Paunović and Milenković 2021 findings on misophonia symptoms, noise sensitivity, and noise annoyance

Paunović and Milenković (2021) found that high perceived misophonia was associated with greater annoyance from several common environmental noise sources, except entertainment venues, and that misophonia symptoms were positively related to noise sensitivity, anxiety, and depression. High noise sensitivity predicted annoyance across most sources, depression was linked specifically to annoyance from humans and animals, anxiety showed no association, and males reported greater annoyance from construction noise. The authors conclude that misophonia and noise sensitivity independently contribute to noise annoyance, operate independently of age, gender, anxiety, and depression, and may lie on a broader spectrum of environment-related intolerances, while acknowledging that reverse causation cannot be ruled out. (Paunović & Milenković, 2021)

Misophonia Clusters Genetically with MDD, PTSD, and Guilt/Neuroticism Traits, Not with Hearing Loss or ASD

Smit et al. (2023) computed and clustered single-nucleotide-polymorphism-based genetic correlations between a misophonia proxy (a single rage-to-chewing-sounds self-report item in 80,607 European-ancestry 23andMe participants) and a wide set of audiological, psychiatric, and personality traits. Misophonia correlated positively with tinnitus, major depression disorder (MDD), post-traumatic stress disorder (PTSD), anxiety, and both neuroticism/guilt and irritability/sensitivity personality clusters, negatively with autism spectrum disorder (ASD) and educational attainment, and showed null correlations with attention deficit hyperactivity disorder (ADHD), obsessive-compulsive disorder (OCD), and hearing-performance measures, clustering consistently with MDD and PTSD. The authors concluded that misophonia is not primarily a hearing-loss disorder but aligns genetically with internalizing psychiatric disorders and guilt/neuroticism personality dimensions, potentially classifiable as a highly specific obsessive-compulsive personality disorder (OCPD) variant or a related psychiatric/personality disorder (Smit et al., 2023).

Kurt Tunagur 2025 findings on the impact of sex on Misophonia

Kurt Tunagur et al. (2025) administered the A-MISO-S, DASS-21, and CERQ-SF to 200 Turkish medical students and found no sex difference in misophonia prevalence and no mean-level sex differences on any DASS-21 or CERQ-SF subscale. However, regression with sex × predictor interaction terms revealed that anxiety and low acceptance were more strongly associated with misophonia severity in males, while putting into perspective was more strongly associated with misophonia severity in females. The authors concluded that emotion regulation strategies function differently by sex in the context of misophonia even when males and females report similar average levels of distress and strategy use (Kurt Tunagur et al., 2025).

Kurt Tunagur findings of Misophonia comorbidities

Kurt Tunagur et al. (2025) administered the A-MISO-S and DASS-21 to 200 Turkish medical students and found that misophonic participants reported significantly higher anxiety, depression, and stress than non-misophonic participants across both sexes, with anxiety emerging as the most robust predictor of misophonia severity in regression. The authors noted that misophonia frequently co-occurs with anxiety, depression, ADHD, and obsessive-compulsive traits, and acknowledged that excluding these comorbidities from their sample limits applicability of their findings to real-world clinical populations. They concluded that misophonia is closely tied to internalizing symptomatology and heightened emotional reactivity rather than being a mere sensory irritation (Kurt Tunagur et al., 2025).

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 in contrast to earlier reports that Misophonia often co occurs with OCD, Guetta cites works suggesting that no one specific disorder is uniquely associated with Misophonia. additionally, of the common Misophonia co morbidities, the authors proposes anxiety disorders , features of obsessive compulsive personality disorder, and lifetime of mood disorders are the most common. (Guetta et al., 2024)

Misophonia and hyperacusis prevalence in pediatric ASD, with higher female rates

In a 2025 study, Katikar examined misophonia and hyperacusis prevalence in children with ASD by collecting parent-report questionnaire data from 60 ASD-diagnosed children and running rank correlations against age. They found that nearly half exhibited misophonia and over a third exhibited hyperacusis, with slightly higher prevalence in females and no association with age. From this they concluded that these sensory sensitivities are prevalent and persistent in pediatric ASD, may be more pronounced in females, and warrant early, gender-sensitive, sensory-focused intervention (Katikar et al., 2025).

