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29 Sep 2020 at 01:47
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Bibliography on: Misophonia — Cannot Stand the Sound of Chewing


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Misophonia — Cannot Stand the Sound of Chewing

Wikipedia: Misophonia, literally "hatred of sound," was proposed in 2000 as a condition in which negative emotions, thoughts, and physical reactions are triggered by specific sounds. It is also called "select sound sensitivity syndrome" and "sound-rage." Misophonia has no classification as an auditory, neurological, or psychiatric condition, there are no standard diagnostic criteria, it is not recognized in the DSM-IV or the ICD-10, and there is little research on its prevalence or treatment. Proponents suggest misophonia can adversely affect ability to achieve life goals and to enjoy social situations. Treatment consists of developing coping strategies such as cognitive behavioral therapy and exposure therapy. As of 2016 the literature on misophonia was very limited (see below). Some small studies show that people with misophonia generally have strong negative feelings, thoughts, and physical reactions to specific sounds, which the literature calls "trigger sounds." One study found that around 80% of the sounds were related to the mouth (eating, yawning, etc.), and around 60% were repetitive.

Created with PubMed® Query: misophonia OR "sound rage" OR "select sound sensitivity syndrome" NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)


RevDate: 2020-09-25

Osuagwu FC, Osuagwu VC, AM Machoka (2020)

Methylphenidate Ameliorates Worsening Distractibility Symptoms of Misophonia in an Adolescent Male.

The primary care companion for CNS disorders, 22(5):.

RevDate: 2020-09-21

Vanaja CS, MS Abigail (2020)

Misophonia: An Evidence-Based Case Report.

American journal of audiology [Epub ahead of print].

Purpose Misophonia is a sound tolerance disorder condition in certain sounds that trigger intense emotional or physiological responses. While some persons may experience misophonia, a few patients suffer from misophonia. However, there is a dearth of literature on audiological assessment and management of persons with misophonia. The purpose of this report is to discuss the assessment of misophonia and highlight the management option that helped a patient with misophonia. Method A case study of a 26-year-old woman with the complaint of decreased tolerance to specific sounds affecting quality of life is reported. Audiological assessment differentiated misophonia from hyperacusis. Management included retraining counseling as well as desensitization and habituation therapy based on the principles described by P. J. Jastreboff and Jastreboff (2014). A misophonia questionnaire was administered at regular intervals to monitor the effectiveness of therapy. Results A detailed case history and audiological evaluations including pure-tone audiogram and Johnson Hyperacusis Index revealed the presence of misophonia. The patient benefitted from intervention, and the scores of the misophonia questionnaire indicated a decrease in the severity of the problem. Conclusions It is important to differentially diagnose misophonia and hyperacusis in persons with sound tolerance disorders. Retraining counseling as well as desensitization and habituation therapy can help patients who suffer from misophonia.

RevDate: 2020-09-11

Adhikari Y, X Jin (2020)

Intraperitoneal injection of lipopolysaccharide prevents seizure-induced respiratory arrest in a DBA/1 mouse model of SUDEP.

Epilepsia open, 5(3):386-396 pii:EPI412410.

Objective: Sudden unexpected death in epilepsy (SUDEP) is the cause of premature death of 50% patients with chronic refractory epilepsy. Respiratory failure during seizures is regarded as an important mechanism of SUDEP. Previous studies have shown that abnormal serotonergic neurotransmission is involved in the pathogenesis of seizure-induced respiratory failure, while enhancing serotonergic neurotransmission in the brainstem suppresses it. Because peripheral inflammation is known to enhance serotonergic neuron activation and 5-HT synthesis and release, we investigated the effect of intraperitoneal lipopolysaccharide (LPS)-induced inflammation on the S-IRA susceptibility during audiogenic seizures in DBA/1 mice.

Methods: After DBA/1 mice were primed by exposing to sound stimulation for three consecutive days, they were tested for seizure severity and seizure-induced respiratory arrest (S-IRA) induced by sound stimulation under different conditions. We determined the dose and time course of the effects of intraperitoneal administration of LPS on audiogenic seizures and S-IRA. The effects of blocking TLR4 or RAGE receptors and blocking 5-HT receptors on the LPS-induced effect on S-IRA were investigated. Statistical significance was evaluated using the Kruskal-Wallis test.

Results: Intraperitoneal injection of LPS significantly had dose-dependent effects in reducing the incidence of S-IRA as well as seizure severity in DBA/1 mice. The protective effect of LPS on S-IRA peaked at 8-12 hours after LPS injection and was related to both reducing seizure severity and enhancing autoresuscitation. Blocking TLR4 or RAGE receptor with TAK-242 or FPS-ZM1, respectively, prior to LPS injection attenuated its effects on S-IRA and seizure severity. Injection of a nonselective 5-HT receptor antagonist, cyproheptadine, or a 5-HT3 receptor antagonist, ondansetron, was effective in blocking LPS-induced effect on S-IRA. Immunostaining results showed a significant increase in c-Fos-positive serotonergic neurons in the dorsal raphe.

Significance: This is the first study that demonstrates the effect of intraperitoneal LPS injection-induced inflammation on reducing S-IRA susceptibility and provides additional evidence supporting the serotonin hypothesis on SUDEP. Our study suggests that inflammation may enhance brainstem 5-HT neurotransmission to promote autoresuscitation during seizure and prevent SUDEP.

RevDate: 2020-08-23

Naylor J, Caimino C, Scutt P, et al (2020)

The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale.

The Psychiatric quarterly pii:10.1007/s11126-020-09825-3 [Epub ahead of print].

Misophonia is a condition of abnormal emotional responses to specific auditory stimuli. There is limited information available on the prevalence of this condition. This study aimed to estimate the prevalence of misophonia in an undergraduate medical student population at the University of Nottingham. A secondary aim of this study was to assess the psychometric validity of the Amsterdam Misophonia Scale (A-Miso-S) questionnaire tool in this population. The A-Miso-S was administered online to medical students at the University of Nottingham. To assess the validity of the A-Miso-S, a factor analysis was conducted. To determine prevalence and severity the results of the questionnaire were quantitatively analysed using SPSS. Actor analysis was conducted. Free text responses to one questionnaire item were analysed using a thematic approach. Responses were obtained from 336 individuals. Clinically significant misophonic symptoms appear to be common, effecting 49.1% of the sample population. This is statistically significantly higher prevalence than previous studies have found (p < 0.00001). Using the classification of the A-Miso-S, mild symptoms were seen in 37%, moderate in 12%, severe in 0.3% of participants. No extreme cases were seen. The A-Miso-S was found to be a uni-factorial tool, with good internal consistency. This study has provided new information on misophonia and validity of the A-Miso-S questionnaire in a sample population of UK undergraduate medical students. The results indicate that misophonia is a phenomenon that a significant proportion of medical students experience though only a small subset experience it severely.

RevDate: 2020-08-05

Siepsiak M, Sobczak AM, Bohaterewicz B, et al (2020)

Prevalence of Misophonia and Correlates of Its Symptoms among Inpatients with Depression.

International journal of environmental research and public health, 17(15): pii:ijerph17155464.

Misophonia is an underexplored condition that significantly decreases the quality of life of those who suffer from it. It has neurological and physiological correlates and is associated with a variety of psychiatric symptoms; however, a growing body of data suggests that it is a discrete disorder. While comorbid diagnoses among people with misophonia have been a matter of research interest for many years there is no data on the frequency of misophonia among people with psychiatric disorders. This could be the next step to reveal additional mechanisms underlying misophonia. Until recently, the use of a variety of non-validated questionnaires and the dominance of internet-based studies have been also a major obstacles to a proper definition of misophonia. A total of 94 inpatients diagnosed with depression were assessed for misophonia with face-to-face interviews as well as with MisoQuest-a validated misophonia questionnaire. The prevalence of misophonia among these patients and the congruence of MisoQuest with face-to-face interviews were evaluated. Additionally, the patients filled in a series of questionnaires that measured a variety of psychiatric symptoms and psychological traits. Anxiety, depression, impulsivity, somatic pain, vegetative symptoms, post-traumatic stress disorder (PTSD) symptoms, gender, and age were analyzed in relation to the severity of symptoms of misophonia. Between 8.5 to 12.76% of inpatients with depression were diagnosed with misophonia (depending on measurement and inclusion criteria). MisoQuest accuracy was equal to 92.55%, sensitivity-66.67% and specificity-96.34%. Severity of misophonia symptoms was positively correlated to the greatest extent with anxiety. Moderate positive correlation was also found between severity of misophonia symptoms and depressive symptoms, intrusions, and somatic pain; a weak positive correlation was found between severity of misophonia and non-planning impulsivity, motor impulsivity, avoidance, and vegetative symptoms. There was no relationship between the severity of misophonia symptoms and attentional impulsivity or the age of participants.

RevDate: 2020-05-05

Sharan R, V Sharma (2020)

A Case of Bipolar Disorder and Misophonia.

The primary care companion for CNS disorders, 22(3):.

RevDate: 2020-04-15

Jager I, de Koning P, Bost T, et al (2020)

Misophonia: Phenomenology, comorbidity and demographics in a large sample.

PloS one, 15(4):e0231390 pii:PONE-D-19-35412.

OBJECTIVE: Analyze a large sample with detailed clinical data of misophonia subjects in order to determine the psychiatric, somatic and psychological nature of the condition.

METHODS: This observational study of 779 subjects with suspected misophonia was conducted from January 2013 to May 2017 at the outpatient-clinic of the Amsterdam University Medical Centers, location AMC, the Netherlands. We examined DSM-IV diagnoses, results of somatic examination (general screening and hearing tests), and 17 psychological questionnaires (e.g., SCL-90-R, WHOQoL).

