Properties (12)
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- Beyond the Sound
- (Müfreze et al., 2024)
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Beyond the Sound: The Role of the Source of Human-Made Trigger Sounds in Misophonia
Status:: #status/reviewed
Metadata
- Item Type: #journalArticle
- Authors: Pelinsu Müfreze, Cumhur Avcil, Oğuzhan Herdi,
- Date:
- Date Added: 1745366926000
- URL: https://www.noropsikiyatriarsivi.com/submission/MakaleKontrol?Id=VFdwbk0wNUVVVDA9
- DOI: 10.29399/npa.28744
- Cite Key: mufrezeSoundRoleSource2024
- Topics: [object Object]
- Tags: #Misophonia, #reviewed #source, #subjective-disturbance,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia involves disproportionate affective and physiological responses to certain (often human‑made) sounds; common triggers include eating and breathing sounds. • Prior work and clinical reports suggest human sounds, especially from close others (family/partners), are particularly aversive, but rigorous experimental tests of “who produced the sound” have been scarce. Purpose- • Primary hypothesis: When a misophonic trigger is presented as being produced by a relative, it will elicit greater subjective discomfort than when presented as being produced by a non-relative. • Aim: To experimentally isolate the effect of perceived source from the actual sound. |
| Participants/samples | • N = 15 adults (18–65 years) from Antalya, Türkiye; recruitment targeted individuals with at least moderate misophonia on screening scales. Inclusion: age 18–65, moderate/high MQ & A‑MISO‑S, no neurological disorder, no severe psychiatric disorder (e.g., schizophrenia or bipolar). • Demographics (Table 1): 80% female; M_age = 29.53 (SD = 5.66); other distributions reported for education, employment, marital/parental status, medication use, and psychiatric history. |
| Measures | • A‑MISO‑S — Misophonia severity categories and scoring as above. • MQ — Symptom + emotion/behavior factors (0–68 total); clinically significant threshold noted in the severity section. • Subjective discomfort (VAS) — 1–10 verbal rating during each sound exposure; defined to participants prior to the task. |
| Procedures | Behavioral responses recorded— • VAS ratings to each sound/story pairing across three experimental phases. Physiological responses— • None; authors note this as a limitation. Stimuli used- • Participant‑supplied recordings of their most disturbing relative‑produced trigger (12 slurping; 3 crunching/smacking); plus two “fixed” sounds (one slurping, one crunchy) from a sound bank for deception/control stories; Spotify “water” sound as neutral baseline. Task/experiment- • Standardized lab setting with headphones; each trial began with 5 breathing‑exercise repetitions + 1‑min neutral water sound. Then three 20‑s exposures with intervening neutral/breathing and 5‑min breaks: 1. Sound bank voice presented as relative’s voice; 2. Relative’s voice presented as someone else’s; 3. Relative’s voice presented as relative’s voice. 4. VAS ratings collected after each exposure. • Order and delivery were constant across participants; volume standardized at ~75%. • Analysis: Wilcoxon Signed‑Rank tests on VAS across phases; α = .05. |
| Results | • Group characteristics: Median A‑MISO‑S = 15 (range 13–20); MQ median = 46 (41–66). VAS medians: Phase 1 = 8, Phase 2 = 5, Phase 3 = 8 (see Table 2). • Main comparisons (Wilcoxon): • P1 vs P2: Sound bank as relative’s voice > Relative’s voice as someone else (p < .001; Z = −3.482). • P3 vs P2: Relative’s voice as relative’s voice > Relative’s voice as someone else (p = .001; Z = −3.472). • P1 vs P3: No difference — Sound bank as relative’s voice ≈ Relative’s voice as relative’s voice (p = .783; Z = −0.276). • Covariates: No significant differences in A‑MISO‑S or MQ scores by gender, education, marital/occupational status, children, psychiatric disorder, or medication status. |
| Discussion/Limits | Conclusion- • Belief about the source (i.e., that a relative produced the sound) robustly increases subjective disturbance independent of the acoustic origin, supporting the primacy of contextual attribution over acoustic features for human‑made triggers. • Findings align with prior observations that human/relative sounds are especially aversive and extend them by demonstrating an experimental source‑attribution effect. |
| Limitations:: | • Sample restricted to moderate/high misophonia; recruitment difficulty/avoidance may bias generalizability. • Potential expectancy/story bias (participants already know relatives are disturbing); authors attempted to minimize but acknowledge residual bias. • Neutral “water” sound not individually validated as neutral (though no discomfort reported). • Uncontrolled irritability factors (e.g., smoking, fasting, caffeine). • No physiological indices (e.g., HR/EDA) or neuroimaging. |
| Future Directions:: | • Larger samples; incorporate physiological/fMRI measures; refine experimental design to disentangle source, identity certainty, and acoustic content. |
| Relevance:: | • example of the cognitive influence of Misophonia. showing how hearing trigger sounds and being told that they are/not coming from a close relative modulates the Misophonia response in the predictable way ( worse responses when thinking the source is a family member) . • describes an interesting idea (that the article does not tests) where the Misophonia response can be partial; explained by abnormal hippocampus function in response to chronic stress. pointing to a proposed role of the hippocampus in in regulating stress from the amygdala, the misfunctioning of the hippocampus due to stress may result in trigger sounds invoking the retrieval of negative memories with the unconscious effect of of giving negative affect to the sound and thus producing automatic sensory resposnes via its connection to the amygdala. (this is an idea that could use further investigating) • coined a neat term for the sound source effect in misophonia” “the source effect” |
Notes
key Terms
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Misophonia — A neuropsychiatric disorder marked by abnormally strong negative emotional and physiological reactions to specific trigger sounds (e.g., eating sounds), often leading to anger, anxiety, disgust, muscle tension, and autonomic arousal.
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A‑MISO‑S (Amsterdam Misophonia Scale) — 6‑domain Likert scale (0–24) adapted from Y‑BOCS to index misophonia severity; cut‑points: 0–4 subclinical, 5–9 mild, 10–14 moderate, 15–19 severe, 20–24 extreme.
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MQ (Misophonia Questionnaire) — 17‑item measure with symptom and emotion/behavior factors (0–68 total); higher scores indicate more frequent symptoms/negative reactions; final section (1–15) gauges severity; ≥7 indicates clinically significant misophonia (not part of factor scores).
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VAS (Visual Analog Scale) — 1–10 verbal rating of momentary subjective discomfort to each sound presentation (1 = little/none; 10 = extreme/intolerable).
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Source effect — The influence of who is believed to produce a trigger sound (e.g., a relative vs. a non‑relative) on misophonic discomfort.
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reading notes
• Neurobiological framing: Authors discuss amygdala‑centered affective mapping and hippocampal/PFC interactions as plausible mechanisms for stronger reactions to perceived relative‑produced sounds; they also note evidence for hyper‑mirroring/orofacial motor system involvement in misophonia, which could be engaged by imagining a relative making the sound.
• Stimulus set realism: All participant‑provided triggers were orofacial eating sounds, consistent with common clinical reports; fixed “bank” sounds were matched to these categories to support deception conditions.
• Clinical takeaway (applied): Interventions may benefit from targeting source attribution and context (e.g., cognitive reattribution, family‑contextual work) alongside sound‑focused exposure, given the robust source effect observed. (Inference consistent with authors’ conclusion.)
zettlekasten
idea of abnormal activity of hippocampus- amygdala relationship in misophonia
Müfreze 2024 findings about the impact of believed sound source on Misophonic responses