Clinical characteristics of a treatment seeking sample of adults with misophonia: Onset, course, triggers, context, and comorbidity

Misophonia is characterized by intense emotional reactions to specific repetitive sounds. The clinical characteristics and developmental course of misophonia remain underexplored, particularly in treatment-seeking adults. In this study, we characterized the onset, symptom progression, trigger noises, and psychiatric comorbidities associated with misophonia. Additionally, we investigated the relationships between these clinical attributes and the severity of self- and clinician-rated misophonia symptoms. The sample included 60 adults with misophonia enrolled in a randomized controlled trial. Most participants (79%) reported symptom onset in childhood and early adolescence, with symptoms often worsening over time. All participants reported being bothered by human produced sounds. However, responses to trigger noises vary based on the context surrounding the sound. Those who reported equivalent distress across misophonic triggers –regardless of the individual producing the sound—endorsed significantly higher self-reported misophonia symptoms. Approximately half of the sample met diagnostic criteria for another psychiatric condition, with attention-deficit hyperactivity disorder and generalized anxiety disorder being the most prevalent. These findings underscore the complexity of misophonia and highlight the importance of considering the individual clinical histories and contextual factors influencing reactions to misophonic sounds.