RESULTS: The diagnosis of misophonia was confirmed in 575 of 779 referred subjects (74%). In the sample of misophonia subjects (mean age, 34.17 [SD = 12.22] years; 399 women [69%]), 148 (26%) subjects had comorbid traits of obsessive-compulsive personality disorder, 58 (10%) mood disorders, 31 (5%) attention-deficit (hyperactivity) disorder, and 14 (3%) autism spectrum conditions. Two percent reported tinnitus and 1% hyperacusis. In a random subgroup of 109 subjects we performed audiometry, and found unilateral hearing loss in 3 of them (3%). Clinical neurological examination and additional blood test showed no abnormalities. Psychological tests revealed perfectionism (97% CPQ>25) and neuroticism (stanine 7 NEO-PI-R). Quality of life was heavily impaired and associated with misophonia severity (rs (184) = -.34 p = < .001, p = < .001).

LIMITATIONS: This was a single site study, leading to possible selection-and confirmation bias, since AMC-criteria were used.

CONCLUSIONS: This study with 575 subjects is the largest misophonia sample ever described. Based on these results we propose a set of revised criteria useful to diagnose misophonia as a psychiatric disorder.

RevDate: 2020-03-13

Siepsiak M, Śliwerski A, W Łukasz Dragan (2020)

Development and Psychometric Properties of MisoQuest-A New Self-Report Questionnaire for Misophonia.

International journal of environmental research and public health, 17(5): pii:ijerph17051797.

Background: Misophonia is a condition related to experiencing psychophysiological sensations when exposed to specific sound triggers. In spite of progress in research on the subject, a fully validated questionnaire assessing misophonia has not been published yet. The goal of this study was to create and validate a new questionnaire to measure misophonia. Methods: MisoQuest is based on the diagnostic criteria proposed by Schröder et al. in 2013, with minor changes implemented by the authors of MisoQuest. A total of 705 participants took part in the study, completing the online questionnaires. Exploratory Factor Analysis (EFA) and analyses using the Item Response Theory (IRT) were performed. Internal consistency was evaluated with Cronbach's alpha. Results: The reliability of the MisoQuest was excellent (α = 0.955). The stability at five weeks was strong. There was a significant difference in results between people classified as those with misophonia and those without misophonia. Conclusions: MisoQuest has good psychometric values and can be helpful in the identification of misophonia. A deeper analysis showed that certain triggers might be more specific for people with misophonia. Consideration of violent behavior in response to misophonic triggers as a symptom of misophonia was undermined.

RevDate: 2020-02-29

Schröder A, van Wingen G, Eijsker N, et al (2020)

Publisher Correction: Misophonia is associated with altered brain activity in the auditory cortex and salience network.

Scientific reports, 10(1):4066 pii:10.1038/s41598-020-59862-y.

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

RevDate: 2020-01-16

Daniels EC, Rodriguez A, DL Zabelina (2020)

Severity of misophonia symptoms is associated with worse cognitive control when exposed to misophonia trigger sounds.

PloS one, 15(1):e0227118 pii:PONE-D-19-19741.

The present study aimed to investigate the extent to which the severity of misophonia symptoms is linked with cognitive control under misophonia symptom-provocation circumstances in the general population sample. Participants (N = 79) completed a measure of cognitive control-a Stroop color naming task, which consists of congruent and incongruent stimuli, and requires inhibition of a prepotent response (reading a word) in the service of a less predominant response (naming a color), while listening to misophonia symptom-provocation or universally unpleasant sounds. Participants' misophonia sound sensitivity, and emotional behaviors towards trigger sounds were assessed using the Misophonia Questionnaire. Stronger emotional behavioral reactions to misophonia trigger sounds were significantly associated with the larger Stroop effect when participants were exposed to the misophonia trigger sounds, but not when they were exposed to the universally unpleasant sounds. This effect held when controlling for the personality trait of Neuroticism and for baseline levels of anxiety. Both elevated misophonia sound sensitivity and emotional behaviors towards trigger sounds significantly correlated with higher self-reported anxiety when performing the Stroop task. However, only elevated emotional behaviors towards trigger sounds were linked with higher anxiety levels at baseline, suggesting that people who experience stronger emotions and behavioral reactions to misophonia trigger sounds may have higher anxiety at a trait level. Limitations and future directions are discussed.

RevDate: 2019-11-26

Aazh H, Landgrebe M, Danesh AA, et al (2019)

Cognitive Behavioral Therapy For Alleviating The Distress Caused By Tinnitus, Hyperacusis And Misophonia: Current Perspectives.

Psychology research and behavior management, 12:991-1002.

This article reviews the evidence related to the efficacy of Cognitive Behavioral Therapy (CBT) for alleviating the distress caused by tinnitus, hyperacusis and misophonia. Where available, the review was focused on meta-analyses of randomized controlled trials (RCTs) using either passive control groups (typically waiting list or education only) or active control groups (receiving some other form of treatment). Where data from RCTs were not available, case studies and retrospective studies were reviewed. Analyses were conducted separately for studies of patients with tinnitus, hyperacusis and misophonia. RCTs show that CBT is effective in alleviating the distress caused by tinnitus in comparison to passive control groups and sometimes active control groups. CBT for tinnitus can be effective both in individual and in group settings, whether delivered by psychiatrists, clinical psychologists, or specially trained audiologists. CBT for tinnitus can also be effective when delivered via the internet, when combined with help from audiologists. Usually, CBT does not reduce the loudness of tinnitus but it can improve quality of life. Case studies and some limited RCTs suggest that CBT can also be effective in alleviating the distress caused by hyperacusis and misophonia. However, RCTs with active control groups are currently lacking. There is strong evidence supporting the effectiveness of CBT in alleviating the distress caused by tinnitus. However, it is not yet clear whether CBT is more effective than some other forms of treatment. RCTs with active control groups are needed to establish more clearly the extent to which CBT is effective in alleviating the distress caused by hyperacusis and misophonia.

RevDate: 2019-11-14

Eijsker N, Schröder A, Smit DJA, et al (2019)

Neural Basis of Response Bias on the Stop Signal Task in Misophonia.

Frontiers in psychiatry, 10:765.

Objective: Misophonia is a newly described condition in which specific ordinary sounds provoke disproportionately strong negative affect. Since evidence for psychobiological dysfunction underlying misophonia is scarce, we tested whether misophonia patients, like many patients with impulse control or obsessive-compulsive spectrum disorders, show impaired ability to inhibit an ongoing motor response. Methods: We collected functional magnetic resonance imaging data during a stop signal task in 22 misophonia patients and 21 matched healthy controls. Results: Compared to controls, patients tended to show longer stop signal delays, which is the time between stimuli signaling response initiation and inhibition. Additionally, patients tended to activate left dorsolateral prefrontal cortex more during responding rather than successful inhibition, as was seen in controls. Furthermore, patients lacked inhibition success-related activity in posterior cingulate cortices and activated the superior medial frontal gyri less during inhibition success compared to failure, a feature correlated with stop signal delays over the sample. Conclusions: Misophonia patients did not show impaired response inhibition. However, they tended to show a response bias on the stop signal task, favoring accuracy over speed. This implies perfectionism and compulsive, rather than impulsive, behavior. Moreover, brain activations were in line with patients, compared to controls, engaging more cognitive control for slowing responses, while employing more attentional resources for successful inhibition.

RevDate: 2020-01-08

Frank B, Roszyk M, Hurley L, et al (2020)

Inattention in misophonia: Difficulties achieving and maintaining alertness.

Journal of clinical and experimental neuropsychology, 42(1):66-75.

Introduction: Misophonia is marked by abnormal negative reactions to specific and idiosyncratic sounds. Despite unclear etiology and diagnostic conceptualization, neuropsychology may be able to help characterize the syndrome. In the current study, we administered the Attention Network Test (ANT) under symptom provocation conditions, as well as secondary measures of concept formation, perseveration, processing speed, and frustration tolerance. We assessed treatment seeking individuals with misophonia and non-clinical controls. We hypothesized higher alerting, orienting, and conflict effects on the ANT suggesting overall poorer performance for the misophonia group.Methods: The sample consisted of symptomatic individuals recruited from a randomized treatment trial prior to the mandatory waitlist (n = 11) and age, gender matched controls (n = 11). Symptomatic individuals were screened with the Misophonia Questionnaire, as well as a number of additional self-report and diagnostic measures.Results: Robust Bayesian estimation in multi-level models suggested worse alerting attention for symptomatic individuals, βMedian = 2.766, βSD = 1.253, 95% CI [0.322, 5.2876], Bayes factor = 31.41. There were no effects respective to block (i.e., blocks before versus during and after symptom provocation) or interaction effects. There were also no effects particular to executive functioning measures but some evidence this domain should be further explored (e.g., ANT conflict effects, perseveration, and serial math accuracy).Conclusions: We propose that symptom provocation alone does not explain the observed group difference in alerting attention, which could reflect a long-standing neuropsychological weakness. Future studies should attempt to characterize misophonia with more comprehensive neuropsychological batteries and larger samples.

RevDate: 2019-07-18

Siepsiak M, W Dragan (2019)

Misophonia - a review of research results and theoretical concepts.

Psychiatria polska, 53(2):447-458.

Misophonia is a new and relatively under-explored condition characterized by experiencing strong emotions (mainly anger and disgust) and a physical response (such as muscle constriction, increased heart rate) when exposed to specific sounds. Among the most frequent aversive triggers are the sounds of eating, breathing, or typing. The experience of misophonia is associated with suffering and a significant decrease in quality of life. The phenomenon was first described in 2002. Since then, numerous case studies and data from psychophysiological and neurological and survey research on this phenomenon have been published. These data indicate that misophonia is a consistent phenomenon and preliminary identification is possible. The most recent results show that misophonia occurs independent of other disorders. There are still, however, many questions regarding the definition and diagnostic criteria to be answered. The most important diagnostic issues that are faced during clinical work with people with misophonia are described in this article. Furthermore, the main theoretical concepts and research on misophonia are reviewed and analyzed.

RevDate: 2019-11-20

Schröder A, Wingen GV, Eijsker N, et al (2019)

Misophonia is associated with altered brain activity in the auditory cortex and salience network.

