Checklist for an Explanatory Model of Misophonia

Any complete theory of misophonia must be able to explain or account for the following obsevations.

Modalities

Triggers can be visual, audial, olfactory, or tactile/kinaesthetic/proprioceptive. Thinking about or replaying trigger stimuli can also evoke an emotional response.

Perceived source & context

Perceived source and context of the sound are important (see A social cognition perspective on misophonia).

Primarily (but not always) orofacial

Trigger sounds are typically to do with the mouth, but non-mouth-related sounds can also be triggers.

Person-dependent

The strongest triggers typically come from family members or close friends, but strangers and even animals can also be sources of triggers.

Self-triggering

Sufferers can trigger themselves, for example audially with eating or (as in my own case) kinaesthetically/proprioceptively.

Change over time

Triggers can evolve over long periods of time or be acquired, and increase in strength, over a period of minutes or hours.

Diversity of triggers

People have all kinds of triggers. Typical audial and visual triggers include human mouth sounds, pen clicking, rustling or crunching sounds, and leg swinging, but the following have also been reported, to give a random selection of examples:

  • People speaking in a language the sufferer doesn’t speak.

  • Baby-talk or cooing.

  • Certain word (mis)pronunciations.

  • Certain vowel sounds.

Diversity of emotions

The emotion varies by individual and has been characterised as rage, anxiety, and disgust, as well as various physical sensations. I argue, according to the construction view of emotion, that a theory of misophonia does not have to explain each of these emotional expressions, but merely to explain the underlying negative affect.

General/demographic

  • Misophonia typically starts around age 9–12, but can start earlier or later.

  • Prevalence seems to be 5%–20% of the population.

  • Misophonics are not abnormally sensitive to non-trigger stimuli, whether pleasant, neutral, or unpleasant.

  • Misophonics have higher interoceptive sensibility (brain basis paper).

  • Misophonics do not get used to triggers through exposure; repeated exposure generally worsens the condition.