reduced connectivity in the salience network (SN), while individuals with SPS exhibit increased connectivity in the SN. Furthermore, ASMR induces relaxation and temporarily reduces symptoms of depression, in contrast to SPS and misophonia, which are linked to depression. These observations lead us to propose that ASMR is a distinct phenomenon owing to its attention dispatch mechanism and its connection with emotion regulation. We suggest that increased activations in the insula, along with reduction in connectivity within the salience and default mode networks in ASMR responders, may account for their experiences of relaxation and flow states. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.},
}

Humans
*Brain/physiology
Nerve Net/physiology
Sensation/physiology
Synesthesia

@article {pmid39005036,
year = {2024},
author = {Mednicoff, SD and Barashy, S and Vollweiler, DJ and Benning, SD and Snyder, JS and Hannon, EE},
title = {Misophonia reactions in the general population are correlated with strong emotional reactions to other everyday sensory-emotional experiences.},
journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences},
volume = {379},
number = {1908},
pages = {20230253},
doi = {10.1098/rstb.2023.0253},
pmid = {39005036},
issn = {1471-2970},
mesh = {Humans ; *Emotions ; Adult ; Female ; Male ; *Music/psychology ; Young Adult ; Middle Aged ; Adolescent ; Auditory Perception ; Arousal/physiology ; },
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'.},
}

Humans
*Emotions
Adult
Female
Male
*Music/psychology
Young Adult
Middle Aged
Adolescent
Auditory Perception
Arousal/physiology

@article {pmid39005025,
year = {2024},
author = {Berger, JI and Gander, PE and Kumar, S},
title = {A social cognition perspective on misophonia.},
journal = {Philosophical transactions of the Royal Society of London. Series B, Biological sciences},
volume = {379},
number = {1908},
pages = {20230257},
doi = {10.1098/rstb.2023.0257},
pmid = {39005025},
issn = {1471-2970},
mesh = {Humans ; *Social Cognition ; *Emotions/physiology ; Auditory Perception/physiology ; Cognition ; Social Perception ; },
abstract = {Misophonia is commonly classified by intense emotional reactions to common everyday sounds. The condition has an impact both on the mental health of its sufferers and societally. As yet, formal models on the basis of misophonia are in their infancy. Based on developing behavioural and neuroscientific research we are gaining a growing understanding of the phenomenology and empirical findings in misophonia, such as the importance of context, types of coping strategies used and the activation of particular brain regions. In this article, we argue for a model of misophonia that includes not only the sound but also the context within which sound is perceived and the emotional reaction triggered. We review the current behavioural and neuroimaging literature, which lends support to this idea. Based on the current evidence, we propose that misophonia should be understood within the broader context of social perception and cognition, and not restricted within the narrow domain of being a disorder of auditory processing. We discuss the evidence in support of this hypothesis, as well as the implications for potential treatment approaches. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.},
}

Humans
*Social Cognition
*Emotions/physiology
Auditory Perception/physiology
Cognition
Social Perception

@article {pmid38963546,
year = {2024},
author = {Pfeiffer, E and Allroggen, M and Sachser, C},
title = {The prevalence of misophonia in a representative population-based survey in Germany.},
journal = {Social psychiatry and psychiatric epidemiology},
volume = {},
number = {},
pages = {},
pmid = {38963546},
issn = {1433-9285},
abstract = {PURPOSE: Misophonia is a new disorder, currently defined as significant emotional and physiological distress when exposed to certain sounds. Although there is a growing body of literature on the characteristics of the disorder, the prevalence in the general population is still relatively unknown. This study therefore aims at determining the prevalence and symptom severity of misophonia in a large and representative general population sample in Germany.

METHODS: To examine the prevalence of misophonic sounds, misophonic reactions and misophonia severity, a cross-sectional population representative survey in Germany has been conducted. Participants (N = 2.522) were questioned retrospectively about misophonic symptoms using the Amsterdam Misophonie Scale - Revised (AMISOS-R).

RESULTS: Overall 33.3% reported to be sensitive to at least one specific misophonic sound. Within the total sample, subthreshold symptoms were reported by 21.3%, mild symptoms were reported by 9.9%, moderate to severe symptoms were reported by 2.1%, and severe to extreme symptoms were reported in 0.1% of participants.

CONCLUSION: Based on the diverging presentations and prevalence rates of misophonic sounds, reactions and symptoms according to the severity, it seems worthwhile to conceptualize misophonia as a rather continuous spectrum disorder (subthreshold, mild, moderate to severe), still taking into account that an additional categorical diagnostic approach might be necessary to derive a diagnosis in clinical practice.},
}

@article {pmid38962216,
year = {2024},
author = {Uglik-Marucha, N and Siepsiak, M and Zielińska, J and Dragan, WŁ and Gregory, J and Vitoratou, S},
title = {Beyond sound irritation: cross-cultural evidence on the robustness of the five aspects of misophonic experience measured by the S-Five in a Polish sample.},
journal = {Frontiers in psychology},
volume = {15},
number = {},
pages = {1372870},
pmid = {38962216},
issn = {1664-1078},
abstract = {Misophonia is commonly associated with negative emotional or physiological responses to specific sounds. However, the consensus definition emphasizes that misophonia entails much more than that. Even in cases of subclinical misophonia, where individuals do not meet the disorder criteria, the experience can still be burdensome, despite not currently causing significant distress or impairment. The S-Five is a psychometric tool for comprehensive assessment of five aspects of misophonic experience: internalizing, externalizing, impact, threat, and outburst, and includes S-Five-T section to evaluate feelings evoked by triggering sounds and their intensity. We examined whether the five-factor structure developed in the UK could be replicated in a Polish sample, including individuals with and without self-identified misophonia. The Polish version of the S-Five was translated and tested on 288 Polish-speaking individuals. Comprehensive psychometric evaluation, including factor structure, measurement invariance, test-retest reliability, internal consistency, and concurrent validity evaluations, was conducted on the translated scale. Exploratory factor analysis suggested similar structure to the original English study, while bootstrap exploratory graph analysis showed the factor structure to be reproducible in other samples. The scale was found to be bias free with respect to gender, internally consistent and stable in time, and evidence of validity was provided using MisoQuest and Misophonia Questionnaire. These results offer support for the cross-cultural stability of the five factors and provide preliminary evidence for the suitability of the Polish version for clinical and research purposes. The study also investigated five facets of misophonia, triggering sounds, emotional responses, and their associations with symptoms of psychopathology across various cultures. It underscores the central role of anger, distress, and panic, while also highlighting the mixed role of irritation and disgust in misophonia across different cultural contexts. Mouth sounds evoked the most pronounced reactions compared to other repetitive sounds, although there were discernible cultural differences in the nature and intensity of reactions to various trigger sounds. These findings hold significant implications for future research and underscore the importance of considering cultural nuances in both research and the clinical management of misophonia.},
}

@article {pmid38929278,
year = {2024},
author = {Bodo, CR and Salcudean, A and Nirestean, A and Lukacs, E and Lica, MM and Muntean, DL and Anculia, RC and Popovici, RA and Neda Stepan, O and Enătescu, VR and Strete, EG},
title = {Association between Chronic Misophonia-Induced Stress and Gastrointestinal Pathology in Children-A Hypothesis.},
journal = {Children (Basel, Switzerland)},
volume = {11},
number = {6},
pages = {},
doi = {10.3390/children11060699},
pmid = {38929278},
issn = {2227-9067},
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.},
}

@article {pmid38891944,
year = {2024},
author = {Fichna, JP and Chiliński, M and Halder, AK and Cięszczyk, P and Plewczynski, D and Żekanowski, C and Janik, P},
title = {Structural Variants and Implicated Processes Associated with Familial Tourette Syndrome.},
journal = {International journal of molecular sciences},
volume = {25},
number = {11},
pages = {},
pmid = {38891944},
issn = {1422-0067},
support = {UMO-2016/23/B/NZ2/03030//National Science Center, Poland/ ; 2019/35/O/ST6/02484//National Science Center, Poland/ ; 2020/37/B/NZ2/03757//National Science Center, Poland/ ; PPN/STA/2021/1/00087/DEC/1//National Agency for Academic Exchange, Poland/ ; 7054/IA/SP/2020//Ministry of Science and Higher Education, Poland/ ; },
mesh = {Humans ; *Tourette Syndrome/genetics ; Male ; Female ; *Pedigree ; Genetic Predisposition to Disease ; Extracellular Matrix Proteins/genetics/metabolism ; Adult ; Whole Genome Sequencing ; },
abstract = {Gilles de la Tourette syndrome (GTS) is a neurodevelopmental psychiatric disorder with complex and elusive etiology with a significant role of genetic factors. The aim of this study was to identify structural variants that could be associated with familial GTS. The study group comprised 17 multiplex families with 80 patients. Structural variants were identified from whole-genome sequencing data and followed by co-segregation and bioinformatic analyses. The localization of these variants was used to select candidate genes and create gene sets, which were subsequently processed in gene ontology and pathway enrichment analysis. Seventy putative pathogenic variants shared among affected individuals within one family but not present in the control group were identified. Only four private or rare deletions were exonic in LDLRAD4, B2M, USH2A, and ZNF765 genes. Notably, the USH2A gene is involved in cochlear development and sensory perception of sound, a process that was associated previously with familial GTS. In addition, two rare variants and three not present in the control group were co-segregating with the disease in two families, and uncommon insertions in GOLM1 and DISC1 were co-segregating in three families each. Enrichment analysis showed that identified structural variants affected synaptic vesicle endocytosis, cell leading-edge organization, and signaling for neurite outgrowth. The results further support the involvement of the regulation of neurotransmission, neuronal migration, and sound-sensing in GTS.},
}

Humans
*Tourette Syndrome/genetics
Male
Female
*Pedigree
Genetic Predisposition to Disease
Extracellular Matrix Proteins/genetics/metabolism
Adult
Whole Genome Sequencing

@article {pmid38868724,
year = {2023},
author = {Simner, J and Rinaldi, LJ},
title = {Misophonia, self-harm and suicidal ideation.},
journal = {PCN reports : psychiatry and clinical neurosciences},
volume = {2},
number = {4},
pages = {e142},
doi = {10.1002/pcn5.142},
pmid = {38868724},
issn = {2769-2558},
abstract = {AIM: Misophonia is a sound sensitivity disorder characterized by an unusually strong aversion to a specific class of sounds-often human bodily sounds (e.g., chewing). These sounds can cause intense negative emotions which can cause profound difficulties in everyday life. The condition is linked with higher rates of anxiety and depression, and here we ask whether it co-occurs with elevated self-harm and suicidal thinking.

METHODS: We measured self-harm and misophonia in the general population by examining a birth cohort sample from the Avon Longitudinal Study of Parents and Children (ALSPAC). We screened them for misophonia as adults, then analyzed their earlier data on well-being, self-harm, and suicidal thinking.

RESULTS: Adults with misophonia had significantly higher rates of self-harm and suicidal ideation, as well as poorer well-being in a number of different measures at ages 16-17 and 23-24 years. Female misophonics were particularly at risk, from as early as their teenage years, though males, too, show elevated self-harm at 24 years compared to nonmisophonic peers.

CONCLUSION: Our data provide evidence of elevated risks of self-harm associated with misophonia and suggest the need for greater recognition and treatment pathways.},
}

@article {pmid38824419,
year = {2024},
author = {Krog, E and Falck, A and Nielsen, GE},
title = {Preliminary validation of the Norwegian version of the Berlin Misophonia Questionnaire Revised (BMQ-R-NOR).},
journal = {Scandinavian journal of psychology},
volume = {},
number = {},
pages = {},
doi = {10.1111/sjop.13030},
pmid = {38824419},
issn = {1467-9450},
abstract = {OBJECTIVE: To perform a psychometric evaluation of a Norwegian version of the Berlin Misophonia Questionnaire Revised (BMQ-R-NOR).

DESIGN: Participants completed online versions of the self-report questionnaire BMQ-R-NOR on two occasions and MQ-NOR on one occasion. Convergent validity was assessed through Spearman's correlation between BMQ-R-NOR and MQ-NOR. Internal consistency was evaluated with McDonald's omega and Cronbach's alpha. Test-retest reliability was evaluated using Cohen's weighted kappa and intraclass correlation.

STUDY SAMPLE: 82 participants with self-reported misophonia took part in the study at T1, and 53 of these participated at T2. However, only 41 of them were included in the test-retest analyses due to 12 participants being in treatment between T1 and T2.

RESULTS: Subscales from the BMQ-R-NOR and MQ-NOR were significantly positively correlated, indicating evidence of convergent validity (rs = 0.22*-0.74**). The BMQ-R-NOR showed overall good internal consistency (omega = 0.72-0.93; alpha = 0.70-0.93) and satisfactory test-retest reliability (ICC = 0.35-0.92).

CONCLUSION: The psychometric properties of the BMQ-R-NOR are considered satisfactory. However, it is advised to exercise caution when using it until further comprehensive validation studies are conducted to ensure robustness and reliability in clinical practice.},
}

@article {pmid38780601,
year = {2024},
author = {Dixon, LJ and Schadegg, MJ and Clark, HL and Sevier, CJ and Witcraft, SM},
title = {Prevalence, phenomenology, and impact of misophonia in a nationally representative sample of U.S. adults.},
journal = {Journal of psychopathology and clinical science},
volume = {},
number = {},
pages = {},
doi = {10.1037/abn0000904},
pmid = {38780601},
issn = {2769-755X},
support = {//Misophonia Research Fund/ ; },
abstract = {Misophonia is characterized by decreased tolerance for and negative reactions to certain sounds and associated stimuli, which contribute to impairment and distress. Research has found that misophonia is common in clinical, college, and online samples; yet, fewer studies have examined rates of misophonia in population-based samples. The current study addresses limitations of prior research by investigating misophonia prevalence, phenomenology, and impairment in a large, nationally representative sample of adults in the United States. Probability-based sampling was used to administer a survey to a representative sample of U.S. households. Data were adjusted with poststratification weights to account for potential sampling biases and examined as weighted proportions to estimate the outcomes. The sample included 4,005 participants (51.5% female; 62.5% White). Sensitivity to misophonia sounds was reported by 78.5% of the sample, and 4.6% reported clinical levels of misophonia. Results demonstrated significant demographic differences in misophonia symptom severity. Specifically, significantly higher misophonia symptoms were observed for participants who identified as female, less than 55 years old, less than a high school education, never married, lower income, and those working part time, compared to each of the respective comparison groups. Those with clinically significant misophonia symptoms reported that symptoms often onset in childhood and adolescence, were persistent, and contributed to severe impairment in at least one life domain. These findings provide a prevalence estimate of misophonia in the general population of the United States and inform our understanding of who is affected by misophonia. (PsycInfo Database Record (c) 2024 APA, all rights reserved).},
}

