Properties (13)
Id 1fa9e753-bc0c-4b09-81d0-295ad9ca50a4
Year 2026
Abstract Misophonia has a serious impact on children and families. Few studies have, however, assessed the specific phenomenology of misophonia in youth. We investigated clinical characteristics in a treatment-seeking sample of youth with misophonia (n = 95, 8-18 years), using validated instruments to assess misophonia phenomenology, psychiatric comorbidity, emotional/behavioral problems, attention problems, sensory processing, and quality of life. The most prevalent triggers were eating sounds and the most common responses irritation/anger and anticipation anxiety. Psychiatric comorbidity was present in 27.4% of cases (eg, anxiety disorders 10.5%; attention-deficit hyperactivity disorder 8.4%). Internalizing psychopathology was more prevalent than externalizing. Adolescents reported differences in auditory, tactile, visual, and taste/smell sensory processing compared with a norm group, as well as heightened sensory awareness and avoidance. Misophonia severity was inversely related to quality of life in children/parents. Future research should investigate the underlying mechanisms of misophonia in youth. Pre-registered: The Netherlands Trial Register (CCMO): NL-OMON20775, https://onderzoekmetmensen.nl/nl/trial/20775
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- purpleRed
Aliases
- (Rappoldt et al., 2026)
Import Date 10-01-2026
Dv Authors Lotte R. Rappoldt, Carola De Wit, Marthe M. Van Der Pol, Simone Slaghekke, Caroline Houben, Kees J. Kan, André B. Rietman, Damiaan Denys, Elisabeth M. W. J. Utens, Nienke C. C. Vulink,
Dv Status #status/Bare-bones-review
Dv Limitations • Generalizability: predominantly girls from high-SES families and stringent inclusion criteria limit generalization to the broader youth misophonia population. • Misophonia measures were validated during the study, and diagnostic cutoffs were not used for inclusion. • Visual triggers, behavioral/physical responses, and hearing-related conditions (hyperacusis, tinnitus, phonophobia) were not systematically assessed. • Most SCID-5 Junior interviews were conducted by one rater without interrater reliability assessment. • SSP-NL findings should be interpreted cautiously because of the small younger subsample.
Dv Future Directions • Qualitative research to promote understanding of misophonia phenomenology across socio-cultural contexts. • Research in diverse samples to inform unified diagnostic guidelines differentiating misophonia from disorders with similar symptom presentation (e.g., social anxiety disorder, hyperacusis); consider a multidisciplinary approach. • Delineate the extent to which family accommodation could be adaptive or related to non-adaptive outcomes. • Replicate the sensory processing findings. • Assess predisposing, precipitating, and perpetuating factors of misophonia in youth in more detail while remaining sensitive to social and cultural context.
Dv Relevance Misophonia Study in Children and Adolescents: - Predictable trends in qualified triggers identified - Standard psychiatric comorbidities observed - Internalizing psychopathology more prevalent than externalizing psychopathology - Self-reports of altered auditory/tactile/visual/olfactory sensory processing compared to normative group
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Clinical Characteristics of Children and Adolescents With Misophonia
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Lotte R. Rappoldt, Carola De Wit, Marthe M. Van Der Pol, Simone Slaghekke, Caroline Houben, Kees J. Kan, André B. Rietman, Damiaan Denys, Elisabeth M. W. J. Utens, Nienke C. C. Vulink,
- Date:
- Date Added: 1790909664000
- URL: https://journals.sagepub.com/doi/10.1177/00099228261467192
- DOI: 10.1177/00099228261467192
- Cite Key: rappoldtClinicalCharacteristicsChildren2026
- Tags:: #Bare-bones-review-🦴, #Misophonia, #quality-of-life, #sensory-processing,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia triggers are context-dependent, often stronger for close family members, and may involve hyperfocus, anticipatory anxiety, avoidance, and confrontation. • A 2022 expert consensus defined misophonia as a disorder, but unified diagnostic criteria remain lacking, and it is not included in DSM-5 or ICD-11. Recent evidence supports distinguishing it from conditions such as hyperacusis. • Misophonia typically develops in childhood or early adolescence and can substantially impair family relationships and quality of life. • Three youth studies found