Glossary
This glossary is provided by Misophonia UK as an informational aid only. It is no substitute for professional medical advice. If you are in any doubt about your symptoms, you should see your GP or consultant in the first instance. No warranty is made, express or implied, to the effectiveness or otherwise of the treatments and therapies described. Misophonia UK reserves the right to amend definitions as scientific knowledge of the condition advances.
Author: Guy Fitzmaurice. Last content review: 1 June 2012.
4S
See “selective sound sensitivity syndrome”.
abdominal breathing
The process of breathing air into the lungs using the diaphragm (the muscle between your chest and stomach), which delivers more oxygen to the body than chest breathing. This is a helpful technique in coping with panic attacks and has the additional health benefit of increased energy if practised regularly (10 minutes a day).
acousticophobia
Literally "fear of noise". Another synonym for phonophobia. This word is not in common usage and Misophonia UK prefers not to assign any special meaning to it. See phonophobia.
aetiology
A medical term for the causes of a disease. Spelt etiology in American English.
age of onset of symptoms
People with misophonia often experience their first symptoms from the ages of 8-12.
allergy
The development of misophonia has been compared with that of an allergy. The trigger/allergen may at first provoke no response but over time, a reaction can become stronger and stronger. However, there is no evidence to suggest that misophonia is in fact caused by allergic mechanisms.
allodynia
See auditory allodynia.
anticipatory anxiety
The anxiety experienced by misophonia sufferers before a full -blown attack, provoked by audio-visual cues from their trigger person.
audiological medicine
Audiological medicine concerns the investigation, diagnosis and management of auditory, balance and communication disorders, including misophonia, tinnitus and auditory processing difficulties.
audiological physician
A doctor who practises audiological medicine. Also known as an audiovestibular physician.
audiologist
A healthcare professional who specialises in the evaluation and rehabilitation of those with hearing loss and related disorders, including misophonia. An audiologist assesses hearing function and dispenses hearing aids and other devices to assist hearing. Some audiologists have a doctorate (PhD or AuD) in audiology, but they are not to be confused with medical doctors (MDs).
audiology
The study of hearing.
audiovestibular physician
See audiological physician.
auditory allodynia
A condition where the hearer suffers pain from only some normal-volume sounds, where there is an affective component to the experience of the sound. May result from tissue or nerve damage.
auditory hypervigilance
Many people with misophonia are hyper-aware of people's breathing and eating sounds, particularly in members of their close family. Even if their trigger sound is not being made, they are constantly "on the look-out" for it.
autism
People with autism often suffer an intolerance of certain sounds. The connection between misophonia and autism has not been investigated in the research literature. However, Koegel and others (2004) have indicated that sound sensitivity in people with autism may be generated by fear rather than pain.
autogenic
Self-produced, coming from one's own body. See autogenic training.
autogenic training
Relaxation techniques, such as self-hypnosis, meditation and biofeedback, that centre on the patient controlling their own body states, such as body temperature and blood pressure.
autophonia
Autophonia is intolerance to the sound of one's own voice. This symptom may be accompanied by a similar intolerance to other autogenic sounds, such as breathing and eating.
brown noise
See colour noise.
cat
See household pets.
CAT
See cognitive analytic therapy.
CBT
See cognitive behavioural therapy.
chasmology
The science of yawning.
Cinderella diagnosis
A medical condition which attracts little professional interest, awareness and research funding.
clinical misophonia
A term used to distinguish misophonia as a medical condition. Virtually everybody has sounds they don't like. An oft-quoted example is fingernails scratching against a blackboard. That dislike could properly be described as "misophonia" as it is a "dislike of sound". However, we use "clinical misophonia" to refer to a condition where the reaction to the sound has grown out of all proportion to what might be considered normal. A useful analogy would be the use of the expressions "depression" and "clinical depression". People often say "I'm a little depressed today" to refer to the fact that they are a little "down in the dumps". However, clinical depression is a much more serious condition which usually requires medical attention. It is the same with clinical misophonia.
clinical psychologist
Clinical psychologists diagnose or assess mental and emotional disorders. They then devise treatment programs with the aim of reducing psychological distress.
cognitive analytic therapy
Cognitive analytic therapy focuses on analysing coping strategies that have been ineffective in the past, particularly in childhood, and modifying them so that they become more effective in the present. It relies on both cognitive and traditional psychoanalytic approaches. The emphasis is on brevity (or, rather, value for money to the NHS!). The client can expect to have anything between 8-24 sessions, although 16 is most common. CAT employs buzzwords such as Reciprocal Roles, Snags, Dilemmas and Traps. It is practised mainly in the UK. Despite their slightly different theoretical underpinnings, the difference between CBT and CAT in practice may be minimal. Cf cognitive behavioural therapy.
cognitive behavioural therapy
Cognitive behavioural therapy is a relatively brief form of psychotherapy which asks people to focus on the ways they think (cognitive) and act (behaviour) in the present, rather than dwelling on past experiences and underlying psychological causes. The emphasis is on problem solving. A clinical psychologist will devise an individual treatment plan with the patient, which seeks to eradicate inaccurate negative thoughts and improve response to more positive stimuli.
colour noise
A noise's "colour" simply refers to the bias it has towards a particular range of frequencies. Colour noises sounds something like the background hum on a radio set, although those of a more imaginative disposition may be reminded of the sound of the ocean or other natural phenomena. On a more practical level, some courts use white noise to mask the deliberations of the bench in court. People with misophonia can use colour noise to help mask their trigger sounds, usually by playback through earphones or headphones. Although there are a wide range of colours, the more popular ones tend to be white, pink and brown noise. Some practitioners and sufferers claim that over-use of colour noise can exacerbate sound sensitivity, but Misophonia UK are not aware of any published research on the subject, and it is a popular coping mechanism.
confrontational coping skills
See coping skills.
continuum theory
One suggestion is that everyone has an intolerance to sounds to varying degrees, in various environments, due to any number of factors. According to this theory, people presenting with clinical misophonia simply have a stronger reaction to various sounds than the general population. While it is no doubt true that sound intolerance is universal to a certain extent, this theory does not really explain the emergence of a very clear set of symptoms in people with soft sound misophonia.