@article {pmid38776286,
year = {2024},
author = {Trumbull, J and Lanier, N and McMahon, K and Guetta, R and Rosenthal, MZ},
title = {Using a standardized sound set to help characterize misophonia: The International Affective Digitized Sounds.},
journal = {PloS one},
volume = {19},
number = {5},
pages = {e0301105},
doi = {10.1371/journal.pone.0301105},
pmid = {38776286},
issn = {1932-6203},
mesh = {Humans ; Female ; Male ; Adult ; *Sound ; Middle Aged ; Acoustic Stimulation ; Surveys and Questionnaires ; Young Adult ; Affect/physiology ; },
abstract = {Misophonia is a condition characterized by negative affect, intolerance, and functional impairment in response to particular repetitive sounds usually made by others (e.g., chewing, sniffing, pen tapping) and associated stimuli. To date, researchers have largely studied misophonia using self-report measures. As the field is quickly expanding, assessment approaches need to advance to include more objective measures capable of differentiating those with and without misophonia. Although several studies have used sounds as experimental stimuli, few have used standardized stimuli sets with demonstrated reliability or validity. To conduct rigorous research in an effort to better understand misophonia, it is important to have an easily accessible, standardized set of acoustic stimuli for use across studies. Accordingly, in the present study, the International Affective Digitized Sounds (IADS-2), developed by Bradley and Lang (Bradley MM et al., 2007), were used to determine whether participants with misophonia responded to certain standardized sounds differently than a control group. Participants were 377 adults (132 participants with misophonia and 245 controls) recruited from an online platform to complete several questionnaires and respond to four probes (arousal, valence, similarity to personally-relevant aversive sounds, and sound avoidance) in response to normed pleasant, unpleasant, and neutral IADS-2 sounds. Findings indicated that compared to controls, participants with high misophonia symptoms rated pleasant and neutral sounds as significantly more (a) arousing and similar to trigger sounds in their everyday life, (b) unpleasant and (c) likely to be avoided in everyday life. For future scientific and clinical innovation, we include a ranked list of IADS-2 stimuli differentiating responses in those with and without misophonia, which we call the IADS-M.},
}

Humans
Female
Male
Adult
*Sound
Middle Aged
Acoustic Stimulation
Surveys and Questionnaires
Young Adult
Affect/physiology

@article {pmid38745685,
year = {2024},
author = {Nazeri, A and Majidpour, A and Nazeri, A and Kamrani, A and Aazh, H},
title = {Prevalence of Ear-Related Problems in Individuals Recovered From COVID-19.},
journal = {Iranian journal of otorhinolaryngology},
volume = {36},
number = {3},
pages = {489-497},
pmid = {38745685},
issn = {2251-7251},
abstract = {INTRODUCTION: The aim was to assess prevalence of tinnitus, hyperacusis, hearing and balance problems among patients recovered from COVID-19 infection. Self-reported ear and hearing symptoms were compared in three groups comprising: confirmed COVID-19, possible COVID-19, and non-COVID-19.

MATERIALS AND METHODS: 1649 participants completed the survey in this cross-sectional study. The mean age was 34 years and 65% were female. Participants with confirmed and possible COVID-19 were asked if after their infection (compared to the past) they experienced hearing loss, ringing or whistling noises, fullness or blockage in their ears, loudness of the sounds that are normal to other people bother them more (an indication of hyperacusis), dizziness, giddiness, or imbalance.

RESULTS: Among participants with confirmed COVID-19, 16% reported that compared to the past their hearing has decreased, 21.5% noticed tinnitus, 22.5% aural fullness, 26.1% hyperacusis and 17.3% balance problems. Regression models showed that compared to the non-COVID-19 group, participants with confirmed COVID-19 had odds ratios (ORs) of significantly greater than 1 in predicting presence of self-reported symptoms of hearing loss, tinnitus, aural fullness, hyperacusis and balance problems, OR=1.96 (p=0.001), OR=1.63 (p=0.003), OR=1.8 (p<0.001), OR=2.2 (p<0.001), and OR=2.99 (p<0.001), respectively.

CONCLUSIONS: There seem to be higher prevalence of self-report symptoms of ear-related problems among individuals with confirmed COVID-19 infection compared to a non-COVID-19 group during the pandemic.},
}

@article {pmid38722993,
year = {2024},
author = {Hansen, HA and Leber, AB and Saygin, ZM},
title = {The effect of misophonia on cognitive and social judgments.},
journal = {PloS one},
volume = {19},
number = {5},
pages = {e0299698},
doi = {10.1371/journal.pone.0299698},
pmid = {38722993},
issn = {1932-6203},
mesh = {Humans ; Male ; Female ; *Judgment ; *Cognition/physiology ; Adult ; Young Adult ; Acoustic Stimulation ; Memory/physiology ; },
abstract = {Misophonia, a heightened aversion to certain sounds, turns common cognitive and social exercises (e.g., paying attention during a lecture near a pen-clicking classmate, coexisting at the dinner table with a food-chomping relative) into challenging endeavors. How does exposure to triggering sounds impact cognitive and social judgments? We investigated this question in a sample of 65 participants (26 misophonia, 39 control) from the general population. In Phase 1, participants saw faces paired with auditory stimuli while completing a gender judgment task, then reported sound discomfort and identification. In Phase 2, participants saw these same faces with novel ones and reported face likeability and memory. For both oral and non-oral triggers, misophonic participants gave higher discomfort ratings than controls did-especially when identification was correct-and performed slower on the gender judgment. Misophonic participants rated lower likeability than controls did for faces they remembered with high discomfort sounds, and face memory was worse overall for faces originally paired with high discomfort sounds. Altogether, these results suggest that misophonic individuals show impairments on social and cognitive judgments if they must endure discomforting sounds. This experiment helps us better understand the day-to-day impact of misophonia and encourages usage of individualized triggers in future studies.},
}

Humans
Male
Female
*Judgment
*Cognition/physiology
Adult
Young Adult
Acoustic Stimulation
Memory/physiology

@article {pmid38718050,
year = {2024},
author = {Aazh, H and Moore, BCJ and Erfanian, M},
title = {Confirmatory factor analysis of the Tinnitus Impact Questionnaire using data from patients seeking help for tinnitus alone or tinnitus combined with hyperacusis.},
journal = {PloS one},
volume = {19},
number = {5},
pages = {e0302837},
doi = {10.1371/journal.pone.0302837},
pmid = {38718050},
issn = {1932-6203},
mesh = {Humans ; *Tinnitus/complications/diagnosis ; *Hyperacusis/complications ; Middle Aged ; Male ; Female ; Surveys and Questionnaires ; Factor Analysis, Statistical ; Adult ; Aged ; Cross-Sectional Studies ; Retrospective Studies ; Psychometrics/methods ; },
abstract = {A confirmatory factor analysis (CFA) of the Tinnitus Impact Questionnaire (TIQ) was performed. In contrast to commonly used tinnitus questionnaires, the TIQ is intended solely to assess the impact of tinnitus by not including items related to hearing loss or tinnitus loudness. This was a psychometric study based on a retrospective cross-sectional analysis of clinical data. Data were available for 155 new patients who had attended a tinnitus and hyperacusis clinic in the UK within a five-month period and had completed the TIQ. The mean age was 54 years (standard deviation = 14 years). The TIQ demonstrated good internal consistency, with Cronbach's α = 0.84 and McDonald's ω = 0.89. CFA showed that two items of the TIQ had low factor loadings for both one-factor and two-factor models and their scores showed low correlations with scores for other items. Bi-factor analysis gave a better fit, indicated by a relative chi-square (χ2) of 18.5, a Root-Mean Square Error of Approximation (RMSEA) of 0.103, a Comparative Fit Index (CFI) of 0.97, a Tucker Lewis Index (TLI) of 0.92, and a Standardized Root-Mean Residual (SPMR) of 0.038. Total TIQ scores were moderately correlated with scores for the Visual Analogue Scale of effect of tinnitus on life and the Screening for Anxiety and Depression-Tinnitus questionnaire, supporting the convergent validity of the TIQ. The TIQ score was not correlated with the pure-tone average hearing threshold, indicating discriminant validity. A multiple-causes multiple-indicator (MIMIC) model showed no influences of age, gender or hearing status on TIQ item scores. The TIQ is an internally consistent tool. CFA suggests a bi-factor model with sufficient unidimensionality to support the use of the overall TIQ score for assessing the impact of tinnitus. TIQ scores are distinct from the impact of hearing impairment among patients who have tinnitus combined with hearing loss.},
}

Humans
*Tinnitus/complications/diagnosis
*Hyperacusis/complications
Middle Aged
Male
Female
Surveys and Questionnaires
Factor Analysis, Statistical
Adult
Aged
Cross-Sectional Studies
Retrospective Studies
Psychometrics/methods

@article {pmid38689723,
year = {2024},
author = {Ay, E and Huviyetli, M and Çakmak, E},
title = {The mediating role of anxiety in the relationship between misophonia and quality of life: findings from the validated Turkish version of MisoQuest.},
journal = {Frontiers in psychology},
volume = {15},
number = {},
pages = {1361645},
doi = {10.3389/fpsyg.2024.1361645},
pmid = {38689723},
issn = {1664-1078},
abstract = {INTRODUCTION: Misophonia is a disorder characterized by decreased tolerance to certain sounds or their associated stimuli, and many measurement tools have been developed for its diagnosis and evaluation. The aims of the current study were to develop the Turkish version of MisoQuest, a fully validated misophonia questionnaire, to evaluate the relationships between misophonia, anxiety, and quality of life, and to examine the mediating role of anxiety in the relationship between misophonia and quality of life.

METHODS: The reliability of the Turkish version of MisoQuest was conducted using data from 548 participants (Mean age = 28.06 ± 9.36). Then, the relationships between misophonia, anxiety, and quality of life were evaluated in a separate sample of 117 participants (Mean age = 25.50 ± 6.31) using the State-Trait Anxiety Inventory (STAI) and the Short Form 36 (SF-36) questionnaire.

RESULTS: The results showed that the Turkish version of MisoQuest has good psychometric properties. Close-to-moderate positive correlations were found between misophonia and anxiety, and weak negative correlations were found between misophonia and quality of life. Anxiety mediated the relationships between misophonia and quality of life.

DISCUSSION: These results emphasize that misophonia may be an important problem affecting people's quality of life and reveal the mediating role of anxiety on this effect.},
}

@article {pmid38670671,
year = {2024},
author = {Storch, EA and Guzick, AG and D'Souza, J and Clinger, J and Ayton, D and Kook, M and Rork, C and Smith, EE and Draper, IA and Khalfe, N and Rast, CE and Murphy, N and Lijfijjt, M and Goodman, WK and Cervin, M},
title = {Family Accommodation in Children and Adolescents With Misophonia.},
journal = {Behavior therapy},
volume = {55},
number = {3},
pages = {595-604},
doi = {10.1016/j.beth.2023.09.001},
pmid = {38670671},
issn = {1878-1888},
mesh = {Humans ; Male ; Female ; Adolescent ; Child ; *Family/psychology ; Anxiety Disorders/psychology ; Parents/psychology ; Family Relations/psychology ; Adaptation, Psychological ; },
abstract = {Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life.},
}

Humans
Male
Female
Adolescent
Child
*Family/psychology
Anxiety Disorders/psychology
Parents/psychology
Family Relations/psychology
Adaptation, Psychological

@article {pmid38651993,
year = {2024},
author = {Aazh, H and Najjari, A and Moore, BCJ},
title = {A Preliminary Analysis of the Clinical Effectiveness of Audiologist-Delivered Cognitive Behavioral Therapy Delivered via Video Calls for Rehabilitation of Misophonia, Hyperacusis, and Tinnitus.},
journal = {American journal of audiology},
volume = {},
number = {},
pages = {1-16},
doi = {10.1044/2024_AJA-23-00254},
pmid = {38651993},
issn = {1558-9137},
abstract = {PURPOSE: Cognitive behavioral therapy (CBT) is a key intervention for management of misophonia, hyperacusis, and tinnitus. The aim of this study was to perform a preliminary analysis comparing the scores for self-report questionnaires before and after audiologist-delivered CBT via video calls for adults with misophonia, hyperacusis, or tinnitus or a combination of these.

METHOD: This was a retrospective cross-sectional study. The data for 37 consecutive patients who received CBT for misophonia, hyperacusis, or tinnitus from a private institute in the United Kingdom were analyzed. Self-report questionnaires taken as part of routine care were as follows: 4C Questionnaires for tinnitus, hyperacusis, and misophonia (4C-T, 4C-H, and 4C-M, respectively), Tinnitus Impact Questionnaire (TIQ), Hyperacusis Impact Questionnaire (HIQ), Misophonia Impact Questionnaire (MIQ), Sound Sensitivity Symptoms Questionnaire (SSSQ), and Screening for Anxiety and Depression in Tinnitus (SAD-T). Responses were also obtained to other questionnaires related to tinnitus, hyperacusis, insomnia, and anxiety and mood disorders. A linear mixed-model method was used to assess the changes in response to the questionnaires pretreatment and posttreatment.

RESULTS: Pretreatment-posttreatment comparisons showed that scores for the 4C-T, 4C-H, 4C-M, TIQ, HIQ, MIQ, SSSQ, and SAD-T improved, with effect sizes of 1.4, 1.2, 1.3, 2.6, 0.9, 0.7, 0.9, and 1.4, respectively (all p < .05).

CONCLUSIONS: This preliminary analysis suggests that CBT via video calls may be effective in reducing the impact of misophonia, hyperacusis, and tinnitus. However, this study did not have a control group, so its results need to be interpreted with caution.},
}

@article {pmid38566702,
year = {2024},
author = {Sujeeth, PR and Hanji, R and Nayyar, K and Prabhu, P},
title = {Estimation of Prevalence of Misophonia Among High School Students in India.},
journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India},
volume = {76},
number = {2},
pages = {1678-1681},
pmid = {38566702},
issn = {2231-3796},
abstract = {OBJECTIVE: Misophonia, an intriguing psychological disorder is characterized by intense emotional responses to specific sounds produced by others, has gained prominence for its distinct attributes and profound impact on individuals' emotional and psychological well-being. This study addresses the scarcity of research on misophonia's prevalence and severity among high school students, aiming to shed light on the unique challenges faced by this demographic in India.

METHODS: The study enrolled 597 high school students, including 269 females and 328 males, aged 14 to 16, with no history of psychological or otological problems or medication use. The Misophonia Assessment Questionnaire questionnaire, consisting of 21 questions with a 4-point Likert scale response, assessed emotional and behavioral reactions to sensitive sounds. Participants' scores categorized them as Sub-clinical, Mild, Moderate, or Severe misophonia.

RESULTS: The prevalence of misophonia was 34.67% among high school students, with 52.65% categorized as Mild, 45.41% as Moderate, and 1.93% as severe misophonia. A comparison with a similar study on college students in India revealed a higher prevalence of misophonia among high school students. This discrepancy may relate to adolescents' vulnerable psychological states, marked by limited emotional regulation and significant life transitions.

