Properties (15)
Year 2025
Abstract
Cssclasses
- purpleRed
Aliases
- Misophonia in autism
- (Aldakhil & Shaik, 2025)
Import Date 07-08-2026
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Dv Authors Ali Fahad Aldakhil, Riyaz Ahamed Shaik,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Heterogeneity in methodology, demographics, and diagnostic criteria complicates synthesis. • Wide variation in sample sizes limits generalizability. • Reliance on self-report may introduce recall bias. • Predominantly cross-sectional designs prevent causal inference. • Geographic and cultural differences complicate extrapolation. • Underrepresentation of certain groups (non-binary individuals, older adults). • Moderate-to-high risk of bias across many studies; case reports/series limited by small samples.
Dv Future Directions • Larger, well-controlled studies with consistent methodologies. • Standardized diagnostic criteria and assessment tools for autistic populations. • Longitudinal studies to establish causal relationships. • Further investigation of genetic contributions and heritability. • Comprehensive assessment protocols to identify at-risk autistic patients. • Individualized, multidisciplinary interventions (behavioral, pharmacological, family-centered) with early identification and integrated care.
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Misophonia in autism: A systematic review of prevalence, clinical features, and comorbidities
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Ali Fahad Aldakhil, Riyaz Ahamed Shaik,
- Date Added: June 7, 2025
- URL: https://linkinghub.elsevier.com/retrieve/pii/S0891422225000897
- DOI: 10.1016/j.ridd.2025.105005
- Cite Key: aldakhilMisophoniaAutismSystematic2025
- Tags:: #Autism, #Bare-bones-review-🦴, #comorbidity, #literature-review, #Misophonia, #prevelence, #sensory-sensitivity, #treatment,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Atypical sensory processing is a hallmark of autism, involving hyperreactivity or hyporeactivity across modalities. • Auditory hypersensitivity is particularly prevalent among autistic individuals and can trigger anxiety and avoidance, impairing daily functioning. • Misophonia prevalence is suggested to be higher among autistic individuals than the general population. • Screening tools exist (DVMSQ; Misophonia Symptom Checklist). • Misophonia overlaps with OCD and ASD; anterior insular cortex hyperactivity is observed in misophonia. • Misophonia, hyperacusis, and APD are distinct conditions that do not always co-occur. Purpose- • Synthesize current literature on misophonia's prevalence, clinical characteristics, and neurobiological links to sensory sensitivities in autism, plus impact on quality of life. • Explore (a) prevalence in autistic individuals, (b) clinical characteristics and comorbidities, (c) shared neurobiological mechanisms, (d) implications for diagnosis and intervention. • Provide a focus distinct from Williams et al. (2021) by concentrating specifically on autistic individuals. |
| Participants/samples | • 14 studies met inclusion criteria; total N = 89,889 participants across studies. • Ages ranged 3–88 years; individual studies focused on children, adolescents, or adults. • Gender representation varied (some female-predominant, some balanced, some including non-binary or unspecified). • Diagnostic profiles varied: autism with sensory sensitivities, and broader populations (ADHD, OCD, mood disorders, general-population controls). • Study designs: interventional, observational, cross-sectional, and GWAS. • Countries: United States, United Kingdom, Turkey, Netherlands, Brazil, Kuwait, Poland. • Inclusion: autistic participants per DSM-5/ICD-11 criteria (studies with comorbid MH conditions eligible if some participants were autistic); misophonia assessed via recognized tools/scales/frameworks; data on prevalence, severity, characteristics, or correlates; English-language; no year restriction. • Exclusion: review articles, opinion pieces, editorials; studies not directly assessing misophonia with recognized tools; non-English publications. |
| Measures | • Misophonia tools reported across studies: DVMSQ, Misophonia Symptom Checklist / Misophonia Checklist (MCL), A-MISO-S / AMISOS-R, PMHQ. • Autism diagnosis: DSM-5 / ICD-11 criteria. • Quality appraisal: ROBINS-I (observational), AXIS (cross-sectional), Venice criteria (GWAS), JBI (case reports/series). • Interrater agreement: Cohen's Kappa (0.82 for study selection). |
| Procedures | • PECOS framework applied in accordance with PRISMA reporting guidelines. • Search across seven databases (PubMed, Embase, PsycINFO, Scopus, Web of Science, CINAHL, Cochrane Library) using Boolean operators and MeSH terms. • Independent screening by two reviewers; first author adjudicated disagreements. • Data extraction by two trained researchers with external verification. • 308 records identified; 41 duplicates removed; 14 studies retained (see PRISMA flow). • (No experimental stimuli/task — N/A for a systematic review.) |
| Results | Prevalence • Misophonia prevalence among autistic individuals varied but generally showed notable overlap with autism. • Autistic adults showed higher rates of clinically significant misophonia than non-autistic adults. • Broader auditory sensory over-responsivity (misophonia, hyperacusis, phonophobia) was common among autistic children. • Greater misophonia severity was linked to poorer quality of life. • Misophonia prevalence appeared elevated among individuals with anxiety disorders and OCD. Clinical characteristics and triggers • Misophonia involved intense emotional reactions to specific sound triggers disrupting daily functioning. • Common triggers were eating, breathing, throat, and oral/oronasal sounds. • Predominant emotional responses were anger and distress, with avoidance behaviors impacting family life. • Developmental variation was observed: younger children responded with aggression, older children with self-harm. Sensory sensitivities • Adults with misophonia scored higher on autistic-trait subscales; a subset met the clinical threshold for autism. • Children with misophonia showed higher autistic traits and greater sensory hypersensitivity across domains. • Hyperconnectivity in sensory cortices and heightened amygdala activity, observed in both conditions, may underlie hypersensitivity. • Misophonia's sensory profile is distinct, with disproportionate focus on auditory stimuli versus autism's broader sensitivities. Psychiatric comorbidities • High rates of comorbidity were reported (major depressive disorder, anxiety/OCD, ADHD, obsessive-compulsive personality traits, mood disorders, tic disorders). • Misophonia severity was positively correlated with internalizing symptoms. Genetic and environmental factors • Genetic correlations were found with neuroticism and irritability; a negative correlation with educational attainment. • Maternal postpartum depression was more common among mothers of children with misophonia. Interventions • Only two intervention studies were identified. • Risperidone reduced misophonia severity in a single autistic case. • CBT and TRT were described as management approaches in a pediatric case series without detailed quantitative outcomes. Risk of bias • Observational studies showed low risk in detection and attrition domains but frequently unclear selection and performance domains, with reporting biases in several. • One mixed-method study had a serious overall risk of bias; the GWAS had a low overall risk of bias. |
