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Id 896ed475-15f7-45c4-9b9d-0b0cac234b28
Year 2023
Abstract
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- (Stalias-Mantzikos et al., 2023)
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Dv Authors Maria E. Stalias-Mantzikos, Usha Barahmand, Kerry Aguero, Laurisa Peters, Naila Shamsina,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Data are self-reported and retrospective; no clinical diagnostic confirmation of misophonia. • Sample is predominantly female, non-clinical, English-speaking, and primarily White; limits generalizability. • NYMS is a newly developed instrument not yet widely used; psychometric validation is still in early stages. • Low base rate of non-binary participants (n = 15) may have compromised statistical power. • Multiple testing increases risk of Type I error; power may have been compromised. • Length of misophonic symptoms and physical tension reactivity not recorded, limiting interpretation of the insufficient self-control–aggressive reaction link. • Shared variance with third variables (e.g., neuroticism) not controlled; observed EMS–misophonia associations may partially reflect neuroticism.
Dv Future Directions • Replication with larger non-binary samples and studies focused on specific EMS. • Controlled studies comparing high-misophonia individuals with healthy controls. • Examine association between insufficient self-control EMS and symptom duration/length. • Investigate relationship between social withdrawal and misophonic distress longitudinally. • Empirically determine roles of intolerance of uncertainty and perfectionism as transdiagnostic factors in misophonia. • Delineate relative contributions of neuroticism and EMS to misophonia symptom severity. • Conduct empirical trials of schema therapy for misophonia; no such research currently exists.
Dv Relevance • study looked at early maladaptive schemes (EMS) in Misophonia, finding trends overlap with and differentiate it with other comorbidities.
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Early maladaptive schemas in misophonia
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Maria E. Stalias-Mantzikos, Usha Barahmand, Kerry Aguero, Laurisa Peters, Naila Shamsina,
- Date Added: March 23, 2023
- URL: https://www.tandfonline.com/doi/full/10.1080/13284207.2023.2171786
- DOI: 10.1080/13284207.2023.2171786
- Cite Key: stalias-mantzikosEarlyMaladaptiveSchemas2023
- Tags:: #Misophonia, #Bare-bones-review-🦴, #early-maladaptive-schemas, #schema, #therapy, #distress,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia involves reduced tolerance to trigger stimuli (primarily human-generated sounds; also visual, olfactory, tactile). • Associated with multiple psychopathologies (e.g., OCD, ADHD, depression, anxiety, eating disorders) and audiological conditions (tinnitus, hyperacusis). • Linked to heightened auditory–limbic system sensitivity and sound-specific autonomic reactivity. • Not formally recognized as a psychiatric disorder; limited research base (<100 studies by 2021). • Childhood adversities, attachment insecurity, and distorted cognitions are shared risk factors across related disorders. • Young’s schema theory: unmet core needs (attachment, autonomy, emotional expression, spontaneity, self-control) → Early maladaptive schemes (EMS). • EMS show disorder-specific patterns (e.g., anxiety: disconnection/rejection, overvigilance; depression: disconnection/rejection, impaired autonomy; OCD: includes insufficient self-control, vulnerability). • No prior research directly examined EMS in misophonia. • Gender differences in EMS documented, suggesting relevance for treatment. Purpose- • Identify early maladaptive schemas characteristic of individuals with misophonia. • Examine EMS associations with misophonic distress and with aggressive vs. non-aggressive behavioural reactions specifically. • Assess potential gender-specific EMS patterns in misophonia. • Hypothesized schemas of social isolation/alienation, vulnerability to harm or illness, insufficient self-control, and unrelenting standards to be most strongly associated with misophonia. |
| Participants/samples | • Final N = 286 after exclusion of missing data and multivariate outliers (Mahalanobis distance, Cook's distance, leverage). • Age range: 18–62 years; mean = 28.9 years. • Female: 65% (n = 186); male: 29.7% (n = 85); non-binary: 5.2% (n = 15). • Recruited via social media (Reddit, LinkedIn, Facebook) and survey exchange sites (Survey Swap, Survey Tandem) between July–September 2021. • Non-clinical, primarily English-speaking, predominantly White (78.7%), majority middle-class perceived SES (48.3%). • IRB approval obtained from City University of New York; all participants provided informed written consent; no compensation offered. |
| Measures | • YSQ-SF (Young, 1994): 75-item self-report; assesses 15 EMS across 5 domains; 6-point Likert scale (1 = completely untrue of me to 6 = describes me perfectly); Cronbach's α per subscale ranged from .79–.94 in this sample. • NYMS (Barahmand et al., 2023): Two-part self-report; Part 1: 25 triggers rated 0–4 for aversiveness (misophonic distress subscale, range 0–100; α = .91); Part 2: 13 behavioural reactions rated 0–4 for frequency (behavioural reactions subscale, range 0–52; α = .86); behavioural subscale divided into aggressive/confrontational coping and non-aggressive/avoidant coping; total scale α = .93. |
| Procedures | • Questionnaires administered online via Microsoft Forms link distributed through social media and survey exchange platforms. • Survey order: demographic questions → YSQ-SF → NYMS. • Mean completion time: 15–30 minutes. |
| Results | • Females > males on misophonic distress and both reaction types; females > males on abandonment and self-sacrifice; males > non-binary on entitlement; non-binary highest on failure schema. • Insufficient self-control EMS predicted all misophonia outcomes (distress, aggressive, non-aggressive, total). • Social isolation EMS predicted distress and total misophonia. • Vulnerability to harm EMS predicted aggressive reactions and total misophonia. • Non-aggressive reactions predicted by lower dependence, higher unrelenting standards, lower entitlement, and higher insufficient self-control (per Table 6 coefficients). Note that the paper's narrative text contradicts its own table, describing dependence as "higher"; the negative coefficient is the ground truth of what was estimated. • Older age and female gender predicted higher distress, aggressive reactions, and total misophonia (not non-aggressive reactions). • No differences in correlation strength across misophonia subscales). • Other EMS not significant predictors; all regression models significant. |