CONCLUSIONS: This study significantly contributes to the evolving understanding of misophonia by spotlighting its prevalence and severity among high school students in India. The findings underscore the necessity of recognizing and addressing misophonia's impact during adolescence, a crucial developmental phase.},
}

@article {pmid38557310,
year = {2024},
author = {Barber, KE and Pitts, BX and Stiede, JT and Espil, FM and Woods, DW and Specht, MW and Bennett, SM and Walkup, JT and Ricketts, EJ and McGuire, JF and Peterson, AL and Compton, SN and Wilhelm, S and Scahill, L and Piacentini, JC},
title = {Perceived Negative Effects of Tic Management Strategies in Adults With Tic Disorders.},
journal = {Behavior modification},
volume = {},
number = {},
pages = {1454455241236446},
doi = {10.1177/01454455241236446},
pmid = {38557310},
issn = {1552-4167},
abstract = {Behavior therapy is a well-established and empirically supported treatment for tic disorders (TDs). However, concerns have been expressed about the negative effects of behavioral interventions, such as tic worsening, tic substitution, and excessive effort. This study explored perceived negative effects of tic management strategies in adults with TDs and predictors of these experiences. Participants (N = 72) completed semi-structured interviews 11 years after receiving behavior therapy or supportive therapy in a randomized clinical trial. We examined responses to interview questions about managing tics and predictors of reported negative effects. Most participants did not experience tic worsening (84%) or tic substitution (75%) from tic management strategies. The majority felt they could manage tics while participating in their environment (87%) and did not report life interference from tic management (77%). About half (45%) felt less present when managing tics. Treatment non-responders in the original trial were more likely to report negative effects of tic management strategies. No differences in reported negative consequences were found between those who received behavior therapy versus supportive therapy, suggesting that behavior therapy specifically does not lead to such adverse effects. These findings could reduce misconceptions about behavior therapy for TDs and enhance its acceptability and utilization.},
}

@article {pmid38517176,
year = {2024},
author = {Farkas, AH and Ward, RT and Gilbert, FE and Pouliot, J and Chiasson, P and McIlvanie, S and Traiser, C and Riels, K and Mears, R and Keil, A},
title = {Auditory aversive generalization learning prompts threat-specific changes in alpha-band activity.},
journal = {Cerebral cortex (New York, N.Y. : 1991)},
volume = {34},
number = {3},
pages = {},
doi = {10.1093/cercor/bhae099},
pmid = {38517176},
issn = {1460-2199},
support = {//Office of Naval Research/ ; N00014-21-2324//Misophonia Research Fund/ ; },
abstract = {Pairing a neutral stimulus with aversive outcomes prompts neurophysiological and autonomic changes in response to the conditioned stimulus (CS+), compared to cues that signal safety (CS-). One of these changes-selective amplitude reduction of parietal alpha-band oscillations-has been reliably linked to processing of visual CS+. It is, however, unclear to what extent auditory conditioned cues prompt similar changes, how these changes evolve as learning progresses, and how alpha reduction in the auditory domain generalizes to similar stimuli. To address these questions, 55 participants listened to three sine wave tones, with either the highest or lowest pitch (CS+) being associated with a noxious white noise burst. A threat-specific (CS+) reduction in occipital-parietal alpha-band power was observed similar to changes expected for visual stimuli. No evidence for aversive generalization to the tone most similar to the CS+ was observed in terms of alpha-band power changes, aversiveness ratings, or pupil dilation. By-trial analyses found that selective alpha-band changes continued to increase as aversive conditioning continued, beyond when participants reported awareness of the contingencies. The results support a theoretical model in which selective alpha power represents a cross-modal index of continuous aversive learning, accompanied by sustained sensory discrimination of conditioned threat from safety cues.},
}

@article {pmid38479346,
year = {2024},
author = {Steuber, ER and McGuire, JF},
title = {A meta-analysis of transcranial magnetic stimulation in Tourette syndrome.},
journal = {Journal of psychiatric research},
volume = {173},
number = {},
pages = {34-40},
doi = {10.1016/j.jpsychires.2024.02.057},
pmid = {38479346},
issn = {1879-1379},
abstract = {There is growing enthusiasm for the treatment of neuropsychiatric disorders using neuromodulation. While some reports claim that transcranial magnetic stimulation (TMS) can be used to treat Tourette Syndrome (TS), little research exists to support this assertion. This meta-analysis examined the efficacy of TMS to reduce tic severity in patients with TS. Additionally, it explored the effect of TMS to reduce premonitory urge severity-the primary mechanism implicated in the frontline evidence-based treatment of TS. Five treatment comparisons were selected using PRISMA guidelines. All studies included were required to be (1) a randomized controlled trial, (2) compare TMS to a sham condition, and (3) have all participants meet diagnostic criteria for a persistent tic disorder and/or TS. A random effects model meta-analysis examined the efficacy of using TMS to reduce tic severity and explored the effect of TMS to reduce premonitory urge severity. TMS did not significantly reduce tic severity (g = 0.44; 95% CI = -0.17, 1.05; z = 1.40; p = 0.16), but a moderate reduction in premonitory urge severity was found (g = 0.63; 95% CI = 0.9, 1.17; z = 2.27; p < 0.02). Trials with larger sample sizes and a preponderance of women were found to have greater therapeutic effects of TMS for tic severity. There is limited support for the use of TMS to reduce tic severity, though reductions in premonitory urge severity were observed. Major limitations of the existing literature are examined, with a call for research investigating newer TMS protocols and their use as a treatment augmentation strategy.},
}

@article {pmid38440608,
year = {2024},
author = {Bahramian, E and Gohari, N and Aazh, H},
title = {Preliminary Study on Speech in Noise Training in Children with Sensory Processing Disorder and Hyperacusis.},
journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India},
volume = {76},
number = {1},
pages = {344-350},
pmid = {38440608},
issn = {2231-3796},
abstract = {Hyperacusis is the perception of certain everyday sounds as too loud or painful. Past research suggests that some individuals with Sensory Processing Disorder (SPD) may also have a comorbid hyperacusis. The aim of this preliminary study was to explore if hyperacusis symptoms in children with SPD change following Speech in noise training (SPINT). This was a retrospective cross-sectional study. Data were included for 28 children with SPD and sound intolerance (12/28 were female, mean age was 8.7 ± 1.9 years old). Patients were assessed using the Persian Buffalo Model Questionnaire-Revised version (P-BMQ-R) that measures various behavioural aspects of auditory processing disorder and word in noise test (WINT) before and after SPINT. After SPINT the subscales of DEC, TFM with its Noi, and Mem, subcategories, APD, ΣCAP, and Gen of P-BMQ-R questionnaire significantly improved (P < 0.05), however, the changes in subscales of Var, INT and ORG were not statistically significant (P > 0.05). In addition, SPINT led to better performance in WINT in both ears (P < 0.05). This preliminary study showed promising result for the effect of SPINT on improving behavioural indicators of APD (as measured via P-BMQ-R and WINT) and decreasing hyperacusis symptoms (as measured via Noi).},
}

@article {pmid38430053,
year = {2024},
author = {Lewin, AB and Milgram, L and Cepeda, SL and Dickinson, S and Bolen, M and Kudryk, K and Bolton, C and Karlovich, AR and Grassie, HL and Kangavary, A and Harmon, SL and Guzick, A and Ehrenreich-May, J},
title = {Clinical characteristics of treatment-seeking youth with misophonia.},
journal = {Journal of clinical psychology},
volume = {},
number = {},
pages = {},
doi = {10.1002/jclp.23672},
pmid = {38430053},
issn = {1097-4679},
support = {//REAM Foundation/ ; //Misophonia Research Fund/ ; },
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.},
}

@article {pmid38420172,
year = {2024},
author = {Norena, A},
title = {Did Kant suffer from misophonia?.},
journal = {Frontiers in psychology},
volume = {15},
number = {},
pages = {1242516},
pmid = {38420172},
issn = {1664-1078},
abstract = {Misophonia is a disorder of decreased tolerance to specific sounds, often produced by humans but not always, which can trigger intense emotional reactions (anger, disgust etc.). This relatively prevalent disorder can cause a reduction in the quality of life. The causes of misophonia are still unclear. In this article, we develop a hypothesis suggesting that misophonia can be caused by a failure in the organization of the perceived world. The perceived world is the result of both the structure of human thought and the many conditioning factors that punctuate human life, particularly social conditioning. It is made up of abstract symbols that map the world and help humans to orient himself in a potentially dangerous environment. In this context, the role of social rules acquired throughout life is considerable. Table manners, for example, are a set of deeply regulated and controlled behaviors (it's considered impolite to eat with the mouth open and to make noise while eating), which contribute to shape the way the perceived world is organized. So it's not surprising to find sounds from the mouth (chewing etc.) among the most common misophonic sound triggers. Politeness can be seen as an act of obedience to moral rules or courtesy, which is a prerequisite for peaceful social relations. Beyond this example, we also argue that any sound can become a misophonic trigger as long as it is not integrated into the perceived ordered and harmonious world, because it is considered an "anomaly," i.e., a disorder, an immorality or a vulgarity.},
}

@article {pmid38414185,
year = {2024},
author = {Simner, J and Rinaldi, LJ and Ward, J},
title = {An Automated Online Measure for Misophonia: The Sussex Misophonia Scale for Adults.},
journal = {Assessment},
volume = {},
number = {},
pages = {10731911241234104},
doi = {10.1177/10731911241234104},
pmid = {38414185},
issn = {1552-3489},
abstract = {Misophonia is a sound sensitivity disorder characterized by a strong aversion to specific sounds (e.g., chewing). Here we present the Sussex Misophonia Scale for Adults (SMS-Adult), within an online open-access portal, with automated scoring and results that can be shared ethically with users and professionals. Receiver operator characteristics show our questionnaire to be "excellent" and "good-to-excellent" at classifying misophonia, both when dividing our n = 501 adult participants by recruitment stream (self-declared misophonics vs. general population), and again when dividing them with by a prior measure of misophonia (as misophonics vs. non-misophonics). Factor analyses identified a five-factor structure in our 39 Likert-type items, and these were Feelings/Isolation, Life consequences, Intersocial reactivity, Avoidance/Repulsion, and Pain. Our measure also elicits misophonia triggers, each rated for their commonness in misophonia. We offer our open-access online tool for wider use (www.misophonia-hub.org), embedded within a well-stocked library of resources for misophonics, researchers, and clinicians.},
}

@article {pmid38406262,
year = {2023},
author = {McMahon, K and Cassiello-Robbins, C and Greenleaf, A and Guetta, R and Frazer-Abel, E and Kelley, L and Rosenthal, MZ},
title = {The unified protocol for transdiagnostic treatment of emotional disorders for misophonia: a pilot trial exploring acceptability and efficacy.},
journal = {Frontiers in psychology},
volume = {14},
number = {},
pages = {1294571},
pmid = {38406262},
issn = {1664-1078},
abstract = {INTRODUCTION: Misophonia is a recently defined disorder characterized by distressing responses to everyday sounds, such as chewing or sniffling. Individuals with misophonia experience significant functional impairment but have limited options for evidenced-based behavioral treatment. To address this gap in the literature, the current pilot trial explored the acceptability and efficacy of a transdiagnostic cognitive-behavioral approach to treating symptoms of misophonia.

METHODS: This trial was conducted in two studies: In Study 1, the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) was delivered to eight patients in order to receive feedback to guide revisions to the treatment to suit this population. In Study 2, ten patients received the revised UP treatment to explore its acceptability and preliminary efficacy. This study used a single-case experimental design with multiple baselines, randomizing patients to either a 2-week baseline or 4-week baseline prior to the 16 weeks of treatment, followed by four weeks of follow-up.

RESULTS: The findings from these studies suggested that patients found both the original and adapted versions of the UP to be acceptable and taught them skills for how to manage their misophonia symptoms. Importantly, the findings also suggested that the UP can help remediate symptoms of misophonia, particularly the emotional and behavioral responses.

DISCUSSION: These findings provide preliminary evidence that this transdiagnostic treatment for emotional disorders can improve symptoms of misophonia in adults.},
}

@article {pmid38392460,
year = {2024},
author = {Hayes, C and Gregory, J and Aziz, R and Cerejeira, J and Cruz, M and Simões, JA and Vitoratou, S},
title = {Psychometric Evaluation and Misophonic Experience in a Portuguese-Speaking Sample.},
journal = {Behavioral sciences (Basel, Switzerland)},
volume = {14},
number = {2},
pages = {},
doi = {10.3390/bs14020107},
pmid = {38392460},
issn = {2076-328X},
support = {102176/B/13/Z/WT_/Wellcome Trust/United Kingdom ; },
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.},
}

@article {pmid38386641,
year = {2024},
author = {Guetta, RE and Siepsiak, M and Shan, Y and Frazer-Abel, E and Rosenthal, MZ},
title = {Misophonia is related to stress but not directly with traumatic stress.},
journal = {PloS one},
volume = {19},
number = {2},
pages = {e0296218},
doi = {10.1371/journal.pone.0296218},
pmid = {38386641},
issn = {1932-6203},
abstract = {The relationship between misophonia, stress, and traumatic stress has not been well characterized scientifically. This study aimed to explore the relationships among misophonia, stress, lifetime traumatic events, and traumatic stress. A community sample of adults with self-reported misophonia (N = 143) completed structured diagnostic interviews and psychometrically validated self-report measures. Significant positive correlations were observed among perceived stress, traumatic stress, and misophonia severity. However, multivariate analyses revealed that perceived stress significantly predicted misophonia severity, over and above traumatic stress symptoms. The number of adverse life events was not associated with misophonia severity. Among symptom clusters of post-traumatic stress disorder, only hyperarousal was associated with misophonia severity. These findings suggest that transdiagnostic processes related to stress, such as perceived stress and hyperarousal, may be important phenotypic features and possible treatment targets for adults with misophonia.},
}