Scientific reports, 9(1):7542 pii:10.1038/s41598-019-44084-8.

Misophonia is characterized by intense rage and disgust provoked by hearing specific human sounds resulting in social isolation due to avoidance. We exposed patients with symptom provoking audiovisual stimuli to investigate brain activity of emotional responses. 21 patients with misophonia and 23 matched healthy controls were recruited at the psychiatry department of the Amsterdam UMC. Participants were presented with three different conditions, misophonia related cues (video clips with e.g. lip smacking and loud breathing), aversive cues (violent or disgusting clips from movies), and neutral cues (video clips of e.g. someone meditating) during fMRI. Electrocardiography was recorded to determine physiological changes and self-report measures were used to assess emotional changes. Misophonic cues elicited anger, disgust and sadness in patients compared to controls. Emotional changes were associated with increases in heart rate. The neuroimaging data revealed increased activation of the right insula, right anterior cingulate cortex and right superior temporal cortex during viewing of the misophonic video clips compared to neutral clips. Our results demonstrate that audiovisual stimuli trigger anger and physiological arousal in patients with misophonia, associated with activation of the auditory cortex and salience network.

RevDate: 2019-08-20
CmpDate: 2019-08-20

Erfanian M, Kartsonaki C, A Keshavarz (2019)

Misophonia and comorbid psychiatric symptoms: a preliminary study of clinical findings.

Nordic journal of psychiatry, 73(4-5):219-228.

Objective: Misophonia is a neurophysiological disorder, phenotypically characterized by heightened autonomic nervous system arousal which is accompanied by a high magnitude of emotional reactivity to repetitive and pattern-based auditory stimuli. This study identifies the prevalence of psychiatric symptoms in misophonia sufferers, the association between severity of misophonia and psychiatric symptoms, and the association between misophonia severity and gender. Methods: Fifty-two misophonia sufferers, 30 females (mean age = 40.93 ± 15.29) and 22 males (mean age = 51.18 ± 15.91) were recruited in our study and they were diagnosed according the criteria proposed by Schröder et al. The participants were evaluated by the A-MISO-S for the severity of misophonia and the MINI to assess the presence of psychiatric symptoms. Results: The most common comorbid symptoms reported by the misophonia patients were respectively PTSD (N = 8, 15.38%), OCD (N = 6, 11.53%), MDD (N = 5, 9.61%), and anorexia (N = 5, 9.61%). Misophonia severity was associated with the symptoms of MDD, OCD, and PTSD as well as anorexia. There was an indication of a significant difference between men and women in the severity of misophonic symptoms. Conclusion: Our findings highlight the importance of recognizing psychiatric comorbidity among misophonia sufferers. The presence of these varying psychiatric disorders' features in individuals with misophonia suggests that while misophonia has unique clinical characteristics with an underlying neurophysiological mechanism, may be associated with psychiatric symptoms. Therefore, when assessing individuals with misophonia symptoms, it is important to screen for psychiatric symptoms. This will assist researchers and clinicians to better understand the nature of the symptoms and how they may be interacting and ultimately allocating the most effective therapeutic strategies.

RevDate: 2019-12-02

Samermit P, Saal J, N Davidenko (2019)

Cross-Sensory Stimuli Modulate Reactions to Aversive Sounds.

Multisensory research, 32(3):197-213.

We propose that cross-sensory stimuli presenting a positive attributable source of an aversive sound can modulate negative reactions to the sound. In Experiment 1, participants rated original video sources (OVS) of eight aversive sounds (e.g., nails scratching a chalkboard) as more aversive than eight positive attributable video sources (PAVS) of those same sounds (e.g., someone playing a flute) when these videos were presented silently. In Experiment 2, new participants were presented with those eight aversive sounds in three blocks. In Blocks 1 and 3, the sounds were presented alone; in Block 2, four of the sounds were randomly presented concurrently with their corresponding OVS videos, and the other four with their corresponding PAVS videos. Participants rated each sound, presented with or without video, on three scales: discomfort, unpleasantness, and bodily sensations. We found the concurrent presentation of videos robustly modulates participants' reactions to the sounds: compared to the sounds alone (Block 1), concurrent presentation of PAVS videos significantly reduced negative reactions to the sounds, and the concurrent presentation of OVS videos significantly increased negative reactions, across all three scales. These effects, however, did not linger into Block 3 when the sounds were presented alone again. Our results provide novel evidence that negative reactions to aversive sounds can be modulated through cross-sensory temporal syncing with a positive attributable video source. Although this research was conducted with a neurotypical population, we argue that our findings have implications for the treatment of misophonia.

RevDate: 2019-06-11

Potgieter I, MacDonald C, Partridge L, et al (2019)

Misophonia: A scoping review of research.

Journal of clinical psychology, 75(7):1203-1218.

OBJECTIVE: To scope the literature describing misophonia populations, management, and research opportunities.

METHOD: Literature searches for research studies describing patients diagnosed with misophonia, defining a patient profile, or outlining development or testing of an intervention for misophonia. A data extraction form was developed and piloted before data from each article were independently charted by two researchers. Researchers then agreed on a final data set for each article.

RESULTS: Thirty-one records were included. The misophonia population was described in terms of onset age, triggers, reaction, coping strategies, and comorbid conditions. We identified nine outcome measures. Case studies on treatments included cognitive behavioral therapy, counterconditioning, mindfulness and acceptance, dialectical behavioral therapy, and pharmaceuticals. Future research priorities identified included clarifying the phenomenology and prevalence of misophonia, and randomized controlled trials of treatments.

CONCLUSION: Misophonia is under-researched but there are strong foundations for future research to finalize diagnostic criteria, validate outcome measures, and trial treatments.

RevDate: 2019-11-20

Martino D, T Hedderly (2019)

Tics and stereotypies: A comparative clinical review.

Parkinsonism & related disorders, 59:117-124.

Tics and stereotypies are the most common pathological repetitive complex motor behaviors occurring during the neurodevelopmental period. Although they may appear transiently during development without acquiring a pathological status, when they become chronic they may be distressing, socially impairing, or even, in the case of malignant tics, potentially physically harmful. Despite a certain similarity in their phenomenology, physicians should be able to distinguish them for their different variability over time, topographical distribution, association with sensory manifestations, and relationship with environmental triggers. The complex phenomenology of tics and stereotypies is constantly enriched by the characterization of novel variants, e.g. tics triggered by auditory stimuli in association with misophonia and stereotypies associated with intense imagery activity. Their pathophysiology remains partially elusive, but both animal model and brain imaging studies confirm the involvement of all the three major loops (sensorimotor, associative and limbic) within the cortico-basal ganglia circuitry. From a management perspective, the greatest advances witnessed in the last decade involve the diffusion of behavioral strategies (e.g. habit reversal training or response interruption and redirection), including the development of protocols for telehealth on online training in order to optimise access. In the context of severe tics, e.g. in refractory Tourette syndrome, there is increasing experience with deep brain stimulation of the intralaminar thalamic nuclei or the globus pallidus internus, although more research is needed to fine tune target choice and stimulation setting definition.

RevDate: 2019-09-25
CmpDate: 2019-09-25

Aazh H, Knipper M, Danesh AA, et al (2018)

Insights from the third international conference on hyperacusis: causes, evaluation, diagnosis, and treatment.

Noise & health, 20(95):162-170.

Background: Hyperacusis is intolerance of certain everyday sounds that causes significant distress and impairment in social, occupational, recreational, and other day-to-day activities.

Objective: The aim of this report is to summarize the key findings and conclusions from the Third International Conference on Hyperacusis.

Topics covered: The main topics discussed comprise (1) diagnosis of hyperacusis and audiological evaluations, (2) neurobiological aspect of hyperacusis, (3) misophonia, (4) hyperacusis in autism spectrum disorder, (5) noise sensitivity, (6) hyperacusis-related distress and comorbid psychiatric illness, and (7) audiologist-delivered cognitive behavioral therapy for hyperacusis.

Conclusions: Implications for research and clinical practice are summarised.

RevDate: 2019-11-20

Janik McErlean AB, MJ Banissy (2018)

Increased misophonia in self-reported Autonomous Sensory Meridian Response.

PeerJ, 6:e5351.

Background: Autonomous Sensory Meridian Response (ASMR) is a sensory experience elicited by auditory and visual triggers, which so far received little attention from the scientific community. This self-reported phenomenon is described as a relaxing tingling sensation, which typically originates on scalp and spreads through a person's body. Recently it has been suggested that ASMR shares common characteristics with another underreported condition known as misophonia, where sounds trigger negative physiological, emotional and behavioural responses. The purpose of this study was to elucidate whether ASMR is associated with heightened levels of misophonia.

Methods: The Misophonia Questionnaire (MQ) was administered to individuals reporting to experience ASMR and to age and gender matched controls.

Results: Compared to controls ASMR group scored higher on all subscales of MQ including the Misophonia Symptom Scale, the Misophonia Emotions and Behaviors Scale and the Misophonia Severity Scale.

Discussion: Individuals reporting ASMR experience have elevated levels of misophonia.

RevDate: 2019-11-20

Palumbo DB, Alsalman O, De Ridder D, et al (2018)

Misophonia and Potential Underlying Mechanisms: A Perspective.

Frontiers in psychology, 9:953.

There is a growing research interest in the diagnosis rate of misophonia, a condition characterized by a negative emotional/autonomic reaction to specific everyday sounds. Diagnosis of misophonia requires a thorough case history and audiological test procedures. Associative and non-associative learning models for understanding the underlying mechanisms of misophonia have been presented. Currently, there is no cure or pharmaceutical agent for misophonia; however, therapy programs addressing misophonia and its characteristics do exist. Investigation of comorbid conditions and other psychological therapy strategies might help to reveal more about the underlying mechanisms and potentially lead to a successful treatment method.

