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Id 767b19d2-091b-4607-9d0a-731606b04356
Year 2026
Abstract
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- purpleRed
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- Sensory Processing, Dissociation, and Affective Symptoms in Misophonia
- (Koç Apaydın et al., 2026)
Import Date 06-10-2026
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Dv Authors Zuhal Koç Apaydın, Nefise Demir, Rifat Tarhan,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Cross-sectional design; causal inference not possible • Small convenience sample skewed toward university graduates and female participants in Turkey; limited generalizability to clinical, older, or cross-cultural populations • All data self-reported; possible response biases (social desirability, recall); mitigated via validated measures, anonymity, required items, attention checks, and predefined exclusion rules, but residual bias may remain • DES assessed at global level only, not by subdimensions (depersonalization, derealization) • MisQuest ≥7 cut-off not universally standardized; possible misclassification • No laboratory-based sensory or auditory physiological measures; limits mechanistic inference • DES and DASS-21 are screening instruments, not diagnostic tools • Multiple exploratory associations; residual confounding and elevated type I error risk remain possible
Dv Future Directions • Larger, probability-based or stratified samples • Longitudinal and cross-cultural designs • Structured diagnostic assessments to evaluate external validity and stability of effect sizes
Dv Relevance • a cross sectional online study looking at Misophonia comorbidities and general sensory processing stuff. • results suggest that Misophonia is characterized by heightened sensory sensitivity and avoidance, with moderate links to dissociation, leading the authors to propose routine assessment of these sensory and psychiatric domains.
Notes Audited 2026-06-10T15:41:00
Audit Notes audited as review was done
•
Sensory Processing, Dissociation, and Affective Symptoms in Misophonia: A Cross-Sectional Study of 35 Adults
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Zuhal Koç Apaydın, Nefise Demir, Rifat Tarhan,
- Date:
- Date Added: 1771106173000
- URL: https://www.medscimonit.com/abstract/index/idArt/950938
- DOI: 10.12659/MSM.950938
- Cite Key: kocapaydinSensoryProcessingDissociation2026
- Topics: [object Object]
- Tags:: #Misophonia, #Bare-bones-review-🦴, #anxiety, #perception, #MisoQuest, #Emotion-regulation, #depersonalization,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia causes intense negative reactions to everyday sounds; not officially recognized by DSM or ICD • Prevalence estimated at 12.8–20% of the general population; 4.6% met clinical threshold in a US population-based study (n=4005) • Up to 79% of individuals with misophonia have at least one co-occurring psychiatric disorder • Common comorbidities include depression, GAD, OCD, PTSD, suicidal behaviors, and borderline personality disorder • Emotion regulation difficulties and atypical sensory processing likely contribute to misophonia's clinical presentation • Misophonia associated with poorer quality of life across emotional, social, and general health domains • Individuals with misophonia show heightened sensory reactivity across multiple modalities, not only auditory; Kaufman et al. (2022) demonstrated intense reactions to odors as well • Core features of misophonia identified as sensory-attentional in nature; severity closely linked to sensory sensitivity level (Andermane et al., 2023) • Adults with severe misophonia show broadly elevated exteroceptive sensitivities (visual, auditory, olfactory, gustatory, tactile, vestibular) on the Glasgow Sensory Questionnaire; interoceptive awareness on the MAIA does not differ by group • Individuals with misophonia show heightened sensory reactivity across multiple modalities, not only auditory; Kaufman et al. (2022) suggest reactions extend to other sensory cues such as odors • Dissociative symptoms (depersonalization, derealization) frequently emerge in PTSD, panic disorder, and GAD • Overwhelming sensory input proposed as a trigger for dissociative responses as a defensive mechanism in some individuals • Hypervigilance common in misophonia can elevate anxiety; chronic arousal may lead to emotional exhaustion and a "shutdown" response • Few studies have directly examined the misophonia–dissociation relationship • Role of dissociation in misophonia remains unclear • Few studies have directly examined the misophonia–dissociation relationship; the authors describe this gap inconsistently across sections ("few studies" in the Introduction, "no studies" in the Discussion) Purpose- • Characterize sensory processing and psychiatric symptom burden in adults with misophonia (n=35) vs. healthy controls (n=51) • Test whether misophonia severity relates to dissociative experiences and to depression, anxiety, and stress |
| Participants/samples | • N=86 adults, aged 18–65; convenience sample recruited via social media (Turkey), July 26 – August 30, 2025 • Misophonia group: n=35 (MisQuest impairment score ≥7); Control group: n=51 (score <7) • No statistically significant between-group differences in age, gender, marital status, education, psychiatric history, or misophonia awareness • Inclusion: age 18–65, self-reported at least moderate misophonia symptoms, literate, internet access, voluntary consent • Exclusion: moderate–severe hearing loss, current psychosis/mania, neurological disorders (epilepsy, dementia, MS), current substance use disorder, incomplete consent/forms |
| Measures | • MisQuest: 17-item, 2-factor (Symptoms [7 items], 5-point Likert 0–4; Emotions & Behaviors [10 items], 5-point Likert 0–4); total range 0–68; 3 supplementary impairment items (not in total) define case status ≥7; Turkish adaptation Sakarya & Çakmak (2022) • A/ASP: 60 items across 5 modalities (taste/smell, visual, auditory, tactile, vestibular); 4 pattern subscales (Low Registration, Sensation Seeking, Sensory Sensitivity, Sensory Avoiding), each 15–75; 5-point Likert; norm-referenced by age group; pattern scores analyzed as continuous variables • DES: 28 items; percentage ratings 0–100 per item; total = mean of item scores; Turkish adaptation Yargıç, Karancı & Tutkun; Cronbach's α=0.93 for Turkish version; used as continuous variable (no cut-off applied) • DASS-21: 21 items, 3 subscales of 7 items each; 4-point Likert; Turkish adaptation Yılmaz et al. (2017); subscales analyzed as continuous variables |