@article {pmid38309959,
year = {2024},
author = {, and , and , },
title = {[Standard technical specifications for methacholine chloride (Methacholine) bronchial challenge test (2023)].},
journal = {Zhonghua jie he he hu xi za zhi = Zhonghua jiehe he huxi zazhi = Chinese journal of tuberculosis and respiratory diseases},
volume = {47},
number = {2},
pages = {101-119},
doi = {10.3760/cma.j.cn112147-20231019-00247},
pmid = {38309959},
issn = {1001-0939},
support = {2018YFC1311900//State Key Research and Development Plan/ ; SRPG22-018//Guangzhou National Laboratory Independent Project/ ; },
abstract = {The methacholine challenge test (MCT) is a standard evaluation method of assessing airway hyperresponsiveness (AHR) and its severity, and has significant clinical value in the diagnosis and treatment of bronchial asthma. A consensus working group consisting of experts from the Pulmonary Function and Clinical Respiratory Physiology Committee of the Chinese Association of Chest Physicians, the Task Force for Pulmonary Function of the Chinese Thoracic Society, and the Pulmonary Function Group of Respiratory Branch of the Chinese Geriatric Society jointly developed this consensus. Based on the "Guidelines for Pulmonary Function-Bronchial Provocation Test" published in 2014, the issues encountered in its use, and recent developments, the group has updated the Standard technical specifications of methacholine chloride (methacholine) bronchial challenge test (2023). Through an extensive collection of expert opinions, literature reviews, questionnaire surveys, and multiple rounds of online and offline discussions, the consensus addressed the eleven core issues in MCT's clinical practice, including indications, contraindications, preparation of provocative agents, test procedures and methods, quality control, safety management, interpretation of results, and reporting standards. The aim was to provide clinical pulmonary function practitioners in healthcare institutions with the tools to optimize the use of this technique to guide clinical diagnosis and treatment.Summary of recommendationsQuestion 1: Who is suitable for conducting MCT? What are contraindications for performing MCT?Patients with atypical symptoms and a clinical suspicion of asthma, patients diagnosed with asthma requiring assessment of the severity of airway hyperresponsiveness, individuals with allergic rhinitis who are at risk of developing asthma, patients in need of evaluating the effectiveness of asthma treatment, individuals in occupations with high safety risks due to airway hyperresponsiveness, patients with chronic diseases prone to airway hyperresponsiveness, others requiring assessment of airway reactivity.Absolute contraindications: (1) Patients who are allergic to methacholine (MCh) or other parasympathomimetic drugs, with allergic reactions including rash, itching/swelling (especially of the face, tongue, and throat), severe dizziness, and dyspnea; (2) Patients with a history of life-threatening asthma attacks or those who have required mechanical ventilation for asthma attacks in the past three months; (3) Patients with moderate to severe impairment of baseline pulmonary function [Forced Expiratory Volume in one second (FEV1) less than 60% of the predicted value or FEV1<1.0 L]; (4) Severe urticaria; (5) Other situations inappropriate for forced vital capacity (FVC) measurement, such as myocardial infarction or stroke in the past three months, poorly controlled hypertension, aortic aneurysm, recent eye surgery, or increased intracranial pressure.Relative contraindications: (1) Moderate or more severe impairment of baseline lung function (FEV1%pred<70%), but individuals with FEV1%pred>60% may still be considered for MCT with strict observation and adequate preparation; (2) Experiencing asthma acute exacerbation; (3) Poor cooperation with baseline lung function tests that do not meet quality control requirements; (4) Recent respiratory tract infection (<4 weeks); (5) Pregnant or lactating women; (6) Patients currently using cholinesterase inhibitors (for the treatment of myasthenia gravis); (7) Patients who have previously experienced airway spasm during pulmonary function tests, with a significant decrease in FEV1 even without the inhalation of provocative.Question 2: How to prepare and store the challenge solution for MCT?Before use, the drug must be reconstituted and then diluted into various concentrations for provocation. The dilution concentration and steps for MCh vary depending on the inhalation method and provocation protocol used. It is important to follow specific steps. Typically, a specified amount of diluent is added to the methacholine reagent bottle for reconstitution, and the mixture is shaken until the solution becomes clear. The diluent is usually physiological saline, but saline with phenol (0.4%) can also be used. Phenol can reduce the possibility of bacterial contamination, and its presence does not interfere with the provocation test. After reconstitution, other concentrations of MCh solution are prepared using the same diluent, following the dilution steps, and then stored separately in sterile containers. Preparers should carefully verify and label the concentration and preparation time of the solution and complete a preparation record form. The reconstituted and diluted MCh solution is ready for immediate use without the need for freezing. It can be stored for two weeks if refrigerated (2-8 ℃). The reconstituted solution should not be stored directly in the nebulizer reservoir to prevent crystallization from blocking the capillary opening and affecting aerosol output. The temperature of the solution can affect the production of the nebulizer and cause airway spasms in the subject upon inhaling cold droplets. Thus, refrigerated solutions should be brought to room temperature before use.Question 3: What preparation is required for subjects prior to MCT?(1) Detailed medical history inquiry and exclusion of contraindications.(2) Inquiring about factors and medications that may affect airway reactivity and assessing compliance with medication washout requirements: When the goal is to evaluate the effectiveness of asthma treatment, bronchodilators other than those used for asthma treatment do not need to be discontinued. Antihistamines and cromolyn have no effect on MCT responses, and the effects of a single dose of inhaled corticosteroids and leukotriene modifiers are minimal, thus not requiring cessation before the test. For patients routinely using corticosteroids, whether to discontinue the medication depends on the objective of the test: if assisting in the diagnosis of asthma, differential diagnosis, aiding in step-down therapy for asthma, or exploring the effect of discontinuing anti-inflammatory treatment, corticosteroids should be stopped before the provocation test; if the patient is already diagnosed with asthma and the objective is to observe the level of airway reactivity under controlled medication conditions, then discontinuation is not necessary. Medications such as IgE monoclonal antibodies, IL-4Rα monoclonal antibodies, traditional Chinese medicine, and ethnic medicines may interfere with test results, and clinicians should decide whether to discontinue these based on the specific circumstances.(3) Explaining the test procedure and potential adverse reactions, and obtaining informed consent if necessary.Question 4: What are the methods of the MCT? And which ones are recommended in current clinical practice?Commonly used methods for MCT in clinical practice include the quantitative nebulization method (APS method), Forced Oscillalion method (Astograph method), 2-minute tidal breathing method (Cockcroft method), hand-held quantitative nebulization method (Yan method), and 5-breath method (Chai 5-breath method). The APS method allows for precise dosing of inhaled Methacholine, ensuring accurate and reliable results. The Astograph method, which uses respiratory resistance as an assessment indicator, is easy for subjects to perform and is the simplest operation. These two methods are currently the most commonly used clinical practice in China.Question 5: What are the steps involved in MCT?The MCT consists of the following four steps:(1) Baseline lung function test: After a 15-minute rest period, the subjects assumes a seated position and wear a nose clip for the measurement of pulmonary function indicators [such as FEV1 or respiratory resistance (Rrs)]. FEV1 should be measured at least three times according to spirometer quality control standards, ensuring that the best two measurements differ by less than 150 ml and recording the highest value as the baseline. Usually, if FEV1%pred is below 70%, proceeding with the challenge test is not suitable, and a bronchodilation test should be considered. However, if clinical assessment of airway reactivity is necessary and FEV1%pred is between 60% and 70%, the provocation test may still be conducted under close observation, ensuring the subject's safety. If FEV1%pred is below 60%, it is an absolute contraindication for MCT.(2) Inhalation of diluent and repeat lung function test for control values: the diluent, serving as a control for the inhaled MCh, usually does not significantly impact the subject's lung function. the higher one between baseline value and the post-dilution FEV1 is used as the reference for calculating the rate of FEV1 decline. If post-inhalation FEV1 decreases, there are usually three scenarios: ①If FEV1 decreases by less than 10% compared to the baseline, the test can proceed, continue the test and administer the first dose of MCh. ②If the FEV1 decreases by≥10% and<20%, indicating a heightened airway reactivity to the diluent, proceed with the lowest concentration (dose) of the provoking if FEV1%pred has not yet reached the contraindication criteria for the MCT. if FEV1%pred<60% and the risk of continuing the challenge test is considerable, it is advisable to switch to a bronchodilation test and indicate the change in the test results report. ③If FEV1 decreases by≥20%, it can be directly classified as a positive challenge test, and the test should be discontinued, with bronchodilators administered to alleviate airway obstruction.(3) Inhalation of MCh and repeat lung function test to assess decline: prepare a series of MCh concentrations, starting from the lowest and gradually increasing the inhaled concentration (dose) using different methods. Perform pulmonary function tests at 30 seconds and 90 seconds after completing nebulization, with the number of measurements limited to 3-4 times. A complete Forced Vital Capacity (FVC) measurement is unnecessary during testing; only an acceptable FEV1 measurement is required. The interval between two consecutive concentrations (doses) generally should not exceed 3 minutes. If FEV1 declines by≥10% compared to the control value, reduce the increment of methacholine concentration (dose) and adjust the inhalation protocol accordingly. If FEV1 declines by≥20% or more compared to the control value or if the maximum concentration (amount) has been inhaled, the test should be stopped. After inhaling the MCh, close observation of the subject's response is necessary. If necessary, monitor blood oxygen saturation and auscultate lung breath sounds. The test should be promptly discontinued in case of noticeable clinical symptoms or signs.(4) Inhalation of bronchodilator and repeat lung function test to assess recovery: when the bronchial challenge test shows a positive response (FEV1 decline≥20%) or suspiciously positive, the subject should receive inhaled rapid-acting bronchodilators, such as short-acting beta-agonists (SABA) or short-acting muscarinic antagonists (SAMA). Suppose the subject exhibits obvious symptoms of breathlessness, wheezing, or typical asthma manifestations, and wheezing is audible in the lungs, even if the positive criteria are not met. In that case, the challenge test should be immediately stopped, and rapid-acting bronchodilators should be administered. Taking salbutamol as an example, inhale 200-400 μg (100 μg per puff, 2-4 puffs, as determined by the physician based on the subject's condition). Reassess pulmonary function after 5-10 minutes. If FEV1 recovers to within 10% of the baseline value, the test can be concluded. However, if there is no noticeable improvement (FEV1 decline still≥10%), record the symptoms and signs and repeat the bronchodilation procedure as mentioned earlier. Alternatively, add Ipratropium bromide (SAMA) or further administer nebulized bronchodilators and corticosteroids for intensified treatment while keeping the subject under observation until FEV1 recovers to within 90% of the baseline value before allowing the subject to leave.Question 6: What are the quality control requirements for the APS and Astograph MCT equipment?(1) APS Method Equipment Quality Control: The APS method for MCT uses a nebulizing inhalation device that requires standardized flowmeters, compressed air power source pressure and flow, and nebulizer aerosol output. Specific quality control methods are as follows:a. Flow and volume calibration of the quantitative nebulization device: Connect the flowmeter, an empty nebulization chamber, and a nebulization filter in sequence, attaching the compressed air source to the bottom of the chamber to ensure airtight connections. Then, attach a 3 L calibration syringe to the subject's breathing interface and simulate the flow during nebulization (typically low flow:<2 L/s) to calibrate the flow and volume. If calibration results exceed the acceptable range of the device's technical standards, investigate and address potential issues such as air leaks or increased resistance due to a damp filter, then recalibrate. Cleaning the flowmeter or replacing the filter can change the resistance in the breathing circuit, requiring re-calibration of the flow.b. Testing the compressed air power source: Regularly test the device, connecting the components as mentioned above. Then, block the opening of the nebulization device with a stopper or hand, start the compressed air power source, and test its pressure and flow. If the test results do not meet the technical standards, professional maintenance of the equipment may be required.c. Verification of aerosol output of the nebulization chamber: Regularly verify all nebulization chambers used in provocation tests. Steps include adding a certain amount of saline to the chamber, weighing and recording the chamber's weight (including saline), connecting the nebulizer to the quantitative nebulization device, setting the nebulization time, starting nebulization, then weighing and recording the post-nebulization weight. Calculate the unit time aerosol output using the formula [(weight before nebulization-weight after nebulization)/nebulization time]. Finally, set the nebulization plan for the provocation test based on the aerosol output, considering the MCh concentration, single inhalation nebulization duration, number of nebulization, and cumulative dose to ensure precise dosing of the inhaled MCh.(2) Astograph method equipment quality control: Astograph method equipment for MCT consists of a respiratory resistance monitoring device and a nebulization medication device. Perform zero-point calibration, volume calibration, impedance verification, and nebulization chamber checks daily before tests to ensure the resistance measurement system and nebulization system function properly. Calibration is needed every time the equipment is turned on, and more frequently if there are significant changes in environmental conditions.a. Zero-point calibration: Perform zero-point calibration before testing each subject. Ensure the nebulization chamber is properly installed and plugged with no air leaks.b. Volume calibration: Use a 3 L calibration syringe to calibrate the flow sensor at a low flow rate (approximately 1 L/s).c. Resistance verification: Connect low impedance tubes (1.9-2.2 cmH2O·L[-1]·s[-1]) and high impedance tubes (10.2-10.7 cmH2O·L[-1]·s[-1]) to the device interface for verification.d. Bypass check: Start the bypass check and record the bypass value; a value>150 ml/s is normal.e. Nebulization chamber check: Check each of the 12 nebulization chambers daily, especially those containing bronchodilators, to ensure normal spraying. The software can control each nebulization chamber to produce spray automatically for a preset duration (e.g., 2 seconds). Observe the formation of water droplets on the chamber walls, indicating normal spraying. If no nebulization occurs, check for incorrect connections or blockages.Question 7: How to set up and select the APS method in MCT?The software program of the aerosol provocation system in the quantitative nebulization method can independently set the nebulizer output, concentration of the methacholine agent, administration time, and number of administrations and combine these parameters to create the challenge test process. In principle, the concentration of the methacholine agent should increase from low to high, and the dose should increase from small to large. According to the standard, a 2-fold or 4-fold incremental challenge process is generally used. In clinical practice, the dose can be simplified for subjects with good baseline lung function and no history of wheezing, such as using a recommended 2-concentration, 5-step method (25 and 50 g/L) and (6.25 and 25 g/L). Suppose FEV1 decreases by more than 10% compared to the baseline during the test to ensure subject safety. In that case, the incremental dose of the methacholine agent can be reduced, and the inhalation program can be adjusted appropriately. If the subject's baseline lung function declines or has recent daytime or nighttime symptoms such as wheezing or chest tightness, a low concentration, low dose incremental process should be selected.Question 8: What are the precautions for the operation process of the Astograph method in MCT?(1) Test equipment: The Astograph method utilizes the forced oscillation technique, applying a sinusoidal oscillating pressure at the mouthpiece during calm breathing. Subjects inhale nebulized MCh of increasing concentrations while continuous monitoring of respiratory resistance (Rrs) plots the changes, assessing airway reactivity and sensitivity. The nebulization system employs jet nebulization technology, comprising a compressed air pump and 12 nebulization cups. The first cup contains saline, cups 2 to 11 contain increasing concentrations of MCh, and the 12th cup contains a bronchodilator solution.(2) Provocation process: Prepare 10 solutions of MCh provocant with gradually increasing concentrations.(3) Operational procedure: The oscillation frequency is usually set to 3 Hz (7 Hz for children) during the test. The subject breathes calmly, inhales saline solution nebulized first, and records the baseline resistance value (if the subject's baseline resistance value is higher than 10 cmH2O·L[-1]·s[-1], the challenge test should not be performed). Then, the subject gradually inhales increasing concentrations of methacholine solution. Each concentration solution is inhaled for 1 minute, and the nebulization system automatically switches to the next concentration for inhalation according to the set time. Each nebulizer cup contains 2-3 ml of solution, the output is 0.15 ml/min, and each concentration is inhaled for 1 minute. The dose-response curve is recorded automatically. Subjects should breathe tidally during the test, avoiding deep breaths and swallowing. Continue until Rrs significantly rises to more than double the baseline value, or if the subject experiences notable respiratory symptoms or other discomfort, such as wheezing in both lungs upon auscultation. At this point, the inhalation of the provocant should be stopped and the subject switchs to inhaling a bronchodilator until Rrs returns to pre-provocation levels. If there is no significant increase in Rrs, stop the test after inhaling the highest concentration of MCh.Question 9: How to interpret the results of the MCT?The method chosen for the MCT determines the specific indicators used for interpretation. The most commonly used indicator is FEV1, although other parameters such as Peak Expiratory Flow (PEF) and Rrs can also be used to assess airway hyperresponsiveness.Qualitative judgment: The test results can be classified as positive, suspiciously positive, or negative, based on a combination of the judgment indicators and changes in the subject's symptoms. If FEV1 decreases by≥20% compared to the baseline value after not completely inhaling at the highest concentration, the result can be judged as positive for Methacholine bronchial challenge test. If the patient has obvious wheezing symptoms or wheezing is heard in both lungs, but the challenge test does not meet the positive criteria (the highest dose/concentration has been inhaled), and FEV1 decreases between 10% and 20% compared to the baseline level, the result can also be judged as positive. If FEV1 decreases between 15% and 20% compared to the baseline value without dyspnea or wheezing attacks, the result can be judged as suspiciously positive. Astograph method: If Rrs rises to 2 times or more of the baseline resistance before reaching the highest inhalation concentration, or if the subject's lungs have wheezing and severe coughing, the challenge test can be judged as positive. Regardless of the result of the Methacholine bronchial challenge test, factors that affect airway reactivity, such as drugs, seasons, climate, diurnal variations, and respiratory tract infections, should be excluded.Quantitative judgment: When using the APS method, the severity of airway hyperresponsiveness can be graded based on PD20-FEV1 or PC20-FEV1. Existing evidence suggests that PD20 shows good consistency when different nebulizers, inhalation times, and starting concentrations of MCh are used for bronchial provocation tests, whereas there is more variability with PC20. Therefore, PD20 is often recommended as the quantitative assessment indicator. The threshold value for PD20 with the APS method is 2.5 mg.The Astograph method often uses the minimum cumulative dose (Dmin value, in Units) to reflect airway sensitivity. Dmin is the minimum cumulative dose of MCh required to produce a linear increase in Rrs. A dose of 1 g/L of the drug concentration inhaled for 1-minute equals 1 unit. It's important to note that with the continuous increase in inhaled provocant concentration, the concept of cumulative dose in the Astograph method should not be directly compared to other methods. Most asthma patients have a Dmin<10 Units, according to Japanese guidelines. The Astograph method, having been used in China for over twenty years, suggests a high likelihood of asthma when Dmin≤6 Units, with a smaller Dmin value indicating a higher probability. When Dmin is between 6 and 10 Units, further differential diagnosis is advised to ascertain whether the condition is asthma.Precautions:A negative methacholine challenge test (MCT) does not entirely rule out asthma. The test may yield negative results due to the following reasons:(1) Prior use of medications that reduce airway responsiveness, such as β2 agonists, anticholinergic drugs, antihistamines, leukotriene receptor antagonists, theophylline, corticosteroids, etc., and insufficient washout time.(2) Failure to meet quality control standards in terms of pressure, flow rate, particle size, and nebulization volume of the aerosol delivery device.(3) Poor subject cooperation leads to inadequate inhalation of the methacholine agent.(4) Some exercise-induced asthma patients may not be sensitive to direct bronchial challenge tests like the Methacholine challenge and require indirect bronchial challenge tests such as hyperventilation, cold air, or exercise challenge to induce a positive response.(5) A few cases of occupational asthma may only react to specific antigens or sensitizing agents, requiring specific allergen exposure to elicit a positive response.A positive MCT does not necessarily indicate asthma. Other conditions can also present with airway hyperresponsiveness and yield positive results in the challenge test, such as allergic rhinitis, chronic bronchitis, viral upper respiratory infections, allergic alveolitis, tropical eosinophilia, cystic fibrosis, sarcoidosis, bronchiectasis, acute respiratory distress syndrome, post-cardiopulmonary transplant, congestive heart failure, and more. Furthermore, factors like smoking, air pollution, or exercise before the test may also result in a positive bronchial challenge test.Question 10: What are the standardized requirements for the MCT report?The report should include: (1) basic information about the subject; (2) examination data and graphics: present baseline data, measurement data after the last two challenge doses or concentrations in tabular form, and the percentage of actual measured values compared to the baseline; flow-volume curve and volume-time curve before and after challenge test; dose-response curve: showing the threshold for positive challenge; (3) opinions and conclusions of the report: including the operator's opinions, quality rating of the examination, and review opinions of the reviewing physician.Question 11: What are the adverse reactions and safety measures of MCT?During the MCT, the subject needs to repeatedly breathe forcefully and inhale bronchial challenge agents, which may induce or exacerbate bronchospasm and contraction and may even cause life-threatening situations. Medical staff should be fully aware of the indications, contraindications, medication use procedures, and emergency response plans for the MCT.},
}

