On the lack of self-concept and social representation of misophonia and their modulation by an intervention

Abstract

Misophonia is a poorly understood and underdiagnosed disorder. People who suffer from this condition without knowing it has a notable deterioration in their quality of life, affecting their personal and social relationships. The present study characterized the self-concept of 82 people (women:men, 3:2) attending a medical psychology center in Barcelona before and after their diagnosis of misophonia and intervention to raise awareness. The social representation of misophonia was also studied in their close relatives. A lexicometric analysis using IRaMuTeQ software qualified and quantified the 164 participants' words to describe the patient's behavior (associative cards method) in a list of situations reported but not yet identified as triggers of misophonic responses. The corpus of text, branching, and the word clouds of the most used words showed a high frequency of negative qualifiers (attributed to personality) from relatives [ranking:“irritable” (n=30), “narrow-minded” (n=24) and “anxious” (n=15)] and in the self-concept of patients [ranking: “irritable” (n=34) and “anxious” (n=26), tolerant (n=24) and frank (n=18)], with higher diversification in patients than relatives (14:8 qualifiers n>10), and an increased post-intervention (17:10 qualifiers >10). The intervention strongly modified the corpus since “misophonic” and “disorder” appeared in the self-concept post-intervention, but not the concept, suggesting relatives need substantial efforts to be aware of the nature/impact of the disorder. The distribution of misophonia levels differed among sexes (higher representation of women at level 2 [56%], while men mainly were diagnosed at level 3 [50%]) while age only showed tends. Interestingly, the intervention increased 2.71 points the misophonia score obtained in a self-administered questionnaire repeated seven months later and rescued 13.4% of positive diagnoses, suggesting that for the patients to recognize the diagnosis of misophonia in themselves, they must first ­­be aware of this concept. The individuals with less self-concept stability more frequently recognized themselves as misophonic. Besides, 21% of the variance in the change in self-concept was explained by the change in the concept of a close relative. In summary, the lack of self-concept and social representation of misophonia have strong implications for all the actors and are relevant to design interventions to reduce their impact.