Toward cognitive models of misophonia

Abstract

Misophonia is a disorder in which specific common sounds such as another person breathing or chewing, or the ticking of a clock, cause an atypical negative emotional response. Affected individuals may experience anger, irritability, annoyance, disgust, and anxiety, as well as physiological autonomic responses, and may find everyday environments and contexts to be unbearable in which their ‘misophonic stimuli’ (often called ‘trigger sounds’) are present. Misophonia is gradually being recognized as a genuine problem that causes significant distress and has negative consequences for individuals and their families. It has only recently come under scientific scrutiny, as researchers and clinicians are establishing its prevalence, distinguishing it from other disorders of sensory sensitivity such as hyperacusis, establishing its neurobiological bases, and evaluating the effectiveness of potential treatments. While ideas abound as to the mechanisms involved in misophonia, few have coalesced into models. The aim of the present work is to summarize and extend recent thinking on the mechanistic basis of misophonia, with a focus on moving towards neurologically-informed cognitive models that can (a) account for extant findings, and (b) generate testable predictions. We hope this work will facilitate future refinements in our understanding of misophonia, and ultimately inform treatments.