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Characterizing real time course of Misophonic responses

In a 2026 study, Shan attempted to characterize real-time emotional responses to misophonia triggers in naturalistic settings and examine their temporal dynamics and individual variability, by having 40 adults with misophonia complete smartphone surveys five times daily for 10 days, rating 16 negative emotions during both trigger and no-trigger periods. They found that triggers elicited significant elevations in negative emotions (particularly irritability and anger, with large effect sizes), most emotions returned to baseline within 31-60 minutes, but substantial individual variability existed in both reactivity magnitude and recovery speed, with greater reactivity associated with higher baseline negative affect, misophonia severity, and co-occurring psychopathology. From this they concluded that misophonia involves phasic context-dependent emotional reactivity centered on anger rather than chronic distress or primarily fear-based responses, and that treatment should move beyond one-size-fits-all fear-based approaches toward personalized, process-based interventions targeting individual emotional patterns, anger regulation, and distress tolerance. (Shan et al., 2026)