Misophonia is defined as an
abnormally strong emotional and behavioral reaction to particular sounds or
groups of sounds that have a specific pattern and meaning to the patient (Jastreboff
& Jastreboff 2003), although a consensus paper bringing together
experts from a wide range of disciplines suggested using the term “annoyance
hyperacusis” for the experience of negative emotional reaction to sound (Tyler et al.
2014). Andrea E. Cavanna (Department of
Neuropsychiatry, Birmingham, UK) discussed the possible mechanisms underlying
misophonia. Although misophonia is not listed in any major psychiatric
classification system, a few psychiatric clinics have reported treating
patients with misophonia (Bernstein et
al. 2013; McGuire et al. 2015; Schroder et al. 2013; Webber et al. 2014). Systematic studies of misophonia
are very limited (Cavanna &
Seri 2015). In the field of psychiatry, there
is a growing debate as to whether misophonia is a distinct psychiatric disorder
or a variety of hyperacusis that is often co-morbid with neuropsychiatric
disorders (Cavanna 2014;
Cavanna & Seri 2015; Neal & Cavanna 2013; Schroder et al. 2013; Taylor 2017). Specifically, neuro-developmental
disorders including Tourette syndrome (Cavanna &
Seri 2013) and autism spectrum disorder (see
the following section) have been shown to be associated with misophonia in a
proportion of cases, suggesting shared neuro-developmental trajectories.
Most research studies in the
field of audiology have not distinguished misophonia from hyperacusis (Andersson et
al. 2002; Fackrell et al. 2015; Juris et al. 2014; Schecklmann et al. 2014;
Schecklmann et al. 2015; Sheldrake et al. 2015; Zaugg et al. 2016). Jastreboff and
Jastreboff (2015)reported that people with severe hyperacusis always experience misophonia.
Recent studies conducted within the National Health Service (NHS) in the UK
suggest that severe hyperacusis is typically characterized by strong
across-frequency variations in sensitivity to sound, which is an indication of
adverse reaction only to specific sounds, a feature that is associated with
misophonia (Aazh &
Moore 2017; Aazh & Moore 2018).
Based on the above mentioned
studies, it is likely that misophonia forms part of the spectrum of hyperacusis
and needs to be considered when assessing patients with sound intolerance
Aazh, H., &
Moore, B. C. J. (2017). Factors related to Uncomfortable Loudness Levels for
patients seen in a tinnitus and hyperacusis clinic. International Journal of Audiology 56, 793-800.
Aazh, H., & Moore, B. C. J. (2018). Prevalence and
characteristics of patients with severe hyperacusis among patients seen in a
tinnitus and hyperacusis clinic Journal of American Academy of Audiology,
Andersson, G., Lindvall, N., Hursti, T., et al. (2002).
Hypersensitivity to sound (hyperacusis): a prevalence study conducted via the
Internet and post. Int J Audiol, 41, 545-54.
Bernstein, R. E., Angell, K. L., & Dehle, C. M. (2013). A brief
course of cognitive behavioural therapy for the treatment of misophonia: a case
example. The Cognitive Behaviour
Therapist, 6, e10.
Cavanna, A. E. (2014). What is misophonia and how can we treat it? Expert Rev Neurother, 14, 357-9.
Cavanna, A. E., & Seri, S. (2013). Tourette's syndrome. Bmj, 347,
Cavanna, A. E., & Seri, S. (2015). Misophonia: current
perspectives. Neuropsychiatr Dis Treat,
Fackrell, K., Fearnley, C., Hoare, D. J., et al. (2015). Hyperacusis
Questionnaire as a tool for measuring hypersensitivity to sound in a tinnitus
research population. Biomed Res Int, 2015, 290425.
Jastreboff, P. J., & Jastreboff, M. M. (2003). Tinnitus
retraining therapy for patients with tinnitus and decreased sound tolerance. Otolaryngologic Clinics of North America,
Jastreboff, P. J., & Jastreboff, M. M. (2015). Decreased sound
tolerance: hyperacusis, misophonia, diplacousis, and polyacousis. Handb Clin Neurol, 129, 375-87.
Juris, L., Andersson, G., Larsen, H. C., et al. (2014). Cognitive
behaviour therapy for hyperacusis: A randomized controlled trial. Behav Res Ther, 54c, 30-37.
McGuire, J. F., Wu, M. S., & Storch, E. A. (2015).
Cognitive-behavioral therapy for 2 youths with misophonia. J Clin Psychiatry, 76,
Neal, M., & Cavanna, A. E. (2013). Selective sound sensitivity
syndrome (misophonia) in a patient with Tourette syndrome. J Neuropsychiatry Clin Neurosci, 25, E01.
Schecklmann, M., Landgrebe, M., Langguth, B., et al. (2014).
Phenotypic characteristics of hyperacusis in tinnitus. PLoS One, 9, e86944.
Schecklmann, M., Lehner, A., Schlee, W., et al. (2015). Validation
of Screening Questions for Hyperacusis in Chronic Tinnitus. Biomed Res Int, 2015, 191479.
Schroder, A., Vulink, N., & Denys, D. (2013). Misophonia:
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Sheldrake, J., Diehl, P. U., & Schaette, R. (2015). Audiometric
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Taylor, S. (2017). Misophonia: A new mental disorder? . Medical
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Tyler, R. S., Pienkowski, M., Rojas Roncancio, E., et al. (2014). A
review of hyperacusis and future directions: part I. definitions and
manifestations. American Journal of
Audiology, 23, 402-419.
Webber, T. A., Johnson, P. L., & Storch, E. A. (2014). Pediatric
misophonia with comorbid obsessive-compulsive spectrum disorders. Gen Hosp Psychiatry, 36, 231.e1-2.
Zaugg, T. L., Thielman, E. J., Griest, S., et al. (2016). Subjective
Reports of Trouble Tolerating Sound in Daily Life versus Loudness Discomfort
Levels. Am J Audiol, 25, 359-363.