News & Events

There are several misophonia questionnaires available for people to use. But how do you know which one is the right one for you?

In this campaign, we ask MRF funded investigators and researchers about their work developing and validating misophonia questionnaires, and why people with misophonia should take the results of one questionnaire or another to their physician. Read on to learn more about the Duke-Vanderbilt Misophonia Screening Questionnaire.

Q: What is the purpose of a questionnaire? How are they used for diagnostic, treatment evaluation, and research purposes?

A: Questionnaires are sets of standardized written prompts, usually with multiple-choice or rating-scale type answers that can be scored to quantify some dimension of a person’s health, behavior, or attitudes (among many other “constructs”). Some questionnaires are used to screen for diseases and medical conditions, meaning you will fill them out, and they will tell your doctor or another health care provider that you might have a certain condition (and potentially should be assessed further if the questionnaire did not confirm the diagnosis). Other questionnaires are used as outcome measures, meaning that they are administered multiple times over the course of a given treatment, and scores are tracked over those time points to determine whether the treatment is effective.

Questionnaire measures can be used multiple different ways for research—sometimes they are used to include people in studies by making sure those people meet some level of “severity,” but more frequently, the researchers have specific hypotheses about how the construct represented by the questionnaire (e.g., “misophonia symptoms”) differs between groups in the study or correlates with some other variable. Studies testing those hypotheses are much more common than studies using questionnaires for inclusion or exclusion purposes.

Q: What does it mean for a questionnaire to be validated? Why is this important?

A: As I mentioned earlier, questionnaires are designed for specific purposes, and so it’s extremely important that when someone writes a bunch of questions and turns them into a questionnaire that they’re actually tested with real people (in the population of interest). This shows that the questionnaire behaves as intended, and then it can be rolled out for use in the clinic or research setting it was intended for.

Additionally, certain psychometric properties of the questionnaire, like how reliable it is [internal consistency, test-retest reliability] and how good it is at screening for a given disease [sensitivity, specificity, etc.], are determined in these initial validation studies (different metrics based on the kind of questionnaire being validated).

Q: What gaps (clinically and for research purposes) exist with the current questionnaires? And what ongoing research may be in the works to address those?

A: Right now, there are a lot of gaps in the current questionnaires being used for misophonia. There are a lot of them out there, but almost all of the existing measures have only ever been validated in relatively small studies by the people who made them. Almost none of those studies were actually conducted in clinical settings, meaning we don’t really know how any of the existing measures perform when people are seeking medical care (i.e., when you would actually want to use them in practice), because the people the questions were “validated” on were just recruited from either the internet or an in-person research study (which usually recruits locally in and around a university and/or medical center).

There is definitely ongoing work to attempt to further validate some of these measures in larger samples, as well as determine how these measures compare with one another. Because of the general lack of misophonia clinical services, I’m unaware of any plans at the moment by researchers in the clinical space to systematically collect these questionnaires for the purpose of validating them.

Q: How does the Duke-Vanderbilt Misophonia Screening Questionnaire (DVMSQ) measure misophonia compared to other questionnaires? Has it been validated yet?

A: The purpose of the DVMSQ is to screen someone for misophonia. The threshold is fairly high, but if you reach the clinical cutoff on that questionnaire, you may want to bring it up to your doctor. If your misophonia significantly bothers you (regardless of whether you meet DVMSQ criteria), then it may very well be appropriate for you to seek out some form of treatment or intervention.

The total score on the DVMSQ can also be used like an outcome measure, and the form can be completed multiple times over time to track progress in treatment (although it is arguably not as comprehensive as other measures such as the Duke Misophonia Questionnaire, which I also helped to write, or the S-Five, and those may be better outcome measures for long-term symptom tracking once a diagnosis is made).

Like many other measures, the DVMSQ has been validated in a single study (this one consisting of approximately 2,200 individuals sampled from two large online participant databases), and there’s not actually any published data on how well its screening algorithm compares to clinical diagnoses of misophonia. However, the scale definitely measures the unified construct of misophonia, is highly reliable, and associates with other measures in the ways we would expect. There is still a whole lot more to do before we would want to recommend it as the way to screen for misophonia, however.

Q: Why should someone with misophonia bring the results of the Duke-Vanderbilt Misophonia Screening Questionnaire to their clinician/physician over other questionnaires?

A: The DVMSQ is still one of the only questionnaires that is specifically designed as a misophonia screening tool, and its algorithm is actually based on the consensus clinical definition of misophonia, meaning that if one actually meets all of the criteria they endorse on the questionnaire, then they actually should meet the criteria for a diagnosis of misophonia by the consensus definition (as far as I’ve operationalized it).

It is also unique insofar as it’s been specifically validated for use in autistic adults (and found to be an equivalent measure when filled out by autistic and non-autistic respondents, an important result). Autistic people in particular will find the DVMSQ helpful when determining whether they have misophonia as opposed to some other sound tolerance condition.

Q: Do any resources exist to help clinicians and researchers find more information or on how to use the Duke-Vanderbilt Misophonia Screening Questionnaire?

A: I have provided a link to the most recent version of the DVMSQ on my ResearchGate profile, which includes

• some additional instructions on scoring
• bonus questions that are scored separately and do not need to be administered with the measure

If there are still questions about using or scoring the form, people are encouraged to direct-message me on ResearchGate.

‍

To take the Duke-Vanderbilt Misophonia Screening Questionnaire and explore more of Dr. William’s work on misophonia, visit his ResearchGate profile. We thank him and the rest of the team that created the Duke-Vanderbilt Misophonia Screening Questionnaire for their dedication to misophonia research and advocacy.