Properties (16)
- purpleRed
- (Abramovitch et al., 2023)
- Hot vs Cold cognition
- #Misophonia
- neuro
- verbal memory
- Attention
A neuropsychological study of misophonia
Status:: #status/complete
Metadata
- Item Type: #journalArticle
- Authors: Amitai Abramovitch, Tanya A. Herrera, Joseph L. Etherton,
- Date Added: August 28, 2023
- URL: https://linkinghub.elsevier.com/retrieve/pii/S0005791623000642
- DOI: 10.1016/j.jbtep.2023.101897
- Cite Key: abramovitchNeuropsychologicalStudyMisophonia2023
- Tags: #Misophonia, #attention, #comorbidity, #executive-function, #selective-sound-sensitivity, #impulsivity, #recommended-by-rosenthal
- [PDF Attachments]([Abramovitch et al_2023_A neuropsychological study of misophonia.pdf](file://C:\Users\attra\Zotero\storage\VYFCZ4L5\Abramovitch%20et%20al_2023_A%20neuropsychological%20study%20of%20misophonia.pdf))
Article Review Table: (Abramovitch et al., 2023)
| Background/Purpose | Background- • there is a lack of research looking at basic cognitive function in misophonia • Misophonia is increasingly recognized but lacks formal diagnostic criteria and is inconsistently defined across studies. • Prior research has linked misophonia to emotional dysregulation, impulsivity, and psychiatric comorbidities (e.g., OCD, ADHD), but cognitive profiles remain poorly understood. • Most cognitive research in misophonia has focused on performance under emotional provocation ("hot" cognition); little is known about performance in "cold" contexts. Purpose- • because of the lack of studies looking at “cold” cognitive functioning ( only two by the authors estimation) the present study aimed to give a neuropsychological examination of misophonia through the lens of cold cognitive function ( i.e. function without trigger exposure) (page 2) • To conduct the first comprehensive neuropsychological assessment of misophonia under non-provocative, emotionally neutral stimuki • To examine associations between misophonia symptoms, cognitive function, clinical symptoms (e.g., anxiety, impulsivity), comorbidity, and real-world functioning. |
| Participants/samples | • N = 96 college students (32 misophonia, 64 control), selected from a larger neuropsychological study. • English fluency, and lacked major neurological conditions ( epilepsy, brain injury). subjects also refrained from the use of recreational drugs, benzodiazepines, simulant medications, or have more then 2 alcoholic drinks in the 24 hours before session. • Misophonia status established via scores on the MQ ( scores ≥7 on single item sound sensitivity severity scale) |
| Measures | Mini-International Neuropsychiatric Interview 7.0 (MINI), • Depression, Stress, Anxiety Scale-21 (DASS-21), • Six Item-State Trait Anxiety Inventory (STAI-6), • The Eysenck Impulsiveness-Venturesomeness-Empathy Questionnaire (I-7), • Barkley Functional Impairment Scale (BFIS), • Misophonia Questionnaire (MQ), • The Trail Making Test, Part B, • The Wisconsin Card Sorting Test, • The Tower of London, • Verbal Fluency (VF), • The Symbol Span Test, • The Digit Span task (DS) , • The Conners’ Continuous Performance Test – 3rd Edition (CPT-III), • The Rey-Osterrieth Complex Figure Test (RCFT), • California Verbal Learning Test (CVLT) (page 2) |
| Procedures | subjects complete the 15 measures. measures were delivered digitally/ in person by qualified RA’s as needed. total session time = 3.5 hours (page 4) |
| Results | • authors found no evidence of difference in WM for the Misophonia group when assessed without using trigger presentation. (page 4) • Cognitive performance: • Misophonia group underperformed significantly on only two measures: • CVLT short-delay verbal recall (d = 0.63) • Semantic (category) verbal fluency (d = 0.47) • No significant group differences on executive function, working memory, attention, or non-verbal memory. • Suggests a subtle, domain-specific weakness in verbal memory retrieval under non-provocative conditions. • Symptom correlations: • In misophonia group only: • Greater attention lapses (CPT-III omission errors) correlated with higher MQ-1, MQ-2, and total MQ scores. • Lower Digit Span forward scores correlated with higher MQ-3 (sound sensitivity). • Impulsivity (I-7) correlated with MQ-2, MQ-3, and total MQ, but not MQ-1. • Comorbidities: • No statistically significant differences in DSM-5 diagnoses across groups. • Higher numerical prevalence of: • ADHD: 15.6% in misophonia vs. 9.4% in controls • OCD: 9.4% vs. 3.1% • Panic disorder: 6.3% vs. 3.1% • Functional impairment: • Misophonia group reported greater impairment in: • Household chores (d = 0.47) • Money management (d = 0.61) • Driving (d = 0.58) • Higher mean impairment and percent of impaired domains overall (d = 0.53–0.64) • Impairments remained below clinical thresholds but were consistently higher across domains. |
| Discussion/Limits | Conclusion- • no significant effect of Misophonia on verbal memory retrieval or sustained attention measures • supports elevated comorbidity of OCD and ADHD with Misophonia • results support role of behavioral/emotional impulsivity in Misophonia (page 8) • Misophonia was associated with modest deficits in verbal memory retrieval but not general cognitive impairment. • Emotional impulsivity may play a significant role in misophonia symptom expression and distress. • Elevated anxiety, impulsivity, and subclinical functional impairments were notable. • No consistent link between misophonia symptom severity and overall cognitive deficits under ‘cold’ conditions. |
| Limitations:: | • small sample of Misophonics , with a 2/1 Misophonic to control ratio. • Misophonia status determined by MQ3 impairment scale, which does not directly asses symptoms but just impairment from sound sensitivity • did not account for hyperacusis • technical issues meant that one of the measures ( the BFIS) only had some of its items shown to subjects • technical issues meant that one measure ( the CPT-III) was only shown to a small subsection of the sample. • limited generalizability due to sample consisting only of college students. (page 8) • Small sample size for misophonia group (n = 32). • Misophonia classification based on MQ-3 cutoff; no formal diagnostic algorithm used. • Limited assessment of hyperacusis. • College student sample may limit generalizability; may underestimate impairment due to cognitive resilience in student populations. • Only 10 of 15 BFIS domains were assessed due to a technical issue. |
| Future Directions:: | • Replication in clinical and community samples. • Integration of ‘hot’ cognition paradigms (i.e., testing during provocation). • Investigation into emotional impulsivity as a transdiagnostic mechanism. • Clarification of attentional processing in misophonia at rest vs. during symptom elicitation. |