co-operative coping skills
See coping skills.
coping skills
Methods a person uses to deal with stressful situations. These may "help a person face a situation, take action, and be flexible and persistent in solving problems" [taken from the US National Cancer Institute's Dictionary of Cancer Terms]. In the absence of a reliable and effective medical therapy, people with misophonia often rely on coping skills to mitigate the worst effects of their condition. Coping skills may be classified as co-operative/non-confrontational (for instance, asking the trigger person to stop or discreetly covering one ear) and confrontational (for instance, overt mimicking or display of annoyance).
decreased sound tolerance
An umbrella term used to describe hyperacusis, misophonia and phonophobia.See "misophonia" for a comparison of these terms. Go here for a tabular representation of the suggested differences in terminology.
definitional clarity
As in any new field, terms have been introduced or meanings appropriated from existing terminology, when describing misophonia, in slightly different ways by different commentators. Misophonia UK does not claim to have a "monopoly on the truth", particularly since so little research has been conducted around this Cinderella diagnosis. However, in the interests of everyone knowing what we mean when we use a particular term, we have introduced a schema for words commonly used to describe sound intolerance. Please refer to the "misophonia" entry. Go here for a tabular representation of the suggested differences in terminology.
desensitisation
See systematic desensitisation.
dog
See household pets.
ear, nose and throat specialist
A medical or surgical doctor who specialises in otolaryngology. Also called an otolaryngologist or otorhinolaryngologist.
echolalia
See mimicking.
echopraxia
See mimicking.
elective deafness
A desire to become deaf, either through surgical intervention or self-harm.
emotional component
If misophonia is a neurological, rather than psychological, condition, there is however an emotional component. This is most clearly evidenced when a person with misophonia hears what they think is their trigger sound, but then realises it is not. Their panic/rage reaction may subside in a fraction of a second. This is not to say that the sufferer is necessarily in a position to control their reaction.
ENT
See ear, nose and throat specialist.
epidemiology
The study of factors affecting illness in a population.
etiology
See aetiology.
"exploding head" syndrome
A rare symptom that has been associated with decreased sound tolerance, where the listener spontaneously hears a noise akin to an explosion or gunshot going off in their head, often during drowsiness or sleep. May be accompanied by visual phenomena, such as a flash. While the subjective experience of "exploding head" syndrome can be quite distressing, it is not believed to be otherwise harmful. May occur with use of some antidepressants.
fight or flight response
The physiological response, including nervous and endocrine changes, to a perceived acute threat to survival that prepares a human (or animal) to react or retreat, first described in detail by the American neurologist Walter Cannon in the early twentieth century.
flooding
Also known as exposure therapy or immersion therapy. The patient is exposed to an extremely anxiogenic (anxiety-causing) situation, with no gradual introduction. Once their fear has receded, it is claimed that they will enjoy lasting relief. Anecdotal evidence suggests that flooding is ineffective as a therapy for misophonia and may even exacerbate it. Cf systematic desensitisation.
genetic basis for soft sound aversion
US audiologist Dr Marsha Johnson reports that selective sound sensitivity syndrome often runs in families and she strongly suspects a genetic element to the condition.
habituation
A decrease in the psychological and behavioural responses to a stimulus after repeated exposure over a period of time. See flooding and systematic desensitisation. Reports in the literature suggest that some, if not most, forms of decreased sound tolerance are impervious to habituation therapy.
household pets
Household pets, particularly cats and dogs, are known to trigger some people with misophonia. The noises they make when grooming themselves or eating may trigger a misophonic reaction.
hyperacusis
An intolerance to normal environmental sound due to oversensitivity to certain frequency ranges. A person with hyperacusis can experience normal sounds as unpleasantly loud or hear soft sounds that are imperceptible to others. See odynacusis. Cf misophonia, soundscape sensitivity.
hyperreflexia
Literally "overactive reflexes", a symptom of which can accompany loud sound misophonia. The sufferer displays a pronounced startle reflex (ie "jumps") on hearing a sound, even if they are anticipating it.
ideation, violence (or violent)
See violence ideation.
incidence (epidemiology)
The rate of occurrence of new cases of a particular illness, ie the likelihood of being diagnosed with it. Not be confused with prevalence.
Jastreboff model
A neurophysiological model of tinnitus, developed by Pawel Jastreboff at Yale University in the 1980s, and now widely accepted. It posits a central role for the limbic (emotional) and autonomic nervous systems in tinnitus and hyperacusis. Empirical support for Prof Jastreboff's model has been provided by positron emission tomography (PET) scanning.
known trigger (person or sound)
A sound (or person) that a person with misophonia knows will (or is likely to) trigger a misophonic reaction in them, on the basis of past experience or emotional connection.
ligyrophobia
Literally, "fear of sharp noises", particularly sudden and unexpected sounds, such as a balloon popping. Ligyrophobia is often used to describe loud sound misophonia (LSM) and this is Misophonia UK's preferred definition. See "definitional clarity." For a website dedicated to ligyrophobia, click here.
loudness discomfort levels (LDLs)
The intensity at which sound, particularly speech, causes discomfort - a term used by audiologists in the evaluation of decreased sound tolerance and other conditions. LDLs are of doubtful utility in soft sound sensitivity as the patient’s tolerance of loud sounds is often normal. It is soft sounds which they are unable to tolerate.
loud sound misophonia (LSM)
Loud sound misophonia is, as the name implies, an extreme fear of loud sounds. Also called "ligyrophobia". This may be accompanied by hyperreflexia, where the sufferer displays a pronounced startle reflex (ie "jumps") on hearing a sound, even when they are expecting it. Loud sound misophonia may well have a different aetiology [cause or causes] to soft sound misophonia, but research needs to be done to back any claims in this area. Cf soft sound misophonia (SSM).
LSM
See loud sound misophonia.
