Properties (12)
Id f291eaa0-f8f8-4e32-99b6-83d22ef292cb
Year 2020
Abstract
Cssclasses
- purpleRed
Aliases
- Inattention in misophonia
- (Frank et al., 2020)
Key Terms
- Misophonia
- Attention Network Test (ANT)
- Orienting Attention
- Conflict Effect
- Wisconsin Card Sorting Test (WCST)
Import Date 08-27-2025
Dv Status #status/reviewed
Dv Limitations • Small sample size (N = 22). • Lack of full neuropsychological battery. • Trigger sounds not time-locked to ANT trials—limits specificity of provocation. • didn’t use individualized sound rankings for trigger selection • Potential for ceiling effects in ANT accuracy measures. • cross sectional methods means the effects cant be for sure said to reflect a long-standing neuropsychological weakness. The results of the symptom provocation paradigm suggests this possibility
Dv Future Directions • Larger samples and more comprehensive cognitive batteries needed. • Include "cold" ANT (task with no symptom provocation) conditions to clarify whether deficits are symptom-related or trait-based. • Examine executive functioning (e.g., perseveration, inhibition) more deeply. • Longitudinal studies to assess inattention as potential causal or consequential factor. • Explore modality-specific attention differences (e.g., visual vs. auditory ANT). • Investigate predictive coding deficits and sensory over-responsivity as broader framework for misophonia.
Dv Relevance • a study looking at attention in Misophonia • a good source fort a possible attention task to use in Misophonia research ( the Attention Network Test (ANT):) • found evidence that Individuals with misophonia show impaired alerting attention, possibly indicating a stable neuropsychological weakness. • No evidence that symptom provocation alone accounts for attentional deficits. • Misophonia may involve a chronic deficit in attentional vigilance. • authors call for more looks into executive functioning in misophonia
Checked For Zettle Notes true
Inattention in misophonia: Difficulties achieving and maintaining alertness
Status:: #status/reviewed
Metadata
- Item Type: #journalArticle
- Authors: Brandon Frank, Meaghan Roszyk, Landon Hurley, Loreta Drejaj, Dean McKay,
- Date:
- Date Added: 1756148571000
- URL: https://www.tandfonline.com/doi/full/10.1080/13803395.2019.1666801
- DOI: 10.1080/13803395.2019.1666801
- Cite Key: frankInattentionMisophoniaDifficulties2020
- Topics: [object Object]
- Tags: #Misophonia, #Attention, #decreased-sound-tolerance-DST , #Attentional-networks, #frontal-systems, #bayseian-analysis,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia is under-recognized, with unclear etiology and diagnostic status. • Prior reports suggest attentional deficits in misophonia but lack systematic neuropsychological investigation. • Physiological and neuroimaging evidence (e.g., insular hyperactivation, altered ERPs) points to atypical sensory processing. • Misophonia may involve attentional dysregulation similar to tinnitus and sensory over-responsivity. Purpose- • Assess attentional functioning in individuals with misophonia using ANT and symptom provocation. specifically target functioning of frontal systems in misophonia • Explore executive functioning, perseveration, and frustration tolerance through additional cognitive tasks. • Hypothesize greater attentional deficits (alerting, orienting, conflict) in the misophonia group. • predicted Misophonics would have higher alerting, orienting, and conflict effects on the ANT |
| Participants/samples | • N = 22 (11 misophonia, 11 matched controls). • Matched for age, gender, education; mostly non-Hispanic White. • Misophonia group recruited from a treatment trial and screened for moderate symptom severity (MQ score ≥ 7). • Exclusions: significant cognitive impairment, psychosis, ASD, personality disorder, history of aggression. |