| Relevance:: | • ! found no difference on WM performance for the miso vs control group when probed without using triggers. • a correlational study showing association of Misophonia with reduced performance on some cognitive tasks. specifically suggest issues with attention regulation and impulsivity may be a characteristic relevant to misophonia. • introduces the idea of hot/cold cognition, referring to cognitive processes that happen in response to emotionally charged vs neutral conditions/stim. id did not see much on these terms when doing a google, so it is likely not a widely used term, but I thought it was cool anyway • was a recommended read from Rosenthal |
Notes
Key Terms
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Hot vs Cold cognition- refers to cognition with (hot) vs without (cold) emotion. id did not see much on these terms when doing a google, so it is likely not a widely used term, but I thought it was cool anyway (page 2)
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Misophonia – A condition marked by strong negative emotional and physiological responses (e.g., anger, anxiety) to specific trigger sounds, commonly human-generated (e.g., chewing, sniffing).
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‘Cold’ cognitive function – Cognitive performance under emotionally neutral conditions, as opposed to during emotional or symptomatic provocation.
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Verbal memory retrieval – Cognitive processes related to the recall of verbally encoded information, assessed via tests like semantic fluency and word list recall.
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Executive function – Higher-order cognitive abilities including working memory, set-shifting, inhibition, and planning.
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Impulsivity – A personality trait marked by actions without adequate forethought, measured here via the I-7 questionnaire.
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Functional impairment – Real-life disruptions in daily functioning (e.g., managing finances, chores), measured via the Barkley Functional Impairment Scale (BFIS).
my engagement notes
my questions
my comments
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authors claim first neuropsychological examination of miso. might double check that claim?. (page 1)
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id did not see much on these terms when doing a google, so it is likely not a widely used term, but I thought it was cool anyway (page 2)
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this is a LOT of measures. by my count they used 15! seems excesive and maybe we should take a closer look at the power they had to look at all these things? (page 2)
reading notes
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past research has shown miso to likely be related to rigidity, and impaired impulse control/ emotion inhibition. the authors cite two papers.
- (Cassiello-Robbins et al., 2020): looked at correlations with misophonia symptoms and: trait neuroticism, issues with emotion regulation. they found strong positive correlations with these two traits and rates of misophonia symptoms. it says nothing about rigidity, but does support the “impulse control” and ‘ emotion regulation” claims -
author claims past work supports idea the miso triggers are more about subjective evaluation and recognition of sounds rather then the sounds themselves. cites : (cowan 2022) this is one i don't have and need to get an interlibrary loan for (page 1)
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authors define the current study as a pilot, given the lack of existing neuropsychological studies on Misophonia (page 4)
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bookmark talking about results of probes of functional impairments (page 8)
Hot vs cold cognitive function studies
Hot cognition
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author references (Daniels et al., 2020) as an example of a “hot” cognitive functioning study, where they found impaired stroop task performance in the presence of triggers. this source is another one the prelims reading list and the citation statement is verified (page 2)
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author cites (Silva & Sanchez, 2019) as showing impaired performance on dichotic listing tasks for Misophonics when exposed to triggers. this article was already in our database but had no existing notes. cursory review of abstract verifies the citation statement (page 2)
cold cognition
- the author cites two papers as examples of “cold” cognitive functioning in Misophonia, that being task’s without the presence of triggers, and neither found any misophonia status effects. suggesting that Trigger exposure is required for impairments to cognitive tasks.
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(Simner et al., 2021) was cited as showing no change/difference in performance on visual attention on embedded figures. this citation was not in our database, and i did not add it because it did not seem interesting, but a quick review of the abstract verifies this citation statement.
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(Eijsker et al., 2019) was cited as showing no difference on a stop signal task in Misophonics when given without triggers. this source was another one on our reading list and the citation statement is verified (page 2)
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Misc
Key clinical patterns:
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Misophonia may involve altered neural connectivity and verbal memory processes (temporal lobe, precuneus).
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Impairment is functionally impactful but subclinical in many domains.
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Emotional regulation and behavioral impulsivity may be central to symptom severity.
Methodological contributions:
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First study to examine misophonia with a full neuropsychological battery under non-provocative conditions.
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Introduces nuanced distinctions between verbal memory and executive function profiles in misophonia.
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Provides preliminary evidence supporting future inclusion of misophonia in transdiagnostic models involving attention and impulsivity.
Zettlekasten
Abramovich 2023 findings on cold cognition in Misophonia
Abramovich 2023 discussion of hot vs cold cognition studies in Misophonia