Argument for interventions targeted at early responses forming before reactions start

Savard et al. (2026) had 30 adults with misophonia and 30 age- and sex-matched controls attend either to music in one ear or to trigger, unpleasant, or neutral sounds in the other while pupil size and skin conductance were recorded. Directing attention to the music did not reduce the elevated responses to trigger sounds in the misophonia group. The authors argued that attention-based strategies come too late because they are deployed after the trigger has already been recognized. They proposed that interventions targeting how trigger sounds are identified and appraised, before the physiological response begins, may work better. In support, they cited Mahzouni et al. (2024), where showing an alternative visual source for a trigger sound reduced unpleasantness, and emotion regulation work showing that strategies used earlier in the emotion-generative process work better than those used once a response is underway (Gross, 1998, 2001) (Savard et al., 2026).