| Measures | • Misophonia Questionnaire (MQ) – A self-report instrument used to assess the severity and behavioral impact of misophonia symptoms. It consists of two subscales: •Symptom Subscale: Measures frequency and intensity of emotional and physiological responses to trigger sounds. •Behavior Subscale: Captures behavioral reactions and avoidance patterns associated with sound triggers. • Depression Anxiety Stress Scale – 21 (DASS-21) – A 21-item self-report scale that assesses three dimensions of negative emotional states: •Depression: Measures dysphoria, hopelessness, and devaluation of life. •Anxiety: Captures symptoms such as autonomic arousal and situational anxiety. • Stress: Assesses tension, irritability, and difficulty relaxing. • Anxiety Sensitivity Index – 3 (ASI-3) – A 18-item self-report tool that evaluates the extent to which individuals fear anxiety-related sensations due to beliefs that they have harmful implications (e.g., social embarrassment, physical illness, cognitive dyscontrol). • Distress Tolerance Scale (DTS) – A 15-item self-report measure assessing perceived ability to tolerate emotional distress. Includes dimensions such as: • Tolerance: Endurance of distress without avoidance. • Appraisal: Perceived acceptability of distress. • Absorption: Extent to which distress interferes with functioning. • Regulation: Beliefs about how controllable or manageable distress is. • Attention Network Test (ANT) – A computerized task that evaluates three components of attention: • Alerting: Ability to achieve and sustain a state of readiness for incoming stimuli. • Orienting: Capacity to shift attention toward a location or sensory event. • Conflict (Executive Control): Proficiency in managing interference from conflicting information, assessed via flanker stimuli (e.g., incongruent arrow directions). conflict monitoring is a function and indicator or executive functioning • Wisconsin Card Sorting Test (WCST) – A neuropsychological task measuring higher-order executive functions: • Concept Formation: Ability to identify abstract rules and use them to guide responses. • Perseveration: Tendency to persist in using previously reinforced rules even when no longer correct, reflecting cognitive rigidity and set-shifting difficulties. |
| Procedures | • General Setup: • All tasks were administered digitally to minimize experimenter-induced variability and uncontrolled symptom provocation. • Participants completed testing remotely and were monitored via the HIPAA-compliant video conferencing platform VSee. • The full session lasted approximately 120 minutes and included structured breaks between tasks to manage fatigue and distress. • Attention Network Test (ANT): • Participants first completed 24 practice trials (with feedback), followed by 288 experimental trials. • Each trial involved identifying the direction of a central arrow, flanked by congruent or incongruent arrows, with variable cueing conditions: • No Cue vs. Double Cue for alerting attention. • Center Cue vs. Spatial Cue for orienting attention. • Congruent vs. Incongruent Flankers for conflict (executive control). • Reaction times and accuracy were recorded, and attentional effects were calculated as differences between specific condition pairs. cited (Fan et al., 2002) to justify how they calculated effects. • Symptom Provocation Protocol (Embedded in ANT): • To assess effects of misophonia triggers, a symptom provocation paradigm was integrated into the ANT. • Aversive auditory stimuli (e.g., chewing sounds) rated as highly triggering by a misophonia sample were played during one of the three ANT trial blocks (trials 1–96, 97–192, or 193–288), with block assignment randomized. • Sounds were delivered in 15-second intervals in a randomized sequence, not time-locked to task stimuli, to simulate real-world exposure. • Wisconsin Card Sorting Test (WCST): • Administered in a digital format with 64 response cards. • Participants sorted cards based on an unknown rule (e.g., color, shape, number), and were required to adjust sorting strategies when feedback indicated that the rule had changed. • Standardized scoring captured perseverative errors, total errors, and number of correct categories. • Paced Auditory Serial Addition Task – Computerized (PASAT-C): • Participants heard a sequence of single-digit numbers and were required to continuously add the most recent number to the one immediately prior • Designed to be cognitively taxing and stress-inducing, it served as an indirect measure of frustration tolerance, accuracy under pressure, and sustained attention. • Self-Report Measures: •All questionnaires (MQ, DASS-21, ASI-3, DTS, BPQ Health History) were completed via SurveyMonkey prior to the neuropsychological tasks. •These provided dimensional assessment of symptom severity, comorbid emotional states, and functional impact of misophonia. |
