Should we screen for misophonia in patients with eating disorders? A report of three cases

Abstract

In this case report, the authors describe three cases of misophonia in people with eating disorders. Misophonia is a condition where a specific trigger sound provokes an intense emotional reaction in an individual. Case 1 is a 29-year-old with childhood eating issues, anorexia nervosa and bulimia nervosa whose trigger was a high-pitched female voice. Case 2 is a 15-year-old diagnosed with anorexia nervosa after misophonia onset. Her trigger was people chewing and eating noisily. Case 3 is a 24-year-old woman who presented with anorexia nervosa prior to misophonia onset. Her trigger was the clinking and chewing of her mother and aunt eating cereal. All three cases identified an eating-related trigger sound with a violent aversive reaction and coping mechanisms involving eating avoidance or having a full mouth. Misophonia may be associated with presentations of eating disorders. This case report adds to the literature about the presentation of misophonia.

A Large‐Scale Study of Misophonia

“…Some participants indicate that their symptoms have worsened a lot . Our findings are in line with the misophonic case studies, reporting a worsening of symptoms over time (Kluckow et al., ). We did not test children, and therefore, cannot examine if this implies that the symptoms are worse in adults than in children or if older children have worse symptoms than younger children.…”

“…This indicates that comorbidity with other conditions or diseases is related to an increase in the severity of misophonic complaints. This finding is in line with previous studies noting shared pathology between misophonia and other diseases, such as anorexia nervosa and OCD (Kluckow et al., ); general sensory sensitivities, obsessive‐compulsive symptoms, anxiety, and depressive symptoms (Wu et al., ); or OCPD (Schröder et al, ). These findings of comorbidity are however not necessarily pertaining specifically to the misophonic condition.…”

“…At the end of our test, we presented previously published misophonia tests: Misophonia Activation Scale (MAS‐1; Fitzmaurice, , Kluckow et al., , Dozier, ), Misophonia Physical Sensation Scale (MPRS; Bauman, ), and Amsterdam Misophonia Scale (A‐MISO‐S; Schröder et al., ; 1. time, 2. interfere, 3. distress). In our test, the same types of questions do not always succeed each other, to counter automatic answering or answer biases.…”

“…Or is misophonia even perhaps only a symptomatic manifestation of another underlying "real" disorder? Although comorbidity with other conditions has been obtained (e.g., Ferreira et al, 2013;Kluckow, Telfer, & Abraham, 2014;Schröder et al, 2013), it is not yet clear if these co-occurrences are coincidental or not.…”

“…Another hypothesis was that the participants would report symptoms as getting worse over time (Edelstein et al, 2013;Kluckow et al, 2014;Bernstein et al, 2013), supposedly caused by the negative reinforcement provided by the reactions to the trigger (Jastreboff & Jastreboff, 2014). We also tested hypotheses related to environmental influences, in particular substance abuse.…”