Symposia
Obsessive Compulsive and Related Disorders
M. Zachary Rosenthal, PhD
Associate Professor
Duke University
Durham, North Carolina
Kibby McMahon, Ph.D.
Post-doc
Duke University Medical Center
Durham, North Carolina
Clair Cassiello-Robbins, Ph.D.
Therapist
Triangle Area Psychology Clinic
Durham, North Carolina
Anna Greenleaf
Research Assistant
Duke University
Durham, North Carolina
Rachel Guetta, PhD
Graduate Student
Duke University
Durham, North Carolina
Jaqueline Trumbull, PhD
Graduate Student
Duke University
Durham, North Carolina
Deepika Anand, Ph.D.
Therapist
CBT Center of Chicago
Durham, North Carolina
Lisalynn Kelley, B.A., C.C.R.P
Research Program Leader
Duke University Medical Center
Durham, North Carolina
Misophonia is characterized by decreased tolerance and defensive motivational system responding to certain aversive sounds and contextual cues (Brout et al., 2018). Such cues (sometimes called “triggers”) commonly are repetitive oral or facial stimuli (e.g., eating, throat clearing, or sniffing; Jager et al., 2020), and are typically produced by other humans but can be animal-produced (e.g., pets grooming themselves) or generated environmentally (e.g., clock ticking). Once triggered, individuals with misophonia can have significantly distressing and impairing sudden changes in emotional functioning and associated sequelae, including (a) affect (e.g., increases in irritation, anger, anxiety, and disgust), (b) arousal (e.g., sympathetic nervous system activation), and (c) behavior (e.g., escape behavior and verbal aggression; Rouw and Erfanian, 2018). Research on misophonia is new, dating back only to 2013. This raises the question: Is misophonia a unique condition? To date, studies addressing this question have used self-report measures, small samples, and limited diagnostic assessment to a subset of disorders. In the present study, our team conducted SCID-5 interviews in 212 adults with misophonia. This is the first phenotyping study to use the SCID-5 to comprehensively characterize the co-occurrence of current and lifetime psychiatric disorders in misophonia. Results indicate that anxiety (lifetime 71%; current 56%) and mood (lifetime 60%; current 15%) were the most prevalent co-occurring classes of disorders. OCPD (6% met full criteria) was the most common personality disorder observed in this sample. Higher misophonia symptom severity was significantly and moderately positively correlated with a range of psychiatric disorders (e.g., current/lifetime presence of anxiety, mood, OC-related, trauma-related, substance use, and personality disorders; ps < .05), but not uniquely with any one disorder or class of disorders. Misophonia was not associated with presence of lifetime/current eating or impulse control disorders. Results suggest that misophonia is a clinical presentation most commonly observed in those with anxiety disorders, but is not associated uniquely with anxiety disorders. The clinical implications of this study are clear with direct relevance to healthcare providers treating clients across the lifespan: Treatment of Misophonia should be tailored idiographically to attend appropriately to co-occurring problems and not provided in a one-size-fits-all manner.