Abstract
The aim of the present study was to investigate whether dispositional disgust sensitivity and affective styles are associated with features of misophonia and whether emotion dysregulation plays a role in this relationship. We anticipated disgust sensitivity and emotion dysregulation to be vulnerability factors for the emotional distress and behavioral reactions seen in misophonia. A sample of 334 adults (223 females, 104 males, and 7 non-binary individuals) ranging in age from 18 to 65 years were recruited through online social media websites and completed an online battery of scales that consisted of the Disgust Scale-Revised, the Difficulties in Emotion Regulation Scale-Short Form, the Affective Styles Questionnaire, and the New York Misophonia Scale. Significant correlations were obtained among the study variables. Results of mediation analysis indicated that disgust sensitivity has both direct and indirect effects on misophonic distress but only indirect effects on behavioral reactions in misophonia. The affective styles adjusting and tolerating had only indirect effects on misophonia symptomology. While emotion dysregulation partially mediated the relationship between disgust sensitivity and misophonic distress, it completely mediated the relationship between disgust sensitivity and misophonic behavioral reactions. These findings imply that the aggressive and avoidance reactions in misophonia may be a consequence of emotional dysregulation while misophonic distress may be a reflection of mental contamination associated with dispositional disgust sensitivity. Findings of the study have theoretical and clinical implications. Interventions focusing on disgust sensitivity reduction may benefit individuals with misophonia.
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References
Aldao, A., & Dixon-Gordon, K. (2014). Broadening the scope of research on emotion regulation strategies and psychopathology. Cognitive Behaviour Therapy, 43(1), 22–33. https://doi.org/10.1080/16506073.2013.816769
Aldao, A., & Nolen-Hoeksema, S. (2012). When are adaptive strategies most predictive of psychopathology? Journal of Abnormal Psychology, 121(1), 276–281.
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237.
Badour, C., Feldner, M., Babson, K., Blumenthal, H., & Dutton, C. (2012). Disgust, mental contamination, and posttraumatic stress: Unique relations following sexual versus non-sexual assault. Journal of Anxiety Disorders, 27(1), 155–162. https://doi.org/10.1016/j.janxdis.2012.11.002
Baker, R., Holloway, J., Thomas, P., Thomas, S., & Owens, M. (2004). Emotional processing and panic. Behaviour Research and Therapy, 42(11), 1271–1287. https://doi.org/10.1016/j.brat.2003.09.002
Barahmand, U., Stalias-Mantzikos, M., Xiang, Y., & Rotlevi, E. (2021). New York misophonia screener: A new instrument to identify misophonia in the general population. A poster accepted for presentation at the Annual Meeting of the Eastern Psychological Association,
Besharat, M., Nia, M., & Farahani, H. (2012). Anger and major depressive disorder: The mediating role of emotion regulation and anger rumination. Asian Journal of Psychiatry, 6(1), 35–41. https://doi.org/10.1016/j.ajp.2012.07.013
Bruxner, G. (2016). Mastication rage’: A review of misophonia - An under-recognised symptom of psychiatric relevance? Australian Psychiatry, 24(2), 195–197. https://doi.org/10.1177/1039856215613010
Bujor, L., & Turliuc, M. (2020). The personality structure in the emotion regulation of sadness and anger. Personality and Individual Differences, 162, 109999. https://doi.org/10.1016/j.paid.2020.109999
Chapman, H. A., Kim, D. A., Susskind, J. M., & Anderson, A. K. (2009). In bad taste: Evidence for the oral origins of moral disgust. Science, 323(5918), 1222–1226.