| Discussion/Limits | Conclusion- • insufficient self-control EMS (impaired limits domain) is the central schema common to all aspects of misophonia, reflecting deficits in emotion regulation and impulse control. • social isolation/alienation EMS may be activated and reinforced across the course of misophonia, as repeated trigger exposure may deepen the belief of being different from others and promote avoidance coping. • schemas from the disconnection/rejection and over vigilance/inhibition domains are shared between misophonia and anxiety disorders, while schemas from the other-directedness domain may distinguish misophonia from anxiety disorders. • The authors conclude that insufficient self-control is the only schema common to both misophonia and OCD, indicating shared difficulties with personal and interpersonal limits. • The data support the characterization of misophonia as fundamentally a condition of emotion and impulse regulation problems. • The authors conclude that overcompensation for vulnerability to harm or illness schema (acting without regard for danger) may explain aggressive reactions to misophonic triggers. • The combination of unrelenting standards (rigidity/perfectionism), low entitlement (conformity to social rules), dependence (emotion regulation deficits), and insufficient self-control could jointly explain non-aggressive reactions and emotional distress in misophonia. • The identification of relevant EMS in misophonia supports schema therapy as a potentially effective intervention, including targeting unmet core needs as a prevention strategy. • Female gender is significant to the experience of misophonic distress and aggressive reactions, potentially reflecting greater severity of misophonia in women reported in prior literature. |
| Limitations:: | • Data are self-reported and retrospective; no clinical diagnostic confirmation of misophonia. • Sample is predominantly female, non-clinical, English-speaking, and primarily White; limits generalizability. • NYMS is a newly developed instrument not yet widely used; psychometric validation is still in early stages. • Low base rate of non-binary participants (n = 15) may have compromised statistical power. • Multiple testing may have compromised statistical power. • Length of misophonic symptoms and physical tension reactivity not recorded, limiting interpretation of the insufficient self-control–aggressive reaction link. • Shared variance with third variables (e.g., neuroticism) not controlled; observed EMS–misophonia associations may partially reflect neuroticism. |
| Future Directions:: | • Replication with larger non-binary samples and studies focused on specific EMS. • Controlled studies comparing high-misophonia individuals with healthy controls. • Examine association between insufficient self-control EMS and symptom duration/length. • Investigate the relationship between social withdrawal and misophonic distress . • Empirically determine roles of intolerance of uncertainty and perfectionism as transdiagnostic factors in misophonia. • Delineate relative contributions of neuroticism and EMS to misophonia symptom severity. • Conduct empirical trials of schema therapy for misophonia; no such research currently exists. |
| Relevance:: | • study looked at early maladaptive schemes (EMS) in Misophonia, finding trends overlap with and differentiate it with other comorbidities. |
Notes
key terms and concepts
- misophonia – disorder in which specific sounds or stimuli related to those sounds decreases one's tolerance to the stimuli, eliciting negative affect (anger, irritation, disgust, anxiety) and behavioural reactions including escape/avoidance, aggression, or mimicking.
- early maladaptive schema (EMS) – dysfunctional thinking pattern about the self and others, originating in childhood when core emotional needs are unmet; central to the development and maintenance of psychopathology per Young's schema theory.
- YSQ-SF – Young Schema Questionnaire–Short Form; 75-item self-report measure assessing 15 EMS across 5 domains on a 6-point Likert scale.
- NYMS – New York Misophonia Scale; two-part self-report instrument rating (1) severity of emotional distress to misophonic triggers and (2) nature of behavioural reactions, subdivided into aggressive and non-aggressive subscales.
- schema mode – the combination of an activated maladaptive schema and the coping strategy employed (surrender, avoidance, or overcompensation) describing an individual's emotional-cognitive-behavioural state.
- schema therapy (ST) – multiphasic psychotherapy targeting identification and modification of EMS; incorporates psychodynamic, attachment, and experiential techniques.
- disconnection/rejection domain – EMS domain reflecting detached, cold family of origin and unmet need for secure attachment; includes abandonment, mistrust/abuse, emotional deprivation, defectiveness/shame, and social isolation/alienation schemas.
- impaired limits domain – EMS domain reflecting permissive parenting and unmet need for realistic limits and self-control; includes entitlement/grandiosity and insufficient self-control schemas.
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contextual statement
In a 2023 study, Stalias-Mantzikos attempted to identify early maladaptive schemas characteristic of misophonia by administering the YSQ-SF and the NYMS to a non-clinical community sample of 286 adults (65% female) recruited via social media.
summary statement
In a 2023 study, Stalias-Mantzikos examined which early maladaptive schemas predict misophonic distress and behavioural reactions (aggressive and non-aggressive) by administering the YSQ-SF and NYMS to 286 non-clinical adults recruited via social media, using correlational and multiple regression analyses. They found that insufficient self-control EMS predicted all aspects of misophonia, social isolation/alienation predicted emotional distress, vulnerability to harm or illness predicted aggressive reactions, and dependence, unrelenting standards, and low entitlement predicted non-aggressive reactions, with female gender and older age also predicting distress and aggression. From this they concluded that misophonia is fundamentally characterized by emotion and impulse regulation problems, that its EMS profile overlaps partially with anxiety, depression, and OCD while retaining distinguishing features, and that schema therapy represents a potentially viable intervention for misophonic distress.
zettelkasten
early maladaptive schemes in Misophonia
future directions for maladaptive early schemes in Misophonia