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Similar to the previously described study, Dr. Jeff Pavlacic's research team at the Medical University of South Carolina used ecological momentary assessment (EMA) to examine how emotion regulation (ER) related to changes in misophonia symptoms throughout daily life. Their findings suggest that misophonia symptoms and the link to ER can fluctuate meaningfully across individuals and throughout the day for each individual. This highlights the importance of understanding what factors contribute to these moment-to-moment changes, to inform the best intervention strategies to help individuals with their fluctuating symptoms.

Misophonia symptoms can vary significantly across individuals and can even fluctuate for individuals. When individuals with a disorder vary in the intensity, type, and daily expression of that disorder, it can increase challenges in diagnosing or evaluating their condition and identifying useful interventions to reduce symptoms and symptom impact. Most research studies happen in a clinical laboratory setting, which cannot capture the full picture of misophonia variability in daily life, and rely on participants reflecting on previous experiences.

This EMA study made several observations that contribute to a growing understanding of how misophonia impacts individuals on a moment-by-moment basis.

More specifically, researchers made the following observations from 3,000 surveys over a 30-day period across 60 individuals with elevated misophonia symptoms:

• 25-50% of the overall variability in ER and misophonia symptoms in their collected data was due to differences across individuals
• 25% of the variability they saw in misophonia symptoms was due to moment-by-moment changes for the individual
• Lower misophonia symptoms were linked to greater use of emotion regulation strategies, including mindfulness
• Higher misophonia symptoms were linked to higher overall emotion dysregulation
• ER was associated with misophonia symptoms both during trigger experiences and during periods without triggers, which may include periods of trigger anticipation

These findings highlight the highly individualized nature of misophonia and suggest that symptoms are influenced by factors that can change throughout the day. The authors express an interest in future interventions that provide support in real time, adapting to an individual's current symptoms, trigger exposure, and emotional state.

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Research Paper Title: MERGE: Misophonia and Emotion Regulation in a Guided Experience Sampling Study

Authors: Jeffrey M. Pavlacic, Laura J. Dixon, Allie Freshley, Erin M. Buchanan, Bernadette Cortese, Alyssa A. Rheingold, John Young, Thomas Uhde

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ABOUT THE RESEARCH TEAM

Jeffrey Pavlacic, PhD, is a Clinical Psychologist in the Sleep, Mood, Anxiety Research & Treatment Division at the Medical University of South Carolina. He provides therapy to adults with anxiety disorders, trauma- and stressor-related disorders, sleep disturbances, and co-occurring difficulties such as acute and chronic pain and sensory processing conditions. Dr. Pavlacic is the primary investigator on a 2025 Data Discovery Award titled “Examining Momentary and Longitudinal Associations Between Misophonia and Emotion Regulation: An Intensive Experience Sampling Approach”.

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