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Many people with misophonia use music or other distractions to help cope with trigger sounds, but can shifting attention away from a trigger and towards music reduce the body's physical response? Marie-Anick Savard and colleagues at Concordia University in Montreal investigated whether directing attention toward music could reduce physical reactions to trigger sounds. They found that heightened physiological responses persisted even when participants focused on music rather than the triggers. The researchers also found that people with misophonia reported greater mental effort when listening to competing sounds, despite performing the listening task as accurately as people without misophonia.

Although previous research has shown that people with misophonia experience heightened physical responses to trigger sounds, less is known about whether intentionally shifting attention elsewhere can change those responses. This study examined that question using direct measurements of physical activity in the body, rather than relying solely on participants' descriptions of their experiences.

The study included 30 adults with misophonia and 30 adults without misophonia. Participants listened through headphones to trigger sounds, generally unpleasant sounds, and neutral sounds, sometimes presented alone and sometimes alongside unfamiliar piano music in the opposite ear. During the listening task, participants were instructed to focus on either the sounds or the music and identify a brief bell sound in the ear they were attending to. Researchers continuously measured changes in skin electrical activity, pupil size, and heart rate, and asked participants to rate the mental effort required.

Researchers found the following:‍

• Trigger sounds produced heightened physical responses in participants with misophonia. When sounds were presented alone, participants with misophonia showed greater skin electrical activity in response to trigger sounds than to generally unpleasant or neutral sounds. Their pupils also dilated more in response to trigger sounds than neutral sounds. These differences were not observed in participants without misophonia under the same listening conditions.
• Focusing on music did not substantially reduce physiological responses to trigger sounds. When trigger sounds and piano music played simultaneously, participants with misophonia continued to show heightened responses in skin electrical activity and pupil size, regardless of which sound they were instructed to focus on. The researchers found little evidence that shifting attention toward music meaningfully reduced these physical reactions.
• Participants with misophonia reported greater mental effort despite similar task performance. When music and other sounds played simultaneously, participants with misophonia reported approximately 10% greater mental workload than those without misophonia. However, both groups performed similarly on the listening task, with generally high accuracy, and reported greater mental workload when listening to unpleasant sounds compared with neutral sounds. This suggests that maintaining attention amid competing sounds may require greater effort for people with misophonia, even when their performance is not affected.
• Generally unpleasant sounds produced different responses than misophonia triggers. Heart rate decreased in response to generally unpleasant sounds across both groups but did not show a distinct response to trigger sounds among participants with misophonia. The researchers also observed that focusing on music changed pupil responses to generally unpleasant sounds, while responses to trigger sounds remained elevated. These findings suggest that different physical measurements may capture different aspects of responses to unpleasant and trigger sounds.

Together, these findings suggest that simply directing attention away from an already recognized trigger sound towards unfamiliar music may not be enough to reduce the associated physical response. The researchers propose that future studies could explore an earlier stage of the response, particularly how sounds are identified and interpreted before they are recognized as triggers.

The researchers also note that the study used standardized trigger sounds and unfamiliar piano music. Therefore, the findings do not establish whether personally selected music, other forms of distraction, or different listening environments might produce different results.

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Research Paper Title: Autonomic responses to trigger sounds persist despite attentional redirection in misophonia

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Authors: Marie-Anick Savard, Mary Brooks, Emily B. J. Coffey, and Mickael L. D. Deroche

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ABOUT THE RESEARCH TEAM

Marie-Anick Savard is a graduate student co-supervised by Emily Coffey, PhD and Mickael Deroche, PhD at Concordia University in Montreal, Canada. This work was supported by a 2021 Misophonia Research Impact Award.