@article {pmid38269111,
year = {2024},
author = {Webb, J and Williamson, A},
title = {Steroids for the Treatment of Misophonia and Misokinesia.},
journal = {Case reports in psychiatry},
volume = {2024},
number = {},
pages = {3976837},
pmid = {38269111},
issn = {2090-682X},
abstract = {Misophonia and misokinesia are disorders characterized by intensely negative physical and emotional reactions to specific auditory and visual stimuli. The availability of effective treatments, especially pharmacological ones, is limited. This report presents a case of a 35-year-old male with severe misophonia and misokinesia who experienced nearly complete resolution of symptoms while undergoing high-dose steroid therapy for an unrelated muscular injury. Two days after starting a 20 mg oral prednisone taper pack (in which the steroid dose is reduced by 4 mg daily), his Amsterdam Misophonia Scale (A-Miso-S) score drastically reduced from a baseline of 23 (i.e., extreme symptoms) to 1, with symptom relief persisting for approximately 2 weeks after completing the taper. Months later, a daily dose of prednisone (4 mg) was reintroduced. This again resulted in a marked reduction in symptoms (A-Miso-S of 6), enabling him to resume working in an office setting despite his triggers. Symptom improvement remained stable over several months. This case raises the possibility of the steroid prednisone as a novel treatment for misophonia and misokinesia. However, further investigation is needed to determine the generalizability of this observation.},
}

@article {pmid38228276,
year = {2024},
author = {Neacsiu, AD and Beynel, L and Gerlus, N and LaBar, KS and Bukhari-Parlakturk, N and Rosenthal, MZ},
title = {An experimental examination of neurostimulation and cognitive restructuring as potential components for Misophonia interventions.},
journal = {Journal of affective disorders},
volume = {350},
number = {},
pages = {274-285},
doi = {10.1016/j.jad.2024.01.120},
pmid = {38228276},
issn = {1573-2517},
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.},
}

@article {pmid38169247,
year = {2023},
author = {Guzick, A and Storch, EA and Smárason, O and Minhajuddin, A and Drummond, K and Riddle, D and Hettema, JM and Mayes, TL and Pitts, S and Dodd, C and Trivedi, MH},
title = {Psychometric properties of the GAD-7 and PROMIS-Anxiety-4a among youth with depression and suicidality: Results from the Texas youth depression and suicide research network.},
journal = {Journal of psychiatric research},
volume = {170},
number = {},
pages = {237-244},
doi = {10.1016/j.jpsychires.2023.12.033},
pmid = {38169247},
issn = {1879-1379},
abstract = {There is a tremendous need for brief, valid, and free assessments of anxiety in child mental healthcare. The goal of this study was to determine the psychometric properties of two such measures, the GAD-7 and PROMIS-Anxiety-4a, in 1000 children, adolescents, and young adults (8-20 years-old) with depression and/or suicidality. The GAD-7, the PROMIS-Anxiety-4a, and other validated assessments of anxiety, physical functioning, and psychiatric diagnoses were completed. Confirmatory factor analyses showed an acceptable fit for a single factor in both measures via all indices but the RMSEA. They demonstrated measurement invariance across pre-adolescents (8-12 years-old) and adolescents and emerging adults (13-20 years-old), though scalar invariance was not observed for the GAD-7. Both measures showed strong convergent validity, GAD-7: r = 0.68; PROMIS-Anxiety-4a: r = 0.75, divergent validity with a measure of physical function, GAD-7: r = -0.24; PROMIS-Anxiety-4a: r = -0.28, good internal consistency, ω = 0.89 for both, and high test-retest reliability, GAD-7: r = 0.69; PROMIS-Anxiety-4a: r = 0.71. Both measures also showed acceptable sensitivity and specificity in detecting the presence of any anxiety disorder, GAD-7 cut-off score of 10: AUC = 0.75; PROMIS-Anxiety-4a cutoff score of 12: AUC = 0.79. The GAD-7 correlated similarly with the Screen for Child Anxiety Related Disorders total score and generalized anxiety subscale, and also showed similar diagnostic sensitivity and specificity when used to detect the presence of any anxiety disorder vs. generalized anxiety disorder specifically. Results suggest that both of these brief, publicly available instruments are valid and reliable assessments of anxiety among youth in treatment for depression and/or suicidality.},
}

@article {pmid38125011,
year = {2023},
author = {Gregory, J and Foster, C},
title = {Session-by-session change in misophonia: a descriptive case study using intensive CBT.},
journal = {Cognitive behaviour therapist},
volume = {16},
number = {},
pages = {s1754470x23000107},
pmid = {38125011},
issn = {1754-470X},
support = {102176/WT_/Wellcome Trust/United Kingdom ; },
abstract = {There is preliminary evidence that CBT may be helpful for improving symptoms of misophonia, but the key mechanisms of change are not yet known for this disorder of decreased tolerance to everyday sounds. This detailed case study aimed to describe the delivery of intensive, formulation-driven CBT for an individual with misophonia and report on session-by-session outcomes using a multidimensional measurement tool (S-Five). The patient was offered twelve hours of treatment over five sessions, using transdiagnostic and misophonia-specific interventions. Reliable and clinically significant change was found from baseline to one-month follow up. Visual inspection of outcome graphs indicated that change occurred on the "outbursts" and "internalising appraisals" S-Five subscales following assessment, and on the "emotional threat" subscale after first treatment session. The other two subscales started and remained below a clinically significant level. The biggest symptom change appeared to have occurred after second session, which included interventions engaging with trigger sounds. The results demonstrated the individualised nature of misophonia, supporting the use of individually tailored treatment for misophonia and highlighting the importance of using a multidimensional measurement tool.},
}

@article {pmid38083504,
year = {2023},
author = {Bahmei, B and Birmingham, E and Arzanpour, S},
title = {Misophonia Sound Recognition Using Vision Transformer.},
journal = {Annual International Conference of the IEEE Engineering in Medicine and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual International Conference},
volume = {2023},
number = {},
pages = {1-4},
doi = {10.1109/EMBC40787.2023.10340283},
pmid = {38083504},
issn = {2694-0604},
mesh = {Humans ; *Emotions ; *Sound ; Noise ; Hearing Disorders/psychology ; },
abstract = {Misophonia is a condition characterized by an abnormal emotional response to specific sounds, such as eating, breathing, and clock ticking noises. Sound classification for misophonia is an important area of research since it can benefit in the development of interventions and therapies for individuals affected by the condition. In the area of sound classification, deep learning algorithms such as Convolutional Neural Networks (CNNs) have achieved a high accuracy performance and proved their ability in feature extraction and modeling. Recently, transformer models have surpassed CNNs as the dominant technology in the field of audio classification. In this paper, a transformer-based deep learning algorithm is proposed to automatically identify trigger sounds and the characterization of these sounds using acoustic features. The experimental results demonstrate that the proposed algorithm can classify trigger sounds with high accuracy and specificity. These findings provide a foundation for future research on the development of interventions and therapies for misophonia.},
}

Humans
*Emotions
*Sound
Noise
Hearing Disorders/psychology

@article {pmid38064911,
year = {2024},
author = {O'Brien, B and Lee, J and Kim, S and Nandra, GS and Pannu, P and Tamman, A and Amarneh, D and Swann, AC and Murphy, N and Averill, L and Jha, M and Mathew, SJ},
title = {Anti-suicidal effects of IV ketamine in a real-world setting.},
journal = {Psychiatry research},
volume = {331},
number = {},
pages = {115604},
doi = {10.1016/j.psychres.2023.115604},
pmid = {38064911},
issn = {1872-7123},
mesh = {Humans ; Male ; Adult ; Female ; *Ketamine/pharmacology/therapeutic use ; Psychometrics ; Suicidal Ideation ; *Suicide ; Risk Factors ; },
abstract = {The current study evaluated the effectiveness of intravenous ketamine treatment for suicidality in a community-based clinical sample of 295 outpatients (mean age= 40.37; 58.6 % male). We conducted growth mixture modeling to estimate latent classes of changes in symptoms of suicidality measured by the Concise Health Risk Tracking - Self-Report (CHRT-SR) across five infusions in a two-week course of treatment. Best-fit indices indicated three trajectory groups demonstrating non-linear, quadratic changes in CHRT-SR scores during ketamine treatment. The largest group of patients (n= 170, 57.6 %) had moderate CHRT-SR scores at baseline and showed gradual improvement during treatment. The other two groups of patients had severe CHRT-SR scores at baseline and diverged into one group with no improvement throughout treatment (n = 63, 21 %) and one group with rapid improvement (n = 62, 21 %). Of the clinical and demographic variables available and tested, only higher scores pertaining to active thoughts of death and/or plan were found to predict which of the patients with severe CHRT-SR scores at baseline would not benefit from treatment. The present study provides an important contribution to the knowledge of ketamine's effects on symptoms related to suicide over time. providing support for the possible effectiveness of ketamine in a proportion of patients.},
}

Humans
Male
Adult
Female
*Ketamine/pharmacology/therapeutic use
Psychometrics
Suicidal Ideation
*Suicide
Risk Factors

@article {pmid38042307,
year = {2024},
author = {Murphy, N and Lijffijt, M and Guzick, AG and Cervin, M and Clinger, J and Smith, EEA and Draper, I and Rast, CE and Goodman, WK and Schneider, S and Storch, EA},
title = {Alterations in attentional processing in youth with misophonia: A phenotypical cross-comparison with anxiety patients.},
journal = {Journal of affective disorders},
volume = {347},
number = {},
pages = {429-436},
doi = {10.1016/j.jad.2023.11.088},
pmid = {38042307},
issn = {1573-2517},
mesh = {Child ; Humans ; Female ; Adolescent ; Male ; *Anxiety ; *Anxiety Disorders/psychology ; Emotions ; Hearing Disorders ; },
abstract = {BACKGROUND: Misophonia is a complex condition characterized by extreme emotional distress in response to specific sounds or specific visual stimuli. Despite a growing body of clinical and neuroscientific literature, the etiology of this condition remains unclear. Hyperarousal, that is, a state of heightened alertness and disinhibition, as a core feature of misophonia is supported by behavioral and neuroimaging literature and might represent a viable clinical target for the development of both behavioral and pharmacological interventions. The aim of this study was to investigate how hyperarousal might be linked to neurocognitive processes associated with vigilance and stimulus discrimination in youth with misophonia.

METHODS: We compared 72 children and adolescents with misophonia (13.74 ± 2.44 years) (64 % female) and 89 children and adolescents with anxiety (12.35 ± 2.57 years) (58.4 % female) on behavioral and signal detection performance of the immediate memory task (IMT). Anxiety patients were used as a clinical control group to distinguish attentional processes specific for misophonia.

RESULTS: Both groups demonstrated similar behavioral performance, including response rate and reaction time. However, misophonia was associated with elevated stimulus discrimination (d prime), which in turn was positively correlated with the severity of misophonia trigger reports.

