Distinguishing Misophonia From Nonclinical Sound Aversion: Emotional Response Profiles for Auditory Triggers

PURPOSE: This study examined how individuals with and without clinically significant misophonia differ in trigger sounds, emotional response types, and reaction intensities to determine whether specific sound-emotion pairings distinguish misophonia from typical sound aversion. METHOD: A total of 168 participants (84 misophonia, 84 control) completed online surveys including the Duke-Vanderbilt Misophonia Screening Questionnaire (DVMSQ) for group classification and the Selective Sound Sensitivity Syndrome Scale Trigger Checklist, which assessed emotional responses and intensity ratings for 37 sounds. Demographic variables and comorbidities were examined as potential confounds. Heat map visualizations displayed sound-emotion relationships by group. RESULTS: The misophonia group reported significantly more trigger sounds, higher DVMSQ scores, and higher emotional intensity across emotions than controls. While both groups frequently reported irritation, individuals with misophonia exhibited significantly higher frequencies of anger, disgust, distress, and panic, with large effect sizes for anger. Heat maps revealed that misophonia participants reported anger at significantly higher rates for 18 sounds, particularly eating and oral sounds, whereas controls predominantly experienced irritation. Demographic variables and mental health diagnoses showed minimal associations with primary outcomes and did not account for group differences in emotional response patterns. CONCLUSIONS: Misophonia was distinguished by experiencing anger and disgust rather than irritation, at substantially higher intensities, particularly to human-produced sounds. These findings suggest that emotional response type and intensity, assessed alongside trigger identification, may help audiologists as part of multidisciplinary teams differentiate clinical misophonia requiring intervention from typical sound aversion. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.33334227.