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Year 2024
Abstract Abstract Background Misophonia is often referred to as a disorder that is characterized by excessive negative emotional responses, including anger and anxiety, to “trigger sounds” which are typically day‐to‐day sounds, such as those generated from people eating, chewing, and breathing. Misophonia (literally “hatred of sounds”) has commonly been understood within an auditory processing framework where sounds cause distress due to aberrant processing in the auditory and emotional systems of the brain. However, a recent proposal suggests that it is the perceived action (e.g., mouth movement in eating/chewing sounds as triggers) of the trigger person, and not the sounds per se, that drives the distress in misophonia. Since observation or listening to sounds of actions of others are known to prompt mimicry in perceivers, we hypothesized that mimicking the action of the trigger person may be prevalent in misophonia. Apart from a few case studies and anecdotal information, a relation between mimicking and misophonia has not been systematically evaluated. Method In this work, we addressed this limitation by collecting data on misophonia symptoms and mimicry behavior using online questionnaires from 676 participants. Results Analysis of these data shows that (i) more than 45% of individuals with misophonia reported mimicry, indicating its wide prevalence, (ii) the tendency to mimic varies in direct proportion to misophonia severity, (iii) compared to other human and environmental sounds, trigger sounds of eating and chewing are more likely to trigger mimicking, and (iv) the act of mimicking provides some degree of relief from distress to people with misophonia. Conclusion This study shows prevalence of mimicry and its relation to misophonia severity and trigger types. The theoretical framework of misophonia needs to incorporate the phenomenon of mimicry and its effect on management of misophonia distress.
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  • Mimicry in misophonia
  • (Ash et al., 2024)
Import Date 10-06-2025
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Dv Authors Paris A. Ash, Ester Benzaquén, Phillip E. Gander, Joel I. Berger, Sukhbinder Kumar,
Dv Limitations • Mimicry data are self-reported, potentially underestimating involuntary mimicry. • Limited range and granularity of mimicry questions. • Underrepresentation of non-orofacial triggers may have influenced generalizability.
Dv Future Directions • Use physiological (e.g., EMG) methods to detect subtle, unconscious mimicry. • Develop validated, comprehensive mimicry assessment tools. • Explore mimicry responses to broader classes of trigger sounds (e.g., non-human, environmental).
Dv Relevance • looks at the rates of self reported use of mimicry as a coping mechanism in Misophonia, finding that greater Misophonia severity as measured on the MQ was associated with greater rates of mimicry use. they also found that eating/chewing triggers were more associated with mimicry responses and that mimicry provided some relief from Misophonia symptoms. describes the concept of “spontaneous mimicry” as the automatic reproduction of of another persons motor movements, behaviors, or facial expressions without conscious intention to do so. this could be relevant to the Kumar motor model • explains the observation that Mimicry dampens Misophonia responses as the result of the act of mimicking enabling sensory prediction and restoring a sense of agency • discusses the concept of the perception-action link in the context of Misophonia • postulates that enhanced mimicry could be the result of stronger sensory-motor cortex connectivity in Misophonia
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  • Misophonia MOC
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Mimicry in misophonia: A large‐scale survey of prevalence and relationship with trigger sounds

Status:: #status/reviewed

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Abstract
Background/Purpose Background-
• Misophonia is increasingly recognized as involving both auditory and social components, not just sound sensitivity.
• The dominant model ("sound-processing framework") emphasizes abnormal auditory-emotional brain processing but ignores social context and the role of actions producing the sound.
• Mimicry of trigger actions is a known social behavior, but its prevalence and role in misophonia remain largely unexamined beyond anecdotal/case reports.