broadly similar presentations: eating, breathing, and throat-sound triggers; irritation/anger, distress, anxiety, disgust, and frustration; verbal and occasional physical aggression; and frequent avoidance of family members or meals. • Comorbidity findings are mixed. Anxiety was reported across two studies, while depression, OCD, autistic traits, and ADHD varied across samples. • Cross-study comparison is limited by differing inclusion criteria, lack of unified diagnostic guidelines, and unclear differentiation from hyperacusis. • Sensory-processing difficulties have been proposed as a transdiagnostic contributor to misophonia. Preliminary GSQ findings capture affective/behavioral responses to sensory stimuli but not neurological thresholds. • Sensory processing in youth with misophonia has not yet been assessed using the AASP. Purpose- • Extend current knowledge by investigating demographic characteristics, misophonia phenomenology, psychiatric comorbidity, emotional and behavioral problems, attention problems/ADHD characteristics, sensory processing, and quality of life in a large treatment-seeking sample of youth with misophonia. |
| Participants/samples | • N = 95 treatment-seeking children/adolescents with misophonia, aged 8–17 (mean ~13); majority girls and from high-SES families. • Referred by general practitioners across the Netherlands to an academic clinic; data were baseline assessments from an RCT of group treatment. • Misophonia was identified using the Amsterdam UMC 2020 proposed diagnostic criteria. • Inclusion: age 8–18, referred for misophonia assessment/treatment before January 2023, and written informed consent. • Exclusion: another primary presenting problem; psychiatric symptoms or serious family problems interfering with group treatment; CBT for misophonia in the past year; current/recent self-injury; estimated IQ <85; or inability to read/write Dutch. |
| Measures | • Parent-reported demographic questionnaire- parental highest completed education and parental occupation as SES proxies. • Misophonia Screening List- Child and Youth (child- and parent-report) – misophonia phenomenology. • AMISOS-Y (child- and parent-report) – descriptive items on triggers and emotional responses; Likert-scale severity items. • SCID-5 Junior- psychiatric comorbidity. • CBCL (parent) and YSR (child 11+) – Total, Internalizing, Externalizing problem scales and syndrome scales. • AVL (Dutch ADHD questionnaire) – Total scale; attention deficit, hyperactivity, impulsivity subscales. • SSP-NL (parent-report, ages 8–10) – seven sensory processing domains. • AASP-NL (self-report, ages 11+) – four quadrants; six domain scores. • CHQ-PF28 (parent) and CHQ-CF45 (child) – quality of life. |
| Procedures | • Sequential inclusion procedure: file review, telephone screening, extensive intake, SCID-5 Junior diagnostic interview. • Intake conducted by trained psychiatrists/psychologists with misophonia expertise using a standardized protocol; included screener questions for hearing problems, hyperacusis, tinnitus, and phonophobia. • SCID-5 Junior administered online; child and parent(s) together for ages 8–12, separately for ages 13–18; most interviews conducted by the first author under supervision. • Questionnaires completed online after inclusion and randomization. • CBCL/YSR, AVL, SSP-NL, and AASP-NL scores compared with norm data; one-sample Wilcoxon signed-rank tests for SSP-NL and one-sample t tests for AASP-NL. • Pearson correlations between CHQ scales and AMISOS-Y misophonia severity. |
| Results | • Phenomenology: eating sounds were the most common triggers, followed by nose/mouth and tapping sounds; irritation, anger, and anticipatory anxiety were the predominant emotional responses, while disgust was less common. • Psychiatric comorbidity: most participants had no comorbid diagnosis; reported conditions included anxiety disorders, ADHD, tic disorders, and insomnia. • Emotional/behavioral problems: borderline/clinical problems occurred in about one-third of parent reports and one-fifth of child reports, with internalizing problems more common than externalizing. • ADHD characteristics: (sub)clinical ADHD symptoms occurred in a minority, most often involving attention deficits. • Sensory processing: compared with norms, younger children showed greater taste/smell, movement, visual/auditory sensitivity, and sensory seeking/under-responsivity. Older youth showed greater sensory sensitivity/avoidance, less low registration/sensation seeking, lower taste/smell, tactile, and visual scores, and higher auditory scores. • Quality of life: greater misophonia severity was associated with poorer quality of life, particularly in family activities and several emotional/mental-health domains. • Null findings: no group differences emerged for several tactile, auditory-filtering, energy, movement, or activity measures, and misophonia severity was unrelated to family cohesion. |
