Misophonia: A Hatred of Specific Sounds

Post by Anastasia Sares

Characterizing a “new” disorder

Have you ever known someone who couldn’t stand the sound of people chewing? Are you that person? This isn’t just a fringe behavior or a quirk, it has a name: misophonia, literally, “hatred of sound”. The term was newly coined in 2001, describing a condition that may affect up to 20% of people despite not yet being in any official diagnostic manual. People with misophonia have aversive emotional reactions, including anger and distress, to specific sounds that do not bother other people. There are many proposed diagnostic tests for it, but no consensus on a gold standard yet.

Sensations and attention

Researchers have proposed relationships between misophonia and several other disorders: obsessive-compulsive disorder, phobias, hyperacusis (sensitivity to sound frequencies or volume), or synesthesia (when sensory stimulation produces a response in other senses). However, misophonia seems to occupy a niche all on its own. It is unlike a phobia because the primary emotion is anger rather than fear. It is different from synesthesia because sounds are associated with emotions, rather than with other sensory characteristics. People with misophonia sometimes avoid social situations, but not out of fear of judgment (like those with social anxiety)—they simply want to avoid situations where trigger sounds are likely to occur.

The brains of people with misophonia show differences in structure and function, in areas such as the anterior insula (which processes emotions such as anger and disgust), and the amygdala (involved in the fight-or-flight response). There are also differences in connectivity of the brain’s attention and salience networks. The interplay between these networks and the amygdala may be a key feature of misophonia.

What’s new?

Misophonia is rapidly garnering increased interest from researchers. There are already 25 new publications with the keyword “misophonia” this year alone (according to listings on PubMed). This year, people worked to characterize the prevalence of misophonia in different populations and refine tests for it. Though common triggers of misophonia include human oral/nasal sounds like chewing and breathing, Hansen and colleagues highlighted that not all misophonic triggers are human-produced (for example, a crow cawing or a bonfire), and called for a revision of the proposed “diagnostic” criteria. Ferrer-Torres and colleagues focused on the COVID-19 pandemic and the isolation that came with it, showing that people with misophonia experienced worse quality of life and even increased heart-rate variability, perhaps due to an inability to escape trigger sounds during confinement (trigger sounds are often associated with close family members or friends).

What’s the bottom line?

The recognition of misophonia and its prevalence is important to better understand the condition. Further, its recognition validates the experiences of people with these symptoms. There is still a lot of scientific work to be done in characterizing misophonia before we reach a good understanding, but fortunately, research on this condition is growing more and more each year.

References

Jastreboff, M.M., and Jastreboff, P.J. (2001). Components of decreased sound tolerance: hyperacusis, misophonia, phonophobia. ITHS News Lett. 2, 5–7.

Kılıç, C., Öz, G., Avanoğlu, K. B., & Aksoy, S. (2021). The prevalence and characteristics of misophonia in Ankara, Turkey: population-based study. BJPsych Open, 7(5), e144. https://doi.org/10.1192/bjo.2021.978

Ferrer-Torres, A., & Giménez-Llort, L. (2021). Sounds of Silence in Times of COVID-19: Distress and Loss of Cardiac Coherence in People With Misophonia Caused by Real, Imagined or Evoked Triggering Sounds. Frontiers in Psychiatry, 12(June), 1–12. https://doi.org/10.3389/fpsyt.2021.638949

Ferrer-Torres, A., & Giménez-Llort, L. (2021). Confinement and the Hatred of Sound in Times of COVID-19: A Molotov Cocktail for People With Misophonia. Frontiers in Psychiatry, 12(May), 1–12. https://doi.org/10.3389/fpsyt.2021.627044

Kumar, S., Tansley-Hancock, O., Sedley, W., Winston, J. S., Callaghan, M. F., Allen, M., Griffiths, T. D. (2017). The Brain Basis for Misophonia. Current Biology, 27(4), 527–533. https://doi.org/10.1016/j.cub.2016.12.048

Eijsker, N., Schroder, A., Smit, D. J. A., van Wingen, G., & Denys, D. (2020). Structural and Functional Brain Abnormalities in Misophonia. Biological Psychiatry, 87(9), S225–S226. https://doi.org/10.1016/j.biopsych.2020.02.585

Siepsiak, M., & Dragan, W. (2019). Misophonia - A review of research results and theoretical concepts. Psychiatria Polska, 53(2), 447–458. https://doi.org/10.12740/PP/92023

Hansen, H. A., Leber, A. B., & Saygin, Z. M. (2021). What sound sources trigger misophonia? Not just chewing and breathing. Journal of Clinical Psychology, (February), 1–17. https://doi.org/10.1002/jclp.23196

Wu, M. S., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2014). Misophonia: Incidence, phenomenology, and clinical correlates in an undergraduate student sample. Journal of Clinical Psychology, 70(10), 994–1007. https://doi.org/10.1002/jclp.22098