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dozier 2017 dx criteria for Misophonia

Dozier et al. (2017) propose diagnostic criteria for misophonia that conceptualize it as a multisensory conditioned aversive reflex disorder. The condition is characterized by an immediate and impulsive emotional and physical response, typically beginning with irritation or disgust and rapidly escalating to anger, triggered by specific sensory stimuli such as sounds, visual cues, or vibrations, often at low intensity. These stimuli must be conditioned rather than innate, which differentiates misophonia from sensory over-responsiveness. A core feature is the presence of an involuntary physical reflex response, such as muscle movement or internal sensations, which occurs immediately upon exposure. Continued exposure to the stimulus often results in general physiological arousal, including increased heart rate, muscle tension, or sweating. Individuals commonly experience emotional dysregulation in response to triggers, sometimes including aggressive outbursts, particularly in children, and typically recognize their reactions as disproportionate. The disorder leads to either avoidance of triggering situations or distress when endured, and it causes significant interference in daily functioning across work, education, or social settings. (Dozier et al., 2017)