CONCLUSIONS: Our findings are in line with previous cognitive and neuroimaging studies, and support an arousal-based model of misophonia, where individuals with misophonia experience a state of heightened vigilance, being more aware of stimuli in the environment. Our findings provide a neurocognitive basis for future study of neurochemical imaging that might further progress towards clinical targets.},
}

Child
Humans
Female
Adolescent
Male
*Anxiety
*Anxiety Disorders/psychology
Emotions
Hearing Disorders

@article {pmid38040623,
year = {2024},
author = {Guzick, AG and Cervin, M and Smith, EEA and Clinger, J and Draper, I and Goodman, WK and Lijffijt, M and Murphy, N and Lewin, AB and Schneider, SC and Storch, EA},
title = {Corrigendum to "Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia" [J. Affect. Disord. volume 324 (2023) 395-402].},
journal = {Journal of affective disorders},
volume = {348},
number = {},
pages = {410},
doi = {10.1016/j.jad.2023.11.045},
pmid = {38040623},
issn = {1573-2517},
}

@article {pmid38033539,
year = {2023},
author = {Dibb, B and Golding, SE},
title = {Corrigendum: A longitudinal investigation of quality of life and negative emotions in misophonia.},
journal = {Frontiers in neuroscience},
volume = {17},
number = {},
pages = {1266908},
doi = {10.3389/fnins.2023.1266908},
pmid = {38033539},
issn = {1662-4548},
abstract = {[This corrects the article DOI: 10.3389/fnins.2022.900474.].},
}

@article {pmid38019467,
year = {2023},
author = {Greenberg, RL and Guzick, AG and Schneider, SC and Weinzimmer, SA and Kook, M and Perozo Garcia, AB and Storch, EA},
title = {Depressive Symptoms in Autistic Youth with Anxiety Disorders.},
journal = {Journal of developmental and behavioral pediatrics : JDBP},
volume = {44},
number = {9},
pages = {e597-e603},
pmid = {38019467},
issn = {1536-7312},
support = {P50HD103555//Eunice Kennedy Shriver National Institute of Child Health and Human Development/ ; },
mesh = {Child ; Adolescent ; Humans ; *Depression/epidemiology ; *Autistic Disorder ; Anxiety Disorders/epidemiology/therapy ; Anxiety ; Emotions ; },
abstract = {OBJECTIVE: Anxiety and depression often coexist in youth and share overlapping symptomatology; however, little is known about the comorbidity of anxiety and depression in autistic youth. This study explores (1) the frequency of depressive symptoms among autistic children with clinically significant anxiety, (2) clinical variables that may be associated with elevated depressive symptoms, and (3) whether pretreatment depressive symptoms predict cognitive behavioral therapy (CBT) outcomes for anxiety.

METHOD: Children aged 7 to 13 years (N = 87) and their parents participated in a randomized controlled trial comparing 2 versions of a parent-led, telehealth-delivered CBT program. Parents and children completed a variety of clinical assessments and self-report questionnaires before and after treatment.

RESULTS: Fifty-seven percent of the child sample reported experiencing elevated depressive symptoms while roughly 20% of parents reported elevated depressive symptoms in their child. A strong association between anxiety and depression was found. Heightened feelings of loneliness, per child report, and functional impairment, per parent report, were found to be uniquely associated with elevated depressive symptoms. Finally, depressive symptoms were not a significant predictor of CBT outcomes for anxiety.

CONCLUSION: Findings suggest high degrees of comorbidity between anxiety and depression among autistic children and that feelings of loneliness, anxiety, and functional impairment may be early indicators of mood-related concerns. Further research is needed to determine the full extent of the association between anxiety and depression and additional options for treating depression in autistic children.},
}

Child
Adolescent
Humans
*Depression/epidemiology
*Autistic Disorder
Anxiety Disorders/epidemiology/therapy
Anxiety
Emotions

@article {pmid37932925,
year = {2023},
author = {Chan, KH and Baker, A and Gilbert, D and Tong, S and Rinaldi, J and Cypers, S and Zhu, A and Schoenborn, A},
title = {The Impact of Mental Health Symptoms in Children With Tinnitus and Misophonia: A Multi-disciplinary Approach.},
journal = {Clinical pediatrics},
volume = {},
number = {},
pages = {99228231211155},
doi = {10.1177/00099228231211155},
pmid = {37932925},
issn = {1938-2707},
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.},
}

@article {pmid37910210,
year = {2023},
author = {Aryal, S and Prabhu, P},
title = {Auditory cortical functioning in individuals with misophonia: an electrophysiological investigation.},
journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery},
volume = {},
number = {},
pages = {},
pmid = {37910210},
issn = {1434-4726},
abstract = {PURPOSE: Misophonia is characterized by a reduced tolerance for specific sound triggers. This aspect has been relatively underexplored in audiology, with limited research from the audiological angle. Our primary objective is to compare the auditory late latency response (ALLR) findings between individuals with misophonia and those without it.

METHODS: A study compared individuals with significant misophonia to a healthy control group. Thirty misophonia participants were categorized into mild and moderate-to-severe groups based on their Amsterdam Misophonia Scale scores. The latency and amplitude of auditory response peaks were analyzed across the groups using the ALLR. Statistical tests included Shapiro-Wilk for data normality, one-way ANOVA for group differences, and Bonferroni post hoc analysis for detailed variation sources.

RESULTS: The result showed a significant difference in latency of P1 and N1 peaks (p < 0.05) of ALLR between the groups in both ears. This suggests a deficit in auditory processing at the cortical level in individuals with misophonia.

CONCLUSION: Our study substantiates the potential utility of the ALLR as a valuable instrument for evaluating misophonia, particularly from the audiological standpoint.},
}

@article {pmid37892760,
year = {2023},
author = {Raj-Koziak, D and Gos, E and Kutyba, JJ and Skarzynski, PH and Skarzynski, H},
title = {Hyperacusis Assessment Questionnaire-A New Tool Assessing Hyperacusis in Subjects with Tinnitus.},
journal = {Journal of clinical medicine},
volume = {12},
number = {20},
pages = {},
pmid = {37892760},
issn = {2077-0383},
abstract = {Hyperacusis, a kind of decreased sound tolerance, is difficult to measure objectively. It often co-occurs with tinnitus. There is a need for valid and reliable patient-reported outcome measures to capture this subjective phenomenon. The aim of the study was to create a questionnaire capturing hyperacusis in terms of loudness, fear, and pain and to evaluate its psychometric properties. The study sample consisted of 106 adult patients with hyperacusis and tinnitus with a mean age of 45.2 years. A medical interview, an audiological examination, and several questionnaires (the Tinnitus Handicap Inventory, the Hyperacusis Questionnaire, the State-Trait Anxiety Inventory, and Visual Analog Scales) were applied. The final 14-item Hyperacusis Assessment Questionnaire showed an appropriate three-factor structure with 70.5% of the variance explained. Convergent and divergent validity were confirmed by correlations with other measures of hyperacusis, anxiety, tinnitus severity, misophonia, and hearing thresholds. The internal consistency assessed with Cronbach's alpha was excellent (α = 0.91), as was reproducibility (intraclass correlation, ICC = 0.96). The new Hyperacusis Assessment Questionnaire is a psychometrically sound and brief tool assessing the severity of hyperacusis in terms of loudness, fear, and pain. It can be used in clinical practice and scientific research for patients with hyperacusis and tinnitus.},
}

@article {pmid37881332,
year = {2023},
author = {Dozier, T and Mitchell, N},
title = {Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder.},
journal = {F1000Research},
volume = {12},
number = {},
pages = {808},
pmid = {37881332},
issn = {2046-1402},
mesh = {Humans ; *Emotions/physiology ; *Hearing Disorders/psychology ; Anxiety ; Reflex ; },
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.},
}

Humans
*Emotions/physiology
*Hearing Disorders/psychology
Anxiety
Reflex

@article {pmid37855114,
year = {2023},
author = {Gregory, J and Graham, T and Hayes, B},
title = {Targeting beliefs and behaviours in misophonia: a case series from a UK specialist psychology service.},
journal = {Behavioural and cognitive psychotherapy},
volume = {},
number = {},
pages = {1-16},
doi = {10.1017/S1352465823000462},
pmid = {37855114},
issn = {1469-1833},
support = {102176/WT_/Wellcome Trust/United Kingdom ; },
abstract = {BACKGROUND: Misophonia, a disorder of decreased sound tolerance, can cause significant distress and impairment. Cognitive behavioural therapy (CBT) may be helpful for improving symptoms of misophonia, but the key mechanisms of the disorder are not yet known.

AIMS: This case series aimed to evaluate individual, formulation-driven CBT for patients with misophonia in a UK psychology service.

METHOD: A service evaluation of one-to-one therapy for patients with misophonia (n=19) was conducted in a specialist psychology service. Patients completed an average of 13 hours of therapy with a focus on the meaning applied to their reactions to sounds and associated behaviours. Primary outcome measures were the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Scale (A-MISO-S). Repeated measures t-tests were used to compare scores from pre-treatment to follow-up, and reliable and clinically significant change on the MQ was calculated.

RESULTS: Scores significantly improved on both misophonia measures, with an average of 38% change on the MQ and 40% change on the A-MISO-S. From pre-treatment to follow-up, 78% of patients showed reliable improvement on the MQ and 61% made clinically significant change.

CONCLUSIONS: Limitations included a lack of control group, small sample size, and the use of an outcome measure that had not been thoroughly validated for a treatment-seeking sample. These results suggest that one-to-one, formulation-driven CBT for misophonia is worth exploring further using experimental design. Potential mechanisms to explore further include feared consequences of escalating reactions, the role of safety-seeking behaviours and the impact of early memories associated with reactions to sounds.},
}

@article {pmid37850971,
year = {2024},
author = {Ash, PA and Benzaquén, E and Gander, PE and Berger, JI and Kumar, S},
title = {Mimicry in misophonia: A large-scale survey of prevalence and relationship with trigger sounds.},
journal = {Journal of clinical psychology},
volume = {80},
number = {1},
pages = {186-197},
doi = {10.1002/jclp.23605},
pmid = {37850971},
issn = {1097-4679},
support = {//Misophonia Research Fund/ ; },
mesh = {Humans ; Prevalence ; *Emotions ; *Hearing Disorders ; Surveys and Questionnaires ; },
abstract = {BACKGROUND: Misophonia is often referred to as a disorder that is characterized by excessive negative emotional responses, including anger and anxiety, to "trigger sounds" which are typically day-to-day sounds, such as those generated from people eating, chewing, and breathing. Misophonia (literally "hatred of sounds") has commonly been understood within an auditory processing framework where sounds cause distress due to aberrant processing in the auditory and emotional systems of the brain. However, a recent proposal suggests that it is the perceived action (e.g., mouth movement in eating/chewing sounds as triggers) of the trigger person, and not the sounds per se, that drives the distress in misophonia. Since observation or listening to sounds of actions of others are known to prompt mimicry in perceivers, we hypothesized that mimicking the action of the trigger person may be prevalent in misophonia. Apart from a few case studies and anecdotal information, a relation between mimicking and misophonia has not been systematically evaluated.

METHOD: In this work, we addressed this limitation by collecting data on misophonia symptoms and mimicry behavior using online questionnaires from 676 participants.

RESULTS: Analysis of these data shows that (i) more than 45% of individuals with misophonia reported mimicry, indicating its wide prevalence, (ii) the tendency to mimic varies in direct proportion to misophonia severity, (iii) compared to other human and environmental sounds, trigger sounds of eating and chewing are more likely to trigger mimicking, and (iv) the act of mimicking provides some degree of relief from distress to people with misophonia.

CONCLUSION: This study shows prevalence of mimicry and its relation to misophonia severity and trigger types. The theoretical framework of misophonia needs to incorporate the phenomenon of mimicry and its effect on management of misophonia distress.},
}

Humans
Prevalence
*Emotions
*Hearing Disorders
Surveys and Questionnaires

@article {pmid37846484,
year = {2023},
author = {Aazh, H and Moore, BCJ and Scaglione, T and Remmert, N},
title = {Psychometric Evaluation of the Misophonia Impact Questionnaire (MIQ) Using a Clinical Population of Patients Seeking Help for Tinnitus, Hyperacusis and/or Misophonia.},
journal = {Journal of the American Academy of Audiology},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2192-5668},
pmid = {37846484},
issn = {2157-3107},
abstract = {BACKGROUND: Misophonia is a decreased tolerance of certain sounds related to eating noises, lip smacking, sniffing, breathing, clicking sounds, and tapping. While several validated self-report misophonia questionnaires exist, none focus solely on the impact of misophonia on the patient's life. Additionally, there are no available validated pediatric self-report measures of misophonia. Therefore, a tool was needed to assess the impact of misophonia on both adult and pediatric patients.

PURPOSE: To evaluate the psychometric properties of the 8-item Misophonia Impact Questionnaire (MIQ).

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

STUDY SAMPLE: Patients who attended the Tinnitus and Hyperacusis Therapy Specialist Clinic (THTSC) in the UK seeking help for tinnitus, hyperacusis and/or misophonia (n = 256). A subsample of children aged 16 years or younger (n=15) was included for preliminary analyses of a version of the MIQ to be filled in by a parent (MIQ-P).

DATA COLLECTION AND ANALYSIS: Data were collected retrospectively from the records of patients held at the audiology department. These included demographic data, audiological measures and self-report questionnaires taken as part of routine care. Descriptive statistics and psychometric analyses were conducted. The MIQ was analyzed for item difficulty, factor structure, reliability, and construct validity.

RESULTS: Confirmatory factor analysis revealed that a one-factor model for the MIQ gave an excellent fit and its estimated reliability was excellent, with Cronbach's α = 0.94. The total MIQ scores were highly correlated with scores for the Hyperacusis Impact Questionnaire (HIQ) and Sound Sensitivity Symptoms Questionnaire (SSSQ). MIQ scores were not significantly correlated with scores for the Tinnitus Impact Questionnaire (TIQ) or average hearing thresholds. Preliminary data from the sub-sample indicated excellent internal consistency for the MIQ-P, with Cronbach's α = 0.92.

CONCLUSIONS: The MIQ is a promising questionnaire for assessing the impact of misophonia. Future studies should focus on establishing test/re-test reliability, identifying clinically significant change in MIQ scores, defining the severity of misophonia impact categories, and further exploring the psychometric properties of the MIQ-P.},
}

@article {pmid37837477,
year = {2023},
author = {Suraj, U and Nisha, KV and Prabhu, P},
title = {Normal linear and non-linear cochlear mechanisms and efferent system functioning in individuals with misophonia.},
journal = {European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery},
volume = {},
number = {},
pages = {},
pmid = {37837477},
issn = {1434-4726},
abstract = {BACKGROUND: Misophonia, a condition characterized by heightened sensitivity and strong emotional reactions to specific sounds, has sparked considerable interest and debate regarding its underlying auditory mechanisms. The study aimed to understand the auditory underpinnings of two such potential inner ear systems, non-linear and linear outer hair cell functioning along with auditory efferent functioning in individuals with misophonia.

METHODS: 40 ears with misophonia (20 participants) and 37 ears without misophonia (20 participants), both having normal hearing sensitivity were included in this study. Transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs) were obtained in two conditions (with and without contralateral noise).

