A psychoacoustic test for misophonia assessment

Abstract

Misophonia is a condition where a strong arousal response is triggered when hearing specific human generated sounds, like chewing, and/or repetitive tapping noises, like pen clicking. It is diagnosed with clinical interviews and questionnaires since no psychoacoustic tools exist to assess its presence. The present study was aimed at developing and testing a new assessment tool for misophonia. The method was inspired by an approach we have recently developed for hyperacusis. It consisted of presenting subjects (n = 253) with misophonic, pleasant, and unpleasant sounds in an online experiment. The task was to rate them on a pleasant to unpleasant visual analog scale. Subjects were labeled as misophonics (n = 78) or controls (n = 55) by using self-report questions and a misophonia questionnaire, the MisoQuest. There was a significant difference between controls and misophonics in the median global rating of misophonic sounds. On the other hand, median global rating of unpleasant, and pleasant sounds did not differ significantly. We selected a subset of the misophonic sounds to form the core discriminant sounds of misophonia (CDSMiso). A metric: the CDS score, was used to quantitatively measure misophonia, both with a global score and with subscores. The latter could specifically quantify aversion towards different sound sources/events, i.e., mouth, breathing/nose, throat, and repetitive sounds. A receiver operating characteristic analysis showed that the method accurately classified subjects with and without misophonia (accuracy = 91%). The present study suggests that the psychoacoustic test we have developed can be used to assess misophonia reliably and quickly.

Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping

“…The presence of multiple misophonia presentations suggests that misophonia symptoms may lie on a spectrum with varying levels of overlap with other brain disorders. The spectrum presentation conclusion is an important consideration for the approach to understanding and treating misophonia, previously assessed or diagnosed via questionnaire and recently via psychoacoustic methods [ Schroder et al, 2013 ; Jager et al, 2020 ; Enzler et al, 2021 ; Hansen et al, 2021 ; Swedo et al, 2021 (Preprint)]. In many ways, misophonia shares a clinical presentation similar to the sensory and cognitive control aspects of ASD which could implicate similar potential underlying mechanisms for sensory sensitivity and emotional reactivity symptoms ( Schroder et al, 2014 ; Jastreboff and Jastreboff, 2015 ; Daniels et al, 2020 ).…”

“…Most studies assessing misophonia utilized questionnaires to informally diagnose misophonia, with only three known studies performing full medical and psychiatric evaluation of participants ( Schroder et al, 2013 ; Erfanian et al, 2019 ; Jager et al, 2020 ). More recent studies investigating misophonia and sound hypersensitivity have also used psychoacoustic methods, providing a quick and reliable means of assessing misophonia ( Dozier and Morrison, 2017 ; Enzler et al, 2021 ; Hansen et al, 2021 ). However, limited studies have explored variability in the clinical presentation of misophonia ( Cassiello-Robbins et al, 2021 ; Hansen et al, 2021 ).…”

Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field

“…A 2021 study, which assessed ( n = 253) misophonia with an online psychoacoustic test, suggested that such a test can be used to assess misophonia reliably and quickly [ 72 ]. However, although audiological measurement is historically a suggested component of the assessment of misophonia, there is no agreement on the protocol that should be performed [ 24 ].…”

“…However, although the audiological evaluation does not confirm misophonia in itself, it can be important to make the differential diagnosis of other auditory conditions with which it frequently coexists, such as hyperacusis and tinnitus, so that in these cases, the evaluation would be highly indicated [ 2 , 4 , 40 ]. The last study with this type of measurement is from 2021, and its authors suggested this online psychoacoustic test as a reliable and rapid test for the measurement of misophonia [ 72 ].…”

A Multidimensional Investigation of Sensory Processing in Autism: Parent- and Self-Report Questionnaires, Psychophysical Thresholds, and Event-Related Potentials in the Auditory and Somatosensory Modalities

“…For example, if autistic hyper-sensitivities reflect stimulus discomfort rather than altered psychophysical thresholds, measures of stimulus discomfort, such as Loudness Discomfort Levels (see Khalfa et al, 2004 ), might yield more robust group differences than measures of stimulus detection and discrimination. These sorts of group differences might be most naturalistically valid if everyday, real-world sounds are included in task batteries (as in, e.g., Enzler et al, 2021a , b ; Hansen et al, 2021 ). To further enhance naturalistic validity, paradigms could include distracting, task-irrelevant stimuli (e.g., Karhson and Golob, 2016 ; Keehn et al, 2016 ; Blomberg et al, 2021 ).…”