Properties (12)
Year 2023
Abstract Several studies have suggested that misophonia should be categorized as an obsessive-compulsive disorder (OCD) due to similar neural manifestations, such as impairments in limbic structures, and psychological features, such as perfectionism and disgust sensitivity. However, the two disorders may differ in the domains of disgust sensitivity. In OCD, the domain of pathogen disgust has been studied extensively as per the contamination subtype. In misophonia, pathogen disgust has not been reported. We hypothesized that moral disgust may better characterize individuals with misophonia, as studies indicate that people with misophonia view their triggers as morally unacceptable. Furthermore, neuroimaging has shown anterior cingulate cortex (ACC) activation particularly during exposure to misophonic triggers, which is an area associated with moral assessment of stimuli. Another psychological factor that may point to the two disorders being discrete is intolerance of uncertainty (IU), an aversion to undetermined events. IU has been well documented in OCD: It has been found to be positively associated with striatal volume and dysfunction in the ACC—both of which are common findings in OCD. We expected people with misophonia not to exhibit IU since they experience distress in response to specific triggers and, unlike individuals with OCD, do not experience preemptive anxiety. Multivariate logistic regression analysis run on survey-gathered data revealed IU as a significant predictor of OCD symptoms and moral disgust as a significant predictor of misophonia. Consistent with our hypotheses, our findings suggest that IU and moral disgust and the associated neural underpinnings differentiate misophonia from OCD. [ Psychiatr Ann . 2023;53(12):570–580.]
Cssclasses
- purpleRed
Aliases
- (Iskander et al., 2023)
Key Terms
- Misophonia
- OCD
- Intolerance of Uncertainty (IU)
- Disgust sensitivity
- Three-Domains of Disgust Scale (TDDS)
- Intolerance of Uncertainty Scale (IUS)
- Obsessive-Compulsive Inventory-Revised (OCI-R)
- New York Misophonia Scale (NYMS)
Import Date 10-10-2025
Dv Authors Simona Iskander, Usha Barahmand, Monica Soni, Ravinder Kaur, Dylan Arnero,
Dv Status #status/Bare-bones-review
Dv Limitations • Self-report data may introduce bias • Small sample size for subgroup analysis • Limited item scope for moral disgust assessment
Dv Future Directions • Develop better tools for assessing domain-specific disgust, especially internal moral contamination (self vs others) • Examine neural correlates of disgust domains in misophonia • Expand neuroscience-informed therapeutic approaches for both disorders
Dv Relevance • study looking at the Misophonia- OCD link. findings suggest they are different things, with Misophonia is predicted more by moral disgust whereas OCD is more predicted by uncertainty intolerance. • if I ever decide to dig back into the OCD link thing, this would be a good source to go back to
Checked For Zettle Notes true
Neurological Underpinnings of Psychological Factors Distinguishing Obsessive-Compulsive Disorder From Misophonia
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Simona Iskander, Usha Barahmand, Monica Soni, Ravinder Kaur, Dylan Arnero,
- Date:
- Date Added: 1703009881000
- URL: https://journals.healio.com/doi/10.3928/23258160-20231106-02
- DOI: 10.3928/23258160-20231106-02
- Cite Key: iskanderNeurologicalUnderpinningsPsychological2023
- Topics: [object Object]
- Tags:: #diagnosis, #Misophonia, #Bare-bones-review-🦴, #ocd,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia and OCD show overlapping symptoms and neural abnormalities (e.g., amygdala, insula, ACC). • Debate exists on whether misophonia should be classified under OCD. • IU and disgust sensitivity are well-established traits in OCD but understudied in misophonia. Purpose- • Determine if IU and specific domains of disgust can distinguish OCD from misophonia. • Test whether: A) IU and pathogen disgust predict OCD. B) Moral and sexual disgust predict misophonia. |
| Participants/samples | • Total N = 264 • Age: 18–65 years (M = 28.6, SD = 9.5) • Sex: 59.4% female, 33.0% male, 7.6% nonbinary • Race: 73.5% White, 9.5% Asian, others < 10% • Recruited via social media and crowdsourcing platforms • Inclusion: Age ≥ 18, fluent in English |
| Measures | • Three-Domains of Disgust Scale (TDDS) – Assesses pathogen, sexual, and moral disgust (α = .77–.86) • Intolerance of Uncertainty Scale (IUS) – 27-item measure of IU (α = .95) • Obsessive-Compulsive Inventory-Revised (OCI-R) – 18-item OCD symptom measure (α = .95) • New York Misophonia Scale (NYMS) – Assesses emotional and behavioral responses to trigger sounds (α = .94) |
| Procedures | • Online survey (162 items) administered via Microsoft Forms • Data collection: Nov 2021 – Feb 2022 • Excluded participants over 65 or with insufficient English fluency • Used multivariate and binomial logistic regression analyses |
| Results | Significant positive correlations: • IU with OCD (r = .61) and misophonia (r = .39) • Pathogen disgust with OCD (r = .37) and misophonia (r = .38) • Sexual disgust with both disorders (r ≈ .24–.38) • Moral disgust weakly correlated with OCD (r = .13) and more with misophonia (r = .26) Logistic regression findings: • IU significantly predicts OCD (OR = 1.055, p = .004) • Moral disgust significantly predicts misophonia (OR = 0.873, p = .014) • Pathogen and sexual disgust not significant predictors in multivariate model |
| Discussion/Limits | Conclusion- • IU is a robust predictor of OCD, aligning with its role in anxiety-driven compulsions. • Moral disgust better characterizes misophonia, possibly due to anger and moral judgment toward trigger sources. • Results support the neuropsychological distinction between OCD and misophonia. |
| Limitations:: | • Self-report data may introduce bias • Small sample size for subgroup analysis • Limited item scope for moral disgust assessment |
| Future Directions:: | • Develop better tools for assessing domain-specific disgust, especially internal moral contamination (self vs others) • Examine neural correlates of disgust domains in misophonia • Expand neuroscience-informed therapeutic approaches for both disorders |
| Relevance:: | • study looking at the Misophonia- OCD link. findings suggest they are different things, with Misophonia is predicted more by moral disgust whereas OCD is more predicted by uncertainty intolerance. • if I ever decide to dig back into the OCD link thing, this would be a good source to go back to |
Notes
key terms and concepts
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Misophonia – A neurophysiological disorder characterized by disproportionate emotional and autonomic responses to specific sounds, such as chewing or pen-clicking.
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Obsessive-Compulsive Disorder (OCD) – A psychiatric disorder characterized by intrusive thoughts (obsessions) and repetitive behaviors (compulsions) aimed at reducing anxiety.
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Intolerance of Uncertainty (IU) – A cognitive bias marked by an aversion to uncertain situations, associated with anticipatory anxiety and compulsive behavior in OCD.
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Disgust Sensitivity – A measure of emotional reactivity to disgust stimuli, categorized into:
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Pathogen Disgust – Aversion to contaminants (e.g., bodily fluids, dirt).
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Moral Disgust – Aversion to violations of moral norms (e.g., lying, cheating).
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Sexual Disgust – Aversion to inappropriate sexual behavior.
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CSTC Circuit – Cortico-striato-thalamo-cortical circuit implicated in OCD; involves excitatory and inhibitory pathways regulating behavior and emotion.