What are the other Names for this Condition? (Also known as/Synonyms)

• Hatred of Sound
• Selective Sound Sensitivity Syndrome

What is Misophonia? (Definition/Background Information)

• Misophonia is a chronic condition in which an individual exhibits an “excessive” emotional response to a specific sound. The term directly translates to “Hatred of Sound”
• Apart from hatred, the affected individuals may exhibit annoyance and fear in response to certain sounds. Young girls (around puberty) are known to be affected the most by this condition. It is believed that the condition may be under- reported/diagnosed
• Individuals who have some form of hearing loss and those with certain mental disorders may be at an increased risk for developing Misophonia. The exact cause of the condition is unclear, although recent research indicates hyperactivity in the anterior insular cortex (of the brain) in affected individuals
• In order to evaluate Misophonia, a set of 6 criteria has been proposed for the diagnosis of this condition, which is based on self-reported symptoms by the affected individual. An abnormal response to certain sounds can lead to long-term complications ranging from social isolation and inability to perform tasks, to depression and suicidal thoughts
• Treatment for the condition involves adopting coping mechanisms and the use of medications, such as anti-depressants. Misophonia is a chronic condition and lifelong management of the condition may be necessary for an optimal outcome

Who gets Misophonia? (Age and Sex Distribution)

• Misophonia may affect individuals of all ages, races, and ethnic predisposition. The typical age of symptom-onset is reported to be between 10-12 years
• Prepubescent girls are affected the most, in comparison to males of the same age group. They are affected more than individuals of any age group
• The exact prevalence of Misophonia is not clear; it is a newly-described disorder, and not much statistical data is available

What are the Risk Factors for Misophonia? (Predisposing Factors)

The following are some possible risk factors for developing Misophonia:

• Having a preexisting hearing-related problem
• Girls in the 10-12 year’ age group, prior to puberty
• Psychiatric disorders including obsessive-compulsive disorder, obsessive-compulsive personality disorder, and Tourette’s disorder
• Certain eating disorders

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Misophonia? (Etiology)

The exact cause of Misophonia is not known. Recent research has made the following observations:

• An increased autonomic (without conscious effort) response to sound triggers in the affected individuals, when compared to those who are unaffected. The exact mechanism of this process is unclear
• An overactive anterior insular cortex (part of the brain) in the affected individuals, as a function of altered connectivity pattern of the frontal lobe of the brain. This region in the brain is responsible for emotional awareness and processing external and internal stimuli. Additionally, the study also found an increased myelination in the grey matter of a region, known as the ventromedial prefrontal cortex (vmPFC). The researchers believe that there is a difference in the control mechanism between the anterior insular cortex and the frontal lobe

What are the Signs and Symptoms of Misophonia?

The signs and symptoms of Misophonia may be mild or severe and may include:

• Reacting to a specific sound trigger with
  • Annoyance
  • Anxiety or panic, fear
  • Hatred, rage, or violence
  • Emotional outburst
• The sound triggers may include:
  • Chewing sounds, chewing with one’s mouth kept open
  • Talking with food in mouth
  • Lip smacking, slurping
  • Breathing sound, wheezing
  • Snoring
  • Grinding of teeth
  • Loud noise of throat clearing
  • Sniffling
  • Clicking of a pen

How is Misophonia Diagnosed?

Currently, there is no formal diagnostic method established towards the diagnosis of Misophonia in the Diagnostic and Statistical Manual of Mental Disorders 5 (DSM 5, APA publication). The diagnosis of the condition may be made by:

• A physical examination and assessment of symptoms
• An evaluation of medical history to check for pre-existing conditions that are known to predispose an individual to Misophonia
• Psychological evaluation using presence of the following 6 criteria, as proposed by Schroder and coworkers (in 2013):
  • Actual existence or anticipation of a sound that is a trigger, and an aversive reaction to it, which may be annoyance, hatred, and rage
  • A loss of self-control
  • Realization that loss of control is excessive
  • Avoidance of situations with possible sound triggers
  • The reaction to a sound causes significant distress; it interferes with the quality of daily life
  • The excessive reaction is not attributable to another disorder

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Misophonia?

The potential complications of Misophonia may include:

• Disruption of normal, day-to-day activities
• Decreased quality of life
• Social isolation
• Inability to concentrate and perform tasks
• Anxiety and depression
• Outbursts, which may be violent
• Thoughts of suicide

How is Misophonia Treated?

The treatment for Misophonia is determined by the severity of symptoms in the affected individual. In general, there is no cure for the condition, and the treatment modalities are geared towards offering relief from symptoms. Such measures may include:

• Lifestyle changes:
  • Canceling out the offending sound by use of earplugs or music
  • A conscious refocusing to own sounds
  • Distracting oneself, when triggers are present
  • Talking to oneself, to avoid an excessive reaction
  • Reducing caffeine intake, to reduce symptom exacerbation
  • Leading an active life for better management of stress
• Medications for anxiety and depression
• Seeking advice and counseling
• Cognitive behavioral therapy to enable the individual develop coping mechanisms

How can Misophonia be Prevented?

Presently, there are no guidelines or methods available for the prevention of Misophonia.

• Seeking medical attention for certain psychological conditions and eating disorders may help decrease the possibility of excessive emotional reactions seen in this disorder
• Caffeine is known to exacerbate the symptoms of Misophonia. Therefore, limiting caffeine intake may help manage the symptoms better
• Active research is currently being conducted to explore the possibilities for treatment and prevention of Misophonia
• Regular medical screening may be recommended

What is the Prognosis of Misophonia? (Outcomes/Resolutions)

• The prognosis of Misophonia is determined by the severity of symptoms. In general, the condition is chronic and may require lifelong management
• With proper diagnosis and treatment, approximately 80% of the affected individuals report relief from symptoms

Additional and Relevant Useful Information for Misophonia:

Misophonia can be a potentially-disabling disorder. It requires medical attention to enable one to manage the condition, in many cases.