Decreased Sound Tolerance (Dst): Prevalence, Clinical Correlates, and Development of a DST Assessment Instrument

Cash, Therese V.

doi:10.25772/je67-v432

Cited by 4 publications

(3 citation statements)

References 102 publications

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“…Misophonia likely affects more than 10% of adults in the United States and is more prevalent in clinical populations. Studies reported 13.5% prevalence in a community sample (Cash, 2015), 19.9% and 18.4% in undergraduate psychology students (Cash, 2015;Wu et al, 2014), 20.3% in females living in university dormitories (Roushani & Honarmand, 2021), and 35.0% and 66.7% in clinical populations (Ferrer-Torres & Giménez-Llort, 2021;Quek et al, 2018).…”

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confidence: 99%

Case Study of Relaxation and Counterconditioning Therapy for Misophonia: A Conditioned Aversive Reflex Disorder

Dozier¹

2022

PSYCT

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This article presents a case study of conceptualization of misophonia as a conditioned aversive reflex disorder consisting of a physical (e.g., muscle) reflex elicited by the misophonic trigger stimulus and subsequent emotional, physiological, and behavioral responses. This case describes a successful behavioral treatment of a middle-aged woman who was disabled by severe misophonia. The treatment included identifying the initial physical reflex, progressive muscle relaxation, and counterconditioning the initial physical reflex. Counterconditioning was accomplished by relaxing the initial physical reflex muscle during exposure to in vivo trigger stimuli, while using ambient sound as needed to reduce the severity of the misophonic response. The overall severity of misophonia reduced over the course of the 13-week treatment, based on client self-report. Data were analyzed using recovery percentage formula. The recovery percentage average of 3 scales was 82.1% at end of treatment and 93.1% at 1-year follow-up. In this case, when the initial physical reflex’s muscle was held relaxed by the patient when exposed to trigger stimuli, the initial physical reflex and the emotional reflex diminished and extinguished.

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confidence: 99%

Case Study of Relaxation and Counterconditioning Therapy for Misophonia: A Conditioned Aversive Reflex Disorder

Dozier¹

2022

PSYCT

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“…For over a century extensive research has been conducted on Pavlovian or classical conditioning. Yet a newly identified condition known as misophonia illustrates a substantial deficiency in our understanding of Pavlovian conditioning; a condition which is fundamentally a Pavlovian conditioned reflex, likely affecting hundreds of millions of people worldwide ( Cash, 2015 ; Kılıç et al, 2021 ; Vitoratou et al , 2023 ).…”

Section: Introductionmentioning

confidence: 99%

“…Misophonia is a clinically significant mental health issue, with prevalence estimates in adults based on community samples reported at 12.8% ( Kılıç et al, 2021 ), and 13.5% ( Cash, 2015 ), 5.9% in a German large-scale representative population survey ( Jakubovski et al , 2022 ), and 18.4% in a representative UK sample ( Vitoratou et al , 2023 ). Surveys of clinical populations such as those seeking help from a psychiatric or psychological clinic have been reported at 35% in center intake screening ( Ferrer-Torres and Giménez-Llort, 2021 ) and 66% in a center exit survey ( Quek et al, 2018 ).…”

Section: Introductionmentioning

confidence: 99%

Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder

Dozier,

Mitchell

2023

F1000Res

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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 contribute 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. A newly identified feature of phase four is a covert review of the trigger experience. Phase five includes the consequences of those behaviors with internal consequences of beliefs and new emotions (e.g., shame, guilt) based on environmental responses to anger and panic. Conclusions: We assert the Mitchell-Dozier model provides a novel framework to understanding misophonia as a multi-sensory reflex condition. Our model states that misophonia initially develops as a Pavlovian-conditioned physical reflex and subsequent conditioned emotional responses. Treatments that identify patients’ specific conditioned physical reflex of phase two have shown promising early results, further supporting this model

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Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder

Dozier¹,

Mitchell²

2023

F1000Res

View full text Add to dashboard Cite

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 5 includes the consequences of those behaviors. Internal consequences include beliefs and 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.

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Decreased Sound Tolerance (Dst): Prevalence, Clinical Correlates, and Development of a DST Assessment Instrument

Cited by 4 publications

References 102 publications

Case Study of Relaxation and Counterconditioning Therapy for Misophonia: A Conditioned Aversive Reflex Disorder

Case Study of Relaxation and Counterconditioning Therapy for Misophonia: A Conditioned Aversive Reflex Disorder

Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder

Novel five-phase model for understanding the nature of misophonia, a conditioned aversive reflex disorder

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