RESULTS: Results of independent-samples t-test showed no statistically significant difference (p > 0.05) in the absolute amplitudes of both TEOAEs and DPOAEs between the individuals with and without misophonia. There was no statistically significant difference (p > 0.05) observed in the magnitude of suppression amplitude between the two groups for in both TEOAEs and DPOAEs between individuals with and without misophonia.

CONCLUSION: These results suggest that the cochlear and efferent auditory underpinnings examined in this study may not be major contributors to the development or manifestation of misophonia.},
}

@article {pmid37789522,
year = {2023},
author = {Brennan, CR and Lindberg, RR and Kim, G and Castro, AA and Khan, RA and Berenbaum, H and Husain, FT},
title = {Misophonia and Hearing Comorbidities in a Collegiate Population.},
journal = {Ear and hearing},
volume = {},
number = {},
pages = {},
doi = {10.1097/AUD.0000000000001435},
pmid = {37789522},
issn = {1538-4667},
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.},
}

@article {pmid37771338,
year = {2023},
author = {Rosenthal, MZ and Campbell, J and Altimus, C},
title = {Editorial: Advances in understanding the nature and features of misophonia.},
journal = {Frontiers in neuroscience},
volume = {17},
number = {},
pages = {1267682},
pmid = {37771338},
issn = {1662-4548},
}

@article {pmid37692107,
year = {2023},
author = {Armstrong, GM and Greenberg, RL and Smárason, O and Frederick, RM and Guzick, AG and Schneider, SC and Spencer, SD and Cervin, M and Storch, EA},
title = {Factors associated with internalizing and externalizing symptoms in a clinical sample of youth with misophonia.},
journal = {Journal of obsessive-compulsive and related disorders},
volume = {39},
number = {},
pages = {},
pmid = {37692107},
issn = {2211-3649},
support = {P50 HD103555/HD/NICHD NIH HHS/United States ; },
abstract = {Misophonia is an often chronic condition characterized by strong, unpleasant emotional reactions when exposed to specific auditory or visual triggers. While not currently defined within existing classification systems, and not clearly fitting within the framework of extant psychiatric conditions, misophonia has historically been studied most frequently within the context of obsessive-compulsive and related disorders. Internalizing and externalizing psychiatric symptoms are common in misophonia, but specific factors that confer risk for these symptoms remain unknown. The present cross-sectional study examined whether sensory sensitivity and cognitive emotion regulation facets are associated with co-occurring internalizing and externalizing symptoms in 102 youth with misophonia aged 8-17 years (Nfemales = 69). Participants completed self-report assessments of misophonia severity, sensory sensitivity, cognitive emotion regulation, and emotional-behavioral functioning. In the final model, controlling for all variables, multiple linear regression analyses revealed that sensory sensitivity and age were significant predictors of internalizing symptoms, while sensory sensitivity and the other-blame cognitive emotion regulation facet were significant predictors of externalizing symptoms. Further, findings demonstrated that the positive reappraisal cognitive emotion regulation facet moderated the effect of misophonia severity on internalizing symptoms. Results highlight a strong, consistent relation between sensory sensitivities (beyond sound sensitivity) and psychiatric symptoms in misophonic youth. Further research is necessary to determine mechanisms and clinical variables impacting internalizing and externalizing symptoms within youth with misophonia.},
}

@article {pmid37684420,
year = {2023},
author = {Siepsiak, M and Turek, A and Michałowska, M and Gambin, M and Dragan, WŁ},
title = {Misophonia in Children and Adolescents: Age Differences, Risk Factors, Psychiatric and Psychological Correlates. A Pilot Study with Mothers' Involvement.},
journal = {Child psychiatry and human development},
volume = {},
number = {},
pages = {},
pmid = {37684420},
issn = {1573-3327},
support = {IV.4.1 IDUB University of Warsaw//Uniwersytet Warszawski/ ; IV.4.1 IDUB University of Warsaw//Uniwersytet Warszawski/ ; },
abstract = {Misophonia is a type of disorder characterized by decreased sound tolerance. While it typically begins in childhood, research on its characteristics in this population is limited. We assessed 90 children aged 7-18 with and without misophonia, along with their mothers, using interviews, questionnaires, and performance-based tests. Younger children with misophonia were more likely to use aggression in response to triggers than older, while adolescents largely reported self-harm during triggers. Children with misophonia did not differ from their peers in terms of ADHD, ODD, ASD, dyslexia, social and emotional competencies, head injuries, epilepsy, tinnitus, being prematurely born, or delivered via cesarean sections. However, they had significantly higher symptoms of anxiety and depression, more frequent occurrences of OCD, migraines, and psychosomatic complaints. Their mothers self-reported postpartum depression significantly more frequently than mothers in the control group. There is a need for further research on pediatric misophonia, with the involvement and assessment of parents.},
}

@article {pmid37657963,
year = {2024},
author = {Abramovitch, A and Herrera, TA and Etherton, JL},
title = {A neuropsychological study of misophonia.},
journal = {Journal of behavior therapy and experimental psychiatry},
volume = {82},
number = {},
pages = {101897},
doi = {10.1016/j.jbtep.2023.101897},
pmid = {37657963},
issn = {1873-7943},
mesh = {Humans ; *Hearing Disorders/diagnosis/psychology ; *Emotions ; Anxiety ; Anxiety Disorders/psychology ; },
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.},
}

Humans
*Hearing Disorders/diagnosis/psychology
*Emotions
Anxiety
Anxiety Disorders/psychology

@article {pmid37593659,
year = {2023},
author = {Spencer, SD and Guzick, AG and Cervin, M and Storch, EA},
title = {Mindfulness and cognitive emotion regulation in pediatric misophonia.},
journal = {Journal of contextual behavioral science},
volume = {29},
number = {},
pages = {182-191},
pmid = {37593659},
issn = {2212-1447},
support = {P50 HD103555/HD/NICHD NIH HHS/United States ; R01 HD080096/HD/NICHD NIH HHS/United States ; },
abstract = {Misophonia is characterized by decreased tolerance of ordinary human-generated trigger sounds and associated visual stimuli (e.g., chewing, sniffing, lip smacking), coupled with intense affective reactions. The disorder often begins during childhood or adolescence and is associated with impairment and distress in numerous life domains. Research has begun to examine the underlying psychological mechanisms of misophonia in adults, but studies in youth are limited. Trait mindfulness (i.e., nonjudgmental and nonavoidant present-moment awareness) and cognitive emotion regulation (i.e., cognitive processing, or responding to, emotionally arousing situations) are two proposed mechanisms that may underpin pediatric misophonia and associated functional impairment. In the present exploratory cross-sectional study, we examined trait mindfulness and cognitive emotion regulation and their relations with misophonia features and adaptive functioning in 102 youth with misophonia (Mage = 13.7; SD = 2.5; range = 8-17). More severe misophonia was significantly associated with decreased levels of both trait mindfulness and adaptive functioning across domains, in addition to deficits in certain facets of cognitive emotion regulation, particularly self-blame. Neither trait mindfulness nor facets of cognitive emotion regulation moderated the association between misophonia severity and adaptive functioning across domains, with the notable exception that difficulties with adaptive functioning in peer relationships was attenuated in those high in mindfulness. Findings suggest that trait mindfulness- and to a lesser extent cognitive emotion regulation- may be potentially relevant processes in pediatric misophonia. However, more research is needed to uncover the precise nature of these processes to aid future characterization and intervention efforts, especially in light of equivocal findings in the present study.},
}

@article {pmid37501042,
year = {2023},
author = {Rinaldi, LJ and Simner, J},
title = {Mental Health Difficulties in Children who Develop Misophonia: An Examination of ADHD, Depression & Anxiety.},
journal = {Child psychiatry and human development},
volume = {},
number = {},
pages = {},
pmid = {37501042},
issn = {1573-3327},
support = {G9815508/MRC_/Medical Research Council/United Kingdom ; MC_PC_15018/MRC_/Medical Research Council/United Kingdom ; MC_PC_19009/MRC_/Medical Research Council/United Kingdom ; },
abstract = {Misophonia is a sound sensitivity disorder characterized by unusually strong aversions to a specific class of sounds (e.g., eating sounds). Here we demonstrate the mental health profile in children who develop misophonia, examining depression, anxiety and ADHD. Our participants were members of the birth cohort ALSPAC (Avon Longitudinal Study of Parents and Children). We screened them for misophonia as adults, then analysed their retrospective mental health data from ages 7 to 16 years inclusive, reported from both children and parents. Data from their Development and Wellbeing Assessments (7-15 years) and their Short Mood and Feelings Questionnaires (9-16 years) show that our misophonia group had a greater likelihood of childhood anxiety disorder and depression in childhood (but not ADHD). Our data provide the first evidence from a large general population sample of the types of mental health co-morbidities found in children who develop misophonia.},
}

@article {pmid37497334,
year = {2023},
author = {Aryal, S and Prabhu, P},
title = {Auditory brainstem functioning in individuals with misophonia.},
journal = {Journal of otology},
volume = {18},
number = {3},
pages = {139-145},
pmid = {37497334},
issn = {2524-1753},
abstract = {PURPOSE: Misophonia is not investigated much from an audiological perspective. Our study aims to examine the processing of the auditory retro-cochlear pathways in individuals with misophonia.

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

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

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

@article {pmid37494117,
year = {2024},
author = {Eberhart, L and Seegan, P and McGuire, J and Hu, H and Tripuraneni, BR and Miller, MJ},
title = {Attributes of Provider Referrals for Digital Mental Health Applications in an Integrated Health System, 2019-2021.},
journal = {Psychiatric services (Washington, D.C.)},
volume = {75},
number = {1},
pages = {6-16},
doi = {10.1176/appi.ps.20220401},
pmid = {37494117},
issn = {1557-9700},
mesh = {Humans ; Mental Health ; *Cognitive Behavioral Therapy ; Referral and Consultation ; *Delivery of Health Care, Integrated ; },
abstract = {OBJECTIVE: This article describes trends and attributes associated with digital mental health application (DMHA) referrals from December 2019 through December 2021.

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

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

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

Humans
Mental Health
*Cognitive Behavioral Therapy
Referral and Consultation
*Delivery of Health Care, Integrated

@article {pmid37463856,
year = {2023},
author = {Holohan, D and Marfilius, K and Smith, CJ},
title = {Misophonia: A Review of the Literature and Its Implications for the Social Work Profession.},
journal = {Social work},
volume = {68},
number = {4},
pages = {341-348},
doi = {10.1093/sw/swad029},
pmid = {37463856},
issn = {1545-6846},
mesh = {Humans ; *Social Work ; *Emotions/physiology ; Hearing Disorders/psychology ; Anxiety Disorders/psychology ; },
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.},
}

Humans
*Social Work
*Emotions/physiology
Hearing Disorders/psychology
Anxiety Disorders/psychology

@article {pmid37449825,
year = {2023},
author = {Barahmand, U and Stalias-Mantzikos, ME and Xiang, Y and Rotlevi, E},
title = {The New York Misophonia Scale (NYMS): A New Instrument to Identify Misophonia in the General Population.},
journal = {Journal of psychiatric practice},
volume = {29},
number = {4},
pages = {269-281},
pmid = {37449825},
issn = {1538-1145},
mesh = {Adult ; Humans ; New York ; Reproducibility of Results ; *Hearing Disorders/psychology ; *Sound ; },
abstract = {Misophonia is a condition in which certain sounds and behaviors elicit distress that ranges from mild annoyance to disgust or anger. The aim of this research was to develop and validate an instrument to screen for misophonia in the general population. Study 1 developed and explored the factor structure and item quality of the New York Misophonia Scale (NYMS), which originally included 42 triggers and 13 behavioral reactions. A sample of 441 American adults responded to the instrument via social media platforms. Of the original 42 triggers, 25 clustered into 4 factors: repetitive actions, mouth sounds, ambient object sounds, and ambient people sounds. The 13 behavioral reactions loaded on to 2 factors, aggressive and nonaggressive reactions. Study 2 evaluated the psychometric properties of the final version of the NYMS using a sample of 200 American adults. The results supported the validity of the factor structure and the reliability of the final version of the NYMS from Study 1. Finally, Study 3 explored the concurrent and convergent validity of the final version of the NYMS with the Misophonia Questionnaire (MQ) and the Difficulties in Emotion Regulation Scale-Short Form (DERS-SF). A sample of 171 adult participants completed all of the scales. Good concurrent validity was found with the MQ and good convergent validity was found with the DERS-SF. Overall, the NYMS appears to be a useful and promising instrument for assessing misophonia triggers, severity of distress elicited, and behavioral reactions to the distress in the general population.},
}

Adult
Humans
New York
Reproducibility of Results
*Hearing Disorders/psychology
*Sound

@article {pmid37429565,
year = {2023},
author = {Campbell, J},
title = {Misophonia: A Need for audiologic diagnostic guidelines.},
journal = {Journal of the American Academy of Audiology},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2125-7645},
pmid = {37429565},
issn = {2157-3107},
abstract = {PURPOSE: The goal of this commentary is to present to audiologists the recent consensus definition of misophonia along with current clinical measures useful for audiologists in the diagnosis of misophonia. Up and coming behavioral methods that may be sensitive to misophonia are highlighted. Finally, a call is put out for translational audiologic research with the goal of developing diagnostic criteria for misophonia.

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

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

@article {pmid37352813,
year = {2023},
author = {Seegan, PL and Miller, MJ and Heliste, JL and Fathi, L and McGuire, JF},
title = {Efficacy of stand-alone digital mental health applications for anxiety and depression: A meta-analysis of randomized controlled trials.},
journal = {Journal of psychiatric research},
volume = {164},
number = {},
pages = {171-183},
pmid = {37352813},
issn = {1879-1379},
support = {UL1 TR003098/TR/NCATS NIH HHS/United States ; },
mesh = {Humans ; Anxiety/therapy/etiology ; Anxiety Disorders/therapy ; *Depression/therapy/etiology ; *Mental Health ; Randomized Controlled Trials as Topic ; },
abstract = {BACKGROUND: Anxiety and depressive disorders affect 20% of the population, cause functional impairment, and represent a leading cause of disability. Although evidence-based treatments exist, the shortage of trained clinicians and high demand for mental health services have resulted in limited access to evidence-based care. Digital mental health applications (DMHA) present innovative, scalable, and sustainable solutions to address disparities in mental health care.

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

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

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

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

Humans
Anxiety/therapy/etiology
Anxiety Disorders/therapy
*Depression/therapy/etiology
*Mental Health
Randomized Controlled Trials as Topic

@article {pmid37341653,
year = {2023},
author = {Andermane, N and Bauer, M and Simner, J and Ward, J},
title = {A symptom network model of misophonia: From heightened sensory sensitivity to clinical comorbidity.},
journal = {Journal of clinical psychology},
volume = {79},
number = {10},
pages = {2364-2387},
doi = {10.1002/jclp.23552},
pmid = {37341653},
issn = {1097-4679},
mesh = {Humans ; *Hearing Disorders ; *Anxiety Disorders ; Anxiety/epidemiology ; Comorbidity ; },
abstract = {OBJECTIVES: Misophonia-an unusually strong intolerance of certain sounds-can cause significant distress and disruption to those who have it but is an enigma in terms of our scientific understanding. A key challenge for explaining misophonia is that, as with other disorders, it is likely to emerge from an interaction of traits that also occur in the general population (e.g., sensory sensitivity and anxiety) and that are transdiagnostic in nature (i.e., shared with other disorders).

