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Previous research has linked difficulties regulating emotions to misophonia symptoms, but how do factors driving emotion regulation, like anxiety sensitivity and distress tolerance, fluctuate in everyday life? Dr. Jeffrey Pavlacic and colleagues at the Medical University of South Carolina and collaborating institutions investigated how emotion regulation and other psychological characteristics relate to misophonia symptom severity over time. They found that anxiety sensitivity was consistently associated with more severe misophonia symptoms, both during trigger experiences and when triggers were absent.

Building on previously featured research from the same team that tracked misophonia symptoms and emotion regulation throughout daily life, this follow-up study examined data from 58 adults with misophonia who completed surveys three times daily for 30 days. Researchers assessed participants' misophonia symptoms and difficulties regulating emotions throughout the month, alongside psychological characteristics measured at the beginning of the study. By examining both differences between participants and changes within individuals over time, researchers investigated how factors influencing emotion regulation relate to misophonia symptoms as they fluctuate in everyday life.

Researchers found the following:

• Anxiety sensitivity was associated with more severe misophonia symptoms. Participants with greater anxiety sensitivity (fear of physical sensations associated with anxiety) tended to report more severe misophonia symptoms, both during trigger experiences and when triggers were absent.
• Distress tolerance and obsessive-compulsive symptoms did not independently predict misophonia severity. Neither difficulty tolerating distress nor obsessive-compulsive symptoms were significant predictors of misophonia symptom severity after accounting for initial misophonia severity, emotion regulation difficulties, and anxiety sensitivity.

Together, these findings extend previous research linking emotion regulation difficulties to misophonia by pointing to anxiety sensitivity as one possible area of intervention. Further research is needed to evaluate the benefit of anxiety sensitivity reduction on misophonia symptoms in daily life.

The study also had limitations, including a relatively small sample and limited demographic diversity. Further research with larger, more diverse samples will be important for understanding how these relationships vary across individuals.

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Research Paper Title: Transdiagnostic and clinical predictors of longitudinal misophonia symptoms

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Authors: Jeffrey M. Pavlacic, Averi N. Gaines, Sara M. Witcraft, Allie Freshley, Erin M. Buchanan, Bernadette Cortese, Christopher Sege, Alyssa A. Rheingold, Thomas Uhde, and Laura J. Dixon

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ABOUT THE RESEARCH TEAM

Jeffrey Pavlacic, PhD is a licensed clinical psychologist in the Sleep, Mood, Anxiety Research & Treatment Division at the Medical University of South Carolina. Dr. Pavlacic completed this study as a primary investigator on a 2025 Data Discovery Award.

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