Misophonia and hyperacusis are strongly related in children

Keenehan et al. (2026) assessed 375 pediatric otolaryngology patients aged 3 to 18 years with the Hyperacusis Assessment Questionnaire (HAQ) and a modified Duke Misophonia Questionnaire (DMQ), and compared hyperacusis severity between children with and without misophonia. They found that children meeting criteria for misophonia had markedly higher HAQ scores than those without misophonia, indicating substantial overlap between the two conditions. The authors concluded that this relationship points to shared auditory sensitivities and a possible shared neurobiological basis, while still treating misophonia and hyperacusis as related but distinct disorders. (Keenehan et al., 2026).

Study gives evidence misophonia is linked to visual sensitivity, at least in severe cases

Andermane et al. (2023), assessing 419 online participants across non-misophonic, moderate, and severe misophonia with the Penn Online Evaluation of Migraines (POEM) and a pattern glare task, found that the severe misophonia group was more likely to experience migraine with aura and gave stronger somatic reactions and visual distortions to aversive striped patterns at mid and high spatial frequencies. The authors described this as the most compelling evidence to date that misophonia is linked to visual sensitivity, at least in the more severe cases, while noting that previously observed visual triggers such as repetitive actions remain ambiguous because it is unclear whether they reflect visual sensitivity itself or the fact that such actions imply a sound. They concluded that migraine and pattern glare may share a common mechanism of increased cortical excitability (Andermane et al., 2023b).

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the author describes the idea that hyperacusis acts as a mediating factor for the Misophonia-tinnitus link, pointing to the finings of (Aazh et al., 2022) showing that 40% of surveyed tinnitus patients reported hyperacusis symptoms while up to 30% of Misophonics experience hyperacusis. (Melanthiou et al., 2026)

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in their 2026 literature review, Melanthiou describes how Hyperacusis, tinnitus, and misophonia share increased central auditory gain and hyperactivity in regions like the inferior colliculus (IC), auditory cortex, and salience network (anterior insula, ACC), suggesting hyperacusis may act as a general sensory hypersensitivity that amplifies symptom severity and distress in the other conditions (Melanthiou et al., 2026 ).

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the author describes the idea that hyperacusis acts as a mediating factor for the Misophonia-tinnitus link, pointing to the finings of (Aazh et al., 2022) showing that 40% of surveyed tinnitus patients reported hyperacusis symptoms while up to 30% of Misophonics experience hyperacusis. (Melanthiou et al., 2026)

sensory sensitivity as a the bridge between Misophonia and other conditions

Andermane et al. (2023), modeling data from 419 online participants across non-misophonic, moderate, and severe misophonia in a symptom network built from the Sussex Misophonia Scale (SMS), Glasgow Sensory Questionnaire (GSQ), Autism Spectrum Quotient (AQ), Obsessive-Compulsive Inventory (OCI), Anxiety Sensitivity Index (ASI-3), and other clinical measures, found that sensory sensitivity as indexed by the GSQ occupied a central position on all centrality measures and remained central even when auditory items were removed. They identified sensory sensitivity as the main bridge linking misophonia to other clinical symptoms, noting that this includes but is not limited to auditory sensitivity and that the misophonia Pain subscale carried the strongest connection outward. The authors concluded that sensory sensitivity is the central trait connecting the misophonic experience to the broader profile of sensory and clinical traits, though they cautioned that the network is not a causal model (Andermane et al., 2023b).

