A study of individuals with misophonia found that approximately 65% of them have received at least one other psychological disorder diagnosis. The most common additional diagnoses were depression (49%) and anxiety disorders (47%). The paper was published in Psychiatry Research.
Misophonia is a condition characterized by intense emotional and physiological reactions to specific everyday sounds. Common trigger sounds include chewing, breathing, tapping, or repetitive clicking noises. Individuals with misophonia experience anger, disgust, anxiety, or an urge to escape when exposed to these triggers. The reaction is typically immediate and disproportionate to the actual loudness or objective intensity of the sound.
Research suggests that misophonia involves heightened connectivity between auditory processing regions and brain areas involved in processing the emotional importance of stimuli and threat detection. Unlike general sound sensitivity, misophonia is usually selective for particular patterns rather than all loud noises.
The condition can significantly interfere with social relationships, work, and family life, especially when triggers involve close others. Some researchers conceptualize it as involving atypical emotional conditioning to specific auditory (sound) cues. There is ongoing debate about whether misophonia should be classified as a distinct disorder or as related to anxiety, obsessive-compulsive spectrum conditions, or sensory processing differences.
Study author Alexandra Freshley and her colleagues note that existing research suggests that misophonia is typically associated with heightened rates of various psychological and auditory-sensory disorders. However, previous studies have often relied on skewed clinical or college convenience samples. To address this, the researchers conducted a study investigating the mental health conditions commonly associated with misophonia using a probability-based, nationally representative sample of U.S. adults.
Study participants were 185 individuals with misophonia drawn from a larger sample of U.S. adults (via the Ipsos KnowledgePanel). An additional 1,644 participants from this study, who reported no misophonia symptoms, were included as the control group. The average age of the misophonia group was 41 years, while it was 51 in the control group. 53% of participants with misophonia, and 49% of control group participants, were women.
Study participants completed assessments of misophonia symptoms (the A-MISO-S and the Misophonia Questionnaire Severity Scale), which the authors used to identify individuals with misophonia. Aside from this, study participants completed screeners for anxiety (GAD-2) and depression symptoms (PHQ-2), as well as tinnitus, hyperacusis, autonomous sensory meridian response (ASMR), and hearing loss symptoms. They also completed a checklist about their history of psychological, auditory-sensory, and communication disorders, indicating if they had ever been diagnosed with the listed conditions.
Results showed that most of the examined disorders were between 2 and 37 times more likely to occur among individuals with misophonia compared to the control group, even after adjusting for demographic factors. 53% of individuals with misophonia screened positive for current anxiety, while this was the case for only 8% of individuals in the control group.
The share of people screening positively for current depression was 42% among participants with misophonia and 6% in the control group. Auditory symptoms were also highly prevalent: tinnitus (ringing in the ears) was reported by 44% of the misophonia group compared to 23% of the control group. Hyperacusis symptoms (painful or heightened sensitivity to everyday sounds) were present in 42% of individuals with misophonia and just 2% of the control group. The smallest difference was in hearing loss symptoms (30% in the misophonia group and 26% in the control group).
Looking at the self-reported lifetime diagnoses, the situation was similar. 49% of individuals with misophonia reported being diagnosed with depression (vs. 11% in the control group) and 47% with an anxiety disorder (vs. 10% in the control group). 29% had PTSD (vs. 3% in the control group).
Overall, 65% of participants with misophonia had at least one other disorder diagnosis. Notably, there were exceptions: after adjusting for demographics, misophonia was not significantly associated with an increased likelihood of being diagnosed with Autism Spectrum Disorder (ASD) or repetitive behavior disorders (like Tourette Syndrome or trichotillomania), which diverges from some previous, smaller studies.
“Results indicated that those with misophonia are significantly more likely to report symptoms and diagnoses of all mental health, auditory-sensory, and communication disorders, with a few exceptions (e.g., hyperacusis) [this refers to reports of a previous official hyperacusis diagnosis, not the hyperacusis symptoms assessment at the time of the study]. The high rates of comorbidity also emphasize the importance of identifying common underlying mechanisms,” the study authors concluded.
The study contributes significantly to the scientific knowledge about misophonia by utilizing a nationally representative sample. However, it should be noted that study data came from self-reports, leaving room for reporting bias.
Additionally, there were pronounced differences for some disorders between the share of participants with previous official diagnoses and those with elevated symptoms at the time of the study. This reflects the reality that some disorders (e.g., hyperacusis) are less frequently recognized in routine clinical practice, and individuals suffering from them may be less likely to seek or receive an official diagnosis.
The paper, “Clinical correlates of individuals with and without misophonia in the U.S.: Results from a population-based study,” was authored by Alexandra Freshley, Heather L. Clark, Mary J. Schadegg, and Laura J. Dixon.
