Associate Professor Texas State University San Marcos, Texas
Introduction: Misophonia is a new condition characterized by a strong dislike of specific auditory stimuli associated with specific sounds produced by humans (e.g., mouth smacking, chewing, mouth breathing) that results in an intense negative emotional reaction and is related to functional impairments. Research has been largely focused on neuroimaging, psychophysiology, and psychopathology of the disorder. However, little is known about cognitive functioning in misophonia, which is important to examine since it is unclear if misophonia is related to problems such as general distractibility, or difficulties inhibiting certain stimuli. Therefore, the present study aimed at conducting the first comprehensive neuropsychological examination of cognitive functions in misophonia and its association with clinical aspects of the disorder.
Methods: The study sample included 64 control participants, and 32 participants were included in the misophonia group. Screening for comorbid DSM disorders was assessed via semi-structured clinical interview (Mini International Neuropsychiatric Interview). Participants’ misophonia sound sensitivity, as well as emotional and behavioral response to trigger sounds were assessed using the Misophonia Questionnaire. Participants also completed several self-report measures assessing impulsivity, depression, state and trait anxiety, stress, and daily life functional impairment. All participants completed an extensive neuropsychological battery assessing all cognitive domains including executive functioning, memory, attention, spatial functions, and processing speed. Holm’s correction for multiple comparisons was employed.
Results: No significant group differences were found on all demographics, and comorbid conditions (p = 0.50, Cohen’s d = 0.14). The misophonia group presented with significantly higher levels of general anxiety (p = 0.016, d = 0.52), state anxiety (p = 0.011, d = 0.62), and impulsivity (p = 0.006, d = 0.61). No significant differences were found in depression or stress symptoms. Functional impairments were found in money management (p = 0.006, d = 0.60), and problems related to driving (p = 0.016, d = 0.58). In terms of neuropsychological test performance, the misophonia group performed worse on tests of verbal memory (p = 0.01, d = 0.63), verbal fluency (p = 0.02, d = 0.47), and exemplified slower processing speed (p = 0.015, d = 0.66).
Conclusion: To our knowledge, this is the first comprehensive neuropsychological examination of misophonia. Results show that individuals with misophonia exhibit elevated levels of anxiety and impulsivity and demonstrated some everyday functional impairments. More importantly, individuals with misophonia demonstrated slower processing speed, worse semantic verbal fluency, and verbal memory (with medium effect sizes). However, this underperformance was in the normative range. No association between misophonia severity and cognitive functions were found, speculatively because misophonia is an episodic disorder. More research is needed on cognitive function in misophonia, particularly examining the hypothesis that misophonia may hinder cognitive function exclusively during exposure to trigger sounds.
