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Misophonia, literally "hatred of sound," was proposed in 2000 as a condition in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "select sound sensitivity syndrome" and "sound-rage." Misophonia has no classification as an auditory, neurological, or psychiatric condition, there are no standard diagnostic criteria, it is not recognized in the DSM-IV or the ICD-10, and there is little research on its prevalence or treatment. Proponents suggest misophonia can adversely affect ability to achieve life goals and to enjoy social situations. Treatment consists of developing coping strategies such as cognitive behavioral therapy and exposure therapy.
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Classification
The diagnosis of misophonia is not recognized in the DSM-IV or the ICD 10, and it is not classified as a hearing, neurological, or psychiatric disorder. It may be a form of sound–emotion synesthesia, and has parallels with some anxiety disorders.
Signs and symptoms
As of 2016 the literature on misophonia was very limited. Some small studies show that people with misophonia generally have strong negative feelings, thoughts, and physical reactions to specific sounds, which the literature calls "trigger sounds." These sounds are apparently usually soft, but can be loud. One study found that around 80% of the sounds were related to the mouth (eating, yawning, etc.), and around 60% were repetitive. A visual trigger may develop related to the trigger sound. It also appears that a misophonic reaction can occur in the absence of an actual sound.
Reactions to the triggers can include aggression toward the origin of the sound, leaving, or remaining in its presence but suffering, trying to block it, or trying to mimic the sound.
The first misophonic reaction may occur when a person is young and can originate from someone in a close relationship, or a pet.
People with misophonia are aware they experience it and that it is not normal; the disruption it causes to their lives ranges from mild to severe. Avoidance and other behaviors can make it harder for people with this condition to achieve their goals and enjoy interpersonal interactions.
Mechanism
Any mechanism behind misophonia is not known, but it appears that, like tinnitus and hyperacusis, it may be caused by a dysfunction of the central auditory system in the brain and not of the ears. The perceived origin and context of the sound appears to be essential to triggering a reaction.
Diagnosis
There are no standard diagnostic criteria. Misophonia is distinguished from hyperacusis, which is not specific to a given sound and does not involve a similar strong reaction, and from phonophobia, which is a fear of a specific sound, but it may occur with either.
It is not clear whether people with misophonia usually have comorbid conditions, nor whether there is a genetic component.
Management
There are no evidence-based treatments for the condition; health care providers generally try to help people cope with it by recognizing what the person is experiencing, and by working on coping strategies with the person. Some small studies have been published on the use of sound therapy similar to tinnitus retraining therapy and on cognitive behavioral therapy and particularly exposure therapy, to help people become less aware of the trigger sound. None of these approaches have been sufficiently studied to determine their effectiveness.
Epidemiology
The prevalence is not known; it is not known whether men or women, or older or younger people, tend to have misophonia.
History
The term "misophonia" was first coined by audiologists Pawel and Margaret Jastreboff in a publication in 2000.
Society and culture
People who experience misophonia have formed online support groups.
The press has sometimes overemphasized the strength of misophonic reactions, which are usually mild to moderate.
In 2016, Quiet Please, a documentary about misophonia, was released.