Misophonia: Incidence, Phenomenology, and Clinical Correlates in an Undergraduate Student Sample: Misophonia

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Item Type: #journalArticle
Authors: Monica S. Wu, Adam B. Lewin, Tanya K. Murphy, Eric A. Storch
Date: 10/2014
Date Added: 2020-01-15
URL: http://doi.wiley.com/10.1002/jclp.22098
DOI: 10.1002/jclp.22098
Cite key: wuMisophoniaIncidencePhenomenology2014
Topics: primary Resources
Tags: #Misophonia
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- R22 Misophonia- Incidence,Phenomenology,andClinical Correlates in an undergraduate sample.pdf

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Background/Purpose	Background- • Misophonia involves extreme sensitivity to selective sounds, often triggering anger, disgust, and avoidance. • Though recognized clinically, empirical research is sparse, with few large-sample or nonclinical studies. • Prior case studies suggest comorbidities with OCD, anxiety, Tourette’s, and internalizing disorders. • Suggested neurological basis involves heightened connectivity between auditory and limbic/autonomic systems. Purpose- • (a): provide descriptive information about misophonia symptoms (e.g., frequency of various misophonia symptoms endorsed); • (b): investigate correlations between misophonia symptoms and impairment in various domains of life (e.g., work/school, social, and family life/home responsibilities) • (c): examine the relationship between misophonia symptoms and other clinical constructs (e.g., sensory sensitivities, OCD, anxiety, depression). • (d): determine possible mediating effects of anxiety on misophonia and misophonia-related anger. •
Participants/samples	483 undergraduate students (79 male, 404 female).
Measures	Demographic information. Scores on the MQ, ASQ, SDS, OCI-R, DASS-21, ROARS. • Misophonia Questionnaire (MQ): 3-part measure developed for this study. • Symptom Scale: 7 items on sound triggers. • Emotions and Behaviors Scale: 10 items on emotional/behavioral responses. • Severity Scale: 1 item adapted from NIMH GOCS (1–15 scale; clinical cutoff ≥7). • ASQ: Assesses sensory defensiveness across modalities. • SDS: 3-item measure of misophonia-related functional impairment. • OCI-R: OCD symptoms. • DASS-21: Depression, anxiety, and stress. • ROARS: Rage episode characteristics.
Procedures	All data collection and measure administration were conducted via online tool. Results were run through correlational analysis.
Results	• 1: Study provided wealth of descriptive data on the condition, demonstrated several significant correlations between variables of interest, and displayed some mediation effects. • 2: With the rate of significantly interfering misophonia symptoms falling around 20% for the study sample, rates of clinically significant misophonia may be higher than previously expected. •
Discussion/Limits	Conclusion- • Misophonia is relatively prevalent (approx. 1 in 5) even in nonclinical populations. • Strongly associated with functional impairment, especially in academic and social domains. • Co-occurs with OCD, anxiety, depressive symptoms, and broader sensory sensitivities. • Anxiety plays a mediating role in misophonia-related anger, pointing to intervention targets. • 1: large disparity between number of male and female participants ( 16.4% vs 83.6%) and fac that they were all undergraduate students limits generalizability. • 2: study used a pilot measure ( The MQ) to test relationships, and despite there being evidence of high psychometric properties for the measure in the form of high internal constancy, high correlations with converging constructs, and significantly smaller correlations with divergent constructs; further research needs to be done to insure validity of the measure. • 3: data collected via self-reports, with authors suggesting future research to incorporate multi-informant reports and clinician rated data. • 4: all data was collected data single point in time, with authors suggesting future research to collect data across multiple points in time to assess possible changes over time. • 5: the clinical cut off used to assess severity of Misophonia have yet to be validated.
Limitations::	• Gender imbalance (mostly female); limits generalizability. • Cross-sectional design prevents causal inference. • Self-report bias; no clinician-administered measures. • Clinical cutoff (MQ) unvalidated in clinical populations. • Limited assessment of related auditory disorders (e.g., hyperacusis, tinnitus).
Future Directions::	• Replication in clinical and pediatric samples. • Longitudinal studies to explore symptom progression and causal pathways. • Validation of MQ and clinical cutoff thresholds. • Explore misophonia in autism and other sensory-processing disorders. • Investigate neurobiological underpinnings and tailored CBT-based interventions.
Relevance::	• an old and out of date look at misophonia in a undergraduate population • primarily useful as a legacy resource, all the estimates and phenomenological descriptions are bet sourced from newer works OLD POINTS----- • 1: great source for detailed demographic information on a significant sample • 2: great sources for details on the MQ, ASQ, SDS, and OCI-R (specifically the MQ as this is the study it was created for) • 3: found correlations between Misophonia, OCD, and depressive symptoms. • Demonstrates that anxiety symptomology mediated relationship between Misophonia and anger outbursts ( I.E higher anxiety was associated with higher Misophonia which was associated with higher anger) • 4: good source for a rationalization of using emotion focused CBT as a treatment.

key terms

Misophonia – A decreased sound tolerance condition characterized by intense negative emotional reactions to specific auditory triggers (e.g., chewing, tapping), leading to distress and avoidance behaviors.
Sensory defensiveness – Oversensitivity and aversive reactions to normally innocuous sensory stimuli (auditory, visual, tactile, etc.).
Misophonia Questionnaire (MQ) – A self-report tool developed for this study, comprising three subscales: Misophonia Symptom Scale, Misophonia Emotions and Behaviors Scale, and Misophonia Severity Scale.
Sheehan Disability Scale (SDS) – Assesses functional impairment across work/school, social life, and family/home responsibilities.
Obsessive Compulsive Inventory–Revised (OCI-R) – Measures OCD-related symptoms.
DASS-21 – A 21-item scale measuring depression, anxiety, and stress symptoms.
ROARS – Rage Outbursts and Anger Rating Scale assessing frequency, intensity, and duration of rage episodes.

My notes

On the MQ instrument:

Developed specifically for this study; high internal consistency (α = .89).
Shows initial support for convergent/discriminant validity with ASQ.

On intervention implications:

Findings support targeting anxiety in treatment (e.g., CBT exposure-based approaches).
Suggests overlap with OCD but highlights unique aspects of misophonia.

Theoretical contributions:

Misophonia may constitute a distinct disorder despite symptom overlap with OCD/anxiety.
Anger, not just anxiety, is a core affective feature—aligns with calls for separate diagnostic criteria.