Misophonia, literally "hatred of sound", is a rarely diagnosed neuropsychiatric disorder in which negative emotions (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 sometimes referred to as selective sound sensitivity syndrome.
The illness has not been classified as a discrete disorder in DSM-5 or ICD-10; in 2013 three psychiatrists at the Academic Medical Center in Amsterdam formulated diagnostic criteria for it and suggested that it be classified as a separate psychiatric disorder.
A 2013 review of neurological studies and fMRI studies of the brain as it relates to the disorder postulated 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.
There is debate about misophonia's cause; it has been described as a developmental, neurological disorder and as a Pavlovian conditioned reflex. There is also recent discussion of misophonia as a subset of sensory processing disorder.
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 experience fight/flight symptoms such as sweating, muscle tension, and 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. Intense anxiety and avoidance behavior often develops, 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 found at clinically significant levels in between 4 and 5% 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 of students, conducted at the University of South Florida found that 20% of the almost 500 participants had misophonia-like symptoms. Misophonia may be correlated with OCD, anxiety and depressive disorders.
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).
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- 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 Association
- Misophonia: Diagnostic Criteria for a New Psychiatric Disorder