Rothman Center for Pediatric Neuropsychiatry


What is Misophonia?

Misophonia, also known as the “hatred or dislike of sound,” is characterized by the sensitivity to specific sounds, accompanied by an unpleasant emotional and/or physical response. People with misophonia liken the experience of the sound trigger more closely to irritation, disgust, or even pain, rather than anxiety or fear. The sounds that trigger this discomfort are typically highly specific, including sounds emitted in the context of common human behavior (e.g., chewing, breathing, swallowing, stepping, tapping, and speaking). In some cases, the extreme sound sensitivity is associated with a specific individual (e.g., “her brother chewing” or “his mother’s voice”). In other cases, symptoms may me more generalized (e.g., “women’s voices”), or to environmental stimuli (e.g., “fluorescent lightening”).

What are the causes of this condition?

The exact causes of misophonia are relatively unknown. However, research suggests that it may be caused by abnormalities in the limbic-autonomic nervous systems and the auditory cortex. Respondent/classical conditioning also plays a role as (previously) neutral stimuli and situations associated with autonomic arousal/discomfort become associated unpleasant sounds. Notably, sensory over-responsively (including heightened sensitivity to sounds) is common among individuals with OCD, anxiety, and Tourette’s syndrome suggesting possible overlap in neuropathology.

Misophonia Symptoms

The symptoms of misophonia can include mild to severe unpleasant emotional and/or physical responses to specific sounds. These responses are often described as causing irritation, disgust, or even pain, rather than anxiety or fear. The magnitude of this disturbance is not necessarily proportional to the length or the volume of the sound trigger. The discomfort associated with misophonia can also cause behavioral responses such as avoiding people or situations. Rage or anger outbursts may also occur among youth with misophonia in the presence of triggering sounds (or stimuli associated with sounds, e.g., being in a room full of candy wrappers may trigger an outburst in a child with extreme sensitivity to the sound of opening a plastic wrapper).

Individuals with misophonia may experience the following when encountering a sound trigger:

  • Disgust
  • Rage
  • Anger
  • Hatred
  • Pain or discomfort
  • Emotional distress
  • Impairment in daily life

Misophonia Treatment