Misophonia as an Internalizing Disorder

In a 2026 study, Rappoldt examined the clinical presentation of misophonia in 95 treatment-seeking children and adolescents aged 8–18 and their parents using a broad battery of clinical and behavioral measures. Youth with misophonia showed more internalizing than externalizing problems, leading the authors to suggest that misophonia may be better conceptualized as an internalizing disorder. Although verbal and physical aggression in response to triggers has been commonly reported in youth with misophonia, these behaviors were not prominent in this sample, raising the possibility that misophonia does not primarily reflect difficulties with impulse control or disinhibition. Instead, the authors proposed that youth with misophonia may inhibit their emotional responses for prolonged periods during daily life, contributing to elevated general stress. They further suggested that distress may arise from the conflict between experiencing intense negative emotions toward loved ones who produce trigger sounds and simultaneously wanting to refrain from acting on those emotions. (Rappoldt et al., 2026)