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Id a7287cab-504a-4bf9-acf1-883727b2d3da
Year 2021
Abstract
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- (Dibb et al., 2021)
Import Date 03-21-2026
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Dv Authors Bridget DibbB. Dibb, Sarah E. GoldingS.E. Golding, Thomas H. DozierT.H. Dozier,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Online recruitment through Misophonia Institute USA may limit generalizability to those not associated with the Institute or without online access. • Lack of formal diagnostic criteria for Misophonia means researchers cannot confirm all participants actually have the condition. • Sample limited to adults aged 18+ so scale appropriateness for younger individuals unknown. • More females than males recruited, limiting gender diversity. • Correlated errors in CFA model may reflect method effects rather than underlying latent constructs. • Method effects may have attenuated correlations in Study 2, potentially impacting discriminant validity interpretation. • Only one expert consulted during item development stage.
Dv Future Directions • Further investigation needed to validate the weighted scoring approach (multiplying subscale means by mean of three single items). • Research needed to determine scale appropriateness for younger age groups. • Studies should recruit more diverse samples, particularly more males. • Research needed to establish whether frequency, number of triggers, or magnitude of response causes greatest distress and disruption. • Work needed to understand true prevalence of Misophonia in the population. • Research needed to explore extent to which Misophonia impacts everyday life
Dv Relevance • describes a Misophonia scale used to assess the strength of the Misophonic response. good source for if I need more Misophonia assessments looking specifically at response intensity
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The development and validation of the Misophonia response scale
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: B. Dibb, S.E. Golding, T.H. Dozier,
- Date Added: March 20, 2026
- URL: https://linkinghub.elsevier.com/retrieve/pii/S0022399921002324
- DOI: 10.1016/j.jpsychores.2021.110587
- Cite Key: dibbDevelopmentValidationMisophonia2021
- Tags:: #Misophonia, #Bare-bones-review-🦴, #clinical, #measures, #sensory-sensitivity, #questionnaire, #scale-development,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia lacks classification in DSM-V or ICD-11, with no standardized diagnostic criteria or treatment. • Proposed diagnostic criteria include: sound/visual stimulus triggering irritation, disgust, or anger; response recognized as excessive; use of avoidance strategies; emotional response causing distress. • Common emotional responses include anxiety, irritation, disgust, and anger. • Physiological responses include breathing changes, sweaty palms, tight chest, and increased heart rate. • Triggers may include auditory, visual, olfactory, and tactile stimuli, with auditory and visual most common. • Limited research suggests negative impact on concentration, family life, and quality of life. • Existing scales either not validated, omit physiological responses, and/or focus only on auditory triggers. • The Misophonia Questionnaire (MQ) is partially validated but has unstable internal structure, omits physiological responses, and focuses only on auditory triggers. • The Misoquest is validated but focuses only on auditory triggers and omits physiological reactions. Purpose- • Develop and validate a measure of the magnitude of Misophonic response that includes emotional and physiological responses across all sensory modalities. • Study 1: Assess face and content validity of initial items. • Study 2: Determine scale structure, reliability, convergent and discriminant validity. • Study 3: Confirm factor structure using CFA. |
| Participants/samples | • Study 1: N=247 adults with self-diagnosed Misophonia; mean age 45.9 years (SD=14.6); 23.5% male, 76.6% female; recruited via Misophonia Institute USA mailing list. • Study 2: N=366 adults with self-diagnosed Misophonia who had not participated in Study 1; mean age 44.3 years (SD=15.5); 12.8% male, 85.0% female, 0.3% other, 1.9% declined; 88.3% white; test-retest subsample n=114 completed MRS 24-48 hours later. • Study 3: N=482 adults with self-diagnosed Misophonia; mean age 44.7 years (SD=14.6); 13.9% male, 84.9% female, 0.8% non-binary, 0.4% transgender; 90.7% white. • Inclusion/exclusion: Self-diagnosed Misophonia; adults only (age ≥18); Study 2 and 3 participants could not have participated in prior studies. |
| Measures | • Study 1: Initial scale with frequency (1 item), emotional responses (9 items), physiological responses (10 items), behavioral responses (7 items), control of thoughts/behaviour (2 items), recovery time (4 items), and distress (2 items); the 5-item participation in life subscale was previously developed but not included in Study 1; demographic and condition-related information also collected. • Study 2: 33-item MRS measuring emotional responses (9 items), physiological responses (11 items), behavioral responses (5 items), plus 3 single items on frequency, avoidance, and recovery; the previously developed participation in life subscale (5 items) was added to assess reliability and validity; all items rated on 7-point scales. • Misophonia Questionnaire (MQ) Emotions and Behaviours scale; 10 items on 5-point scale (convergent validity). • Adapted Newman's Tinnitus Handicap Questionnaire; 4 items on 5-point scale measuring social, job/school, relationship impact (convergent validity for participation subscale). • State-Trait Anxiety Inventory (STAI); two 20-item subscales on 4-point scales (discriminant validity). • Rosenberg Self-Esteem Scale (RSE); 10 items on 4-point scale (discriminant validity). • Study 3: Final 22-item MRS with emotional (7 items), physiological (7 items), participation in life (5 items) subscales, plus 3 single items. |
| Procedures | • All studies: Online questionnaire accessed via electronic link sent through Misophonia Institute USA email list. • Study 1: Participants completed initial scale and provided open-text feedback on wording and relevance of each item. • Study 2: Participants completed MRS and validation measures; all participants invited to complete MRS again 24-48 hours later, with the subset who did (n=114) forming the test-retest sample • Study 3: Participants completed final 22-item MRS. |
