Decreased sound tolerance (DST) conditions, including misophonia and hyperacusis, are emerging clinical conditions in behavioral medicine. Misophonia involves an extreme emotional response (often anger, disgust, or annoyance) to specific sounds (such as people chewing, swallowing, tapping their foot on the floor, etc.), while hyperacusis is defined by high sensitivity to sounds below normal sound sensitivity thresholds. Although research on these DST conditions is increasing, clearly defined prevalence rates, associations with other mental health conditions, and development of assessment tools that can identify and differentiate DST symptoms are needed. Research and clinical reports also suggest that DST problems are more likely to occur in individuals affected by tinnitus, and that drawing upon a bio-psychosocial conceptualization of tinnitus and other behavioral medicine conditions may be useful in understanding and treating DST conditions. This cross-sectional survey study was administered to college student (N=451) and community adult (N=375) samples and investigated DST prevalence rates, clinical correlates, and risk factors and mechanisms of action for misophonia and hyperacusis. In addition, the study developed and validated a new scale to identify misophonia and hyperacusis type sound sensitivity. Nearly 35% of individuals surveyed reported some degree of general auditory sensitivity, with 15-63% endorsing misophonia symptoms, and 17-26% endorsing hyperacusis symptoms, with rates depending on assessment method. Moderate to strong correlations were found between DST conditions and other mental and physical health conditions, including obsessive compulsive disorder, autism-spectrum traits, anxiety, depression, social phobia, medical conditions, and somatic and neurobehavioral symptoms. Mediation models revealed that the process by which misophonia symptoms become clinically significant and functionally impairing is partially mediated by amplification of bodily sensations and anxiety sensitivity. Risk factors for functional impairment related to misophonia symptoms were identified in moderation analyses and included neuroticism, synesthesia, and sensory sensitivity. An assessment instrument, the DST-10, and its subscales the Loudness Sensitivity Scale and Human Sounds Scale, was subjected to exploratory and confirmatory factor analysis and initial evidence for construct validity was demonstrated. This study was the first to assess hyperacusis, misophonia, and tinnitus rates in large general population samples and provides initial support for conceptualizing DST problems as behavioral medicine conditions.

INTRODUÇÃO: A misofonia é caracterizada pela aversão a sons bem seletivos, que provocam uma forte reação emocional. Foi proposto que a misofonia, assim como o zumbido, esteja associada à hiperconectividade entre os sistemas auditivo e límbico. Indivíduos com zumbido de incômodo significativo podem apresentar comprometimento da atenção seletiva, o que ainda não foi demonstrado no caso da misofonia. OBJETIVO: caracterizar uma amostra de indivíduos com misofonia e compará-la com dois grupos controle, um com zumbido (sem misofonia) e outro assintomático (sem zumbido e sem misofonia). METODOLOGIA: Foram avaliados 40 sujeitos normo-ouvintes, sendo 10 com misofonia (grupo misofonia - GM), 10 com zumbido (sem misofonia) (grupo controle zumbido - GCZ) e 20 sem zumbido e sem misofonia (grupo controle assintomático - GCA). Foi realizada anamnese geral em todos os grupos e anamnese específica apenas para o GM. Nos três grupos, foi aplicado o Teste de Identificação de Sentenças Dicóticas em três situações. Na primeira, foi realizado o exame padrão. Em seguida, foi aplicado incluindo mensagem competitiva, uma com som de mastigação (exame mastigação), e outra com white noise (exame white noise). RESULTADOS: A amostra do GM apontou que os primeiros sintomas da misofonia foram percebidos ainda na infância ou adolescência (média 11,5 anos). O grau de incômodo variou de 6 a 10 na escala visual analógica e, dentre os 10 participantes do GM, nove (90%) responderam que a misofonia atrapalha, sempre ou às vezes, a vida social e profissional. No teste de Identificação de Sentenças Dicóticas, foi observado que no exame mastigação, as médias da porcentagem de acertos diferem entre os grupos GM e GCA (valor-p = 0,027) e entre os grupos GM e GCZ (valor-p = 0,002), sendo menor em ambos os casos no GM. Para os exames padrão e white noise, não há diferença entre as médias da porcentagem de acertos nos três grupos (valores-p >= 0,452). CONCLUSÃO: os participantes do GM apresentaram menor porcentagem de acertos no Teste de Identificação de Sentenças Dicóticas na situação de apresentação de um ruído