Curtis, V., de Barra, M., & Aunger, R. (2011). Disgust as an adaptive system for disease avoidance behaviour. Philosophical Transactions. Biological Sciences, 366(1563), 389– 401. https://doi.org/10.1098/rstb.2010.0117
Davey, G. C. L. & Bond, N. (2006). Using controlled comparisons in disgust psychopathology research: The case of disgust, hypochondriasis and health anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 37(1), 4–15. https://doi.org/10.1016/j.jbtep.2005.09.001
Davidson, R. J. (1992). Emotion and Affective Style: Hemispheric Substrates. Psychological Science, 3(1), 39–43. https://doi.org/10.1111/j.1467‐9280.1992.tb00254.x
Dozier. (2015). Etiology, composition, development and maintenance of misophonia: a conditioned aversive reflex disorder. Psychological Thought, 8(1), 114–129. https://doi.org/10.5964/psyct.v8i1.132
Dozier, & Morrison, K. L. (2017). Phenomenology of misophonia: initial physical and emotional responses. The American Journal of Psychology, 130(4), 431–438. https://doi.org/10.5406/amerjpsyc.130.4.0431
Edelstein, M., Brang, D., Rouw, R., & Ramachandran, V. (2013). Misophonia: Physiological investigations and case descriptions. Frontiers in Human Neuroscience, 25(7), 296. https://doi.org/10.3389/fnhum.2013.00296
Ekman. (1992). Are There Basic Emotions? Psychological Review, 99(3), 550–553. https://doi.org/10.1037/0033-295X.99.3.550
Elliott, C., & Radomsky, A. (2013). Meaning and mental contamination: Focus on appraisals. Clinical Psychologist (australian Psychological Society), 17(1), 17–25. https://doi.org/10.1111/cp.12002
Erwin, B., Heimberg, R., Schneier, F., & Liebowitz, M. (2003). Anger experience and expression in social anxiety disorder: Pretreatment profile and predictors of attrition and response to cognitive-behavioral treatment. Behavior Therapy, 34(3), 331–350. https://doi.org/10.1016/S0005-7894(03)80004-7
Fong, Z., & Sündermann, O. (2020). Modulating disgust in mental contamination: Experimental evidence for the role of disgust. Journal of Behavior Therapy and Experimental Psychiatry, 68, 101567–101567. https://doi.org/10.1016/j.jbtep.2020.101567
Giner-Sorolla, R., & Chapman, H. A. (2017). Beyond purity: Moral disgust toward bad character. Psychological Science, 28, 80–91. https://doi.org/10.1177/0956797616673193
Giner-Sorolla, R., Kupfer, T., & Sabo, J. (2018). Chapter five - What makes moral disgust special? An integrative functional review. Advances in Experimental Social Psychology, 57, 223–289.
Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. https://doi.org/10.1037/0022-3514.85.2.348
Gross, & Jazaieri, H. (2014). Emotion, Emotion Regulation, and Psychopathology: An Affective Science Perspective. Clinical Psychological Science, 2(4), 387–401. https://doi.org/10.1177/2167702614536164
Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3–24). The Guilford Press.
Harvey, A. D., Murray, G., Chandler, R. A., & Soehner, A. (2011). Sleep disturbance as transdiagnostic: Consideration of neurobiological mechanisms. Clinical Psychology Review, 31(2), 225–235. https://doi.org/10.1016/j.cpr.2010.04.003
Harvey, A. G., Watkins, E., Mansell, W., & Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic approach to research and treatment. Oxford University Press.
Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression‐based approach. Guilford Press.
Hofmann, S. G., & Kashdan, T. B. (2010). The Affective Style Questionnaire: Development and psychometric properties. Journal of Psychopathology and Behavioral Assessment, 32(2), 255–263. https://doi.org/10.1007/s10862-009-9142-4
Hofmann, S. G., Sawyer, A. T., Fang, A., & Asnaani, A. (2012). Emotion dysregulation model of mood and anxiety disorders. Depression and Anxiety, 29, 409–416. https://doi.org/10.1002/da.21888
Ille, R., Schöggl, H., Kapfhammer, H. P., Arendasy, M., Sommer, M., & Schienle, A. (2014). Self-disgust in mental disorders—Symptom-related or disorder-specific? Comprehensive Psychiatry, 55, 938–943.
Izard, C. E. (2007). Basic emotions, natural kinds, emotion schemas, and a new paradigm. Perspectives on Psychological Science, 2, 260–280.