| Results | Study 1 • Over 90% experienced triggers daily; some experienced over 50 triggers per day. • Auditory triggers most common (98.4%), followed by visual (90.3%), olfactory (17.0%), and tactile. • Most common trigger sources were parents (60.7%), romantic partners (58.7%), colleagues (58.7%), strangers (55.1%). • Participant feedback led to emotional subscale modifications (adding hopelessness and shame; merging violence and aggression items; adding examples). • Physiological subscale modifications included collapsing three pain items into one and adding shortness of breath, dizziness, and unwanted sexual feelings. • Recovery items collapsed from 4 to 2; participants found the control items confusing and similar to feeling distracted (and they do not appear in the subsequent scale). • Behavioral subscale modified by adding imitate/mimic item and removing fleeing and acting violently items. • Study 2 • PCA with oblique rotation identified three-component solution explaining 53.97% of variance. • All items loaded between 0.45 and 0.84 on their respective components. • Final scale consists of 22 items across three subscales: emotional (7 items), physiological (7 items), participation in life (5 items), plus 3 single items (frequency, avoidance, recovery). • Behavioral items did not form stable subscale and were removed. • Emotional subscale items showed greater mean scores than physiological subscale items. • Three single items (frequency, avoidance, recovery) positively correlated with total MRS scores (frequency r=0.45; avoidance r=0.41; recovery r=0.46). • Convergent validity demonstrated by strong positive correlations between MRS total/subscales and MQ (all r>0.5, all p<.001). • Strong positive correlation between participation in life subscale and adapted Newman's handicap scale. • Discriminant validity demonstrated by weak to moderate positive correlations with state and trait anxiety (all r<0.5, all p<.001). • Discriminant validity demonstrated by weak to moderate negative correlations with self-esteem (all r<0.5, all p<.001). Study 3 • CFA confirmed three-factor structure with satisfactory model fit. • Errors correlated based on theoretical links among anger-related emotions, disgust-related emotions, physiological arousal indicators, and intimate relationship items. |
| Discussion/Limits | Conclusion- • The authors conclude the MRS is a valid and reliable 22-item scale measuring the magnitude of Misophonic responses. • The findings indicate the scale includes three subscales (emotional, physiological, participation in life) plus three single items (frequency, avoidance, recovery time). • The data support the scale can be used across all sensory modalities, not just auditory triggers. • The findings indicate the scale demonstrates good internal consistency, test-retest reliability, convergent validity, and discriminant validity. • The authors conclude the scale structure is stable, confirmed through CFA. • The findings indicate behavioral responses did not form a stable separate subscale, possibly because behaviors vary more between individuals or depend on context and relationships. • The data support that the MRS addresses gaps in existing Misophonia measures by including physiological responses and accommodating non-auditory triggers. • The authors conclude the scale can be used to determine magnitude of response and potentially account for impact on quality of life in research. • The findings indicate anxiety is associated with but distinct from Misophonia. |
| Limitations:: | • Online recruitment through Misophonia Institute USA may limit generalizability to those not associated with the Institute or without online access. • Lack of formal diagnostic criteria for Misophonia means researchers cannot confirm all participants actually have the condition. • Sample limited to adults aged 18+ so scale appropriateness for younger individuals unknown. • More females than males recruited, limiting gender diversity. • Correlated errors in CFA model may reflect method effects rather than underlying latent constructs. • Method effects may have attenuated correlations in Study 2, potentially impacting discriminant validity interpretation. • Only one expert consulted during item development stage. |
| Future Directions:: | • Further investigation needed to validate the weighted scoring approach (multiplying subscale means by mean of three single items). • Research needed to determine scale appropriateness for younger age groups. • Studies should recruit more diverse samples, particularly more males. • Research needed to establish whether frequency, number of triggers, or magnitude of response causes greatest distress and disruption. • Work needed to understand true prevalence of Misophonia in the population. • Research needed to explore extent to which Misophonia impacts everyday life |
| Relevance:: | • describes a Misophonia scale used to assess the strength of the Misophonic response. good source for if I need more Misophonia assessments looking specifically at response intensity |
Notes
key terms and concepts
- Misophonia – A condition where individuals experience extreme negative emotional and physiological reactions to innocuous stimuli (often common everyday sounds, but also potentially visual, olfactory, or tactile stimuli) that interfere with daily life.
- Trigger – An innocuous sensory stimulus (auditory, visual, olfactory, or tactile) that provokes an immediate negative response in individuals with Misophonia.
- Magnitude of response – The extent or severity of emotional and physiological reactions experienced when exposed to triggers.
- Principal Component Analysis (PCA) – A statistical technique used to reduce the number of items in a scale by identifying underlying dimensions or factors.
- Confirmatory Factor Analysis (CFA) – A statistical method used to verify whether the proposed structure of a scale fits observed data.
- Convergent validity – Evidence that a scale correlates strongly with measures of similar constructs.
- Discriminant validity – Evidence that a scale correlates weakly with measures of different constructs.