distraidor (exame mastigação) em relação ao mesmo teste aplicado em situação padrão ou white noise, sugerindo que indivíduos com misofonia podem apresentar alteração da atenção seletiva quando expostos a sons que desencadeiam esta condição / INTRODUCTION: Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been proposed that misophonia, as well as tinnitus, is associated with hyperconnectivity between the auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet. OBJECTIVE: to characterize a sample of misophonic subjects and compare it to two control groups, one with tinnitus individuals (without misophonia) and the other one with asymptomatic individuals (without misophonia and without tinnitus), regarding self-perception of the condition and selective attention. METHODOLOGY: we had evaluated 40 normal hearing participants: 10 with misophonia (GM), 10 with tinnitus (without misophonia) (GCZ) and 20 without tinnitus and without misophonia (GCA). General questionnare was applied in all of three groups and specific misophonia questionnaire was applied only in GM. In order to evaluate the selective attention, it was applied the Dichotic Sentence Identification (DSI) Test in three situations: In the first one, it was applied the original test. Then, the test was applied in two other situations including two competitive sounds, one with chewing sound (chewing test), and the other one with white noise sound (white noise test). RESULTS: The GM sample indicated that the onset of misophonia occurred in childhood or adolescence (mean 11.5 years). According to the visual analog scale, the discomfort with misophonia ranged from 5 to 10, and nine (90%) participants answered that misophonia always or sometimes limits their social and professional interactions. In the chewing test, it was observed that the average of correct responses differed between GM and GCA groups (pvalue = 0.027) and between GM and GCZ groups (p-value = 0.002), in both cases it was lower in GM. In the original and white noise tests, no difference was observed between the averages of correct responses in the three groups (p-values >= 0.452). CONCLUSION: The GM participants had a lower percentage of correct responses in the chewing test, suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger the condition

INTRODUÇÃO: A misofonia é caracterizada pela aversão a sons bem seletivos, que provocam uma forte reação emocional. Foi proposto que a misofonia, assim como o zumbido, esteja associada à hiperconectividade entre os sistemas auditivo e límbico. Indivíduos com zumbido de incômodo significativo podem apresentar comprometimento da atenção seletiva, o que ainda não foi demonstrado no caso da misofonia. OBJETIVO: caracterizar uma amostra de indivíduos com misofonia e compará-la com dois grupos controle, um com zumbido (sem misofonia) e outro assintomático (sem zumbido e sem misofonia). METODOLOGIA: Foram avaliados 40 sujeitos normo-ouvintes, sendo 10 com misofonia (grupo misofonia - GM), 10 com zumbido (sem misofonia) (grupo controle zumbido - GCZ) e 20 sem zumbido e sem misofonia (grupo controle assintomático - GCA). Foi realizada anamnese geral em todos os grupos e anamnese específica apenas para o GM. Nos três grupos, foi aplicado o Teste de Identificação de Sentenças Dicóticas em três situações. Na primeira, foi realizado o exame padrão. Em seguida, foi aplicado incluindo mensagem competitiva, uma com som de mastigação (exame mastigação), e outra com white noise (exame white noise). RESULTADOS: A amostra do GM apontou que os primeiros sintomas da misofonia foram percebidos ainda na infância ou adolescência (média 11,5 anos). O grau de incômodo variou de 6 a 10 na escala visual analógica e, dentre os 10 participantes do GM, nove (90%) responderam que a misofonia atrapalha, sempre ou às vezes, a vida social e profissional. No teste de Identificação de Sentenças Dicóticas, foi observado que no exame mastigação, as médias da porcentagem de acertos diferem entre os grupos GM e GCA (valor-p = 0,027) e entre os grupos GM e GCZ (valor-p = 0,002), sendo menor em ambos os casos no GM. Para os exames padrão e white noise, não há diferença entre as médias da porcentagem de acertos nos três grupos (valores-p >= 0,452). CONCLUSÃO: os participantes do GM apresentaram menor porcentagem de acertos no Teste de Identificação de Sentenças Dicóticas na situação de apresentação de um ruído distraidor (exame mastigação) em relação ao mesmo teste aplicado em situação padrão ou white noise, sugerindo que indivíduos com misofonia podem apresentar alteração da atenção seletiva quando expostos a sons que desencadeiam esta condição / INTRODUCTION: Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been proposed that misophonia, as well as