Jacoby, R., Blakey, S., Reuman, L., & Abramowitz, J. (2018). Mental contamination obsessions: An examination across the obsessive-compulsive symptom dimensions. Journal of Obsessive-Compulsive and Related Disorders, 17, 9–15. https://doi.org/10.1016/j.jocrd.2017.08.005
Jager, I., de Koning, P., Bost, T., Denys, D., Vulink, N., & Doering, S. (2020). Misophonia: Phenomenology, comorbidity and demographics in a large sample. PLoS ONE, 15(4), e0231390–e0231390. https://doi.org/10.1371/journal.pone.0231390
Jones, A., & Fitness, J. (2008). Moral hypervigilance: The influence of disgust sensitivity in the moral domain. Emotion (Washington, D.C.), 8(5), 613–627. https://doi.org/10.1037/a0013435
Kalmijn, M., & Liefbroer, A. (2011). Nonresponse of secondary respondents in multi-actor surveys: Determinants, consequences and possible remedies. Journal of Family Issues, 32(6), 735–766. https://doi.org/10.1177/0192513X10390184
Karababa, A. (2020). The relationship between trait anger and loneliness among early adolescents: The moderating role of emotion regulation. Personality and Individual Differences, 159, 109856. https://doi.org/10.1016/j.paid.2020.109856
Kaufman, E.A., Xia, M., Fosco, G., Yaptangco, M., Skidmore, C.R., & Crowell, S. (2016). The Difficulties in Emotion Regulation Scale Short Form (DERS-SF): Validation and replication in adolescent and adult samples. Journal of Psychopathology and Behavioral Assessment, 38(443). https://doi.org/10.1007/s10862-015-9529-3
Kneeland, E. T., Dovidio, J. F., Joorman, J., & Clark, M. S. (2016). Emotion malleability beliefs, emotion regulation, and psychopathology: Integrating affective and clinical science. Clinical Psychology Review, 45, 81–88. https://doi.org/10.1016/j.cpr.2016.03.008
Kulkarni, M., Porter, K., & Rauch, S. (2012). Anger, dissociation, and PTSD among male veterans entering into PTSD treatment. Journal of Anxiety Disorders, 26(2), 271–278. https://doi.org/10.1016/j.janxdis.2011.12.005
Kumar, S., Tansley-Hancock, O., Sedley, W., Winston, J., Callaghan, M., Allen, M., Cope, T., Gander, P., Bamiou, D., & Griffiths, T. (2017). The brain basis for misophonia. Current Biology, 27(4), 527–533. https://doi.org/10.1016/j.cub.2016.12.048
Kumar, S., Hancock, O., Cope, T., Sedley, W., Winston, J., & Griffiths, T. D. (2014). Misophonia: a disorder of emotion processing of sounds. Journal of Neurology, Neurosurgery and Psychiatry, 85(8), e3–e3. https://doi.org/10.1136/jnnp‐2014‐308883.38
Lee, I. A., & Preacher, K. J. (2013). Calculation for the test of the difference between two dependent correlations with one variable in common [Computer software]. Available from http://quantpsy.org
Lieberman, D., Patrick, C. Tybur, J. M., & O'Brien, D. (2014). Are the behavioral immune system and pathogen disgust identical? Evolutionary Behavioral Sciences, 8(4), 244–250. https://doi.org/10.1037/ebs0000018
Martin, R. C., & Dahlen, E. R. (2005). Cognitive emotion regulation in the prediction of depression, anxiety, stress, and anger. Personality and Individual Differences, 39(7), 1249–1260. https://doi.org/10.1016/j.paid.2005.06.004
Martin, R. C., & Dahlen, E. R. (2004). Irrational beliefs and the experience and expression of anger. Journal of Rational-Emotive & Cognitive-Behavior Therapy, 22(1), 3–20.
McNally, R. J. (2002). Disgust has arrived. Journal of Anxiety Disorders, 16(5), 561–566. https://doi.org/10.1016/S0887‐6185(02)00174‐3
Memedovic, S., Grisham, J. R., Denson, T. F., & Moulds, M. L. (2010). The effects of trait reappraisal and suppression on anger and blood pressure in response to provocation. Journal of Research in Personality, 44, 540–543.