| Procedures | • Data collected via Google Forms; automated prescreening applied exclusion criteria • All items set as required; no item-level missing data; simple page/branch logic to minimize skipping • Two reminders issued at 2-week intervals • Incomplete questionnaires excluded listwise; no imputation applied • Survey administered in pre-specified order; participation voluntary and anonymous |
| Results | Group differences • Misophonia group scored higher than controls on both MisQuest Symptom and Emotions/Behaviors subscales • Misophonia group scored higher on Low Registration, Sensory Avoiding, and Sensory Sensitivity; no group difference in Sensation Seeking • Misophonia group showed greater dissociative experiences (DES) • Misophonia group scored higher on depression, anxiety, and stress Correlations with MisQuest-Total • Misophonia severity positively associated with Low Registration, Sensory Sensitivity, Sensory Avoiding, DES, depression, anxiety, and stress • Sensory Sensitivity showed the strongest association with misophonia severity • Dissociation showed a moderate positive association with misophonia severity Hierarchical regression • Model 1 (sensory predictors only, R²=.542): Sensation Seeking, Sensory Sensitivity, and Sensory Avoiding significantly predicted misophonia scores; Low Registration was not a significant predictor • Model 2 (sensory predictors + covariates, R²=.567): sensory predictors remained significant; none of the added variables (age, gender, education, psychiatric history, depression, anxiety, stress) were significant |
| Discussion/Limits | Conclusion- • Misophonia is characterized by heightened multisensory reactivity, consistent with prior evidence that severe misophonia involves hypersensitivity across auditory and non-auditory modalities • Sensory sensitivity and avoidance patterns align with prior literature; multisensory hyperreactivity is a core feature rather than a byproduct of environmental disturbance • Sensation Seeking as a significant predictor likely reflects compensatory sensory regulation — coexistence of sensitivity to unpredictable social sounds with active seeking of stable, controllable stimulation • Within this dataset, misophonia symptoms are determined by sensory processing styles rather than demographic or broad psychological factors • Moderate positive correlation between misophonia and dissociation is consistent with limited prior literature; heightened stress and interoceptive/threat reactivity under expectation of unpredictable triggers may render dissociative responses part of the phenotype • Features common in dissociation — attentional splitting, excessive focus on internal experiences, and impaired perceptual filtering — may further exacerbate misophonic reactions • Psychological symptoms correlate moderately with misophonia; stress showed the strongest association, suggesting links to daily life stressors and emotion regulation difficulties |
| Limitations:: | • Cross-sectional design; causal inference not possible • Small convenience sample skewed toward university graduates and female participants in Turkey; limited generalizability to clinical, older, or cross-cultural populations • All data self-reported; possible response biases (social desirability, recall); mitigated via validated measures, anonymity, required items, attention checks, and predefined exclusion rules, but residual bias may remain • DES assessed at global level only, not by subdimensions (depersonalization, derealization) • MisQuest ≥7 cut-off not universally standardized; possible misclassification • No laboratory-based sensory or auditory physiological measures; limits mechanistic inference • DES and DASS-21 are screening instruments, not diagnostic tools • Multiple exploratory associations; residual confounding and elevated type I error risk remain possible |
| Future Directions:: | • Larger, probability-based or stratified samples • Longitudinal and cross-cultural designs • Structured diagnostic assessments to evaluate external validity and stability of effect sizes |
| Relevance:: | • a cross sectional online study looking at Misophonia comorbidities and general sensory processing stuff. • results suggest that Misophonia is characterized by heightened sensory sensitivity and avoidance, with moderate links to dissociation, leading the authors to propose routine assessment of these sensory and psychiatric domains. |
Notes
key terms and concepts
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Misophonia – a condition causing intense negative emotional reactions (anger, disgust, anxiety) to specific everyday sounds (e.g., chewing, breathing, pen clicking); not yet officially recognized by DSM or ICD.
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Sensory Processing Disorder (SPD) – a condition characterized by difficulties in perceiving, modulating, and interpreting sensory stimuli, producing hyper- or hypo-sensitivity across modalities and negatively affecting daily functioning.
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Dissociation – a temporary disruption or alteration in the connection between internal experience and the outside world; includes depersonalization (detachment from oneself) and derealization (detachment from the external environment).
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A/ASP (Adolescent/Adult Sensory Profile) – a 60-item self-report assessing sensory processing across 4 patterns: Sensory Sensitivity, Sensory Avoiding, Low Registration, and Sensation Seeking.
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MisQuest – Misophonia Questionnaire (Wu et al., 2014); 17-item, 2-factor instrument (Symptoms; Emotions and Behaviors); total range 0–68; 3 supplementary impairment items (not scored in total) classify clinically significant misophonia at ≥7.
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DES (Dissociative Experiences Scale) – 28-item self-report assessing frequency of dissociative phenomena (depersonalization, derealization, time/reality distortions); each item rated as percentage 0–100; total = mean of item scores.
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DASS-21 – Depression Anxiety Stress Scales–Short Form; 21-item, 3-subscale (Depression, Anxiety, Stress) self-report assessing symptoms over the past week; 4-point Likert.
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contextual statement
In a 2026 cross-sectional study, Koç Apaydın and colleagues compared 35 Turkish adults with misophonia (MisQuest ≥7) to 51 healthy controls on sensory processing (A/ASP), dissociative experiences (DES), and affective symptoms (DASS-21) via an anonymous online survey.