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Otalgia predicts hyperacusis severity in children

Keenehan et al. (2026) surveyed parents of 375 pediatric otolaryngology patients aged 3 to 18 years, measuring sound sensitivity with the Hyperacusis Assessment Questionnaire (HAQ) and collecting medical history including reported otalgia (ear pain), then modeled HAQ predictors with multivariate linear regression. They found that frequent otalgia was the strongest predictor of elevated hyperacusis scores, and otalgia also predicted misophonia presence in a separate logistic model. The authors concluded that otalgia may serve as both a symptom and a clinical marker of hyperacusis in children. (Keenehan et al., 2026).

Sleep related problems in Misophonic youth

In a 2025 study, Wagner examined whether youth with misophonia show elevated SRPs and whether misophonia severity predicts SRPs by analyzing an existing pediatric dataset using parent‐report PROMIS‐SD scores and three misophonia severity measures. They found that youth with misophonia had more SRPs than the general population and comparable levels to youth with anxiety disorders, with no difference among misophonia‐only, anxiety‐only, and combined subgroups, and that misophonia severity remained associated with SRPs after controlling for age, gender, and internalizing/externalizing symptoms. From this they concluded that misophonia may be a vulnerability factor for SRPs in youth and that sleep should be assessed and potentially addressed in misophonia treatment (Wagner et al., 2025).

Emotion regulation difficulties mediate the childhood trauma–misophonia relationship

In a 2026 study, Kılınçel examined whether emotion regulation difficulties mediate the relationship between childhood trauma and misophonia symptoms by administering the CTQ, DERS, and Misophonia Scale to 294 university students and estimating bootstrapped mediation models and a full path analysis. Childhood trauma, emotion regulation difficulties, and misophonia symptoms were positively correlated. Emotion regulation difficulties fully mediated the relationship between childhood trauma and misophonia, with impulse control difficulties emerging as the most consistent mediator across trauma subtypes. The authors concluded that emotion regulation difficulties may be an important mechanism linking childhood trauma to misophonia symptoms and that interventions should emphasize skills for managing sudden, intense emotional and behavioral reactions (Kılınçel et al., 2026).

a literature review of Misophonia in autism

In a 2025 study, Aldakhil synthesized the prevalence, clinical characteristics, psychiatric comorbidities, and treatment outcomes of misophonia in autism by systematically reviewing 14 studies following PRISMA guidelines. They found that misophonia was more prevalent among autistic individuals than the general population, frequently co-occurred with psychiatric conditions and sensory hypersensitivities. they concluded that misophonia is a distinct sensory condition requiring standardized diagnostic tools and tailored, multidisciplinary interventions, though not a unique marker for autism diagnosis (Aldakhil & Shaik, 2025).

ADHD and GAD Most Common Comorbidities; OCD and PTSD Rare

In a 2024 study, Woolley attempted to characterize the onset, symptom progression, triggers, and psychiatric comorbidities in treatment-seeking adults with misophonia by conducting structured clinical interviews (Duke Misophonia Interview and DIAMOND) and administering self-report questionnaires to 60 adults meeting clinical criteria for misophonia. they found that ADHD was the most prevalent comorbidity (23%), followed by generalized anxiety disorder (17%), with 52% meeting no criteria for another psychiatric disorder. OCD and PTSD each occurred in only 3% or fewer participants, challenging historical speculation linking these conditions to misophonia. The presence of any psychiatric comorbidity did not predict overall misophonia severity, likely due to heterogeneity in comorbid conditions. These findings suggest misophonia should be treated as a distinct disorder rather than a variant of OCD or trauma-related conditions (Woolley et al., 2024).

moderate Misophonics often lacking comorbidities is dispositive of comorbidities as a cause

Andermane et al. (2023), in a preregistered online study of 1430 participants (a subset of 419 completing clinical measures) grouped by cluster analysis into non-misophonic, moderate, and severe misophonia, found that clinical comorbidities were largely confined to the severe group, with the moderate group often returning sensitive null results on the Autism Spectrum Quotient (AQ), Anxiety Sensitivity Index (ASI-3), and Obsessive-Compulsive Inventory (OCI). Because the moderate group experiences misophonia yet frequently lacks these comorbidities, the authors reasoned that the comorbidities are unlikely to be a primary cause of the condition. They concluded that these comorbidities are not a primary cause but may instead play a role in the transition to a more severe profile (Andermane et al., 2023b).