| Discussion/Limits | Conclusion- - Triggers and predominant emotional responses were broadly consistent with prior youth research, although disgust was less common, potentially reflecting social, cultural, or linguistic factors. - Lower comorbidity rates than prior treatment-seeking samples may reflect stricter inclusion criteria, which the authors recommend for group treatment. - The predominance of internalizing over externalizing problems may support conceptualizing misophonia as more closely related to internalizing psychopathology than impulse-control difficulties. - Misophonia may involve strong inhibition of emotional responses, particularly conflict between intense negative reactions toward loved ones and efforts not to act on them. - Reduced low registration/sensation seeking alongside increased sensory sensitivity/avoidance suggests heightened environmental responsivity and efforts to prevent sensory overload. - Sensory differences extended beyond audition to tactile, taste/smell, and visual domains, supporting general sensory dysregulation as a possible transdiagnostic vulnerability. - Sensory-processing differences may become more pronounced with age, including during puberty. - Clinically, sensory-processing patterns and their functional impact should be assessed individually, including possible non-auditory sensitivities. - Misophonia can substantially affect children and families, highlighting the importance of assessing family accommodation. |
| Limitations:: | • Generalizability: predominantly girls from high-SES families and stringent inclusion criteria limit generalization to the broader youth misophonia population. • Misophonia measures were validated during the study, and diagnostic cutoffs were not used for inclusion. • Visual triggers, behavioral/physical responses, and hearing-related conditions (hyperacusis, tinnitus, phonophobia) were not systematically assessed. • Most SCID-5 Junior interviews were conducted by one rater without interrater reliability assessment. • SSP-NL findings should be interpreted cautiously because of the small younger subsample. |
| Future Directions:: | • Qualitative research to promote understanding of misophonia phenomenology across socio-cultural contexts. • Research in diverse samples to inform unified diagnostic guidelines differentiating misophonia from disorders with similar symptom presentation (e.g., social anxiety disorder, hyperacusis); consider a multidisciplinary approach. • Delineate the extent to which family accommodation could be adaptive or related to non-adaptive outcomes. • Replicate the sensory processing findings. • Assess predisposing, precipitating, and perpetuating factors of misophonia in youth in more detail while remaining sensitive to social and cultural context. |
| Relevance:: | Misophonia Study in Children and Adolescents: - Predictable trends in qualified triggers identified - Standard psychiatric comorbidities observed - Internalizing psychopathology more prevalent than externalizing psychopathology - Self-reports of altered auditory/tactile/visual/olfactory sensory processing compared to normative group |
Notes
key terms and concepts
- misophonia – decreased tolerance for specific sounds such as eating and nasal sounds and/or associated stimuli.
- triggers – stimuli that induce immediate and strong feelings of irritation, anger, or disgust, along with adverse physiological and behavioral reactions.
- hyperacusis – decreased sound tolerance to subjectively experienced loudness of sounds.
- low registration – AASP quadrant: high neurological threshold, passive behavioral response.
- sensation seeking – AASP quadrant: high neurological threshold, active behavioral response.
- sensory sensitivity – AASP quadrant: low neurological threshold, passive behavioral response.
- sensation avoiding – AASP quadrant: low neurological threshold, active behavioral response.
- family accommodation – the way in which parents and other family members participate in certain behaviors to minimize the distress resulting from a disorder (e.g., providing reassurance, modifying behaviors or routines).