tinnitus, is associated with hyperconnectivity between the auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet. OBJECTIVE: to characterize a sample of misophonic subjects and compare it to two control groups, one with tinnitus individuals (without misophonia) and the other one with asymptomatic individuals (without misophonia and without tinnitus), regarding self-perception of the condition and selective attention. METHODOLOGY: we had evaluated 40 normal hearing participants: 10 with misophonia (GM), 10 with tinnitus (without misophonia) (GCZ) and 20 without tinnitus and without misophonia (GCA). General questionnare was applied in all of three groups and specific misophonia questionnaire was applied only in GM. In order to evaluate the selective attention, it was applied the Dichotic Sentence Identification (DSI) Test in three situations: In the first one, it was applied the original test. Then, the test was applied in two other situations including two competitive sounds, one with chewing sound (chewing test), and the other one with white noise sound (white noise test). RESULTS: The GM sample indicated that the onset of misophonia occurred in childhood or adolescence (mean 11.5 years). According to the visual analog scale, the discomfort with misophonia ranged from 5 to 10, and nine (90%) participants answered that misophonia always or sometimes limits their social and professional interactions. In the chewing test, it was observed that the average of correct responses differed between GM and GCA groups (pvalue = 0.027) and between GM and GCZ groups (p-value = 0.002), in both cases it was lower in GM. In the original and white noise tests, no difference was observed between the averages of correct responses in the three groups (p-values >= 0.452). CONCLUSION: The GM participants had a lower percentage of correct responses in the chewing test, suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger the condition

Misophonia is a sensory disorder where specific stimuli, usually auditory, trigger the fight-flight-freeze response, causing extreme reactions, typically anger, panic, or anxiety. Research into treatment for misophonia is limited, primarily consisting of case studies applying common methods of therapy. However, research into similar disorders like tinnitus shows that there are many avenues of treatment that should be investigated, including audiological treatment. To apply audiological treatment to misophonia, selective noise cancelling must be used to control specific trigger sounds. In this research, a basic selective noise cancelling algorithm was developed using a convolutional neural network and was evaluated using a survey. Participants rated their reaction to trigger sounds, non-trigger sounds, and trigger sounds that had been selectively cancelled. The misophonic reactions to selectively cancelled sounds were significantly less than to trigger sounds. This shows that selective noise cancelling could be used to apply audiological treatments to misophonia.

Misophonia is a condition characterized by a strong physiological, emotional, and behaviouralresponse to specific auditory stimuli, which have a significant negative impact on the wellbeingof affected individuals. The present investigation focuses on emotional dysregulation, which arises due to the triggering of specific auditory stimuli. Individuals with misophoniastruggle to regulate their emotions when exposed to sounds, leading to emotional reactions, including anger, anxiety, disgust, avoidance behaviour, fight or flight, and feeling overwhelmed. These reactions might even lead to violent impulses directed towards the source of the sound. Despite its growing recognition, little is yet known about misophonia, and experts have not established any clear boundaries or criteria for the condition to be considered adisorder. As such, it is not yet included in any classification systems for disorders. The aim of this study is to understand how individuals with misophonia experience emotional dysregulation, how do they describe their experience, what is it like to live with misophonia ona day-to-day basis, and how do individuals understand and cope with emotional dysregulation caused by misophonia? The study utilized a qualitative approach with semi-structured interviews as the data collection method. Thematic analysis was used to identify patterns and themes within the data. Participants stated that misophonia causes significant distress and disruption impacting emotional well-being and daily functioning. Validation of this new condition can be very helpful and make a positive impact in their social circle, and that lack of awareness and effective treatment may hold back seeking professional help.

