Misophonia, literally "hatred of sound", is a neurological disorder in which negative experiences (anger, flight, hatred, disgust) are triggered by specific sounds. The sounds can be loud or soft. The term was coined by American neuroscientists Pawel Jastreboff and Margaret Jastreboff and is often used interchangeably with the term selective sound sensitivity.
Misophonia has not been classified as a discrete disorder in DSM-5 or ICD-10, but in 2013 three psychiatrists at the Academic Medical Center in Amsterdam formulated diagnostic criteria for it based on the largest cohort of misophonia patients so far, and suggested that it be classified as a separate psychiatric disorder.
A 2013 review of the most current neurological studies and fMRI studies of the brain as it relates to the disorder postulates that abnormal or dysfunctional assessment of neural signals occurs in the anterior cingulate cortex and insular cortex. These cortices are also implicated in Tourette Syndrome, and are the hub for processing anger, pain, and sensory information. Other researchers concur that the dysfunction is in central nervous system structures. It has been speculated that the anatomical location may be more central than that involved in hyperacusis.
People who have misophonia are most commonly angered by specific sounds, such as slurping, throat-clearing, people clipping their nails, brushing their teeth, chewing crushed ice, eating, drinking, breathing, sniffing, talking, sneezing, yawning, walking, chewing gum, laughing, snoring, typing on a keyboard, coughing, humming, whistling, singing; saying certain consonants; or repetitive sounds. Sufferers may experience such physical symptoms as sweating, muscle tension, and even quickened heartbeat. Some are also affected by visual stimuli, such as repetitive foot or body movements, fidgeting, or movement they observe out of the corners of their eyes; this has been termed misokinesia, meaning hatred of movement. Intense anxiety and avoidant behavior may develop, which can lead to decreased socialization. Some people feel the compulsion to mimic what they hear or see. Mimicry is an automatic, non-conscious, and social phenomenon. It has a palliative aspect, making the sufferer feel better. The act of mimicry can elicit compassion and empathy, which ameliorates and lessens hostility, competition, and opposition. There is also a biological basis for how mimicry reduces the suffering from a trigger.
Prevalence and comorbidity
The prevalence of misophonia is unknown, but groups of people identifying with the condition suggest it is more common than previously recognized. Among patients with tinnitus, which is prevalent in 45% of the general population, some surveys report prevalence as high as 60%, while prevalence in a 2010 study was measured at 10%. A 2014 study conducted at the University of South Florida found that 20% of the almost 500 participants had misophonia-like symptoms. The participants were undergraduate psychology students and mostly women.
The Dutch study published in 2013 of a sample of 42 patients with misophonia found a low incidence of psychiatric disorders, with the exception of Obsessive-Compulsive Personality Disorder (52.4%).
It has been suggested that there is a connection between misophonia and synesthesia, a neurological condition in which stimulation of one sensory or cognitive pathway leads to automatic, involuntary experiences in a second sensory or cognitive pathway. The basic problem may be a pathological distortion of connections between various limbic structures and the auditory cortex, causing sound-emotion synesthesia. There are people with both misophonia and synesthesia, and many people with synesthesia have more than one form of synesthesia (there are over 60 reported types).
- M. Edelstein, D. Brang, V. S. Ramachandran (2012). "Sensory modulation in misophonia" (PDF). Program No. 367.07. 2012 Neuroscience Meeting Planner. New Orleans, LA: Society for Neuroscience. p. 1042. Retrieved 27 January 2013.
- Jonathan Hazell. "Decreased Sound Tolerance: Hypersensitivity of Hearing". Tinnitus and Hyperacusis Centre, London UK. Retrieved February 5, 2012.
- Pawel J. Jastreboff, Margaret M. Jastreboff (April 2003). "Tinnitis retraining therapy for patients with tinnitus and decreased sound tolerance". Otolaryngologic Clinics of North America 36 (2): 321�36. doi:10.1016/s0030-6665(02)00172-x. PMID 12856300.
- Neal, M.; Cavanna, A. E. (2012). "P3 Selective sound sensitivity syndrome (misophonia) and Tourette syndrome". Journal of Neurology, Neurosurgery & Psychiatry 83 (10): e1. doi:10.1136/jnnp-2012-303538.20.
- Schröder, A.; Vulink, N.; Denys, D. (2013). Fontenelle, Leonardo, ed. "Misophonia: Diagnostic Criteria for a New Psychiatric Disorder". PLoS ONE 8: e54706. doi:10.1371/journal.pone.0054706.
- Judith T. Krauthamer (2013). Sound-Rage. A Primer of the Neurobiology and Psychology of a Little Known Anger Disorder. Chalcedony Press, 210 pgs.
- Aage R. Møller (2006). Hearing, Second Edition: Anatomy, Physiology, and Disorders of the Auditory System. Academic Press. ISBN 978-0-12-372519-6.
- Aage R. Møller (2001). Textbook of Tinnitis, part 1. pp. 25�27. doi:10.1007/978-1-60761-145-5_4. Retrieved February 5, 2012.
- Joyce Cohen (September 5, 2011). "When a Chomp or a Slurp is a Trigger for Outrage". The New York Times. Retrieved February 5, 2012.
- George Hadjipavlou, MD, MA, Susan Baer, MD, PhD, Amanda Lau and Andrew Howard, MD (2008). "Selective Sound Intolerance and Emotional Distress: What Every Clinician Should Hear". Psychosomatic Medicine (American Psychosomatic Society) 70 (6): 739/40. doi:10.1097/psy.0b013e318180edc2. Retrieved February 2012.
- Jastreboff, P., Jastreboff, M. (July 2, 2001). "Components of decreased sound tolerance : hyperacusis, misophonia, phonophobia". Retrieved February 5, 2012.
- Sztuka A, Pospiech L, Gawron W, Dudek K. (2010). "DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing.". Auris Nasus Larynx 37 (1): 55–60. doi:10.1016/j.anl.2009.05.001. PMID 19560298.
- Wu, M. S., Lewin, A. B., Murphy, T. K. & Storch, E. A. (2014), Misophonia: Incidence, phenomenology, and clinical correlates in an undergraduate student ample. Journal of Clinical Psychology. Vol. 00(00), 1–14. doi: 10.1002/jclp.22098
- Cytowic, Richard E. (2002). Synesthesia: A Union of the Senses (2nd edition). Cambridge, Massachusetts: MIT Press. ISBN 0-262-03296-1. OCLC 49395033
- EDELSTEIN, M., D. BRANG, and V. S. RAMACHANDRAN. "Sensory Modulation in Misophonia." Poster. Neuroscience 2012 Conference of the Society for Neuroscience. New Orleans, LA. 15 Oct. 2012. Sensory Modulation in Misophonia: A Preliminary Examination via Galvanic Skin Response. UCLA. Web. 4 July 2013.
- Day, Sean, Types of synesthesia. (2009) Types of synesthesia. Online: http://home.comcast.net/~sean.day/html/types.htm, accessed 18 February 2009.
- an online website full of information and a support board to help those with Misophonia
- Misophonia: Diagnostic Criteria for a New Psychiatric Disorder
- Misophonia Treatment Institute - A website dedicated to treatment and management of misophonia.