RevDate: 2019-01-14
CmpDate: 2019-01-14

Quek TC, Ho CS, Choo CC, et al (2018)

Misophonia in Singaporean Psychiatric Patients: A Cross-Sectional Study.

International journal of environmental research and public health, 15(7):.

Misophonia, also known as selective sound sensitivity syndrome, is a condition characterized by strong dislike of specific sounds with accompanying distressing reactions. To date, misophonia is still poorly understood. This study aimed to identify factors associated with severity of misophonic symptoms in Singaporean psychiatric patients. Ninety-two psychiatric patients were recruited from a large teaching hospital in Singapore in a cross-sectional study. Socio-demographics, severity of depression, anxiety and stress, and severity of misophonic symptoms were analyzed. Correlation analysis showed that anxiety, depression, and stress scores&mdash;as measured by the Depression, Anxiety and Stress Scales-21 (DASS-21)&mdash;were significantly positively correlated with the Amsterdam Misophonia Scale (A-MISO-S) scores. After adjustment for confounding factors, multivariate regression analysis showed that anxiety (&beta; = 0.385, p = 0.029) remained significantly associated with A-MISO-S. Age, gender, depression, and stress were not significantly associated with the severity of misophonia. The findings showed that the severity of anxiety was associated with severity of misophonia in Singaporean psychiatric patients. Further research is needed to explore the nature of misophonia and its relationship with other psychiatric disorders.

RevDate: 2019-07-23
CmpDate: 2019-07-23

Aazh H, McFerran D, BCJ Moore (2018)

Uncomfortable loudness levels among children and adolescents seeking help for tinnitus and/or hyperacusis.

International journal of audiology, 57(8):618-623.

OBJECTIVE: To assess the prevalence of hyperacusis and severe hyperacusis among children and adolescents seen at an audiology outpatient tinnitus and hyperacusis service.

DESIGN: This was a retrospective study. Hyperacusis was considered as present if the average uncomfortable loudness level (ULL) at 0.25, 0.5, 1, 2, 4 and 8 kHz for the ear with the lower average ULL, which is denoted as ULLmin, was ≤77 dB HL. Severe hyperacusis was considered as present if the ULL was 30 dB HL or less for at least one of the measured frequencies for at least one ear.

STUDY SAMPLE: There were 62 young patients with an average age of 12 years (SD = 4.1 years, range 4-18 years).

RESULTS: Eighty-five percent of patients had hyperacusis and 17% had severe hyperacusis. On average, ULLs at 8 kHz were 9.3 dB lower than ULLs at 0.25 kHz. For 33% of patients, ULLs were at least 20 dB lower at 8 than at 0.25 kHz.

CONCLUSIONS: Among children and adolescents seen at an audiology outpatient clinic for tinnitus and hyperacusis, hyperacusis diagnosed on the basis of ULLs is very prevalent and it is often characterised by lower ULLs at 8 than at 0.25 kHz.

RevDate: 2019-07-08
CmpDate: 2019-07-08

Silva FED, TG Sanchez (2019)

Evaluation of selective attention in patients with misophonia.

Brazilian journal of otorhinolaryngology, 85(3):303-309.

INTRODUCTION: Misophonia is characterized by the aversion to very selective sounds, which evoke a strong emotional reaction. It has been inferred that misophonia, as well as tinnitus, is associated with hyperconnectivity between auditory and limbic systems. Individuals with bothersome tinnitus may have selective attention impairment, but it has not been demonstrated in case of misophonia yet.

OBJECTIVE: To characterize a sample of misophonic subjects and compare it with two control groups, one with tinnitus individuals (without misophonia) and the other with asymptomatic individuals (without misophonia and without tinnitus), regarding the selective attention.

METHODS: We evaluated 40 normal-hearing participants: 10 with misophonia, 10 with tinnitus (without misophonia) and 20 without tinnitus and without misophonia. In order to evaluate the selective attention, the dichotic sentence identification test was applied in three situations: firstly, the Brazilian Portuguese test was applied. Then, the same test was applied, combined with two competitive sounds: chewing sound (representing a sound that commonly triggers misophonia), and white noise (representing a common type of tinnitus which causes discomfort to patients).

RESULTS: The dichotic sentence identification test with chewing sound, showed that the average of correct responses differed between misophonia and without tinnitus and without misophonia (p=0.027) and between misophonia and tinnitus (without misophonia) (p=0.002), in both cases lower in misophonia. Both, the dichotic sentence identification test alone, and with white noise, failed to show differences in the average of correct responses among the three groups (p≥0.452).

CONCLUSION: The misophonia participants presented a lower percentage of correct responses in the dichotic sentence identification test with chewing sound; suggesting that individuals with misophonia may have selective attention impairment when they are exposed to sounds that trigger this condition.

RevDate: 2019-11-15
CmpDate: 2019-11-15

Robinson S, Hedderly T, Conte G, et al (2018)

Misophonia in Children with Tic Disorders: A Case Series.

Journal of developmental and behavioral pediatrics : JDBP, 39(6):516-522.

OBJECTIVE: Misophonia is a condition characterized by the dislike or hatred (miso) of specific sounds (phonia) that results in an extreme emotional response. There has been growing interest in misophonia, with emerging evidence from neurodevelopmental populations and ongoing debate regarding the psychiatric classification and the mechanisms underlying this phenomenon. This is the first article to report on misophonic experiences and associated clinical characteristics in young people with tic disorders.

METHOD: In this article, we present the cases of 12 children and young people with tic disorders who have attended clinics in the United Kingdom and Italy who report misophonia. Misophonia was classified as a selective aversive response in accordance with the criteria proposed by Schröder.

RESULTS: These cases support the view that a range of auditory stimuli may lead to negative/aversive emotional responses of varying degrees, with misophonia seeming to contribute to behavioral reactions. Among these, the most frequent was anger outbursts, followed by an increase in tics, trigger avoidance, repetition of the sound, and self-injurious behavior. No single treatment approach was effective, with some patients responding to cognitive behavioral therapies and others to pharmacological support.

CONCLUSION: We postulate that misophonia could be an underestimated causative phenomenon for abrupt emotional dysregulation in individuals with tic disorders and should be considered as part of a comprehensive clinical assessment. This article presents findings of relevance to general discussions regarding the classification of misophonia, as well as the potential relationship between sensory abnormalities and the broader phenotype of tic disorders during development.

RevDate: 2018-12-02
CmpDate: 2018-08-06

McKay D, Kim SK, Mancusi L, et al (2018)

Profile Analysis of Psychological Symptoms Associated With Misophonia: A Community Sample.

Behavior therapy, 49(2):286-294.

Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.

RevDate: 2019-11-20

Brout JJ, Edelstein M, Erfanian M, et al (2018)

Investigating Misophonia: A Review of the Empirical Literature, Clinical Implications, and a Research Agenda.

Frontiers in neuroscience, 12:36.

Misophonia is a neurobehavioral syndrome phenotypically characterized by heightened autonomic nervous system arousal and negative emotional reactivity (e. g., irritation, anger, anxiety) in response to a decreased tolerance for specific sounds. The aims of this review are to (a) characterize the current state of the field of research on misophonia, (b) highlight what can be inferred from the small research literature to inform treatment of individuals with misophonia, and (c) outline an agenda for research on this topic. We extend previous reviews on this topic by critically reviewing the research investigating mechanisms of misophonia and differences between misophonia and other conditions. In addition, we integrate this small but growing literature with basic and applied research from other literatures in a cross-disciplinary manner.

RevDate: 2019-11-20

Dozier TH, Lopez M, C Pearson (2017)

Proposed Diagnostic Criteria for Misophonia: A Multisensory Conditioned Aversive Reflex Disorder.

Frontiers in psychology, 8:1975.

RevDate: 2019-11-20

Barratt EL, Spence C, NJ Davis (2017)

Sensory determinants of the autonomous sensory meridian response (ASMR): understanding the triggers.

PeerJ, 5:e3846.

The autonomous sensory meridian response (ASMR) is an atypical sensory phenomenon involving electrostatic-like tingling sensations in response to certain sensory, primarily audio-visual, stimuli. The current study used an online questionnaire, completed by 130 people who self-reported experiencing ASMR. We aimed to extend preliminary investigations into the experience, and establish key multisensory factors contributing to the successful induction of ASMR through online media. Aspects such as timing and trigger load, atmosphere, and characteristics of ASMR content, ideal spatial distance from various types of stimuli, visual characteristics, context and use of ASMR triggers, and audio preferences are explored. Lower-pitched, complex sounds were found to be especially effective triggers, as were slow-paced, detail-focused videos. Conversely, background music inhibited the sensation for many respondents. These results will help in designing media for ASMR induction.

RevDate: 2018-08-14
CmpDate: 2018-08-14

Kamody RC, GS Del Conte (2017)

Using Dialectical Behavior Therapy to Treat Misophonia in Adolescence.

The primary care companion for CNS disorders, 19(5):.

RevDate: 2020-01-09

Erfanian M, Jo Brout J, Edelstein M, et al (2017)

REMOVED: Investigating misophonia: A review of the literature, clinical implications and research agenda reflecting current neuroscience and emotion research perspectives.

European psychiatry : the journal of the Association of European Psychiatrists, 41S:S681.

This article has been removed: please see Elsevier Policy on Article Withdrawal (https://www.elsevier.com/about/our-business/policies/article-withdrawal). This article has been removed at the request of the authors due to errors in the author list.

RevDate: 2019-02-15
CmpDate: 2019-02-05

Sanchez TG, FED Silva (2018)

Familial misophonia or selective sound sensitivity syndrome : evidence for autosomal dominant inheritance?.

Brazilian journal of otorhinolaryngology, 84(5):553-559.

INTRODUCTION: Misophonia is a recently described, poorly understood and neglected condition. It is characterized by strong negative reactions of hatred, anger or fear when subjects have to face some selective and low level repetitive sounds. The most common ones that trigger such aversive reactions are those elicited by the mouth (chewing gum or food, popping lips) or the nose (breathing, sniffing, and blowing) or by the fingers (typing, kneading paper, clicking pen, drumming on the table). Previous articles have cited that such individuals usually know at least one close relative with similar symptoms, suggesting a possible hereditary component.