MAS-1
See Misophonia Activation Scale.
mesophonia
A common misspelling of misophonia. Correctly used, mesophonia is a grammatical term which means: "the repetition of a word or phrase in the middle of a sentence".
mimicking
A coping skill used in misophonia, where the making of a sound identical or similar to that of the trigger sound (or movement similar to that of the trigger movement) can bring some psychological relief to the sufferer. There is obvious scope for misunderstanding by the trigger person that their manners are being adversely commented on. Mimicking is a frequently observed characteristic in autism, but any correspondence with misophonia awaits research. Also known as echolalia (imitation of sounds) and echopraxia (imitation of movements).
misophobia
A common misspelling of misophonia, which, when used correctly, means "fear of dirt" or "fear of contamination".
misophonia
Fear or hatred of certain (or all) sounds. A term coined by US scientists Pawel and Margaret Jastreboff in 2001. Misophonia, SSSS, phonophobia and hyperacusis are often used interchangeably which is not helpful to definitional clarity. Misophonia UK's position is that:
● misophonia should be used to refer to a dislike of some, or all, sounds. Two apparently distinct kinds of misophonia are loud sound misophonia (LSM) and soft sound misophonia (SSM), better known as selective sound sensitivity sydrome or 4S.
● query whether misophonia should not be used to refer to a non-pathological dislike of sounds generally considered to be "noise", such as nails screeching against a blackboard.
● selective sound sensitivity should be considered a type of misophonia, where soft sounds (typically eating and breathing sounds made by emotional attachment figures) are the focus, and the quality of those sounds causes annoyance and rage in the listener.
● ligyrophobia should be restricted to loud sound misophonia.
● phonophobia should restricted to conditions where the patient unreasonably fears the sound will cause damage to their ears (ie not simply an extreme version of misophonia). [Ed: the problem with this definition is that phonophobia is already a term used to describe general noise intolerance associated with migraine].
● hyperacusis should be used to refer to intolerance of the experienced level (quantity) of a sound; noises simply sound "too loud".
Go here for a tabular representation of the suggested differences in terminology.
Misophonia Activation Scale
A diagnostic tool for clinicians and patients, developed by Misophonia UK.
negative affectivity
A disposition to negative moods such as anger, fear and nervousness.
neural plasticity
see plasticity, neural
neurology
A medical specialty which concerns the diagnosis and treatment of diseases of the central, peripheral, and autonomic nervous systems. The related surgical specialism is neurosurgery.
Neuromonics
A tinnitus treatment modality using a pleasant acoustic neural stimulus embedded in music as the therapeutic agent.
neurophysiology
The branch of physiology that deals with the functioning of the nervous system.
neuroplasticity
See plasticity, neural.
noise
Unpleasant, confused or loud sound.
noise sensitivity
Noise is, by definition, more troubling to humans than sound. Stansfeld describes noise as “a prototypical environmental stressor” which has health effects in addition to causing hearing loss. He finds that “[while] the evidence of elevated levels of aircraft noise leading to psychiatric hospital admissions and psychiatric disorder in the community is contradictory… there are well documented associations between noise exposure and changes in performance, sleep disturbance and emotional reactions such as annoyance… Although noise level explains a significant proportion of the variance in annoyance, the other major factor, confirmed in many studies, is subjective sensitivity to noise.”
He finds that noise sensitivity is “moderately stable and associated with current psychiatric disorder and a disposition to negative affectivity… [It is] related to higher tonic skin conductance and heart rate and greater defence/startle responses during noise exposure in the laboratory. Noise-sensitive people attend more to noises, discriminate more between noises, find noises more threatening and out of their control, and react to, and adapt to noises more slowly than less noise-sensitive people.”
non-confrontational coping skills
See coping skills.
nosology
Nosology is the science of classifying diseases, typically by aetiology [cause], pathophysiology [mechanism of action], or occurrence of symptoms.
ocd/ocpd
See obsessive compulsive disorder/obsessive compulsive personality disorder.
obsessive compulsive disorder/obsessive compulsive personality disorder
Obsessive–compulsive disorder (OCD) is a very common mental condition characterised by intrusive thoughts (obsessions) and behaviours (compulsions) that cause anxiety, and the carrying out of repetitive behaviours to attempt to reduce those anxieties. OCD should not be confused with obsessive compulsive personality disorder (OCPD), which involves an obsession with perfection, rules, and organisation. People with OCPD may feel anxious when they perceive that things are not right. This can lead to routines and rules for ways of doing things, whether for themselves or their families. One can have either OCD or OCPD without necessarily having the other. One theory is that SSSS is a form of OCD or OCPD but there is no research to investigate this. [Definitions of OCD and OCPD taken from Wikipedia].
odynacusis
Probably synonymous with hyperacusis, being a lowered uncomfortable-loudness threshold irrespective of the listener's hearing threshold. Differs from misophonia and auditory allodynia because all sounds reaching a certain level are problematic, not simply those with affective connotations.
otolaryngologist
A physician or surgeon who specialises in otolaryngology.
otolaryngology
A medical and surgical specialty concerned with the diagnosis, management and treatment of diseases of the ear, nose and throat. Otolaryngology is more commonly known as ENT and sometimes as otorhinolaryngology.
otorhinolaryngology
See otolaryngology.
panic
A common subjective experience in a person undergoing a "full-blown" misophonic reaction. The reaction has also been described in term of rage and fear.
panic attack
The DSM-IV [the American Psychiatric Association's official classification of mental disorders] describes a panic attack as "a discrete period of intense fear or discomfort in which (at least four of 13) symptoms develop abruptly and reach a peak within 10 minutes." The symptoms are:
● palpitations/accelerated heart rate
● sweating
● trembling or shaking
● sensation of shortness of breath or smothering
● feeling of choking
● chest pain or discomfort
● nausea or abdominal distress
● feeling dizzy, unsteady, light-headed, or faint
● derealisation (feeling of unreality) or depersonalisation (being detached from oneself)
● fear of losing control or going crazy
● fear of dying
● paresthesias (numbness or tingling sensations)
● chills or hot flashes
PET
See positron emission tomography.
phantom (auditory) perception
Phantom auditory perception, a subjective discernment of sound which cannot adequately be explained by external stimuli, has been proposed as a characterisation of misophonia as well as tinnitus. In “Understanding Sound Sensitivity in Individuals with Autism Spectrum Disorders”, Lillian Stiegler and Rebecca Davis, of Southeastern Louisiana University, suggest that misophonia and related conditions may, instead of originating in the auditory pathway, stem from centrally stored information about negative past auditory experiences, citing research by Ramachandran and Hirstein (1998) into the phenomenon of phantom perception in other contexts.
