The present study aimed to investigate the extent to which the severity of misophonia symptoms is linked with cognitive control under misophonia symptom-provocation circumstances in the general population sample. Participants (N = 79) completed a measure of cognitive control – a Stroop color naming task, which consists of congruent and incongruent stimuli, and requires inhibition of a prepotent response (reading a word) in the service of a less predominant response (naming a color), while listening to misophonia symptom-provocation or universally unpleasant sounds. Participants’ misophonia sound sensitivity, and emotional behaviors towards trigger sounds were assessed using the Misophonia Questionnaire. Stronger emotional behavioral reactions to misophonia trigger sounds were significantly associated with the larger Stroop effect when participants were exposed to the misophonia trigger sounds, but not when they were exposed to the universally unpleasant sounds. This effect held when controlling for personality trait of Neuroticism and for baseline levels of anxiety. Both elevated misophonia sound sensitivity and emotional behaviors towards trigger sounds significantly correlated with higher self-reported anxiety when performing the Stroop task. However, only elevated emotional behaviors towards trigger sounds were linked with higher anxiety levels at baseline, suggesting that people who experience stronger emotions and behavioral reactions to misophonia trigger sounds may have higher anxiety at a trait level. Limitations and future directions are discussed.

Background Misophonia is often characterized by excessive negative emotional responses, including anger and anxiety, to “trigger sounds” which are typically day-to-day sounds, such as those generated from people eating. Misophonia (literally ‘hatred of sounds’) has commonly been understood within an auditory processing framework where sounds cause distress due to aberrant processing in the auditory and emotional systems of the brain. However, recent evidence from brain imaging shows involvement of the motor system while listening to trigger sounds suggesting that the perception of an action (e.g., mouth movement) produced by a trigger person, not the sound per se, drives distress in misophonia. Observation or listening to sounds of another’s actions are known to prompt automatic mimicry/imitations. Apart from anecdotal evidence and a few case studies, a relationship between mimicry and misophonia has not been evaluated. Method We addressed this ‘gap’ by collecting data on misophonia symptoms and mimicry behaviour using online questionnaires from 676 participants. Results The analysis shows, (i) the tendency to mimic varies in direct proportion to misophonia severity assessed using a self-reported questionnaire, (ii) compared to other human and environmental sounds, trigger sounds of eating and chewing are more likely to trigger mimicking, and (iii) the act of mimicking provides relief from distress to most people with misophonia. Conclusion Mimicry is widely prevalent in misophonia and is elicited by the most common trigger sounds of eating. The data provides support to the model that misophonia is not a disorder of sound-processing but rather its basis lies in social perception.

Abstract How the human auditory cortex prioritizes relevant information amid concurrent sounds has been a long-standing question in auditory cognitive neuroscience. The present study used auditory steady-state responses to tag the electrocortical response to a tone embedded in concurrent naturalistic sounds, addressing methodological challenges with overlapping auditory streams. Participants endorsing low (high misophonia symptoms) or high misophonia symptoms—a condition with decreased tolerance to specific, typically orofacial, sounds—were recruited. Sounds varied in emotional valence (pleasant, neutral, unpleasant) to investigate how emotional content modulates attentional competition. Orofacial sounds were also included to evaluate how attentional biases are affected by inter-individual sensitivity toward a specific sound category. Affective ratings, alpha-band changes, and pupil dilation were also assessed. Hypothetical models of competition were tested, revealing a facilitation trend in the auditory steady-state responses amplitude when accompanied by pleasant and unpleasant, compared to neutral sounds, regardless of misophonia symptoms. However, auditory steady-state responses was selectively reduced in the high misophonia symptoms but not the high misophonia symptoms group when accompanied by orofacial sounds. Analyses of alpha-band, pupil, and rating data showed that the groups differed primarily in their response to pleasant sounds and orofacial sounds, with the high misophonia symptoms group exhibiting a stronger response to orofacial sounds than the high misophonia symptoms group.

Abstract How the human auditory cortex prioritizes relevant information amid concurrent sounds has been a long-standing question in auditory cognitive neuroscience. The present study used auditory steady-state responses (ASSR) to tag the electrocortical response to a tone embedded in concurrent naturalistic sounds, addressing methodological challenges with overlapping auditory streams. Participants endorsing low (LMS) or high in misophonia symptoms (HMS)—a condition with decreased tolerance to specific, typically orofacial, sounds—were recruited. Sounds varied in their emotional valence (pleasant, neutral, unpleasant, and orofacial) to investigate how emotional content modulates attentional competition and how competition is resolved in listeners with misophonia traits. Affective ratings, alpha-band changes, and pupil dilation in response to the sounds were also assessed. Hypothetical models of competition were tested, revealing a facilitation trend in the ASSR amplitude when accompanied by pleasant and unpleasant, compared to neutral sounds, regardless of misophonia symptoms. However, ASSR was selectively reduced in the HMS but not the LMS group when accompanied by orofacial sounds. Analyses of alpha-band, pupil, and rating data showed that the groups differed primarily in their response to pleasant sounds and orofacial sounds, with the HMS group exhibiting a stronger response to orofacial sounds than the LMS group.

BackgroundMisophonia is often referred to as a disorder that is characterized by excessive negative emotional responses, including anger and anxiety, to “trigger sounds” which are typically day-to-day sounds, such as those generated from people eating, chewing, and breathing. Misophonia (literally ‘hatred of sounds’) has commonly been understood within an auditory processing framework where sounds cause distress due to aberrant processing in the auditory and emotional systems of the brain. However, recent evidence from brain imaging showing involvement of the motor system while listening to trigger sounds suggests that it is the perception of action (e.g., mouth movement) of the trigger person, and not the sounds per se, that drives the distress in misophonia. Since observation or listening to sounds of actions of others are known to prompt automatic mimicry/imitations in perceivers, we hypothesized that mimicking the action of the trigger person may be prevalent in misophonia. Apart from a few case studies and anecdotal information, a relation between mimicking and misophonia has not been systematically evaluated. MethodIn this work, we addressed this limitation by collecting data on misophonia symptoms and mimicry behaviour using online questionnaires from 676 participants. ResultsAnalysis of these data shows that (i) the tendency to mimic varies in direct proportion to misophonia severity assessed using a self-reported questionnaire, (ii) compared to other human and environmental sounds, trigger sounds of eating and chewing are more likely to trigger mimicking, and (iii) the act of mimicking provides relief from distress to most people with misophonia. LimitationsThe format of the study as an online survey used questionnaires to assess misophonia status. The questionnaire has been used extensively in misophonia research, however it is not fully validated for use in clinical populations, therefore we cannot be certain on the degree of severity of symptoms reported in this study population.ConclusionThis study shows that mimicry is widely prevalent in misophonia and is elicited by the most common trigger sounds of eating and chewing. These data reinforce the idea of hyper-mirroring in misophonia proposed in our earlier work (Kumar et al., 2021). Thus, providing crucial implications for how we treat and interpret misophonia moving forward.