OBJECTIVE: We found and described a family with 15 members having misophonia, detailing their common characteristics and the pattern of sounds that trigger such strong discomfort.

METHODS: All 15 members agreed to give us their epidemiological data, and 12 agreed to answer a specific questionnaire which investigated the symptoms, specific trigger sounds, main feelings evoked and attitudes adopted by each participant.

RESULTS: The 15 members belong to three generations of the family. Their age ranged from 9 to 73 years (mean 38.3 years; median 41 years) and 10 were females. Analysis of the 12 questionnaires showed that 10 subjects (83.3%) developed the first symptoms during childhood or adolescence. The mean annoyance score on the Visual Analog Scale from 0 to 10 was 7.3 (median 7.5). Individuals reported hatred/anger, irritability and anxiety in response to sounds, and faced the situation asking to stop the sound, leaving/avoiding the place and even fighting. The self-reported associated symptoms were anxiety (91.3%), tinnitus (50%), obsessive-compulsive disorder (41.6%), depression (33.3%), and hypersensitivity to sounds (25%).

CONCLUSION: The high incidence of misophonia in this particular familial distribution suggests that it might be more common than expected and raises the possibility of having a hereditary etiology.

RevDate: 2019-11-20

Kumar S, TD Griffiths (2017)

Response: Commentary: The Brain Basis for Misophonia.

Frontiers in behavioral neuroscience, 11:127.

RevDate: 2019-11-20

Schröder A, van Wingen G, Vulink NC, et al (2017)

Commentary: The Brain Basis for Misophonia.

Frontiers in behavioral neuroscience, 11:111.

RevDate: 2019-10-08
CmpDate: 2018-08-31

Tavassoli T, Miller LJ, Schoen SA, et al (2018)

Sensory reactivity, empathizing and systemizing in autism spectrum conditions and sensory processing disorder.

Developmental cognitive neuroscience, 29:72-77.

Although the DSM-5 added sensory symptoms as a criterion for ASC, there is a group of children who display sensory symptoms but do not have ASC; children with sensory processing disorder (SPD). To be able to differentiate these two disorders, our aim was to evaluate whether children with ASC show more sensory symptomatology and/or different cognitive styles in empathy and systemizing compared to children with SPD and typically developing (TD) children. The study included 210 participants: 68 children with ASC, 79 with SPD and 63 TD children. The Sensory Processing Scale Inventory was used to measure sensory symptoms, the Autism Spectrum Quotient (AQ) to measure autistic traits, and the Empathy Quotient (EQ) and Systemizing Quotient (SQ) to measure cognitive styles. Across groups, a greater sensory symptomatology was associated with lower empathy. Further, both the ASC and SPD groups showed more sensory symptoms than TD children. Children with ASC and SPD only differed on sensory under-reactivity. The ASD group did, however, show lower empathy and higher systemizing scores than the SPD group. Together, this suggest that sensory symptoms alone may not be adequate to differentiate children with ASC and SPD but that cognitive style measures could be used for differential diagnosis.

RevDate: 2018-03-26
CmpDate: 2018-03-26

Taylor S (2017)

Misophonia: A new mental disorder?.

Medical hypotheses, 103:109-117.

Misophonia, a phenomenon first described in the audiology literature, is characterized by intense emotional reactions (e.g., anger, rage, anxiety, disgust) in response to highly specific sounds, particularly sounds of human origin such as oral or nasal noises made by other people (e.g., chewing, sniffing, slurping, lip smacking). Misophonia is not listed in any of the contemporary psychiatric classification systems. Some investigators have argued that misophonia should be regarded as a new mental disorder, falling within the spectrum of obsessive-compulsive related disorders. Other researchers have disputed this claim. The purpose of this article is to critically examine the proposition that misophonia should be classified as a new mental disorder. The clinical and research literature on misophonia was examined and considered in the context of the broader literature on what constitutes a mental disorder. There have been growing concerns that diagnostic systems such as DSM-5 tend to over-pathologize ordinary quirks and eccentricities. Accordingly, solid evidence is required for proposing a new psychiatric disorder. The available evidence suggests that (a) misophonia meets many of the general criteria for a mental disorder and has some evidence of clinical utility as a diagnostic construct, but (b) the nature and boundaries of the syndrome are unclear; for example, in some cases misophonia might be simply one feature of a broader pattern of sensory intolerance, and (c) considerably more research is required, particularly work concerning diagnostic validity, before misophonia, defined as either as a disorder or as a key feature of some broader syndrome of sensory intolerance, should be considered as a diagnostic construct in the psychiatric nomenclature. A research roadmap is proposed for the systematic evaluation as to whether misophonia should be considered for future editions of DSM or ICD.

RevDate: 2019-12-10
CmpDate: 2019-04-11

Rouw R, M Erfanian (2018)

A Large-Scale Study of Misophonia.

Journal of clinical psychology, 74(3):453-479.

OBJECTIVE: We aim to elucidate misophonia, a condition in which particular sounds elicit disproportionally strong aversive reactions.

METHOD: A large online study extensively surveyed personal, developmental, and clinical characteristics of over 300 misophonics.

RESULTS: Most participants indicated that their symptoms started in childhood or early teenage years. Severity of misophonic responses increases over time. One third of participants reported having family members with similar symptoms. Half of our participants reported no comorbid clinical conditions, and the other half reported a variety of conditions. Only posttraumatic stress disorder (PTSD) was related to the severity of the misophonic symptoms. Remarkably, half of the participants reported experiencing euphoric, relaxing, and tingling sensations with particular sounds or sights, a relatively unfamiliar phenomenon called autonomous sensory meridian response (ASMR).

CONCLUSION: It is unlikely that another "real" underlying clinical, psychiatric, or psychological disorder can explain away the misophonia. The possible relationship with PTSD and ASMR warrants further investigation.

RevDate: 2018-12-02
CmpDate: 2018-01-26

Schröder AE, Vulink NC, van Loon AJ, et al (2017)

Cognitive behavioral therapy is effective in misophonia: An open trial.

Journal of affective disorders, 217:289-294.

BACKGROUND: Misophonia is a psychiatric disorder in which ordinary human sounds like smacking or chewing provoke intense anger and disgust. Despite the high burden of this condition, to date there is no evidence-based treatment available. In this study we evaluated the efficacy of cognitive behavioral therapy (CBT) and investigated whether clinical or demographic characteristics predicted treatment response.

METHODS: Ninety patients with misophonia received eight bi-weekly group CBT sessions. Treatment response was defined as a Clinical Global Impression - Improvement Scale (CGI-I) score at endpoint of 1 or 2 (very much or much improved) and a 30% or greater reduction on the Amsterdam Misophonia Scale (A-MISO-S), a measure of the severity of misophonia symptoms.

RESULTS: Following treatment 48% (N=42) of the patients showed a significant reduction of misophonia symptoms. Severity of misophonia and the presence of disgust were positive predictors of treatment response.

LIMITATIONS: The A-MISO-S is not a validated scale. Furthermore, this was an open-label study with a waiting list control condition.

CONCLUSIONS: This is the first treatment study for misophonia. Our results suggest that CBT is effective in half of the patients.

RevDate: 2018-11-13
CmpDate: 2018-07-13

Kumar S, Tansley-Hancock O, Sedley W, et al (2017)

The Brain Basis for Misophonia.

Current biology : CB, 27(4):527-533.

Misophonia is an affective sound-processing disorder characterized by the experience of strong negative emotions (anger and anxiety) in response to everyday sounds, such as those generated by other people eating, drinking, chewing, and breathing [1-8]. The commonplace nature of these sounds (often referred to as "trigger sounds") makes misophonia a devastating disorder for sufferers and their families, and yet nothing is known about the underlying mechanism. Using functional and structural MRI coupled with physiological measurements, we demonstrate that misophonic subjects show specific trigger-sound-related responses in brain and body. Specifically, fMRI showed that in misophonic subjects, trigger sounds elicit greatly exaggerated blood-oxygen-level-dependent (BOLD) responses in the anterior insular cortex (AIC), a core hub of the "salience network" that is critical for perception of interoceptive signals and emotion processing. Trigger sounds in misophonics were associated with abnormal functional connectivity between AIC and a network of regions responsible for the processing and regulation of emotions, including ventromedial prefrontal cortex (vmPFC), posteromedial cortex (PMC), hippocampus, and amygdala. Trigger sounds elicited heightened heart rate (HR) and galvanic skin response (GSR) in misophonic subjects, which were mediated by AIC activity. Questionnaire analysis showed that misophonic subjects perceived their bodies differently: they scored higher on interoceptive sensibility than controls, consistent with abnormal functioning of AIC. Finally, brain structural measurements implied greater myelination within vmPFC in misophonic individuals. Overall, our results show that misophonia is a disorder in which abnormal salience is attributed to particular sounds based on the abnormal activation and functional connectivity of AIC.

RevDate: 2019-02-06
CmpDate: 2017-03-23

Baguley DM, Cope TE, DJ McFerran (2016)

Functional auditory disorders.

Handbook of clinical neurology, 139:367-378.

There are a number of auditory symptom syndromes that can develop without an organic basis. Some of these, such as nonorganic hearing loss, affect populations similar to those presenting with functional somatosensory and motor symptoms, while others, such as musical hallucination, affect populations with a significantly different demographic and require different treatment strategies. Many of these conditions owe their origin to measurably abnormal peripheral sensory pathology or brain network activity, but their pathological impact is often due, at least in part, to overamplification of the salience of these phenomena. For each syndrome, this chapter briefly outlines a definition, demographics, investigations, putative mechanisms, and treatment strategies. Consideration is given to what extent they can be considered to have a functional basis. Treatments are in many cases pragmatic and rudimentary, needing more work to be done in integrating insights from behavioral and cognitive psychology to auditory neuroscience. The audiology literature has historically equated the term functional with malingering, although this perception is, thankfully, slowly changing. These disorders transcend the disciplines of audiology, otorhinolaryngology, neurology and psychiatry, and a multidisciplinary approach is often rewarding.