clustering approach to Misophonia finds comorbidities

In a 2022 study, Norris attempted to characterize misophonia symptom presentation using cluster-based phenotyping by administering a comprehensive self-report survey indexing misophonia, tinnitus, sensory hypersensitivity, and psychiatric symptoms to 343 undergraduate students. Results indicated that individuals with misophonia showed elevated co-occurrence of tinnitus and broader sensory hypersensitivity across modalities. Misophonia was also associated with increased autism-like traits and schizotypal personality features, particularly in a subgroup with more complex symptom presentations. Additionally, higher rates of anxiety-related diagnoses were observed in the misophonia group, with anxiety partially accounting for heightened emotional reactivity to trigger sounds (Norris et al., 2022).

Machine Learning-Identified Connectivity Markers Dissociating Misophonia from Hyperacusis Comorbidity

In a 2026 study, Ajmera attempted to identify neural connectivity-based markers of misophonia using an optimized machine learning framework applied to resting-state fMRI data from 76 university students (ages 18–25) categorized into misophonia-only, misophonia-with-hyperacusis, and control groups based on structured clinical interviews and established questionnaires. They found that both misophonia-only and comorbid groups showed altered connectivity in salience, somatomotor, and frontoparietal control networks, with misophonia-only specifically showing subcortical basal ganglia disruptions and the comorbid group showing unique visual network alterations. From this they concluded that core misophonia-related brain alterations persist despite hyperacusis comorbidity, that subcortical connectivity dissociates the two conditions, and that the findings support psychology-based (CBT) therapy targeting dysfunctional connectivity in salience and control circuits for treating misophonia. (Ajmera et al., 2026)

İletmiş 2026 findings on Misophonia and bipolar comorbidity

In their 2026 study, İletmiş et al. aimed to assess the prevalence of misophonia in bipolar disorder (BD) patients, examine its relationship with autistic traits and emotion regulation skills, and compare findings to a matched control group. Contrary to expectations, misophonia was more common in controls (63.8%) than BD patients (48.6%). Within the BD group, misophonia was associated with higher autistic traits (p=0.003), a greater history of suicide attempts (p=0.026), and poorer emotion regulation. While misophonia severity did not correlate with autism or emotion regulation in bivariate analysis, regression showed that suicide attempts and AQ scores significantly predicted severity. Common triggers included chewing and breathing sounds; discomfort and disgust were more pronounced in controls. Notably, 7 of 16 reproductive-aged women reported worsened symptoms during menstruation, and BD patients reported more hearing difficulties than controls (p=0.020), suggesting possible sensory and hormonal influences. Findings support the existence of misophonia subtypes (pure vs comorbid) and highlight the need for integrated assessment in psychiatric populations.(İletmiş & Yaman, 2025)

three cluster description of Misophonia symptoms

In a 2022 study, Norris aimed to characterize symptom presentation patterns in misophonia using cluster analysis in a non-clinical undergraduate sample (N=343) with measures assessing misophonia symptoms, tinnitus severity, sensory hypersensitivity, broad autism phenotype characteristics, and psychiatric symptoms. They found a three-cluster solution: Cluster 1 exhibited severe misophonia with fewer co-occurring psychiatric diagnoses, Cluster 3 showed complex presentation with broadband sensory hypersensitivities and increased psychiatric symptoms, and Cluster 2 was relatively unaffected; approximately 15.6% reported clinically relevant misophonia symptoms with increased co-occurrence of tinnitus, and anxiety intensity partially mediated the relationship between misophonia severity and emotional behaviors. From this they concluded that misophonia exists on a spectrum with subgroups potentially reflecting different underlying pathways, ranging from "pure form" misophonia to presentations involving broad sensory and psychiatric symptoms, highlighting the importance of exploring misophonia as a etiologically complex and multidimensional condition (Norris et al., 2022).