Emotion Processes Predicting Outbursts and Functional Impact in Misophonia

Abstract

Misophonia involves a decreased tolerance to certain sounds and is associated with a range of emotions and emotion processes. In addition to the distress caused by misophonia, some individuals report having aggressive outbursts and significant impact on doing things they would like to be able to do. This study aimed to examine whether misophonia-specific cognitive and emotional processes were associated with misophonic outbursts and impact, and whether these relationships could be explained in part by emotion processes not specific to misophonia. A sample of 703 individuals, 315 of whom identified with having misophonia, completed measures of misophonia, depression and anxiety symptoms, anxiety and disgust sensitivity, interoception and beliefs about emotions. Exploratory correlation and regression analyses were used to build mediation models, which were tested using multiple linear regression. Externalising appraisals (blaming others for causing one’s reaction to sounds) were positively associated with misophonic outbursts, and this relationship was partially explained by anxiety symptoms and disgust sensitivity. Sense of emotional threat in misophonia predicted functional impact of misophonia, and this was partially explained by depression symptoms and negative beliefs about emotions. Anxiety sensitivity and interoception were not significant independent predictors of misophonic outbursts or functional impact. These results provide support for the relevance of emotion processes in misophonia and highlight the importance of using multi-dimensional measures of misophonia to improve our understanding of the condition.

The central role of symptom severity and associated characteristics for functional impairment in misophonia

“…However, it remains unclear why these sounds are annoying for so many people. The similarity in trigger sounds in both groups may imply cognitive and emotional processes involved in evaluating the stimuli to be key when trying to make a difference for those affected by misophonia ( 23 ). In the current study, the difference between functionally impaired and non-impaired groups rather lay in the intensity to which these stimuli were experienced and evaluated as annoying.…”

“…Emotion regulation difficulties were reported to be associated with misophonia symptoms, even beyond the associations with depressive and anxiety symptoms ( 21 , 22 ). As both, the experienced emotions toward certain sounds and the appraisals of the emotional reaction (externalizing: blaming others; internalizing: blaming oneself), differ in individuals with versus without misophonia ( 23 ), a closer investigation of emotion regulation processes appears warranted. Many individuals report misophonic symptoms to occur with family members and/or significant others but not, or at least not to the same extent, to unfamiliar others.…”

Psychometric Evaluation and Misophonic Experience in a Portuguese-Speaking Sample

“…Some studies have reported on the potential role of anxiety sensitivity in misophonia [58,59]. However, Wang and Vitoratou [60] proposed that this relationship could be explained by a shared overlap in anxiety symptoms rather than a unique contribution of anxiety sensitivity. More research is needed to investigate further the role of anxiety symptoms and sensitivity in misophonia.…”

Psychometric evaluation and misophonic experience in a Portuguese-speaking sample

“…Some studies have reported on the potential role of anxiety sensitivity in misophonia (Cusack et al, 2018;Dixon et al, 2023). However, Wang et al (2022) proposed that this relationship could be explained by a shared overlap in anxiety symptoms rather than a unique contribution of anxiety sensitivity. More research is needed to investigate further the role of anxiety symptoms and sensitivity in misophonia.…”