RevDate: 2017-03-02
CmpDate: 2017-03-01

Jesus NO, Angrisani RG, Maruta EC, et al (2016)

Suppression effect of otoacoustic emissions in term and preterm infants.

CoDAS, 28(4):331-337.

PURPOSE: This research aims at verifying the occurrence and magnitude of suppression effect of otoacoustic emissions evoked by transient stimulus in term and preterm infants, setting a benchmark for clinical use.

METHODS: The study sample consisted of 40 infants, with a rage of age from five days to four months, without any risk indicators for hearing loss and otoacoustic emissions present at birth: the 20 term and 20 preterm infants spent more than five days in the Neonatal Intensive Care Unit. Linear click was presented at 65 dB Sound Pressure Level, in blocks of 15 seconds without noise, and with contralateral noise at 60 dB Sound Pressure Level. The reduced response in the presence of noise indicates positive suppression effect. Mean values of suppression were established and the comparison between the groups was analyzed statistically.

RESULTS: Suppression occurred in 100% of the children and did not vary as a function of ear side and between the groups.

CONCLUSION: All children presented suppression regardless of the group. The average suppression obtained on the total population was 0.85 dB. The minimum recommended criterion for clinical use was a reduction of 0.20 dB in the overall response.

RevDate: 2017-12-15
CmpDate: 2017-12-15

Blegvad-Nissen C, PH Thomsen (2015)

[Misophonia is a neglected disorder].

Ugeskrift for laeger, 177(48):V04150309.

A 14-year-old girl, who was diagnosed with OCD when she was 11-year-old, experienced emotional reactions and autonomic arousal in response to specific human-made sounds. At first she thought that these symptoms were part of her OCD, but it became clear to her that she suffered from misophonia - a disorder not yet classified.

RevDate: 2017-01-05
CmpDate: 2017-01-04

Bruxner G (2016)

'Mastication rage': a review of misophonia - an under-recognised symptom of psychiatric relevance?.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 24(2):195-197.

OBJECTIVE: To explore the condition of misophonia, its definition, possible neurological correlates, its associated morbidity, its possible psychiatric relevance and potential treatment.

METHOD: Provision of an illustrative case vignette and a review of the limited literature.

RESULTS: Misophonia is a symptom associated with obsessive-compulsive disorder and anxiety disorders and may be a syndrome in itself associated with significant distress and avoidance. Treatments are not well validated.

CONCLUSION: Misophonia may be an under-recognised condition of psychiatric relevance.

RevDate: 2018-12-02
CmpDate: 2015-10-30

Gédance D (2015)

[Misophonia and contemporary psychiatry].

Revue medicale suisse, 11(482):1504-1505.

RevDate: 2017-09-01
CmpDate: 2017-09-01

Parial LL, Torres GC, JR Macindo (2016)

Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS): Instrument Development and Psychometric Validation.

Journal of emergency nursing: JEN : official publication of the Emergency Department Nurses Association, 42(3):213-223.

UNLABELLED: Family presence during resuscitation (FPDR) is a growing health care practice; nevertheless, countless controversies surround this medical principle. Several studies have investigated the perceptions of health care professionals toward FPDR, yet psychometrically sound instruments assessing family members' perceptions of FPDR are scarce. Hence we aimed to develop and psychometrically validate the Family Presence During Resuscitation Benefits-Risks Scale (FPDR-BRS).

METHODS: Using a methodological design, an initial 27-item questionnaire was developed after extensive literature and theoretical review. Psychometric validation assessed content validity through a 2-step process involving expert nurses and doctors, basic item analysis, internal consistency using Cronbach's α, and construct validity via exploratory factor analysis. After acquiring Ethics Review Board approval, the FPDR-BRS was tested on 130 randomly selected eligible family members from a tertiary government hospital in the Philippines.

RESULTS: The initial 27-item questionnaire was reduced to 23 items after content validation, yielding an item content validity index and scale content validity index/Ave rage of 1.00. Basic item analysis revealed acceptable inter-item and item-scale correlations. Exploratory factor analysis extracted 4 factors, namely, personnel risks, personal risks, insight-building benefits, and connection-forming benefits. Cronbach's α for the entire scale was 0.90, with high subscale reliability coefficients.

DISCUSSION: The 23-item FPDR-BRS exhibited satisfactory psychometric properties and may be used to quantitatively measure a family member's perception towards witnessing the resuscitation of his or her significant other. Further comprehensive psychometric evaluations are warranted to ensure robust cross-cultural comparisons.

RevDate: 2018-11-13
CmpDate: 2015-08-28

Cavanna AE, S Seri (2015)

Misophonia: current perspectives.

Neuropsychiatric disease and treatment, 11:2117-2123.

Misophonia is characterized by a negative reaction to a sound with a specific pattern and meaning to a given individual. In this paper, we review the clinical features of this relatively common yet underinvestigated condition, with focus on co-occurring neurodevelopmental disorders. Currently available data on the putative pathophysiology of the condition can inform our understanding and guide the diagnostic process and treatment approach. Tinnitus retraining therapy and cognitive behavior therapy have been proposed as the most effective treatment strategies for reducing symptoms; however, current treatment algorithms should be validated in large population studies. At the present stage, competing paradigms see misophonia as a physiological state potentially inducible in any subject, an idiopathic condition (which can present with comorbid psychiatric disorders), or a symptomatic manifestation of an underlying psychiatric disorder. Agreement on the use of standardized diagnostic criteria would be an important step forward in terms of both clinical practice and scientific inquiry. Areas for future research include phenomenology, epidemiology, modulating factors, neurophysiological underpinnings, and treatment trials.

RevDate: 2018-12-03
CmpDate: 2015-08-10

Stiefel F, S Michael (2015)

[Misophonia and contemporary psychiatry].

Revue medicale suisse, 11(474):1088.

RevDate: 2018-12-02
CmpDate: 2015-08-11

McGuire JF, Wu MS, EA Storch (2015)

Cognitive-behavioral therapy for 2 youths with misophonia.

The Journal of clinical psychiatry, 76(5):573-574.

RevDate: 2015-10-09
CmpDate: 2015-06-22

Jacot CR, Eric T, O Sentissi (2015)

[Misophonia or aversion to human sound: a clinical illustration].

Revue medicale suisse, 11(462):466-469.

Misophonia, meaning hatred of sound, is a cluster of symptoms which is not completely included in anxiety disorders category as obsessive compulsive or as an impulsivity disorder. It is described as a chronic condition characterized by reactions, aversion to specific sounds that result in subsequent emotional. Indeed, this condition is relatively unknown and few psychiatrists have already faced this disorder causing in some individuals severe impairment. The investigation of a patient suffering of misophonia with severe impairment that we took into care in an outpatient psychiatric clinic in Geneva contributes to a better understanding of this condition and indicates potential factors that may co-occur and influence the clinical presentation. The good response in psychotherapy, has led us to carry out a brief review of the literature in order to better define and identify this disorder.

RevDate: 2015-06-04
CmpDate: 2016-02-23

Webber TA, EA Storch (2015)

Toward a theoretical model of misophonia.

General hospital psychiatry, 37(4):369-370.

RevDate: 2015-06-04
CmpDate: 2016-02-23

Schneider RL, JJ Arch (2015)

Letter to the editor: potential treatment targets for misophonia.

General hospital psychiatry, 37(4):370-371.

RevDate: 2018-12-02
CmpDate: 2015-12-28

Jastreboff PJ (2015)

25 years of tinnitus retraining therapy.

HNO, 63(4):307-311.

This year marks 25 years of tinnitus retraining therapy (TRT), the approach that aims to eliminate tinnitus as a problem by extinguishing functional connections between the auditory and the limbic and autonomic nervous systems to achieve habituation of tinnitus-evoked reactions and subsequently habituation of perception. TRT addresses directly decreased sound tolerance (DST) as well as tinnitus. TRT consists of counseling and sound therapy, both based on the neurophysiological model of tinnitus. The main goal of retraining counseling is to reclassify tinnitus into the category of a neutral stimulus, while the main goal of sound therapy is to decrease the strength of tinnitus-related neuronal activity. A unique aspect of TRT is that because treatment is aimed to work above the tinnitus source, and at connections linking the auditory and other systems in the brain, the etiology of tinnitus is irrelevant. Any type of tinnitus, as well as somatosounds, can be successfully treated by TRT. Over 100 publications can be found on Medline when using "tinnitus retraining therapy" as a search term. The majority of these publications indicate TRT offers significant help for about 80 % of patients. A randomized clinical trial showing the effectiveness of TRT has been published and another large study is in progress. The principles of the neurophysiological model of tinnitus, and consequently TRT, have not changed in over 25 years of use, but a number of changes have been introduced in TRT implementation. These changes include the recognition of the importance of conditioned reflexes and the dominant role of the subconscious pathways; the introduction of the concept of misophonia (i.e., negative reactions to specific patterns of sound) and the implementation of specific protocols for its treatment; greater emphasis on the concurrent treatment of tinnitus, hyperacusis, misophonia, and hearing loss; extensive modification of counseling; and refinements in sound therapy. The effectiveness of TRT has increased significantly during the past 25 years, presumably due to changes incorporated in its implementation. The main improvement has been to shorten the average time until seeing clear improvement from 1 year to 1 month, with a statistically significant improvement seen at, and after, 3 months. Furthermore, there is a higher effectiveness and a shorter treatment time for DST and an increased extent of help for hearing loss.

RevDate: 2018-11-13
CmpDate: 2015-04-02

Barratt EL, NJ Davis (2015)

Autonomous Sensory Meridian Response (ASMR): a flow-like mental state.

PeerJ, 3:e851.