| Results | • Alerting Attention: Misophonia group had significantly worse alerting scores. Bayesian estimation showed strong evidence (BF = 31.41). • No Block Effects: Performance differences not limited to symptom-provocation blocks—suggests stable attentional deficit. • Orienting/Conflict Effects: No significant group differences. • Executive Functioning: • No significant effects on WCST or PASAT-C. • Medium effect size for perseveration in WCST noted but not statistically significant. • results slightly conflict with Eijsker 2018’s stop signal task, but this may be due to how that task tests diff cog abilities then the one in this study • Self-Report Findings: • Misophonia group showed higher anxiety sensitivity, stress, and lower distress tolerance. • Higher prevalence of somatic complaints (e.g., migraines, GI issues). |
| Discussion/Limits | Conclusion- • Individuals with misophonia show impaired alerting attention, possibly indicating a stable neuropsychological weakness. • No evidence that symptom provocation alone accounts for attentional deficits. • Misophonia may involve a chronic deficit in attentional vigilance. |
| Limitations:: | • Small sample size (N = 22). • Lack of full neuropsychological battery. • Trigger sounds not time-locked to ANT trials—limits specificity of provocation. • didn’t use individualized sound rankings for trigger selection • Potential for ceiling effects in ANT accuracy measures. • cross sectional methods means the effects cant be for sure said to reflect a long-standing neuropsychological weakness. The results of the symptom provocation paradigm suggests this possibility |
| Future Directions:: | • Larger samples and more comprehensive cognitive batteries needed. • Include "cold" ANT (task with no symptom provocation) conditions to clarify whether deficits are symptom-related or trait-based. • Examine executive functioning (e.g., perseveration, inhibition) more deeply. • Longitudinal studies to assess inattention as potential causal or consequential factor. • Explore modality-specific attention differences (e.g., visual vs. auditory ANT). • Investigate predictive coding deficits and sensory over-responsivity as broader framework for misophonia. |
| Relevance:: | • a study looking at attention in Misophonia • a good source fort a possible attention task to use in Misophonia research ( the Attention Network Test (ANT):) • found evidence that Individuals with misophonia show impaired alerting attention, possibly indicating a stable neuropsychological weakness. • No evidence that symptom provocation alone accounts for attentional deficits. • Misophonia may involve a chronic deficit in attentional vigilance. • authors call for more looks into executive functioning in misophonia |
Notes
key terms and concepts:
-
Misophonia – A condition marked by strong negative emotional reactions to specific sounds (e.g., chewing, pen clicking), often accompanied by physiological and behavioral responses.
-
Attention Network Test (ANT) – A cognitive task assessing three components of attention: alerting, orienting, and executive control (conflict).
-
Alerting Attention – The ability to achieve and maintain an alert state in response to incoming stimuli.
-
Orienting Attention – Directing attention toward sensory stimuli.
-
Executive Attention (Conflict Effect) – Managing conflict among responses; assessed via incongruent vs. congruent cues.
-
Symptom Provocation – Experimentally inducing misophonia symptoms via exposure to aversive auditory stimuli.
-
Bayesian Estimation – Statistical method assessing credible effects using prior distributions and posterior probability.
-
Wisconsin Card Sorting Test (WCST) – A neuropsychological test assessing set shifting, concept formation, and perseveration.
-
PASAT-C – A stress-inducing task measuring processing speed and frustration tolerance.
my engagement notes
my questions
my comments
- could use more info on the triggers used.
Bookmarks
reading notes
Comorbidity and Clinical Implications
-
Misophonia often co-occurs with affective symptoms (anxiety, depression) and poor coping (e.g., substance use).
-
No consistent psychiatric comorbidity pattern; distress appears misophonia-specific.
-
Potential overlap with sensory over-responsivity and interoceptive dysfunction (e.g., anterior insula activity).
Research Design Strengths
-
Use of Bayesian modeling and robust statistical estimation with small sample.
-
Digital administration and remote monitoring increased control over experimental conditions.