| Discussion/Limits | Conclusion- • Misophonia remains underrecognized and underreported despite growing awareness. • Elevated rates among younger and autistic individuals indicate misophonia is not merely sensory but tied to developmental, cultural, and demographic factors. • The clinical profile centers on intense emotional responses to specific sounds, with age-dependent responses warranting age-tailored interventions. • Heightened sensory sensitivities highlight overlap with autism, though this overlap may not reflect a distinct or unified sensory phenotype. • Psychiatric comorbidities complicate the clinical profile and worsen quality of life. • Current evidence does not support misophonia as a unique marker for autism diagnosis; it is a distinct condition also seen in neurotypical individuals and other psychiatric populations. • Misophonia should be carefully considered in managing autistic individuals, addressing both sensory sensitivities and emotional distress. • Treatment outcomes are promising but varied; tailored, combined therapeutic strategies hold value. • Genetic evidence suggests a biological basis linked to neuroticism and irritability, with anterior insular cortex hyperconnectivity a candidate mechanism. • Environmental factors, particularly maternal mental health, may play a crucial role. • A holistic, multidisciplinary approach integrating sensory, psychiatric, genetic, and environmental perspectives is needed. |
| Limitations:: | • Heterogeneity in methodology, demographics, and diagnostic criteria complicates synthesis. • Wide variation in sample sizes limits generalizability. • Reliance on self-report may introduce recall bias. • Predominantly cross-sectional designs prevent causal inference. • Geographic and cultural differences complicate extrapolation. • Underrepresentation of certain groups (non-binary individuals, older adults). • Moderate-to-high risk of bias across many studies; case reports/series limited by small samples. |
| Future Directions:: | • Larger, well-controlled studies with consistent methodologies. • Standardized diagnostic criteria and assessment tools for autistic populations. • Longitudinal studies to establish causal relationships. • Further investigation of genetic contributions and heritability. • Comprehensive assessment protocols to identify at-risk autistic patients. • Individualized, multidisciplinary interventions (behavioral, pharmacological, family-centered) with early identification and integrated care. |
| Relevance:: |
Notes
key terms and concepts
key terms
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misophonia – a condition characterized by extreme emotional responses to specific, repetitive sounds such as chewing, breathing, or tapping; a selective aversion and hyper-reactivity to triggers, often leading to anger, disgust, or fear.
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autism spectrum disorder (ASD) – a condition marked by atypical sensory processing, characterized by hyperreactivity or hyporeactivity to sensory stimuli across modalities.
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hyperacusis – an increased sensitivity to loudness, where moderate or even soft sounds are perceived as intolerably loud or painful.
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auditory processing disorder (APD) – difficulties in processing and interpreting auditory information correctly, leading to challenges in speech comprehension, especially in noisy environments.
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decreased sound tolerance (DST) – umbrella designation encompassing distinct conditions including misophonia and hyperacusis.
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auditory sensory over-responsivity (aSOR) – a combination of hyperacusis, misophonia, and phonophobia.
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salience detection – function of the anterior insular cortex, a hub for salience detection and emotional processing implicated in misophonia.
my engagement notes
my questions
my comments
Bookmarks
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goals (page 3)
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Prevalence of misophonia and its correlates in autism (page 5)
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Clinical characteristics and triggers of misophonia (page 11)
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Sensory sensitivities in autism and misophonia (page 11)
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Genetic and environmental factors of misophonia (page 12)
reading notes
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atypical sensory processing in ASD
- a hallmark of ASD is issues with sensory processing ( hypo/hyperactivity), with a prevalence of around 90% of ASD having some kind of SPD, with the most common being in auditory, tactile, and vision.
- auditory sensory processing issues in ASD is common, with one form of it commonly being Misophonia (Aldakhil & Shaik, 2025) (page 2)
contextual statement
In a 2025 study, Aldakhil attempted to synthesize the prevalence, clinical characteristics, comorbidities, and treatment outcomes of misophonia in autistic individuals by conducting a PRISMA-guided systematic review of 14 studies (n = 89,889) across seven databases, appraising misophonia via validated tools and study quality via ROBINS-I, AXIS, Venice, and JBI.
summary statement
In a 2025 study, Aldakhil synthesized the prevalence, clinical characteristics, psychiatric comorbidities, and treatment outcomes of misophonia in autism by systematically reviewing 14 studies following PRISMA guidelines. They found that misophonia was more prevalent among autistic individuals than the general population, frequently co-occurred with psychiatric conditions and sensory hypersensitivities, and had been addressed by only two intervention studies (risperidone; CBT/TRT). From this they concluded that misophonia is a distinct sensory condition requiring standardized diagnostic tools and tailored, multidisciplinary interventions, though not a unique marker for autism diagnosis.
Zettelkasten
comparing and contrasting Misophonia, hyperacusis, and auditory processing disorder