Autonomous Sensory Meridian Response (ASMR) is a previously unstudied sensory phenomenon, in which individuals experience a tingling, static-like sensation across the scalp, back of the neck and at times further areas in response to specific triggering audio and visual stimuli. This sensation is widely reported to be accompanied by feelings of relaxation and well-being. The current study identifies several common triggers used to achieve ASMR, including whispering, personal attention, crisp sounds and slow movements. Data obtained also illustrates temporary improvements in symptoms of depression and chronic pain in those who engage in ASMR. A high prevalence of synaesthesia (5.9%) within the sample suggests a possible link between ASMR and synaesthesia, similar to that of misophonia. Links between number of effective triggers and heightened flow state suggest that flow may be necessary to achieve sensations associated with ASMR.

RevDate: 2015-03-02
CmpDate: 2015-04-17

Jastreboff PJ, MM Jastreboff (2015)

Decreased sound tolerance: hyperacusis, misophonia, diplacousis, and polyacousis.

Handbook of clinical neurology, 129:375-387.

Definitions, potential mechanisms, and treatments for decreased sound tolerance, hyperacusis, misophonia, and diplacousis are presented with an emphasis on the associated physiologic and neurophysiological processes and principles. A distinction is made between subjects who experience these conditions versus patients who suffer from them. The role of the limbic and autonomic nervous systems and other brain systems involved in cases of bothersome decreased sound tolerance is stressed. The neurophysiological model of tinnitus is outlined with respect to how it may contribute to our understanding of these phenomena and their treatment.

RevDate: 2018-12-02
CmpDate: 2014-07-30

Aazh H, McFerran D, Salvi R, et al (2014)

Insights from the First International Conference on Hyperacusis: causes, evaluation, diagnosis and treatment.

Noise & health, 16(69):123-126.

The First International Conference on Hyperacusis gathered over 100 scientists and health care professionals in London, UK. Key conclusions from the conference included: (1) Hyperacusis is characterized by reduced tolerance of sound that has perceptual, psychological and social dimensions; (2) there is a growing awareness that children as well as adults experience symptoms of hyperacusis or misophonia; (3) the exact mechanisms that give rise to hyperacusis are not clear, but the available evidence suggests that functional changes within the central nervous system are important and in particular, hyperacusis may be related to increased gain in the central auditory pathways and to increased anxiety or emotional response to sound; (4) various counseling and sound therapy approaches seem beneficial in the management of hyperacusis, but the evidence base for these remains poor.

RevDate: 2018-11-13
CmpDate: 2014-04-30

Schröder A, van Diepen R, Mazaheri A, et al (2014)

Diminished n1 auditory evoked potentials to oddball stimuli in misophonia patients.

Frontiers in behavioral neuroscience, 8:123.

Misophonia (hatred of sound) is a newly defined psychiatric condition in which ordinary human sounds, such as breathing and eating, trigger impulsive aggression. In the current study, we investigated if a dysfunction in the brain's early auditory processing system could be present in misophonia. We screened 20 patients with misophonia with the diagnostic criteria for misophonia, and 14 matched healthy controls without misophonia, and investigated any potential deficits in auditory processing of misophonia patients using auditory event-related potentials (ERPs) during an oddball task. Subjects watched a neutral silent movie while being presented a regular frequency of beep sounds in which oddball tones of 250 and 4000 Hz were randomly embedded in a stream of repeated 1000 Hz standard tones. We examined the P1, N1, and P2 components locked to the onset of the tones. For misophonia patients, the N1 peak evoked by the oddball tones had smaller mean peak amplitude than the control group. However, no significant differences were found in P1 and P2 components evoked by the oddball tones. There were no significant differences between the misophonia patients and their controls in any of the ERP components to the standard tones. The diminished N1 component to oddball tones in misophonia patients suggests an underlying neurobiological deficit in misophonia patients. This reduction might reflect a basic impairment in auditory processing in misophonia patients.

RevDate: 2014-09-16
CmpDate: 2015-05-27

Wu MS, Lewin AB, Murphy TK, et al (2014)

Misophonia: incidence, phenomenology, and clinical correlates in an undergraduate student sample.

Journal of clinical psychology, 70(10):994-1007.

OBJECTIVE: Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger outbursts. While there has been increasing interest in misophonia, few data have been published to date.

METHOD: This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self-report measures.

RESULTS: Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive-compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts.

CONCLUSION: This investigation contributes to a better understanding of misophonia and indicates potential factors that may co-occur and influence the clinical presentation of a person with misophonia symptoms.

RevDate: 2014-03-14
CmpDate: 2014-11-04

Cavanna AE (2014)

What is misophonia and how can we treat it?.

Expert review of neurotherapeutics, 14(4):357-359.

Selective sound sensitivity syndrome or misophonia is a chronic condition characterized by unpleasant emotional experiences and autonomic arousal in response to specific sounds. Over the last few years there have been a few reports detailing the clinical features associated with this condition. These focused reports raise interesting questions about the nosological status of this potentially disabling clinical entity.

RevDate: 2018-12-02
CmpDate: 2014-07-24

Kluckow H, Telfer J, S Abraham (2014)

Should we screen for misophonia in patients with eating disorders? A report of three cases.

The International journal of eating disorders, 47(5):558-561.

In this case report, the authors describe three cases of misophonia in people with eating disorders. Misophonia is a condition where a specific trigger sound provokes an intense emotional reaction in an individual. Case 1 is a 29-year-old with childhood eating issues, anorexia nervosa and bulimia nervosa whose trigger was a high-pitched female voice. Case 2 is a 15-year-old diagnosed with anorexia nervosa after misophonia onset. Her trigger was people chewing and eating noisily. Case 3 is a 24-year-old woman who presented with anorexia nervosa prior to misophonia onset. Her trigger was the clinking and chewing of her mother and aunt eating cereal. All three cases identified an eating-related trigger sound with a violent aversive reaction and coping mechanisms involving eating avoidance or having a full mouth. Misophonia may be associated with presentations of eating disorders. This case report adds to the literature about the presentation of misophonia.

RevDate: 2015-11-19
CmpDate: 2014-04-22

Prado-Barreto VM, Salvatori R, Santos Júnior RC, et al (2014)

Hearing status in adult individuals with lifetime, untreated isolated growth hormone deficiency.

Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 150(3):464-471.

OBJECTIVE: To evaluate the hearing status of growth hormone (GH)-naive adults with isolated GH deficiency (IGHD) belonging to an extended Brazilian kindred with a homozygous mutation in the GH-releasing hormone receptor gene.

STUDY DESIGN: Cross-sectional.

SETTING: Divisions of Endocrinology and Otorhinolaryngology of the Federal University of Sergipe.

SUBJECTS AND METHODS: Twenty-six individuals with IGHD (age, 47.6 ± 15.1 years; 13 women) and 25 controls (age, 46.3 ± 14.3 years; 15 women) were administered a questionnaire on hearing complaints and hearing health history. We performed pure-tone audiometry, logoaudiometry, electroacoustic immittance, and stapedial reflex. To assess outer hair cell function in the cochlea, we completed transient evoked otoacoustic emissions (TEOAEs). To assess the auditory nerve and auditory brainstem, we obtained auditory brainstem responses (ABRs).

RESULTS: Misophonia and dizziness complaints were more frequent in those with IGHD than in controls (P = .011). Patients with IGHD had higher thresholds at 250 Hz (P = .005), 500 Hz (P = .006), 3 KHz (P = .008), 4 KHz (P = .038), 6 KHz (P = .008), and 8 KHz (P = .048) and mild high-tones hearing loss (P = .029). Stapedial reflex (P < .001) and TEOAEs (P = .025) were more frequent in controls. There were no differences in ABR latencies. Hearing loss in patients with IGHD occurred earlier than in controls (P < .001).

CONCLUSION: Compared with controls of the same area, subjects with untreated, congenital lifetime IGHD report more misophonia and dizziness, have predominance of mild high-tones sensorineural hearing loss, and have an absence of stapedial reflex and TEOAEs.

RevDate: 2014-03-10
CmpDate: 2014-10-29

Webber TA, Johnson PL, EA Storch (2014)

Pediatric misophonia with comorbid obsessive-compulsive spectrum disorders.

General hospital psychiatry, 36(2):231.e1-2.

OBJECTIVE: Misophonia is a potentially debilitating condition characterized by increased sensitivity to specific sounds, which cause subsequent behavioral and emotional responses. The nature, clinical phenomenology and etiology of misophonia remain unclear, and misophonic clinical presentations are not currently accounted for by existing psychiatric or audiological disorders.

METHOD: We present a case of pediatric misophonia in the context of comorbid obsessive-compulsive disorder and Tourette's syndrome.

RESULTS: Given the interrelationships among obsessive-compulsive spectrum disorders and misophonia, these disorders may share underlying pathophysiology, particularly within the dopaminergic and serotonergic neural systems. Clinical (i.e., treatment) and theoretical implications are discussed.

RevDate: 2013-11-07
CmpDate: 2014-07-10

Ferreira GM, Harrison BJ, LF Fontenelle (2013)

Hatred of sounds: misophonic disorder or just an underreported psychiatric symptom?.

Annals of clinical psychiatry : official journal of the American Academy of Clinical Psychiatrists, 25(4):271-274.

BACKGROUND: Misophonia, or selective sound sensitivity syndrome, is a preoccupation with or aversion to certain types of sounds that evokes feelings of irritability, disgust, or anger. Recently, it has been suggested that misophonia is a discrete clinical entity deserving of its own place in psychiatric diagnostic manuals. In this paper, we describe 3 patients whose misophonia could be attributed to different underlying primary psychiatric disorders.

METHODS: Case series report.

RESULTS: In these patients, we argue that misophonia is better described as a symptom of a) obsessive-compulsive disorder, b) generalized anxiety disorder, and c) schizotypal personality disorder.