Purpose-
• To examine the prevalence of mimicry among individuals with varying misophonia severity.
• To determine whether mimicry is linked to specific trigger sound types.
• To assess whether mimicry modulates distress in individuals with misophonia.
Participants/samples • N = 676 participants
• Age: 18–81 years (Mean = 38.39, SD = 16.10)
• Gender: 74.7% female, 24.6% male, 0.7% other
• Recruited from misophonia support groups and a neuroscience volunteer registry.
• Included individuals with a range of misophonia severity (including no symptoms).
Measures • Misophonia Questionnaire (MQ):
• Symptom Scale (sensitivity to specific sounds)
• Emotions Scale (emotional/behavioral responses)
• Severity Scale (rated 0–15, with anchors for interpretation)

• Mimicry Assessment: 5 custom lab-developed questions (e.g., incidence, control, distress relief), mostly Likert-scale.
Procedures • Online questionnaires delivered via Google Forms.
• Participants provided consent, completed 64 questions (~20 min), and could enter a prize draw.
• Data anonymized and ethics approved by Newcastle University.
Results • Prevalence of Mimicry:
• 46.7% of all participants reported mimicking trigger sounds/actions.
• Mimicry prevalence increased with misophonia severity (e.g., 8% in “no misophonia,” ~57% in “clinical/severe”).

• Sound Category Associations:
• Eating sounds were the most significant predictors of mimicry (OR = 1.341, p = .001).
• Consonant/vowel sounds also predicted mimicry (OR = 1.154, p = .046).

• Relief and Control:
• ~80% reported that mimicry was voluntary.
• ~68% reported relief from distress through mimicry.
• ~60% felt mimicry gave them a sense of control.

• Factor Analysis:
• Mimicry and orofacial sounds (e.g., eating, nasal, throat) loaded together on one factor.
• Non-orofacial/environmental sounds did not show strong associations
Discussion/Limits Conclusion-

• Mimicry is common in misophonia, increases with symptom severity, and is especially tied to orofacial trigger sounds.
• Mimicry may serve as a coping mechanism to reduce distress and restore self-control.
• Findings support a more socially integrated model of misophonia involving sensory-motor processes
Limitations:: • Mimicry data are self-reported, potentially underestimating involuntary mimicry.
• Limited range and granularity of mimicry questions.
• Underrepresentation of non-orofacial triggers may have influenced generalizability.
Future Directions:: • Use physiological (e.g., EMG) methods to detect subtle, unconscious mimicry.
• Develop validated, comprehensive mimicry assessment tools.
• Explore mimicry responses to broader classes of trigger sounds (e.g., non-human, environmental).
Relevance:: • looks at the rates of self reported use of mimicry as a coping mechanism in Misophonia, finding that greater Misophonia severity as measured on the MQ was associated with greater rates of mimicry use. they also found that eating/chewing triggers were more associated with mimicry responses  and that mimicry  provided some relief from Misophonia symptoms.
• describes the concept of “spontaneous mimicry” as the automatic reproduction of of another persons motor movements, behaviors, or facial expressions without conscious intention to do so. this could be relevant to the Kumar motor model
• explains the observation that Mimicry dampens Misophonia responses as the result of the act of mimicking  enabling sensory prediction and restoring a sense of agency
• discusses the concept of the perception-action link in the context of Misophonia
• postulates that enhanced mimicry could be the result of stronger sensory-motor cortex connectivity in Misophonia

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image-5-x38-y32.png FIGURE 1 (a) Distribution of misophonia severity scores from the MQ across all participants (n = 676). Different shades of color represent misophonia severity divided into four categories. (b) Percentage of people who reported mimicking as a function of misophonia severity across the four MQ severity categories. (c) Distribution of different trigger types across all participants (n = 676). page 5

image-6-x35-y459.png FIGURE 2 (a) Univariate logistic regression showing the probability to mimic in relation to the log‐transformed MQ severity score. Response counts for “yes” (1) and “no” (0) are shown as open circles. (b) Odds ratio (OR) with 95% confidence limits for different trigger sound categories page 6

image-6-x36-y237.png TABLE 1 Multivariable logistic regression, predicting the likelihood of mimicry occurrence as a function of misophonia sensitivity to different sound categories. page 6

image-7-x34-y180.png FIGURE 3 Factor analysis with promax rotation. The two components are represented by circles, and the different variables are represented by boxes. Values within boxes and the thickness of arrows going from variables to a component represent the strength of loading on the two components; with transparent arrows indicating a weaker strength. Blue indicates positive loading, and orange indicates negative loading; the loading values are displayed in the boxes (with component one loadings always shown at the top of each box). Loading values closer to −1 or 1 indicate a stronger factor influence. Values greater than 0.5 are marked with an asterisk. page 7

image-8-x36-y216.png FIGURE 4 Response proportions for the mimicry questions. page 8

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