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

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

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

Humans
*Hearing Disorders
*Anxiety Disorders
Anxiety/epidemiology
Comorbidity

@article {pmid37333720,
year = {2023},
author = {Mattson, SA and D'Souza, J and Wojcik, KD and Guzick, AG and Goodman, WK and Storch, EA},
title = {A systematic review of treatments for misophonia.},
journal = {Personalized medicine in psychiatry},
volume = {39-40},
number = {},
pages = {},
pmid = {37333720},
issn = {2468-1725},
support = {P50 HD103555/HD/NICHD NIH HHS/United States ; },
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.},
}

@article {pmid37329250,
year = {2023},
author = {Perez, VW and Friedman, A},
title = {Misophonia matters: A case study of the role of brain imaging in debates over new diagnoses.},
journal = {Sociology of health & illness},
volume = {},
number = {},
pages = {},
doi = {10.1111/1467-9566.13679},
pmid = {37329250},
issn = {1467-9566},
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.},
}

@article {pmid37275093,
year = {2023},
author = {Patel, NM and Fameen, R and Shafeek, N and Prabhu, P},
title = {Prevalence of Misophonia in College Going Students of India: A Preliminary Survey.},
journal = {Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India},
volume = {75},
number = {2},
pages = {374-378},
pmid = {37275093},
issn = {2231-3796},
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.},
}

@article {pmid37263358,
year = {2023},
author = {Cervin, M and Guzick, AG and Clinger, J and Smith, EEA and Draper, IA and Goodman, WK and Lijffijt, M and Murphy, N and Rast, CE and Schneider, SC and Storch, EA},
title = {Measuring misophonia in youth: A psychometric evaluation of child and parent measures.},
journal = {Journal of affective disorders},
volume = {338},
number = {},
pages = {180-186},
doi = {10.1016/j.jad.2023.05.093},
pmid = {37263358},
issn = {1573-2517},
support = {R01 HD080096/HD/NICHD NIH HHS/United States ; P50 HD103555/HD/NICHD NIH HHS/United States ; },
mesh = {Humans ; Adolescent ; Child ; *Quality of Life ; Psychometrics ; *Hearing Disorders/psychology ; Parents ; },
abstract = {BACKGROUND: Misophonia is characterized by intense emotional reactions to specific sounds or visual stimuli and typically onsets during childhood. An obstacle for research and clinical practice is that no comprehensively evaluated measures for pediatric misophonia exist.

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

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

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

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

Humans
Adolescent
Child
*Quality of Life
Psychometrics
*Hearing Disorders/psychology
Parents

@article {pmid37153709,
year = {2023},
author = {Aryal, S and Prabhu, P},
title = {Awareness and perspectives of audiologists on assessment and management of misophonia in India.},
journal = {Journal of otology},
volume = {18},
number = {2},
pages = {104-110},
pmid = {37153709},
issn = {2524-1753},
abstract = {BACKGROUND: The assessment and management of misophonia need a team approach, and audiologists are essential team members. However, the role of an audiologist in this condition is not well understood, and there is a lack of awareness even among professionals about their role in the assessment and management of misophonia.

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

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

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

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

@article {pmid37153450,
year = {2023},
author = {Andermane, N and Bauer, M and Sohoglu, E and Simner, J and Ward, J},
title = {A phenomenological cartography of misophonia and other forms of sound intolerance.},
journal = {iScience},
volume = {26},
number = {4},
pages = {106299},
pmid = {37153450},
issn = {2589-0042},
abstract = {People with misophonia have strong aversive reactions to specific "trigger" sounds. Here we challenge this key idea of specificity. Machine learning was used to identify a misophonic profile from a multivariate sound-response pattern. Misophonia could be classified from most sounds (traditional triggers and non-triggers) and, moreover, cross-classification showed that the profile was largely transferable across sounds (rather than idiosyncratic for each sound). By splitting our participants in other ways, we were able to show-using the same approach-a differential diagnostic profile factoring in potential co-morbidities (autism, hyperacusis, ASMR). The broad autism phenotype was classified via aversions to repetitive sounds rather than the eating sounds most easily classified in misophonia. Within misophonia, the presence of hyperacusis and sound-induced pain had widespread effects across all sounds. Overall, we show that misophonia is characterized by a distinctive reaction to most sounds that ultimately becomes most noticeable for a sub-set of those sounds.},
}

@article {pmid37146655,
year = {2023},
author = {Banks, WA and Hansen, KM and Erickson, MA and Crews, FT},
title = {High-mobility group box 1 (HMGB1) crosses the BBB bidirectionally.},
journal = {Brain, behavior, and immunity},
volume = {111},
number = {},
pages = {386-394},
doi = {10.1016/j.bbi.2023.04.018},
pmid = {37146655},
issn = {1090-2139},
mesh = {Animals ; Mice ; *Blood-Brain Barrier/metabolism ; *HMGB1 Protein/metabolism ; Inflammation ; Lipopolysaccharides ; Toll-Like Receptor 4/metabolism ; },
abstract = {High-mobility group box 1 (HMGB1) is a ubiquitous protein that regulates transcription in the nucleus, and is an endogenous damage-associated molecular pattern molecule that activates the innate immune system. HMGB1 activates the TLR4 and RAGE recepto, inducing downstream signals reminiscent of cytokines that have been found to cross the blood-brain barrier (BBB). Blood HMGB1 increases in stroke, sepsis, senescence, alcohol binge drinking and other conditions. Here, we examined the ability of HMGB1 radioactively labeled with iodine (I-HMGB1) to cross the BBB. We found that I-HMGB1 readily entered into mouse brain from the circulation with a unidirectional influx rate of 0.654 μl/g-min. All brain regions tested took up I-HMGB1; uptake was greatest by the olfactory bulb and least in the striatum. Transport was not reliably inhibited by unlabeled HMGB1 nor by inhibitors of TLR4, TLR2, RAGE, or CXCR4. Uptake was enhanced by co-injection of wheatgerm agglutinin, suggestive of involvement of absorptive transcytosis as a mechanism of transport. Induction of inflammation/neuroinflammation with lipopolysaccharide is known to increase blood HMGB1; we report here that brain transport is also increased by LPS-induced inflammation. Finally, we found that I-HMGB1 was also transported in the brain-to-blood direction, with both unlabeled HMGB1 or lipopolysaccharide increasing the transport rate. These results show that HMGB1 can bidirectionally cross the BBB and that those transport rates are enhanced by inflammation. Such transport provides a mechanism by which HMGB1 levels would impact neuroimmune signaling in both the brain and periphery.},
}

Animals
Mice
*Blood-Brain Barrier/metabolism
*HMGB1 Protein/metabolism
Inflammation
Lipopolysaccharides
Toll-Like Receptor 4/metabolism

@article {pmid37146649,
year = {2023},
author = {Aazh, H and Taylor, L and Danesh, AA and Moore, BCJ},
title = {The Effectiveness of Unguided Internet-Based Cognitive Behavioral Therapy for Tinnitus for Patients with Tinnitus Alone or Combined with Hyperacusis and/or Misophonia: A Preliminary Analysis.},
journal = {Journal of the American Academy of Audiology},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2087-0262},
pmid = {37146649},
issn = {2157-3107},
abstract = {BACKGROUND: In the UK, audiologist-delivered cognitive behavioral therapy (CBT) is a key intervention to alleviate the distress caused by tinnitus and its comorbid hyperacusis. However, the availability of face-to-face CBT is limited, and such therapy involves significant costs. CBT provided via the internet provides a potential solution to improve access to CBT for tinnitus.

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

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

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

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

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

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

@article {pmid37130567,
year = {2023},
author = {Aazh, H and Stevens, J and Jacquemin, L},
title = {Exploding Head Syndrome among patients seeking help for tinnitus and/or hyperacusis at an Audiology Department in the UK: A preliminary study.},
journal = {Journal of the American Academy of Audiology},
volume = {},
number = {},
pages = {},
doi = {10.1055/a-2084-4808},
pmid = {37130567},
issn = {2157-3107},
support = {OJO grant from the Flemish Government//Antwerp Doctoral School of the University of Antwerp/ ; },
abstract = {BACKGROUND: Exploding Head Syndrome (EHS) is characterised by hearing a sudden loud noise or experiencing a sense of explosion in head during the transition of sleep-wake or wake-sleep. The experience of EHS shares similarities with tinnitus, where an individual perceives a sound without any sound source. To the authors' knowledge, the possible relationship between EHS and tinnitus has not been explored.

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

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

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

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

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

@article {pmid37056403,
year = {2023},
author = {Möllmann, A and Heinrichs, N and Illies, L and Potthast, N and Kley, H},
title = {The central role of symptom severity and associated characteristics for functional impairment in misophonia.},
journal = {Frontiers in psychiatry},
volume = {14},
number = {},
pages = {1112472},
pmid = {37056403},
issn = {1664-0640},
abstract = {Misophonia is characterized by a preoccupation with and strong emotional and behavioral reactions to certain triggers, mostly sounds related to eating and breathing. We applied functional impairment due to misophonic symptoms as a central criterion to investigate differences between clinical misophonia and normative decreased sound tolerance in a large non-random sample of n = 1,881 individuals from an online survey. We assessed the frequency of self-reported misophonia symptoms across various symptom measures, compared severity, triggers and emotional reactions, general psychopathology, interpersonal emotion regulation, and quality of life between both groups with and without functional impairing misophonia. Individuals with functional impairment due to misophonia (n = 839) revealed significantly higher general psychopathology symptoms, lower interpersonal emotion regulation skills, and lower quality of life than individuals without impairment (n = 1,042). Anxious/distressed and annoyed reactions to triggers were experienced more frequently compared to emotional reactions of disgust and sadness or depression in both groups. Overall, the group differences were primarily quantitative in nature. We discuss practical implications regarding classification and treatment and provide cutoffs for each symptom measure derived from group assignment for functional impairment.},
}

@article {pmid37034168,
year = {2023},
author = {Jastreboff, PJ and Jastreboff, MM},
title = {The neurophysiological approach to misophonia: Theory and treatment.},
journal = {Frontiers in neuroscience},
volume = {17},
number = {},
pages = {895574},
pmid = {37034168},
issn = {1662-4548},
abstract = {Clinical observations of hundreds of patients who exhibited decreased tolerance to sound showed that many of them could not be diagnosed as having hyperacusis when negative reactions to a sound depend only on its physical characteristics. In the majority of these patients, the physical characteristics of bothersome sounds were secondary, and patients were able to tolerate other sounds with levels higher than sounds bothersome for them. The dominant feature determining the presence and strength of negative reactions are specific to a given patient's patterns and meaning of bothersome sounds. Moreover, negative reactions frequently depend on the situation in which the offensive sound is presented or by whom it is produced. Importantly, physiological and emotional reactions to bothersome sounds are very similar (even identical) for both hyperacusis and misophonia, so reactions cannot be used to diagnose and differentiate them. To label this non-reported phenomenon, we coined the term misophonia in 2001. Incorporating clinical observations into the framework of knowledge of brain functions allowed us to propose a neurophysiological model for misophonia. The observation that the physical characterization of misophonic trigger was secondary and frequently irrelevant suggested that the auditory pathways are working in identical manner in people with as in without misophonia. Descriptions of negative reactions indicated that the limbic and sympathetic parts of the autonomic nervous systems are involved but without manifestations of general malfunction of these systems. Patients with misophonia could not control internal emotional reactions (even when fully realizing that these reactions are disproportionate to benign sounds evoking them) suggesting that subconscious, conditioned reflexes linking the auditory system with other systems in the brain are the core mechanisms of misophonia. Consequently, the strength of functional connections between various systems in the brain plays a dominant role in misophonia, and the functional properties of the individual systems may be perfectly within the norms. Based on the postulated model, we proposed a treatment for misophonia, focused on the extinction of conditioned reflexes linking the auditory system with other systems in the brain. Treatment consists of specific counseling and sound therapy. It has been used for over 20 years with a published success rate of 83%.},
}

@article {pmid36971223,
year = {2023},
author = {Trent, ES and Viana, AG and Raines, EM and Busch, HEC and Silva, K and Storch, EA and Zvolensky, MJ},
title = {Childhood exposure to parental threatening behaviors and anxiety in emerging adulthood: Indirect effects of perceived stress.},
journal = {Journal of clinical psychology},
volume = {79},
number = {9},
pages = {1984-2008},
pmid = {36971223},
issn = {1097-4679},
support = {K23 AA025920/AA/NIAAA NIH HHS/United States ; F31 MH123103/MH/NIMH NIH HHS/United States ; U54 MD015946/MD/NIMHD NIH HHS/United States ; P50 HD103555/HD/NICHD NIH HHS/United States ; },
mesh = {Adult ; Humans ; Child ; Female ; Adolescent ; Male ; Cross-Sectional Studies ; *Anxiety ; *Anxiety Disorders ; Parenting ; Parents ; Stress, Psychological ; },
abstract = {BACKGROUND: Although childhood exposure to parental threatening behaviors is associated with elevated anxiety in emerging adulthood, the underlying mechanisms remain unexplored. Perceived stress-a subjective experience comprised of feelings of helplessness (being unable to cope or exert control) and poor self-efficacy (confidence in one's ability to manage stressors)-is one candidate mechanism. The present investigation examined the underlying role of perceived stress in the association between childhood exposure to parental threatening behaviors and anxiety symptom severity in a sample of emerging adults.

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

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

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

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

Adult
Humans
Child
Female
Adolescent
Male
Cross-Sectional Studies
*Anxiety
*Anxiety Disorders
Parenting
Parents
Stress, Psychological

@article {pmid36950304,
year = {2023},
author = {Rappoldt, LR and van der Pol, MM and de Wit, C and Slaghekke, S and Houben, C and Sondaar, T and Kan, KJ and van Steensel, FJAB and Denys, D and Vulink, NCC and Utens, EMWJ},
title = {Effectiveness of an innovative treatment protocol for misophonia in children and adolescents: Design of a randomized controlled trial.},
journal = {Contemporary clinical trials communications},
volume = {33},
number = {},
pages = {101105},
pmid = {36950304},
issn = {2451-8654},
abstract = {BACKGROUND: Misophonia is a recently identified disorder in which individuals experience intense, uncontrollable and disproportional irritation, anger or disgust when confronted with specific sounds or stimuli associated with these sounds. Prevalence rates in children and adolescents are currently still to be investigated. The reported average age of onset is around 13 years, in clinical practice children from 8 years old are referred.Misophonia is associated with avoidance and anticipation anxiety, possibly leading to serious educational and social consequences for children and families. Worldwide, no evidence-based treatment exists specifically for children and adolescents with misophonia.This article presents the design of a randomized controlled trial testing the effectiveness of cognitive behavioral therapy (CBT) combined with psychomotor therapy (PMT) for misophonia in children and adolescents (aged 8-18).

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

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