Understanding Misophonia

Misophonia is a disorder of decreased tolerance to specific sounds or stimuli associated with such sounds. These stimuli, known as “triggers,” are experienced as unpleasant or distressing and tend to evoke strong negative emotional, physiological, and behavioral responses that are not seen in most other people. Misophonic responses do not seem to be elicited by the loudness of auditory stimuli, but rather by the specific pattern or meaning to an individual. Trigger stimuli are often repetitive and primarily, but not exclusively, include stimuli generated by another individual, especially those produced by the human body. Once a trigger stimulus is detected, individuals with misophonia may have difficulty distracting themselves from the stimulus and may experience suffering, distress, and/or impairment in social, occupational, or academic functioning. The expression of misophonic symptoms varies, as does the severity, which ranges from mild to severe impairments. Some individuals with misophonia are aware that their reactions to misophonic trigger stimuli are disproportionate to the circumstances (Swedo et al., 2022). Misophonia Consensus Definition Project

Although each person may have their own pattern of triggers, some stimuli serve as common misophonic triggers. Auditory triggers are most common, although individuals with misophonia may also identify distress in response to visual triggers. Sounds associated with oral functions are among the most often reported misophonic trigger stimuli, such as chewing, eating, smacking lips, slurping, coughing, throat clearing, and swallowing. Nasal sounds, such as breathing and sniffing, often serve as triggers as well. Auditory triggers may also include non-oral/nasal sounds produced by people such as pen clicking, keyboard typing, finger or foot tapping and shuffling footsteps, as well as sounds produced by objects, such as a clock ticking, or sounds generated by animals. Visual triggers have been reported to include stimuli such as cracking knuckles and jiggling or swinging legs, as well as visual stimuli associated with an auditory trigger, such as watching someone eat (Swedo et al., 2022).

We do not presently know what causes misophonia. It could be genetic (Smit et al., 2022), or it could be caused by or related to stress, but not traumatic stress (Guetta et al., 2024). We’re learning more about what’s happening in the brain of people with misophonia, where some researchers have found associations and distinct neural pathways that are related to misophonic triggers as opposed to other sounds (Schröder et al., 2014, 2019; Kumar et al., 2017, 2021; Eijsker et al., 2021).In a recent study, 26% of misophonia participants had co-morbid conditions, including hyperacusis, obsessive compulsive personality disorder, mood disorders, anxiety disorder, and autism spectrum conditions (Jager et al., 2020).

Studies have found that upwards of 4-20% of the population may have misophonia (Wu et al., 2014; Vitoratou et al., 2023; Dixon et al., 2024). Research is currently being conducted to precisely estimate this prevalence across the US and other countries.

Misophonia symptoms are typically first observed in childhood or early adolescence. People with misophonia have anecdotally reported their symptoms worsening with time (Rouw et al., 2018); however, that has yet to be quantified in longitudinal studies. This question must be further investigated for a full understanding.

Although misophonia is now defined as a disorder, it can be difficult to diagnose. This is because the next step in misophonia research is to establish diagnostic criteria after determining validated misophonia assessments. We are currently funding research aiming to validate current misophonia assessments and hope to have standard methods of diagnosing misophonia soon.

The Diagnostic and Statistical Manual of Mental Disorders (DSM) and the International Classification of Diseases (ICD) are the guides used by healthcare professionals in the United States and around the world to diagnose mental disorders. Currently, misophonia is not defined under either of these two guides. These guides are updated only so often, which is part of why misophonia has yet to be included in them. More information about this topic can be found here.

There is no official treatment yet for misophonia. Some treatments have been impactful for some, but unfortunately, not for all. We recommend visiting our Community Resources Page for links to patient-focused groups as well as information on how you may be able to find a qualified provider within the US and Canada.

soQuiet

Resources to manage symptoms

Resources for families

Peer Support

Accommodation resources in the US

Participate in online Misophonia Research

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Misophonia-hub.org

Resources for families

Resources for clinicians and those seeking clinical help

Peer Support

Accommodation resources in the UK

Participate in Misophonia Research

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Duke Center for Misophonia and Emotion Regulation (CMER)

Resources to manage symptoms

Participate in Misophonia Research

Resources for clinicians and those seeking clinical help

Resources for families

Resources for getting involved with Misophonia Research at Duke

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Misophonia Podcast

Stories from misophones for misophones

You can sign up to directly participate in Misophonia Research!

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To learn more about and participate in MRF-funded research, click here.

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Additionally, opportunities can be found via the soQuiet Misophonia Pool, a centralized misophonia research participant registry.

Learn more about current MRF-funded research here.

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