phonophobia
Literally, "extreme fear of sound". Phonophobia is often used to characterise a particularly severe reaction to sounds. In this respect, phonophobia is often considered a sub-set of misophonia. However, phonophobia is also used to refer to a condition where the patient fears that a sound will actually damage their ears, while another meaning ascribed to it is "fear of telephones/telephoning."The previous "official" meaning of phonophobia was "fear of speaking", but this is now considered a subsidiary definition. To aid definitional clarity, Misophonia UK's view is that the use of phonophobia as a term of art should be restricted to fear of sound causing damage to one's ears. Just to complicate matters further, phonophobia is used to describe a well-recognised symptom in migraine, but this condition's relationship to misophonia has not been investigated in the literature. Cf misophonia and ligyrophobia.
physiology
The science of the functioning of living organisms.
pink noise
See colour noise.
plasticity, neural
A change in the functioning of neural pathways. Neural plasticity may orginally give rise to misophonia and is therefore a potentially fruitful area of research.
positron emission tomography (PET)
Positron emission tomography (PET) is a nuclear medicine imaging technique which produces 3D images of the functioning body. A study using PET has given support to the Jastreboff model of tinnitus.
potentiation
Potentiation refers an increase in sensitivity to the trigger person or trigger sound. A common temporary cause of potentiation is tiredness.
prevalence (epidemiology)
The total number of cases of a particular illness in a population, ie how widespread the condition is. Not to be confused with incidence.
psychiatrist
A medical doctor specialising in psychiatry.
psychiatry
The diagnosis and treatment of mental disorders by a medical doctor. Not to be confused with psychology or psychotherapy.
psychologist
See clinical psychologist.
rage
The most common subjective experience of a person undergoing a "full-blown" misophonic reaction. The experience has also been described as panic, fear etc.
selective sound sensitivity syndrome (SSSS or 4S)
Extreme dislike of everyday sounds, typically eating and breathing noises made by people or animals to whom the sufferer is emotionally attached, eliciting a rage or panic reaction. Some practitioners use the term synonymously with misophonia, while others claim that SSSS is a discrete condition.
self-harm
The intentional injuring of body tissue without suicidal intent. There are anecdotal reports of misophonia sufferers doing self-harm to alleviate the rage reaction in misophonia.
self-triggering
Uncommonly, a person with misophonia may trigger a reaction in themselves by their own eating or breathing sounds, typically when they are overtired.
sexual arousal, unwanted
Some people with misophonia experience a feeling of unwanted sexual arousal on hearing one or more of their trigger sounds. This may be caused by over-activation of the hormonal circuits during the rage/panic stage. Adrenaline (epinephrine in American English) and noradrenaline (norepinephrine in American English) are both involved in fight-or-flight and sexual response.
soft sound misophonia (SSM)
Another term for soft sound sensitivity syndrome, used to differentiate it from loud sound misophonia.
soft sound sensitivity syndrome
See selective sound sensitivity syndrome.
soundscape sensitivity
A non-medical term for hyperacusis.
spelling
Perhaps due to its youth and lack of familiarity, misophonia is a term that is often misspelt. Although there are many permutations, "mesophonia" and "misophobia" seem to make regular appearances. They are both existing English words, meaning "the repetition of a word in the middle of a sentence" and "fear of dirt", respectively.
SSM
See soft sound misophonia.
SSSS
See selective sound sensitivity syndrome.
syndrome
A syndrome is a collection of patient-reported symptoms and/or clinically-observed characteristics that are frequently found together, suggesting the presence of an underlying condition, albeit one whose pathophysiology [mechanism of action] may not yet be understood.
systematic desensitisation
Systematic desensitisation is a graduated exposure therapy, where the patient is exposed to an anxiety-causing situation in discrete, manageable amounts. Once the situation has been confronted and the fear receded, another manageable situation is introduced. Systematic desensitisation should not be confused with flooding, where patients are expected to withstand intense anxiety. See flooding.
Desensitisation is used in Tinnitus Retraining Therapy but the Jastreboffs say that it is not an effective therapy for misophonia. Desensitisation works on the auditory system and consequently does not affect misophonia. What is required is active extinction of conditioned reflexes between the auditory and limbic systems. Their protocol claims to achieve this through the therapeutic use of pleasant music.
term of art
A word or phrase that has a special meaning in a particular context.
therapy
Treatments for misophonia may be classed as a) medical, b) physical and c) talking therapies.
a) No medicine has yet been licensed for misophonia and, to the knowledge of Misophonia UK, none is on the horizon. There are a few anecdotal reports that SSRI (selective serotonin reuptake inhibitor) antidepressants can help with the symptoms but this is not by any means a widely accepted therapy.
b) Talking therapies include cognitive behavioural therapy and psychotherapeutic hypnotherapy.
c) Physical devices that mask ambient sounds can be deployed, but the advice of an audiologist should be sought first.
Again, anecdotal evidence suggests that all these therapies have the potential to do more harm than good. See also: coping skills.
tinnitus
A ringing or other sensation in the ear that is heard only by the sufferer.
Tinnitus Retraining Therapy (TRT)
Treatment based on the Jastreboff model. TRT aims to change the body's reactions to a trigger sound, as well as the perception of the trigger sound itself. The goal is to re-educate the patient so that they accept the trigger sound in the same way as they would the noise of their refrigerator. They are not normally aware of it, and if they become aware, it does not trouble them.
tiredness
Tiredness can cause a person with misophonia to be more sensitive than usual to their trigger sounds. They may even trigger a reaction in themselves with their own breathing or eating sounds.
treatment
see therapy.
trigger person
A person who elicits a misophonic reaction in a sufferer.
trigger sound
A sound which elicits a misophonic reaction in a sufferer.
violence ideation (or violent ideation)
Thinking about doing violence without necessarily intending, or even desiring, to do it. (The Oxford English Dictionary defines ideation as “the formation of ideas or mental images of things not present to the senses.”). Violence ideation is a common although not essential component of the misophonic reaction. Whether those ideas are ever acted out is not clear. There are anecdotal reports of people with misophonia doing violence to others in response to a misophonic attack, but there is no research on how common a phenomenon it is. [Ed:Common sense suggests that most people with misophonia do not assault their trigger people].
white noise
See colour noise.
