A Large-Scale Study of Misophonia
Open accessAbstract
Objective: We aim to elucidate misophonia, a condition in which particular sounds elicit disproportionally strong aversive reactions. Method: A large online study extensively surveyed personal, developmental, and clinical characteristics of over 300 misophonics. Results: Most participants indicated that their symptoms started in childhood or early teenage years. Severity of misophonic responses increases over time. One third of participants reported having family members with similar symptoms. Half of our participants reported no comorbid clinical conditions, and the other half reported a variety of conditions. Only posttraumatic stress disorder (PTSD) was related to the severity of the misophonic symptoms. Remarkably, half of the participants reported experiencing euphoric, relaxing, and tingling sensations with particular sounds or sights, a relatively unfamiliar phenomenon called autonomous sensory meridian response (ASMR). Conclusion: It is unlikely that another “real” underlying clinical, psychiatric, or psychological disorder can explain away the misophonia. The possible relationship with PTSD and ASMR warrants further investigation.
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Anger is not a primary emotional response in misophonia; annoyance is the primary reaction.
“other authors emphasized that anger was not a primary emotional response in misophonia, as another study with more than 300 patients reported annoyance as the primary reaction to this disorder [40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Severity of Symptoms section reports 301 participants and says almost all recognized both “extreme annoyance/irritation” and “anger/rage.” It also identifies a panic/rage response as the most common severity level. The paper therefore does not support the contrast that annoyance is primary while anger is not a primary response. (LLM, conf=0.86)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredHyperacusis and misophonia often coexist.
“let us remember that hyperacusis and misophonia often coexist, so audiological evaluation will be substantial in these cases [2,4,40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
In “Prevalence and Comorbidity” (page unavailable), the paper reports hyperacusis in only 4% of participants with misophonia, rather than describing the two conditions as often coexisting. Its “Comorbidity with other conditions” section also says half of participants reported no additional condition. (LLM, conf=0.84)
Checked by a reasoning model — may be wrong.
Experimental — accuracy not yet measuredMisophonic patients with other comorbid conditions such as OCD or PTSD report more severe symptoms compared to those suffering exclusively from misophonia.
“This was verified in another study, which reported that misophonic patients with other comorbid conditions such as OCD or PTSD report more severe symptoms compared to those suffering exclusively from misophonia [40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Prevalence and Comorbidity results report less severe complaints among participants with no reported comorbid condition and greater severity among those reporting PTSD. They do not establish the same association for OCD; PTSD was the only specific condition associated with severity after correction for multiple comparisons. The study also relied on participants’ self-reports rather than identifying them as clinically assessed patients. (LLM, conf=0.90)
Experimental — accuracy not yet measuredThe association between tinnitus/hyperacusis and misophonia has been confirmed in other studies, and it is estimated that 12% of patients with misophonia also have tinnitus.
“The association between these disorders has been confirmed in other studies, and it is estimated that 12% of patients with misophonia also have tinnitus [2,40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Prevalence and Comorbidity section reports that 12% of the study’s participants reported tinnitus, supporting the figure for this sample rather than an estimate for all patients with misophonia. The Introduction says a connection with tinnitus had been suggested and cites reports of comorbidity with hearing-related conditions, but does not say that other studies confirmed the association. (LLM, conf=0.86)
Experimental — accuracy not yet measuredA 2018 study of nearly 400 misophonic patients showed that only 50% of the participants had comorbidity with another psychiatric disorder, whereby their condition could not be explained as an effect of another diagnostic entity.
“However, a 2018 study of nearly 400 misophonic patients showed that only 50% of the participants had comorbidity with another psychiatric disorder, whereby their condition could not be explained as an effect of another diagnostic entity [40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Prevalence and Comorbidity section reports that 151 of 301 analyzed participants (50%) reported no other conditions or diagnoses, and the Comorbidity discussion says no single reported condition explained away their misophonia. But this was not a finding that 50% had another psychiatric disorder: the questions also covered clinical, neurological, and hearing conditions. The Participants section says 385 people were recruited, but only 301 were analyzed; participants self-reported misophonic complaints rather than all being clinically diagnosed patients. (LLM, conf=0.90)
Experimental — accuracy not yet measured
The symptomatology shared between PTSD and misophonia is the decreased reactivity threshold, since in both cases patients experience muscle tension in response to a triggering stimulus.