Muris, P., Merckelbach, H., Nederkoorn, S., Rassin, E., Candel, I., & Horselenberg, R. (2000). Disgust and psychopathological symptoms in a nonclinical sample. Personality and Individual Differences, 29(6), 1163–1167. https://doi.org/10.1016/S0191‐8869(99)00263‐9
Olatunji, B. O. (2009). Incremental specificity of disgust propensity and sensitivity in the prediction of health anxiety dimensions. Journal of Behavior Therapy and Experimental Psychiatry, 40, 230–239. https://doi.org/10.1016/j.jbtep.2008.10.003
Olatunji, B. O. & Sawchuk, C. N. (2005). Disgust : Characteristic features, social manifestations, and clinical implications. Journal of Social and Clinical Psychology, 24(7), 932–962. https://doi.org/10.1521/jscp.2005.24.7.932
Ojserkis, R., McKay, D., & Lebeaut, A. (2017). Associations between mental contamination, disgust, and obsessive-compulsive symptoms in the context of trauma. Journal of Obsessive-Compulsive and Related Disorders. https://doi.org/10.1016/j.jocrd.2017.02.002
Olatunji, B. O., Armstrong, T., & Elwood, L. (2017). Is disgust proneness associated with anxiety and related disorders? A qualitative review and meta-analysis of group comparison and correlational studies. Perspectives on Psychological Science, 12(4), 613–648. https://doi.org/10.1177/1745691616688879
Olatunji, B. O., Armstrong, T., Fan, Q., & Zhao, M. (2014). Risk and resiliency in posttraumatic stress disorder: Distinct roles of anxiety and disgust sensitivity. Psychological Trauma, 6(1), 50–55. https://doi.org/10.1037/a0029682
Olatunji, B., Cisler, J., McKay, D., & Phillips, M. (2010). Is disgust associated with psychopathology? Emerging research in the anxiety disorders. Psychiatry Research, 175(1), 1–10. https://doi.org/10.1016/j.psychres.2009.04.007
Olatunji, B. O., Ebesutani, C., David, B., Fan, Q., & McGrath, P. B. (2011a). Disgust proneness and obsessive-compulsive symptoms in a clinical sample: Structural differentiation from negative affect. Journal of Anxiety Disorders, 25, 932–938. https://doi.org/10.1016/j.janxdis.2011.05.006
Olatunji, B. O., Tart, C. D., Ciesielski, B. G., McGrath, P. B., & Smits, J. A. J. (2011b). Specificity of disgust vulnerability in the distinction and treatment of OCD”. Journal of Psychiatric Research, 45(9), 1236–1242.
Rachman, S. J. (2004). Fear of contamination. Behaviour Research and Therapy, 42, 1227–1255.
Rachman, S., Radomsky, A., Elliott, C., & Zysk, E. (2011). Mental contamination: The perpetrator effect. Journal of Behavior Therapy and Experimental Psychiatry, 43(1), 587–593. https://doi.org/10.1016/j.jbtep.2011.08.002
Rachman, S., Radomsky, A. S., Elliott, C. M., & Zysk, E. (2012). Mental contamination: The perpetrator effect. Journal of Behavior Therapy and Experimental Psychiatry, 43, 587–593. https://doi.org/10.1016/j.jbtep.2011.08.002
Radomsky, A. S., Rachman, S., Shafran, R., Coughtrey, A. E., & Barber, K. C. (2013). The nature and assessment of mental contamination: A psychometric analysis. Journal of Obsessive-Compulsive and Related Disorders, 3(2), 181–187. https://doi.org/10.1016/j.jocrd.2013.08.003
Ray, D. R., Wilhelm, F. H., & Gross, J. J. (2008). All in the mind’s eye? Anger rumination and reappraisal. Journal of Personality and Social Psychology, 94, 133–145.
Rohrmann, S., Hopp, H., Schienle, A., & Hodap, V. (2009). Emotion regulation, disgust sensitivity, and psychophysiological responses to a disgust-inducing film. Anxiety, Stress, and Coping, 22(2), 215–236. https://doi.org/10.1080/10615800802016591
Rouw, R., & Erfanian, M. (2018). A large-scale study of misophonia. Journal of Clinical Psychology, 74(3), 453–479. https://doi.org/10.1002/jclp.22500
Rozin, P., Haidt, J., & McCauley, C. R. (2000). Disgust. In M. Lewis & J. M. Haviland (Eds.), Handbook of emotions (2nd ed., pp. 637–653). Guilford Press.