Author: Guy Fitzmaurice. Last content review: 1 June 2012.
4S
See “selective sound sensitivity syndrome”.
abdominal breathing
The process of breathing air into the lungs using the diaphragm (the muscle between your chest and stomach), which delivers more oxygen to the body than chest breathing. This is a helpful technique in coping with panic attacks and has the additional health benefit of increased energy if practised regularly (10 minutes a day).
acousticophobia
Literally "fear of noise". Another synonym for phonophobia. This word is not in common usage and Misophonia UK prefers not to assign any special meaning to it. See phonophobia.
aetiology
A medical term for the causes of a disease. Spelt etiology in American English.
age of onset of symptoms
People with misophonia often experience their first symptoms from the ages of 8-12.
allergy
The development of misophonia has been compared with that of an allergy. The trigger/allergen may at first provoke no response but over time, a reaction can become stronger and stronger. However, there is no evidence to suggest that misophonia is in fact caused by allergic mechanisms.
allodynia
See auditory allodynia.
anticipatory anxiety
The anxiety experienced by misophonia sufferers before a full -blown attack, provoked by audio-visual cues from their trigger person.
audiological medicine
Audiological medicine concerns the investigation, diagnosis and management of auditory, balance and communication disorders, including misophonia, tinnitus and auditory processing difficulties.
audiological physician
A doctor who practises audiological medicine. Also known as an audiovestibular physician.
audiologist
A healthcare professional who specialises in the evaluation and rehabilitation of those with hearing loss and related disorders, including misophonia. An audiologist assesses hearing function and dispenses hearing aids and other devices to assist hearing. Some audiologists have a doctorate (PhD or AuD) in audiology, but they are not to be confused with medical doctors (MDs).
audiology
The study of hearing.
audiovestibular physician
See audiological physician.
auditory allodynia
A condition where the hearer suffers pain from only some normal-volume sounds, where there is an affective component to the experience of the sound. May result from tissue or nerve damage.
auditory hypervigilance
Many people with misophonia are hyper-aware of people's breathing and eating sounds, particularly in members of their close family. Even if their trigger sound is not being made, they are constantly "on the look-out" for it.
autism
People with autism often suffer an intolerance of certain sounds. The connection between misophonia and autism has not been investigated in the research literature. However, Koegel and others (2004) have indicated that sound sensitivity in people with autism may be generated by fear rather than pain.
autogenic
Self-produced, coming from one's own body. See autogenic training.
autogenic training
Relaxation techniques, such as self-hypnosis, meditation and biofeedback, that centre on the patient controlling their own body states, such as body temperature and blood pressure.
autophonia
Autophonia is intolerance to the sound of one's own voice. This symptom may be accompanied by a similar intolerance to other autogenic sounds, such as breathing and eating.
brown noise
See colour noise.
cat
See household pets.
CAT
See cognitive analytic therapy.
CBT
See cognitive behavioural therapy.
chasmology
The science of yawning.
Cinderella diagnosis
A medical condition which attracts little professional interest, awareness and research funding.
clinical misophonia
A term used to distinguish misophonia as a medical condition. Virtually everybody has sounds they don't like. An oft-quoted example is fingernails scratching against a blackboard. That dislike could properly be described as "misophonia" as it is a "dislike of sound". However, we use "clinical misophonia" to refer to a condition where the reaction to the sound has grown out of all proportion to what might be considered normal. A useful analogy would be the use of the expressions "depression" and "clinical depression". People often say "I'm a little depressed today" to refer to the fact that they are a little "down in the dumps". However, clinical depression is a much more serious condition which usually requires medical attention. It is the same with clinical misophonia.
clinical psychologist
Clinical psychologists diagnose or assess mental and emotional disorders. They then devise treatment programs with the aim of reducing psychological distress.
cognitive analytic therapy
Cognitive analytic therapy focuses on analysing coping strategies that have been ineffective in the past, particularly in childhood, and modifying them so that they become more effective in the present. It relies on both cognitive and traditional psychoanalytic approaches. The emphasis is on brevity (or, rather, value for money to the NHS!). The client can expect to have anything between 8-24 sessions, although 16 is most common. CAT employs buzzwords such as Reciprocal Roles, Snags, Dilemmas and Traps. It is practised mainly in the UK. Despite their slightly different theoretical underpinnings, the difference between CBT and CAT in practice may be minimal. Cf cognitive behavioural therapy.
cognitive behavioural therapy
Cognitive behavioural therapy is a relatively brief form of psychotherapy which asks people to focus on the ways they think (cognitive) and act (behaviour) in the present, rather than dwelling on past experiences and underlying psychological causes. The emphasis is on problem solving. A clinical psychologist will devise an individual treatment plan with the patient, which seeks to eradicate inaccurate negative thoughts and improve response to more positive stimuli.
colour noise
A noise's "colour" simply refers to the bias it has towards a particular range of frequencies. Colour noises sounds something like the background hum on a radio set, although those of a more imaginative disposition may be reminded of the sound of the ocean or other natural phenomena. On a more practical level, some courts use white noise to mask the deliberations of the bench in court. People with misophonia can use colour noise to help mask their trigger sounds, usually by playback through earphones or headphones. Although there are a wide range of colours, the more popular ones tend to be white, pink and brown noise. Some practitioners and sufferers claim that over-use of colour noise can exacerbate sound sensitivity, but Misophonia UK are not aware of any published research on the subject, and it is a popular coping mechanism.
confrontational coping skills
See coping skills.
continuum theory
One suggestion is that everyone has an intolerance to sounds to varying degrees, in various environments, due to any number of factors. According to this theory, people presenting with clinical misophonia simply have a stronger reaction to various sounds than the general population. While it is no doubt true that sound intolerance is universal to a certain extent, this theory does not really explain the emergence of a very clear set of symptoms in people with soft sound misophonia.
co-operative coping skills
See coping skills.