“The symptomatology shared between PTSD and misophonia is the decreased reactivity threshold since, in both cases, patients experience muscle tension in response to a triggering stimulus; therefore, it was suggested that associative learning may influence the development of the conditioned response in the two disorders [40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The “Relationship with PTSD” section says that altered arousal and reactivity in PTSD resemble the physical response in misophonia, and reports that 90% of participants with misophonia recognized tense muscles as characteristic of their response. It does not establish a decreased reactivity threshold or say that triggering stimuli cause muscle tension in both disorders. The same section explicitly says the findings do not address whether the physical response is conditioned, so it does not support the sentence’s proposed associative-learning mechanism for both disorders. (LLM, conf=0.87)
Experimental — accuracy not yet measuredAlthough audiological evaluation does not confirm misophonia in itself, it can be important to make the differential diagnosis of other auditory conditions with which it frequently coexists, such as hyperacusis and tinnitus.
“However, although the audiological evaluation does not confirm misophonia in itself, it can be important to make the differential diagnosis of other auditory conditions with which it frequently coexists, such as hyperacusis and tinnitus, so that in these cases, the evaluation would be highly indicated [2,4,40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Introduction distinguishes misophonia from tinnitus and hyperacusis and says standard hearing tests show normal hearing in people with misophonia. Prevalence and Comorbidity reports tinnitus in 12% of participants and hyperacusis in 4%. The paper does not recommend audiological evaluation for differential diagnosis or say it is highly indicated; describing both conditions as frequent co-occurrences also overstates the reported rates. (LLM, conf=0.88)
Experimental — accuracy not yet measuredOne of the most frequently associated disorders with misophonia is obsessive-compulsive disorder (OCD).
“This is noteworthy, since one of the most frequently associated disorders with misophonia is obsessive-compulsive disorder (OCD) [20,31,40,41,57,58,105,107].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The Introduction and Comorbidity with other conditions sections report prior findings linking misophonia with OCD. But the Prevalence and Comorbidity section does not establish OCD as one of the most frequently associated disorders: its frequency list includes obsessive-compulsive personality disorder (OCPD), which is distinct from OCD, rather than OCD itself. The supplied passages have no page numbers. (LLM, conf=0.87)
Experimental — accuracy not yet measuredPeople with misophonia have physical reactions such as rising body temperature, sweating, increased heart rate, respiration, and a feeling of tightness in the head and chest.
“physical reactions occur in the form of rising body temperature, sweating, increased heart rate, respiration, and a feeling of tightness in the head and chest (7, 8).”
From Effectiveness of Online Group-mindfulness and Acceptance-based Therapy and Cognitive-behavioral Therapy on Misophonia (2022) · cites this paper as [7]
The “Misophonic complaints: Physical” section says participants reported physical sensations related to misophonia, and “Relationship with PTSD” reports that 90% recognized clenched or tense muscles as a response. The passages found do not substantiate the specific claims of rising body temperature, sweating, increased heart rate or respiration, or tightness in the head and chest; searches for those symptoms and for heart-related responses found no matching report. (LLM, conf=0.84)
Experimental — accuracy not yet measuredIt is common for several members of the same family to present misophonic symptoms.
“it is common for several members of the same family to present misophonic symptoms [20,23,40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
Experimental — accuracy not yet measuredMisophonia was also found to occur with attention deficit disorder with and without hyperactivity (ADD/ADHD) in 12% of cases, eating disorders (8%), and selective mutism (6%).
“It should be noted that misophonia was also found to occur with other pathologies such as attention deficit disorder with and without hyperactivity (ADD/ADHD) in 12% of cases, eating disorders (8%), and selective mutism (6%) [40].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
The rate of comorbidity of PTSD with misophonia amounts to 12%, the same percentage reported for comorbidity with tinnitus.
“Another study with a large sample [40] noted that the rate of this comorbidity amounts to 12%, the same percentage reported for comorbidity with tinnitus.”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
Misophonia also co-occurred with attention deficit disorder with and without hyperactivity (ADD/ADHD).
“It should be noted that different authors found that misophonia also co-occurred with other pathologies such as attention deficit disorder with and without hyperactivity (ADD/ADHD) [40,105].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
Experimental — accuracy not yet measuredMisophonia shares qualities with auditory conditions such as tinnitus and hyperacusis.
