Assessment and Intervention for Individuals With Misophonia

Wiese, Andrew D.; Wojcik, Katharine D.; Storch, Eric A.

doi:10.1007/s42843-021-00025-6

Cited by 10 publications

(9 citation statements)

References 25 publications

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“…It should be noted that nonhuman and environmental sounds as triggers in misophonia do not occur in isolation. That is, these nontypical triggers occur along with the typical triggers (e.g., eating/chewing sounds) in misophonia sufferers ( Muller et al, 2018 ; Jager et al, 2020 ; Wiese et al, 2021 ). A plausible explanation, therefore, is that, after the typical triggers are learned via the mirror system, the nontypical stimuli become triggers via associative learning.…”

Section: Discussionmentioning

confidence: 99%

The Motor Basis for Misophonia

et al. 2021

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Misophonia is a common disorder characterized by the experience of strong negative emotions of anger and anxiety in response to certain everyday sounds, such as those generated by other people eating, drinking, and breathing. The commonplace nature of these “trigger” sounds makes misophonia a devastating disorder for sufferers and their families. How such innocuous sounds trigger this response is unknown. Since most trigger sounds are generated by orofacial movements (e.g., chewing) in others, we hypothesized that the mirror neuron system related to orofacial movements could underlie misophonia. We analyzed resting state fMRI (rs-fMRI) connectivity ( N = 33, 16 females) and sound-evoked fMRI responses ( N = 42, 29 females) in misophonia sufferers and controls. We demonstrate that, compared with controls, the misophonia group show no difference in auditory cortex responses to trigger sounds, but do show: (1) stronger rs-fMRI connectivity between both auditory and visual cortex and the ventral premotor cortex responsible for orofacial movements; (2) stronger functional connectivity between the auditory cortex and orofacial motor area during sound perception in general; and (3) stronger activation of the orofacial motor area, specifically, in response to trigger sounds. Our results support a model of misophonia based on “hyper-mirroring” of the orofacial actions of others with sounds being the “medium” via which action of others is excessively mirrored. Misophonia is therefore not an abreaction to sounds, per se, but a manifestation of activity in parts of the motor system involved in producing those sounds. This new framework to understand misophonia can explain behavioral and emotional responses and has important consequences for devising effective therapies. SIGNIFICANCE STATEMENT Conventionally, misophonia, literally “hatred of sounds” has been considered as a disorder of sound emotion processing, in which “simple” eating and chewing sounds produced by others cause negative emotional responses. Our data provide an alternative but complementary perspective on misophonia that emphasizes the action of the trigger-person rather than the sounds which are a byproduct of that action. Sounds, in this new perspective, are only a “medium” via which action of the triggering-person is mirrored onto the listener. This change in perspective has important consequences for devising therapies and treatment methods for misophonia. It suggests that, instead of focusing on sounds, which many existing therapies do, effective therapies should target the brain representation of movement.

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Section: Discussionmentioning

confidence: 99%

The Motor Basis for Misophonia

et al. 2021

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“…The Misophonia Questionnaire (Wu et al, 2014), reviewed by Wiese et al (2021) as having “robust psychometric properties” (p. 53) was administered in this study. Wiese et al (2021) also noted that “there are no structured or semi-structured interviews for misophonia, to date” (p. 55). Hence, an ancillary goal of this paper is to describe a structured procedure for psychological assessment of misophonia that has thus far been piloted in clinical assessments with four children and adolescents as well as four adults seeking a misophonia assessment.…”

Section: Theoretical and Research Basis For Treatmentmentioning

confidence: 99%

“…Because misophonia is a newly recognized clinical problem, and treatment planning is hampered by the lack of an empirically supported option, little attention has been paid to assessment of misophonia symptoms. In a recent article on the assessment and treatment process in working with an individual with misophonia, Wiese et al (2021) stated that "comprehensive clinical assessment is required to determine whether someone has misophonia" (p. 53) and describes several useful self-report instruments that have been developed. The Misophonia Questionnaire (Wu et al, 2014), reviewed by Wiese et al (2021) as having "robust psychometric properties" (p. 53) was administered in this study.…”

mentioning

confidence: 99%

“…In a recent article on the assessment and treatment process in working with an individual with misophonia, Wiese et al (2021) stated that "comprehensive clinical assessment is required to determine whether someone has misophonia" (p. 53) and describes several useful self-report instruments that have been developed. The Misophonia Questionnaire (Wu et al, 2014), reviewed by Wiese et al (2021) as having "robust psychometric properties" (p. 53) was administered in this study. Wiese et al (2021) also noted that "there are no structured or semi-structured interviews for misophonia, to date" (p. 55).…”

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confidence: 99%

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Treating Adolescent Misophonia With Cognitive Behavioral Therapy: Considerations for Including Exposure

Cecilione

Hitti

Vrana

2021

Clinical Case Studies

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Although misophonia is not yet included in the primary diagnostic manuals used by psychologists or psychiatrists, proposed criteria suggest that this condition is characterized by a strong negative reaction to and avoidance of certain trigger sounds. Misophonic trigger sounds are largely human-made (e.g., chewing and slurping) and evoke responses such as disgust, irritation, and/or anger that are out of proportion to the situation and cause distress and/or impairment. Currently, there is no gold standard evidence-based treatment for misophonia. As the misophonia treatment literature grows, several important questions are arising: (1) should exposure to aversive sound triggers be included in treatment for misophonia and (2) how can clinicians best assess misophonia symptoms. This case offers one example of misophonia being successfully treated with a cognitive-behavioral approach to treatment (including exposures) in an adolescent girl. This case also offers an example of how clinicians may conduct a comprehensive assessment of misophonia symptoms. Theoretically and empirically derived recommendations for including exposure in misophonia treatment are presented. Information from this case may be helpful in informing future research, as there is a paucity of evidence-based assessment and treatment protocols for misophonia.

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“…Telehealth may also be of benefit to patients with rare conditions. The condition of misophonia, for which putative diagnostic criteria and assessment techniques are clearly spelled out in an excellent clinical review provided by Wiese et al (2021), may be amenable to telepsychological assessment devices and possibly interventions. Misophonia is an evolving diagnosis around which consensus is yet developing.…”

mentioning

confidence: 99%