coping skills
Methods a person uses to deal with stressful situations. These may "help a person face a situation, take action, and be flexible and persistent in solving problems" [taken from the US National Cancer Institute's Dictionary of Cancer Terms]. In the absence of a reliable and effective medical therapy, people with misophonia often rely on coping skills to mitigate the worst effects of their condition. Coping skills may be classified as co-operative/non-confrontational (for instance, asking the trigger person to stop or discreetly covering one ear) and confrontational (for instance, overt mimicking or display of annoyance).
decreased sound tolerance
An umbrella term used to describe hyperacusis, misophonia and phonophobia.See "misophonia" for a comparison of these terms. Go here for a tabular representation of the suggested differences in terminology.
definitional clarity
As in any new field, terms have been introduced or meanings appropriated from existing terminology, when describing misophonia, in slightly different ways by different commentators. Misophonia UK does not claim to have a "monopoly on the truth", particularly since so little research has been conducted around this Cinderella diagnosis. However, in the interests of everyone knowing what we mean when we use a particular term, we have introduced a schema for words commonly used to describe sound intolerance. Please refer to the "misophonia" entry. Go here for a tabular representation of the suggested differences in terminology.
desensitisation
See systematic desensitisation.
dog
See household pets.
ear, nose and throat specialist
A medical or surgical doctor who specialises in otolaryngology. Also called an otolaryngologist or otorhinolaryngologist.
echolalia
See mimicking.
echopraxia
See mimicking.
elective deafness
A desire to become deaf, either through surgical intervention or self-harm.
emotional component
If misophonia is a neurological, rather than psychological, condition, there is however an emotional component. This is most clearly evidenced when a person with misophonia hears what they think is their trigger sound, but then realises it is not. Their panic/rage reaction may subside in a fraction of a second. This is not to say that the sufferer is necessarily in a position to control their reaction.
ENT
See ear, nose and throat specialist.
epidemiology
The study of factors affecting illness in a population.
etiology
See aetiology.
"exploding head" syndrome
A rare symptom that has been associated with decreased sound tolerance, where the listener spontaneously hears a noise akin to an explosion or gunshot going off in their head, often during drowsiness or sleep. May be accompanied by visual phenomena, such as a flash. While the subjective experience of "exploding head" syndrome can be quite distressing, it is not believed to be otherwise harmful. May occur with use of some antidepressants.
fight or flight response
The physiological response, including nervous and endocrine changes, to a perceived acute threat to survival that prepares a human (or animal) to react or retreat, first described in detail by the American neurologist Walter Cannon in the early twentieth century.
flooding
Also known as exposure therapy or immersion therapy. The patient is exposed to an extremely anxiogenic (anxiety-causing) situation, with no gradual introduction. Once their fear has receded, it is claimed that they will enjoy lasting relief. Anecdotal evidence suggests that flooding is ineffective as a therapy for misophonia and may even exacerbate it. Cf systematic desensitisation.
genetic basis for soft sound aversion
US audiologist Dr Marsha Johnson reports that selective sound sensitivity syndrome often runs in families and she strongly suspects a genetic element to the condition.
habituation
A decrease in the psychological and behavioural responses to a stimulus after repeated exposure over a period of time. See flooding and systematic desensitisation. Reports in the literature suggest that some, if not most, forms of decreased sound tolerance are impervious to habituation therapy.
household pets
Household pets, particularly cats and dogs, are known to trigger some people with misophonia. The noises they make when grooming themselves or eating may trigger a misophonic reaction.
hyperacusis
An intolerance to normal environmental sound due to oversensitivity to certain frequency ranges. A person with hyperacusis can experience normal sounds as unpleasantly loud or hear soft sounds that are imperceptible to others. See odynacusis. Cf misophonia, soundscape sensitivity.
hyperreflexia
Literally "overactive reflexes", a symptom of which can accompany loud sound misophonia. The sufferer displays a pronounced startle reflex (ie "jumps") on hearing a sound, even if they are anticipating it.
ideation, violence (or violent)
See violence ideation.
incidence (epidemiology)
The rate of occurrence of new cases of a particular illness, ie the likelihood of being diagnosed with it. Not be confused with prevalence.
Jastreboff model
A neurophysiological model of tinnitus, developed by Pawel Jastreboff at Yale University in the 1980s, and now widely accepted. It posits a central role for the limbic (emotional) and autonomic nervous systems in tinnitus and hyperacusis. Empirical support for Prof Jastreboff's model has been provided by positron emission tomography (PET) scanning.
known trigger (person or sound)
A sound (or person) that a person with misophonia knows will (or is likely to) trigger a misophonic reaction in them, on the basis of past experience or emotional connection.
ligyrophobia
Literally, "fear of sharp noises", particularly sudden and unexpected sounds, such as a balloon popping. Ligyrophobia is often used to describe loud sound misophonia (LSM) and this is Misophonia UK's preferred definition. See "definitional clarity." For a website dedicated to ligyrophobia, click here.
loudness discomfort levels (LDLs)
The intensity at which sound, particularly speech, causes discomfort - a term used by audiologists in the evaluation of decreased sound tolerance and other conditions. LDLs are of doubtful utility in soft sound sensitivity as the patient’s tolerance of loud sounds is often normal. It is soft sounds which they are unable to tolerate.
loud sound misophonia (LSM)
Loud sound misophonia is, as the name implies, an extreme fear of loud sounds. Also called "ligyrophobia". This may be accompanied by hyperreflexia, where the sufferer displays a pronounced startle reflex (ie "jumps") on hearing a sound, even when they are expecting it. Loud sound misophonia may well have a different aetiology [cause or causes] to soft sound misophonia, but research needs to be done to back any claims in this area. Cf soft sound misophonia (SSM).
LSM
See loud sound misophonia.
