Misophonia—literally “hatred of sound” and also known as selective sound sensitivity syndrome—is characterized by an intense dislike of specific sounds and is accompanied by distressing emotional and physical reactions [1
]. Recently, this condition has been expanded to include sights and images sufferers see that can provoke similar reactions [3
]. These stimuli are termed “triggers” by sufferers and are highly specific. Examples of auditory triggers described include chewing, low frequency bass sounds, pen clicking, and typing [2
], while visual triggers described include pointing of fingers, legs jiggling, and the twirling of hair [4
]. After an in-depth study into triggers and reactions of 26 misophonics by Dozier and Morrison [3
], the authors concluded that the severity of misophonic reactions are correlated with the amplitude and length of the trigger stimuli. A controlled study by Edelstein et al. [2
] demonstrated that misophonics increases skin conductance responses in response to auditory triggers, leading to the conclusion that a heightened autonomic response to triggers may be present in sufferers.
Studies into the nature of misophonia have been inconclusive [5
], although it is evident that misophonia causes major functional impairment in sufferers [6
]. Given the prevalence of trigger sounds, which is inevitable in modern society, and the rising number of self-identified misophonia sufferers in online support groups, it is imperative that this condition garner more attention among researchers and clinicians alike.
Misophonia has been described in the literature possibly as part of a psychiatric disorder [6
] or as a separate entity with its own set of psychopathology [7
]. A recent large-scale online study of more than 300 misophonia sufferers conducted by Rouw and Erfanian [9
] found post-traumatic stress disorder (PTSD) to be associated with the severity of misophonia. A study in Amsterdam of 42 self-reported misophonics conducted by Schröder et al. in 2013 [1
] found 52.4% of sufferers had comorbid obsessive-compulsive personality disorder (OCPD). A recent large-scale study of 483 undergraduates conducted by Wu et al. [6
] in 2014 found that anxiety and depressive symptoms were correlated with misophonia symptoms. However, it remains unclear if studies done in other countries can be extrapolated to the local Singaporean context. To expand on this finding, the aim of this study was to investigate factors associated with the severity of misophonia in psychiatric patients in Singapore.