Abstract
Misophonia is a recently identified condition in which an individual has an acute reaction of hatred or disgust to a specific commonly occurring sound. We propose that misophonia is a form of conditioned behavior that develops as a physical reflex through Pavlovian conditioning. Although misophonia is generally considered to be a one-step reaction, in which the sound elicits rage or disgust, as well as typical autonomic responses associated with these emotions, we propose that misophonia is a two-step reaction, in which the sound elicits an aversive conditioned physical reflex, and the aversive conditioned physical reflex elicits hatred or disgust. We also propose that the emotional response to trigger stimuli creates a Pavlovian conditioning paradigm that maintains or strengthens the misophonic physical reflex. Finally, we propose that new misophonic trigger stimuli are developed through the pairing of a neutral stimulus with a misophonic trigger stimulus. We suggest that a better name for misophonia is Conditioned Aversive Reflex Disorder (CARD) since it focuses attention on the reflexive nature of this condition and incorporates multiple stimuli modalities. A counterconditioning treatment for misophonia is presented with brief case descriptions which demonstrate the conditioned reflex nature of this disorder.
Highlights
Misophonia is characterized by extreme and irrational reactions of hate, anger, rage or disgust which are elicited by soft, commonly occurring sounds such as chewing or sniffling
Misophonia is often comprised of a physical muscle reflex that is elicited by the trigger stimulus and an emotional response that is elicited by the sensation of the physical muscle movement
Hypotheses Support Each of the first five cases discussed above detail the pairing of a repeating auditory stimulus with a physiological and emotional response during the development of misophonia
Summary
Misophonia is characterized by extreme and irrational reactions of hate, anger, rage or disgust which are elicited by soft, commonly occurring sounds such as chewing or sniffling. Misophonia is often comprised of a physical muscle reflex that is elicited by the trigger stimulus and an emotional response that is elicited by the sensation of the physical muscle movement (see Figure 2) This proposes that misophonia is a two-step process. 3. The misophonic response to trigger stimuli is maintained (or strengthened) due to the physical reflex (e.g., muscle contraction) increasing in intensity during the conditioning episodes associated with each stimulus presentation. The misophonic response to trigger stimuli is maintained (or strengthened) due to the physical reflex (e.g., muscle contraction) increasing in intensity during the conditioning episodes associated with each stimulus presentation This increase in muscle contraction is associated with the emotional response elicited by the physical reflex (i.e., the emotional response of misophonia). Additional trigger stimuli can develop by being paired with previously conditioned trigger stimuli and the reflex response they produce
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