Alla sinnen kan påverka vår matupplevelse och även hur vi upplever smak, men ett sinne som ofta glöms bort är hörseln. Olika ljud i omgivningen, men även matljuden i sig, har möjlighet att påverka hur vi upplever det vi äter. Hur vi upplever de olika matljuden kan ha en evolutionär bakgrund då krispiga ljud kan tala om för oss att maten är färsk eller innehåller mycket fett eller näringsämnen medan skrapande ljud och ljud av olika vätskor, såsom snörvlande påminner om sjukdom eller fara. På sistone har även fenomen som ASMR och streamande av ätande så kallat mukbang blivit populariserat där matljud lockar tittare. De ljud som är populära inom dessa genrer är dock ljud som kan bli triggande för personer med misofoni.     En enkätstudie utfördes med 100 deltagande respondenter varav 34 hade misofoni, 32 angav att de hade en nedsatt tolerans för olika ljud, 7 som inte visste (om de hade någon ljudöverkänslighet) och 27 som inte hade någon ljudöverkänslighet. Enkäten innefattade olika ljudklipp med matljud och ljud vid matbordet som respondenterna fick lyssna på samt fick olika frågor om hur de upplevde ljuden, ifall ljuden kunde påverka deras aptit, hur ljudkänsliga de är (via den så kallade noise sensitivity scale) samt vilka reaktioner som triggande ljud utlöser för personerna. I denna studie ställs frågan hur de olika grupperna skiljer sig åt gällande dessa frågor samt hur ljud upplevs och varför, samt om misofoni påverkar aptiten. Huruvida misofoni borde betraktas som en egen diagnos kommer att diskuteras.    Denna studie visar att personer med misofoni upplever matljud som signifikant värre än de utan någon ljudöverkänslighet. Ljudet av ett äpple som äts upplevs exempelvis som värre än ljudet av en gaffel skrapande mot en tallrik för personer med misofoni medan personer utan ljudöverkänslighet upplever skrapljudet som allra värst. Personer utan ljudöverkänslighet upplever ljudklippen i enkäten som betydligt mer aptithöjande än personer med misofoni. Studien visar även att personer med misofoni reagerar betydligt starkare på olika ljud i jämförelse med personer som svarat att de upplever att de har en nedsatt tolerans för olika ljud. / All our senses can affect our dining experience and how we perceive flavour. One of the senses that is often forgotten in the context of eating is our hearing. Different sounds in the environment, and even the sound of food itself, can affect the way we perceive our meal. How we experience the different sounds of food has an evolutionary background. Crispy sounds can tell us when something is fresh, has a high fat or nutrition content, while various liquid sounds such as snivelling or scraping noises remind us of sickness and danger. Recently phenomena such as ASMR and mukbang, online streaming of someone eating, has become popularized where food sounds attract many viewers. However the sounds that are popular within these genres are the sounds that can be triggering for people with misophonia.     Out of the 100 people surveyed 34 respondents reported that they had misophonia, 32 experienced increased noise sensitivity, 7 didn't know (if they had any increased noise sensitivity), and 27 were not noise sensitive. The survey consisted of different audio clips with food sounds and other sounds from the dinner table, as well as questions about how the respondents experienced the sounds, if the sounds affected their appetite, if they are sensitive to noise (according to the noise sensitivity scale) and what reactions occurred because of the triggering sounds. This study asks the question of how the different groups’ answers differentiate throughout these questions, how sound is perceived and why, and if misophonia has an effect on appetite. If misophonia should be considered as a separate diagnosis will be discussed.    This study shows that people with misophonia perceive sound of food as significantly worse than the people without noise sensitivity. For example, the sound of an apple being eaten is perceived as worse than the sound of a fork scraping against a plate for people with misophonia while people without noise sensitivity rate the scraping sound as the worst. People without sound sensitivity experience the audio clips as significantly more appetite enhancing than people with misophonia. This study also shows that people with misophonia respond significantly stronger to various sounds compared to the people with increased noise sensitivity.