“Regarding auditory disorders, misophonia shares qualities with auditory conditions such as tinnitus [2,40] and hyperacusis [3].”
From Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field (2022) · cites this paper as [40]
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“The symptomatology shared between PTSD and misophonia is the decreased reactivity threshold since, in both cases, patients experience muscle tension in response to a triggering stimulus; therefore, it was suggested that associative learning may influence the development of the conditioned response in the two disorders…”
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Specificity of Affective Responses in Misophonia Depends on Trigger Identification
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“Because psychiatric symptoms are often co-morbid with misophonia (Rouw and Erfanian, 2018; Erfanian et al., 2019), it is possible that some of the reported misophonia symptoms or high ratings of anger and anxiety in the most-misophonic group could be partially explained by co-morbid affective disorders.”
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Toward a Multidimensional Understanding of Misophonia Using Cluster-Based Phenotyping
Norris, J. E., Kimball, S. H., Nemri, D. C., & Ethridge, L. E. (2022) · Frontiers in Neuroscience · doi:10.3389/fnins.2022.832516 · Cited by 25 · see citing works
Misophonia Successfully Treated of with Fluoxetine: A Case Report
Sarigedik, E., & Yurteri, N. (2021) · Clinical Neuropharmacology · doi:10.1097/wnf.0000000000000465 · Cited by 19 · see citing works
EMDR therapy for misophonia: A pilot study of case series
Jager, I., Vulink, N., de Roos, C., & Denys, D. (2021) · European Journal of Psychotraumatology · doi:10.1080/20008198.2021.1968613 · Cited by 18 · see citing works
Williams, Z. J., Suzman, E., & Woynaroski, T. G. (2021) · American Journal of Audiology · doi:10.1044/2021_aja-20-00209 · Cited by 16 · see citing works
Ferrer-Torres, A., & Giménez-Llort, L. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.638949 · Cited by 16 · see citing works
Ghorbani, S., Ashouri, A., Gharraee, B., & Farahani, H. (2022) · Iranian Journal of Psychiatry and Behavioral Sciences · doi:10.5812/ijpbs-120159 · Cited by 9 · see citing works
“People with misophonia have little tolerance for annoying noises (2, 3), and their reaction to stimuli is often in the form of disgust, anger, irritability, anxiety, and distress (4-6), and physical reactions occur in the form of rising body temperature, sweating, increased heart rate, respiration, and a feeling of ti…”
BackgroundInvestigation of Psychometric Properties of Misophonia Questionnaire
Mehrabizadeh Honarmand, M., Department of Psychology, F. O. E. A. P., Roushani, K., & Department of Psychology, F. O. E. A. P. (2019) · The Neuroscience Journal of Shefaye Khatam · doi:10.29252/shefa.7.2.13 · Cited by 5 · see citing works
- Authors
- Rouw, R., & Erfanian, M.
- Affiliations
- University of Amsterdam (NL)
- Maastricht University (NL)
- Corresponding author
- Rouw, Romke
- Venue
- Journal of Clinical Psychology
- Publisher
- Wiley
- Published
- 2017-05-31
- Volume
- 74
- Issue
- 3
- Pages
- 453-479
- ISSN
- 0021-9762 (ISSN-L)
- 1097-4679
- OpenAlex
- W2618601306
- Semantic Scholar
- ee14616aae799194a598a6c4d02479b5c6a70376
- Cited by
- 262
- References
- 49
- Citations by year
- 2026: 32 · 2025: 34 · 2024: 32 · 2023: 33 · 2022: 54 · 2021: 35 · 2020: 14 · 2019: 13 · 2018: 10 · 2017: 4
- FWCI
- 6.99
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Clinical Psychology (publishedVersion)
- PubMed (publishedVersion)
- UvA-DARE (University of Amsterdam) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Topics
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Health Sciences › Health Professions › Speech and Hearing › Noise Effects and Management
- Life Sciences › Neuroscience › Cognitive Neuroscience › Hearing Loss and Rehabilitation
- Keywords
- misophonia, sound sensitivity, family history (medicine), comorbidities, post-traumatic stress disorder, ASMR
- MeSH terms
- Synesthesia, Adult, Affective Symptoms, Female, Hearing Disorders, Humans, Male, Middle Aged, Pain, Perceptual Disorders, Quality of Life, Severity of Illness Index, Stress Disorders, Post-Traumatic, Comorbidity
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