Misophonia in Individuals with Obsessive–Compulsive Disorder: Its Relationship with Anxiety Sensitivity and Mindfulness

<i>Background and Objectives</i>: This study aimed to examine the severity of misophonia symptoms in individuals diagnosed with obsessive-compulsive disorder (OCD) and to evaluate the pattern of the relationship between misophonia and OCD symptom severity in relation to anxiety sensitivity and mindfulness. <i>Materials and Methods</i>: This comparative and cross-sectional study included 108 patients diagnosed with OCD according to DSM-5 criteria and 81 healthy control subjects without any psychiatric diagnosis. Participants completed the Misophonia Symptom List (MSL), Anxiety Sensitivity Index-3 (ASI-3), Mindful Attention Awareness Scale (MAAS), Yale-Brown Obsessive Compulsive Scale (Y-BOCS), and Beck Anxiety Inventory (BAI). Statistical analyses included group comparisons, Pearson correlations, multiple linear regression, and mediation analyses using the PROCESS macro. <i>Results</i>: MSL scores were significantly higher in the OCD group compared to the control group (104.10 ± 33.00 vs. 87.56 ± 20.07, <i>p</i> < 0.001). ASI-3 (33.53 ± 18.72 vs. 18.12 ± 11.55, <i>p</i> < 0.001) and BAI scores (20.74 ± 13.14 vs. 11.04 ± 8.47, <i>p</i> < 0.001) were higher; MAAS scores were lower (53.23 ± 14.92 vs. 60.72 ± 12.70, <i>p</i> < 0.001). In the OCD group, MSL scores were positively correlated with anxiety sensitivity (r = 0.626, <i>p</i> < 0.001) and Beck anxiety (r = 0.515, <i>p</i> < 0.001) and negatively correlated with MAAS (r = -0.357, <i>p</i> < 0.001). In multiple regression analysis, anxiety sensitivity was identified as the only variable significantly predicting misophonia severity (β = 0.523, <i>p</i> < 0.001). Mediation analyses showed that anxiety sensitivity emerged as the dominant indirect pathway between OCD symptom severity and misophonia, whereas the contribution of mindfulness was not independent of anxiety sensitivity in the serial mediation model. <i>Conclusions</i>: The findings indicate that misophonia symptoms are significantly elevated in individuals diagnosed with OCD and that these symptoms are particularly associated with cognitive-emotional variables such as anxiety sensitivity and mindfulness. Given the cross-sectional design, the mediation findings should be interpreted as indirect associations rather than evidence of causal pathways. Considering these variables may be useful in assessing misophonia symptoms accompanying OCD and planning clinical approaches.