MAS-1
See Misophonia Activation Scale.
mesophonia
A common misspelling of misophonia. Correctly used, mesophonia is a grammatical term which means: "the repetition of a word or phrase in the middle of a sentence".
mimicking
A coping skill used in misophonia, where the making of a sound identical or similar to that of the trigger sound (or movement similar to that of the trigger movement) can bring some psychological relief to the sufferer. There is obvious scope for misunderstanding by the trigger person that their manners are being adversely commented on. Mimicking is a frequently observed characteristic in autism, but any correspondence with misophonia awaits research. Also known as echolalia (imitation of sounds) and echopraxia (imitation of movements).
misophobia
A common misspelling of misophonia, which, when used correctly, means "fear of dirt" or "fear of contamination".
misophonia
Fear or hatred of certain (or all) sounds. A term coined by US scientists Pawel and Margaret Jastreboff in 2001. Misophonia, SSSS, phonophobia and hyperacusis are often used interchangeably which is not helpful to definitional clarity. Misophonia UK's position is that:
● misophonia should be used to refer to a dislike of some, or all, sounds. Two apparently distinct kinds of misophonia are loud sound misophonia (LSM) and soft sound misophonia (SSM), better known as selective sound sensitivity sydrome or 4S.
● query whether misophonia should not be used to refer to a non-pathological dislike of sounds generally considered to be "noise", such as nails screeching against a blackboard.
● selective sound sensitivity should be considered a type of misophonia, where soft sounds (typically eating and breathing sounds made by emotional attachment figures) are the focus, and the quality of those sounds causes annoyance and rage in the listener.
● ligyrophobia should be restricted to loud sound misophonia.
● phonophobia should restricted to conditions where the patient unreasonably fears the sound will cause damage to their ears (ie not simply an extreme version of misophonia). [Ed: the problem with this definition is that phonophobia is already a term used to describe general noise intolerance associated with migraine].
● hyperacusis should be used to refer to intolerance of the experienced level (quantity) of a sound; noises simply sound "too loud".
Go here for a tabular representation of the suggested differences in terminology.
Misophonia Activation Scale
A diagnostic tool for clinicians and patients, developed by Misophonia UK.
negative affectivity
A disposition to negative moods such as anger, fear and nervousness.
neural plasticity
see plasticity, neural
neurology
A medical specialty which concerns the diagnosis and treatment of diseases of the central, peripheral, and autonomic nervous systems. The related surgical specialism is neurosurgery.
Neuromonics
A tinnitus treatment modality using a pleasant acoustic neural stimulus embedded in music as the therapeutic agent.
neurophysiology
The branch of physiology that deals with the functioning of the nervous system.
neuroplasticity
See plasticity, neural.
noise
Unpleasant, confused or loud sound.
noise sensitivity
Noise is, by definition, more troubling to humans than sound. Stansfeld describes noise as “a prototypical environmental stressor” which has health effects in addition to causing hearing loss. He finds that “[while] the evidence of elevated levels of aircraft noise leading to psychiatric hospital admissions and psychiatric disorder in the community is contradictory… there are well documented associations between noise exposure and changes in performance, sleep disturbance and emotional reactions such as annoyance… Although noise level explains a significant proportion of the variance in annoyance, the other major factor, confirmed in many studies, is subjective sensitivity to noise.”
He finds that noise sensitivity is “moderately stable and associated with current psychiatric disorder and a disposition to negative affectivity… [It is] related to higher tonic skin conductance and heart rate and greater defence/startle responses during noise exposure in the laboratory. Noise-sensitive people attend more to noises, discriminate more between noises, find noises more threatening and out of their control, and react to, and adapt to noises more slowly than less noise-sensitive people.”
non-confrontational coping skills
See coping skills.
nosology
Nosology is the science of classifying diseases, typically by aetiology [cause], pathophysiology [mechanism of action], or occurrence of symptoms.
ocd/ocpd
See obsessive compulsive disorder/obsessive compulsive personality disorder.
obsessive compulsive disorder/obsessive compulsive personality disorder
Obsessive–compulsive disorder (OCD) is a very common mental condition characterised by intrusive thoughts (obsessions) and behaviours (compulsions) that cause anxiety, and the carrying out of repetitive behaviours to attempt to reduce those anxieties. OCD should not be confused with obsessive compulsive personality disorder (OCPD), which involves an obsession with perfection, rules, and organisation. People with OCPD may feel anxious when they perceive that things are not right. This can lead to routines and rules for ways of doing things, whether for themselves or their families. One can have either OCD or OCPD without necessarily having the other. One theory is that SSSS is a form of OCD or OCPD but there is no research to investigate this. [Definitions of OCD and OCPD taken from Wikipedia].
odynacusis
Probably synonymous with hyperacusis, being a lowered uncomfortable-loudness threshold irrespective of the listener's hearing threshold. Differs from misophonia and auditory allodynia because all sounds reaching a certain level are problematic, not simply those with affective connotations.
otolaryngologist
A physician or surgeon who specialises in otolaryngology.
otolaryngology
A medical and surgical specialty concerned with the diagnosis, management and treatment of diseases of the ear, nose and throat. Otolaryngology is more commonly known as ENT and sometimes as otorhinolaryngology.
otorhinolaryngology
See otolaryngology.
panic
A common subjective experience in a person undergoing a "full-blown" misophonic reaction. The reaction has also been described in term of rage and fear.
panic attack
The DSM-IV [the American Psychiatric Association's official classification of mental disorders] describes a panic attack as "a discrete period of intense fear or discomfort in which (at least four of 13) symptoms develop abruptly and reach a peak within 10 minutes." The symptoms are:
● palpitations/accelerated heart rate
● sweating
● trembling or shaking
● sensation of shortness of breath or smothering
● feeling of choking
● chest pain or discomfort
● nausea or abdominal distress
● feeling dizzy, unsteady, light-headed, or faint
● derealisation (feeling of unreality) or depersonalisation (being detached from oneself)
● fear of losing control or going crazy
● fear of dying
● paresthesias (numbness or tingling sensations)
● chills or hot flashes
PET
See positron emission tomography.
phantom (auditory) perception
Phantom auditory perception, a subjective discernment of sound which cannot adequately be explained by external stimuli, has been proposed as a characterisation of misophonia as well as tinnitus. In “Understanding Sound Sensitivity in Individuals with Autism Spectrum Disorders”, Lillian Stiegler and Rebecca Davis, of Southeastern Louisiana University, suggest that misophonia and related conditions may, instead of originating in the auditory pathway, stem from centrally stored information about negative past auditory experiences, citing research by Ramachandran and Hirstein (1998) into the phenomenon of phantom perception in other contexts.