Schaller, M. & Park, J. H. (2011). The behavioral immune system (and Why It Matters). Current Directions in Psychological Science : A Journal of the American Psychological Society, 20(2), 99–103. https://doi.org/10.1177/0963721411402596
Shallcross, A.J., Troy, A., & Mauss, I.B. (2015). Regulation of emotions under stress. Emerging Trends in the Social and Behavioral Sciences, 1–16https://doi.org/10.1002/9781118900772.etrds0036
Sheppes, G., Suri, G., & Gross, J. (2015). Emotion regulation and psychopathology. Annual Review of Clinical Psychology, 11(1), 379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739
Schröder, A., van Diepen, R., Mazaheri, A., Petropoulos‐Petalas, D., de Amesti, V. S., Vulink, N., & Denys, D. (2014). Diminished N1 auditory evoked potentials to oddball stimuli in misophonia patients. Frontiers in Behavioral Neuroscience, 8, 123–123. https://doi.org/10.3389/fnbeh.2014.00123
Schröder, A., van Wingen, G., Vulink, N., & Denys, D. (2017). Commentary: The brain basis for misophonia. Frontiers in Behavioral Neuroscience, 11, 111–111. https://doi.org/10.3389/fnbeh.2017.00111
Slauson-Blevins, K., & Johnson, K. M. (2016). doing gender, doing surveys? Women’s gatekeeping and men’s non-participation in multi-actor reproductive surveys. Sociological Inquiry, 86(3), 427–449. https://doi.org/10.1111/soin.12
Taylor, S. (2017). Misophonia: A new mental disorder? Medical Hypotheses, 103, 109–117. https://doi.org/10.1016/j.mehy.2017.05.003
Taylor, S. (2019). The psychology of pandemics: preparing for the next global outbreak of infectious disease. Cambridge: Cambridge Scholars Publishing
Tamir, M. (2009). What do people want to feel and why? Pleasure and utility in emotion regulation. Current Directions in Psychological Science : a Journal of the American Psychological Society, 18(2), 101–105. https://doi.org/10.1111/j.1467-8721.2009.01617.x
Tolin, Woods, C. M., & Abramowitz, J. S. (2006). Disgust sensitivity and obsessive–compulsive symptoms in a non‐clinical sample. Journal of Behavior Therapy and Experimental Psychiatry, 37(1), 30–40. https://doi.org/10.1016/j.jbtep.2005.09.003
Totzeck, T., Teisman, T., Hofmann, S. G., von Brachel, R., Zhang, X. C., Wannemuller, A., Pflug, V., & Margraf, J. (2018). Affective styles in mood and anxiety disorders – Clinical validation of the “Affective Style Questionnaire” (ASQ). Journal of Affective Disorders, 238, 392–398. https://doi.org/10.1016/j.jad.2018.05.035
Totzeck, T., Teisman, T., Hofmann, S. G., von Brachel, R., Zhang, X. C., Wannemuller, A., Pflug, V., & Margraf, J. (2020). Affective styles in panic disorder and specific phobia: Changes through cognitive behavior therapy and prediction of remission. Behavior Therapy, 51(3), 375–385. https://doi.org/10.1016/j.beth.2019.06.006
Troy, A. S., Shallcross, A. J., Brunner, A., Friedman, R., Jones, M. C., & Pietromonaco, P. R. (2018). Cognitive reappraisal and acceptance: Effects on emotion, physiology, and perceived cognitive costs. Emotion (Washington, D.C.), 18(1), 58–74. https://doi.org/10.1037/emo0000371
Tybur, J. M., Lieberman, D., Kurzban, R., DeScioli, P. & Anderson, J. (2013). Disgust: Evolved Function and Structure. Psychological Review, 120(1), 65–84. https://doi.org/10.1037/a0030778
van Overveld, W., de Jong, P., Peters, M., Cavanagh, K., & Davey, G. (2006). Disgust propensity and disgust sensitivity: Separate constructs that are differentially related to specific fears. Personality and Individual Differences, 41(7), 1241–1252. https://doi.org/10.1016/j.paid.2006.04.021
Wheeler, R. E., Davidson, R. J., & Tomarken, A. J. (1993). Frontal brain asymmetry and emotional activity: A biological substrate of affective style. Psychophysiology, 30, 82–89. https://doi.org/10.1111/j.1469-8986.1993.tb03207.x
Whitton, A. E., Henry, J. D., & Grisham, J. R. (2015). Cognitive and psychophysiological correlates of disgust in obsessive-compulsive disorder. British Journal of Clinical Psychology, 54, 16–33. https://doi.org/10.1111/bjc.12058
Wu, M., Lewin, A., Murphy, T., & Storch, E. (2014). Misophonia: Incidence, phenomenology, and clinical correlates in an undergraduate student sample: Misophonia. Journal of Clinical Psychology, 70(10), 994–1007. https://doi.org/10.1002/jclp.22098
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Barahmand, U., Stalias-Mantzikos, M.E., Rotlevi, E. et al. Disgust and Emotion Dysregulation in Misophonia: a Case for Mental Contamination?. Int J Ment Health Addiction 21, 1550–1569 (2023). https://doi.org/10.1007/s11469-021-00677-x
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DOI: https://doi.org/10.1007/s11469-021-00677-x