Letter to the Editor: Misophonia: A Need for Audiological Diagnostic Guidelines

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.

Clinical characteristics of treatment‐seeking youth with misophonia

“…Conceptualizations of misophonia have more recently expanded to include a wider range of auditory triggers (i.e., nonhuman as well as human sounds) and responses (i.e., anxiety and disgust in addition to anger; see Swedo et al, 2022). Diagnostic criteria for misophonia have also been proposed from an audiological perspective, though no formal diagnosis has been established in this frame either (Aazh, 2023; Campbell, 2023). Misophonia is not currently included as a psychiatric disorder in the latest versions of the Diagnostic and Statistical Manual of Mental Disorders (DSM‐5‐TR; American Psychiatric Association, 2022) and the International Classification of Diseases (ICD‐11; World Health Organization, 2022), despite previous attempts to categorize the condition and despite the clinical evidence that misophonia is a distinct psychiatric phenomenon not explained by the presence of another disorder, that leads to significant distress and impairment.…”