phonophobia
Literally, "extreme fear of sound". Phonophobia is often used to characterise a particularly severe reaction to sounds. In this respect, phonophobia is often considered a sub-set of misophonia. However, phonophobia is also used to refer to a condition where the patient fears that a sound will actually damage their ears, while another meaning ascribed to it is "fear of telephones/telephoning."The previous "official" meaning of phonophobia was "fear of speaking", but this is now considered a subsidiary definition. To aid definitional clarity, Misophonia UK's view is that the use of phonophobia as a term of art should be restricted to fear of sound causing damage to one's ears. Just to complicate matters further, phonophobia is used to describe a well-recognised symptom in migraine, but this condition's relationship to misophonia has not been investigated in the literature. Cf misophonia and ligyrophobia.
physiology
The science of the functioning of living organisms.
pink noise
See colour noise.
plasticity, neural
A change in the functioning of neural pathways. Neural plasticity may orginally give rise to misophonia and is therefore a potentially fruitful area of research.
positron emission tomography (PET)
Positron emission tomography (PET) is a nuclear medicine imaging technique which produces 3D images of the functioning body. A study using PET has given support to the Jastreboff model of tinnitus.
potentiation
Potentiation refers an increase in sensitivity to the trigger person or trigger sound. A common temporary cause of potentiation is tiredness.
prevalence (epidemiology)
The total number of cases of a particular illness in a population, ie how widespread the condition is. Not to be confused with incidence.
psychiatrist
A medical doctor specialising in psychiatry.
psychiatry
The diagnosis and treatment of mental disorders by a medical doctor. Not to be confused with psychology or psychotherapy.
psychologist
See clinical psychologist.
rage
The most common subjective experience of a person undergoing a "full-blown" misophonic reaction. The experience has also been described as panic, fear etc.
selective sound sensitivity syndrome (SSSS or 4S)
Extreme dislike of everyday sounds, typically eating and breathing noises made by people or animals to whom the sufferer is emotionally attached, eliciting a rage or panic reaction. Some practitioners use the term synonymously with misophonia, while others claim that SSSS is a discrete condition.
self-harm
The intentional injuring of body tissue without suicidal intent. There are anecdotal reports of misophonia sufferers doing self-harm to alleviate the rage reaction in misophonia.
self-triggering
Uncommonly, a person with misophonia may trigger a reaction in themselves by their own eating or breathing sounds, typically when they are overtired.
sexual arousal, unwanted
Some people with misophonia experience a feeling of unwanted sexual arousal on hearing one or more of their trigger sounds. This may be caused by over-activation of the hormonal circuits during the rage/panic stage. Adrenaline (epinephrine in American English) and noradrenaline (norepinephrine in American English) are both involved in fight-or-flight and sexual response.
soft sound misophonia (SSM)
Another term for soft sound sensitivity syndrome, used to differentiate it from loud sound misophonia.
soft sound sensitivity syndrome
See selective sound sensitivity syndrome.
soundscape sensitivity
A non-medical term for hyperacusis.
spelling
Perhaps due to its youth and lack of familiarity, misophonia is a term that is often misspelt. Although there are many permutations, "mesophonia" and "misophobia" seem to make regular appearances. They are both existing English words, meaning "the repetition of a word in the middle of a sentence" and "fear of dirt", respectively.
SSM
See soft sound misophonia.
SSSS
See selective sound sensitivity syndrome.
syndrome
A syndrome is a collection of patient-reported symptoms and/or clinically-observed characteristics that are frequently found together, suggesting the presence of an underlying condition, albeit one whose pathophysiology [mechanism of action] may not yet be understood.
systematic desensitisation
Systematic desensitisation is a graduated exposure therapy, where the patient is exposed to an anxiety-causing situation in discrete, manageable amounts. Once the situation has been confronted and the fear receded, another manageable situation is introduced. Systematic desensitisation should not be confused with flooding, where patients are expected to withstand intense anxiety. See flooding.
Desensitisation is used in Tinnitus Retraining Therapy but the Jastreboffs say that it is not an effective therapy for misophonia. Desensitisation works on the auditory system and consequently does not affect misophonia. What is required is active extinction of conditioned reflexes between the auditory and limbic systems. Their protocol claims to achieve this through the therapeutic use of pleasant music.
term of art
A word or phrase that has a special meaning in a particular context.
therapy
Treatments for misophonia may be classed as a) medical, b) physical and c) talking therapies.
a) No medicine has yet been licensed for misophonia and, to the knowledge of Misophonia UK, none is on the horizon. There are a few anecdotal reports that SSRI (selective serotonin reuptake inhibitor) antidepressants can help with the symptoms but this is not by any means a widely accepted therapy.
b) Talking therapies include cognitive behavioural therapy and psychotherapeutic hypnotherapy.
c) Physical devices that mask ambient sounds can be deployed, but the advice of an audiologist should be sought first.
Again, anecdotal evidence suggests that all these therapies have the potential to do more harm than good. See also: coping skills.
tinnitus
A ringing or other sensation in the ear that is heard only by the sufferer.
Tinnitus Retraining Therapy (TRT)
Treatment based on the Jastreboff model. TRT aims to change the body's reactions to a trigger sound, as well as the perception of the trigger sound itself. The goal is to re-educate the patient so that they accept the trigger sound in the same way as they would the noise of their refrigerator. They are not normally aware of it, and if they become aware, it does not trouble them.
tiredness
Tiredness can cause a person with misophonia to be more sensitive than usual to their trigger sounds. They may even trigger a reaction in themselves with their own breathing or eating sounds.
treatment
see therapy.
trigger person
A person who elicits a misophonic reaction in a sufferer.
trigger sound
A sound which elicits a misophonic reaction in a sufferer.
violence ideation (or violent ideation)
Thinking about doing violence without necessarily intending, or even desiring, to do it. (The Oxford English Dictionary defines ideation as “the formation of ideas or mental images of things not present to the senses.”). Violence ideation is a common although not essential component of the misophonic reaction. Whether those ideas are ever acted out is not clear. There are anecdotal reports of people with misophonia doing violence to others in response to a misophonic attack, but there is no research on how common a phenomenon it is. [Ed:Common sense suggests that most people with misophonia do not assault their trigger people].
white noise
See colour noise.
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