CONCLUSIONS: The nosological status of misophonia remains a matter of debate. Patients who exhibit misophonia as a major complaint should be assessed for other conditions. Further studies on the prevalence, natural history, and additional features of misophonia are needed.

RevDate: 2018-11-13
CmpDate: 2013-06-28

Edelstein M, Brang D, Rouw R, et al (2013)

Misophonia: physiological investigations and case descriptions.

Frontiers in human neuroscience, 7:296.

Misophonia is a relatively unexplored chronic condition in which a person experiences autonomic arousal (analogous to an involuntary "fight-or-flight" response) to certain innocuous or repetitive sounds such as chewing, pen clicking, and lip smacking. Misophonics report anxiety, panic, and rage when exposed to trigger sounds, compromising their ability to complete everyday tasks and engage in healthy and normal social interactions. Across two experiments, we measured behavioral and physiological characteristics of the condition. Interviews (Experiment 1) with misophonics showed that the most problematic sounds are generally related to other people's behavior (pen clicking, chewing sounds). Misophonics are however not bothered when they produce these "trigger" sounds themselves, and some report mimicry as a coping strategy. Next, (Experiment 2) we tested the hypothesis that misophonics' subjective experiences evoke an anomalous physiological response to certain auditory stimuli. Misophonic individuals showed heightened ratings and skin conductance responses (SCRs) to auditory, but not visual stimuli, relative to a group of typically developed controls, supporting this general viewpoint and indicating that misophonia is a disorder that produces distinct autonomic effects not seen in typically developed individuals.

RevDate: 2013-03-14
CmpDate: 2013-09-11

Neal M, AE Cavanna (2013)

Selective sound sensitivity syndrome (misophonia) in a patient with Tourette syndrome.

The Journal of neuropsychiatry and clinical neurosciences, 25(1):E01.

RevDate: 2013-02-22
CmpDate: 2013-08-13

Willems P (2013)

Decision making in surgical treatment of chronic low back pain: the performance of prognostic tests to select patients for lumbar spinal fusion.

Acta orthopaedica. Supplementum, 84(349):1-35.

Chronic low back pain (CLBP) is one of the main causes of disability in the western world with a huge economic burden to society. As yet, no specific underlying anatomic cause has been identified for CLBP. Imaging often reveals degenerative findings of the disc or facet joints of one or more lumbar motion segments. These findings, however, can also be observed in asymptomatic people. It has been suggested that pain in degenerated discs may be caused by the ingrowth of nerve fibers into tears or clefts of the annulus fibrosus or nucleus pulposus, and by reported high levels of pro-inflammatory mediators. As this so-called discogenic pain is often exacerbated by mechanical loading, the concept of relieving pain by spinal fusion to stabilise a painful spinal segment, has been developed. For some patients lumbar spinal fusion indeed is beneficial, but its results are highly variable and hard to predict for the individual patient. To identify those CLBP patients who will benefit from fusion, many surgeons rely on tests that are assumed to predict the outcome of spinal fusion. The three most commonly used prognostic tests in daily practice are immobilization in a lumbosacral orthosis, provocative discography and trial immobilization by temporary external transpedicular fixation. Aiming for consensus on the indications for lumbar fusion and in order to improve its results by better patient selection, it is essential to know the role and value of these prognostic tests for CLBP patients in clinical practice. The overall aims of the present thesis were: 1) to evaluate whether there is consensus among spine surgeons regarding the use and appreciation of prognostic tests for lumbar spinal fusion; 2) to verify whether a thoracolumbosacral orthosisis (TLSO) truly minimises lumbosacral motion; 3) to verify whether a TLSO can predict the clinical outcome of fusion for CLBP; 4) to assess whether provocative discography of adjacent segments actually predicts the long-term clinical outcome fusion; 5) to determine the incidence of postdiscography discitis, and whether there is a need for routine antibiotic prophylaxis; 6) to assess whether temporary external transpedicular fixation (TETF) can help to predict the outcome of spinal fusion; 7) to determine the prognostic accuracy of the most commonly used tests in clinical practice to predict the outcome of fusion for CLBP. The results of a national survey among spine surgeons in the Netherlands were presented in Study I. The surgeons were questioned about their opinion on prognostic factors and about the use of predictive tests for lumbar fusion in CLBP patients. The comments were compared with findings from the prevailing literature. The survey revealed a considerable lack of uniformity in the use and appreciation of predictive tests. Prognostic factors known from the literature were not consistently incorporated in the surgeons' decision making process either. This heterogeneity in strategy is most probably caused by the lack of sound scientific evidence for current predictive tests and it was concluded that currently there is not enough consensus among spine surgeons in the Netherlands to create national guidelines for surgical decision making in CLBP. In Study II, the hypothesized working mechanism of a pantaloon cast (i.e., minimisation of lumbosacral joint mobility) was studied. In patients who were admitted for a temporary external transpedicular fixation test (TETF), infrared light markers were rigidly attached to the protruding ends of Steinman pins that were fixed in two spinal levels. In this way three-dimensional motion between these levels could be analysed opto-electronically. During dynamic test conditions such as walking, a plaster cast, either with or without unilateral hip fixation, did not significantly decrease lumbosacral joint motion. Although not substantiated by sound scientific support, lumbosacral orthoses or pantaloon casts are often used in everyday practice as a predictor for the outcome of fusion. A systematic review of the literature supplemented with a prospective cohort study was performed (Study III) in order to assess the value of a pantaloon cast in surgical decision-making. It appeared that only in CLBP patients with no prior spine surgery, a pantaloon cast test with substantial pain relief suggests a favorable outcome of lumbar fusion compared to conservative treatment. In patients with prior spine surgery the test is of no value. It is believed by many spine surgeons that provocative discography, unlike plain radiographs or magnetic resonance imaging, is a physiologic test that can truly determine whether a disc is painful and relevant in a patient's pain syndrome, irrespective of the morphology of the disc. It has been suggested that in order to achieve a successful clinical outcome of lumbar fusion, suspect discs should be painful and adjacent control discs should elicit no pain on provocative discography. For this reason, a cohort of patients in whom the decision to perform lumbar fusion was based on an external fixation (TETF) trial, was analysed retrospectively in Study IV. The results of preoperative discography of solely the levels adjacent to the fusion were compared with the clinical results after spinal fusion. It appeared that in this select group of patients the discographic status of discs adjacent to a lumbar fusion did not have any effect on the clinical outcome. The most feared complication of lumbar discography is discitis. Although low in incidence, this is a serious complication for a diagnostic procedure and prevention by the use of prophylactic antibiotics has been advocated. In search for clinical guidelines, the risk of postdiscography discitis was assessed in Study V by means of a systematic literature review and a cohort of 200 consecutive patients. Without the use of prophylactic antibiotics, an overall incidence of postdiscography discitis of 0.25% was found. To prove that antibiotics would actually prevent discitis, a randomised trial of 9,000 patients would be needed to reach significance. Given the possible adverse effects of antibiotics, it was concluded that the routine use of prophylactic antibiotics in lumbar discography is not indicated. In Study VI, the middle- and long-term results of external fixation (TETF) as a test to predict the clinical outcome of lumbar fusion were studied in a group of back pain patients for whom there was doubt about the indication for surgery. The test included a placebo trial, in which the patients were unaware whether the lumbar segmental levels were fixed or dynamised. Using strict and objective criteria of pain reduction on a visual analogue scale, the TETF test failed to predict clinical outcome of fusion in this select group of patients. Pin track infection and nerve root irritation were registered as complications of this invasive test. It was concluded that in chronic low back pain patients with a doubtful indication for fusion, TETF is not recommended as a supplemental tool for surgical decision-making. In Study VII, a systematic literature review was performed regarding the prognostic accuracy of tests that are currently used in clinical practice and that are presumed to predict the outcome of lumbar spinal fusion for CLBP. The tests of interest were magnetic resonance imaging (MRI), TLSO immobilisation, TETF, provocative discography and facet joint infiltration. Only 10 studies reporting on three different index tests (discography, TLSO immobilisation and TETF) that truly reported on test qualifiers, such as sensitivity, specificity and likelihood ratios, could be selected. It appeared that the accuracy of all prognostic tests was low, which confirmed that in many clinical practices patients are scheduled for fusion on the basis of tests, of which the accuracy is insufficient or at best unknown. As the overall methodological quality of included studies was poor, higher quality trials that include negatively tested as well as positively tested patients for fusion, will be needed. It was concluded that at present, best evidence does not support the use of any prognostic test in clinical practice. No subset of patients with low back pain could be identified, for whom spinal fusion is a reliable and effective treatment. In literature, several studies have reported that cognitive behavioural therapy or intensive exercise programs have treatment results similar to those of spinal fusion, but with considerably less complications, morbidity and costs. As the findings of the present thesis show that the currently used tests do not improve the results of fusion by better patient selection, these tests should not be recommended for surgical decision making in standard care. Moreover, spinal fusion should not be proposed as a standard treatment for chronic low back pain. Causality of nonspecific spinal pain is complex and CLBP should not be regarded as a diagnosis, but rather as a symptom in patients with different stages of impairment and disability. Patients should be evaluated in a multidisciplinary setting or Spine Centre according to the so-called biopsychosocial model, which aims to identify underlying psychosocial factors as well as biological factors. Treatment should occur in a stepwise fashion starting with the least invasive treatment. The current approach of CLBP, in which emphasis is laid on self-management and empowerment of patients to take an active course of treatment in order to prevent long-term disability and chronicity, is recommended.

RevDate: 2018-11-13
CmpDate: 2013-07-26

Schröder A, Vulink N, D Denys (2013)

Misophonia: diagnostic criteria for a new psychiatric disorder.

PloS one, 8(1):e54706.

BACKGROUND: Some patients report a preoccupation with a specific aversive human sound that triggers impulsive aggression. This condition is relatively unknown and has hitherto never been described, although the phenomenon has anecdotally been named misophonia.

42 patients who reported misophonia were recruited by our hospital website. All patients were interviewed by an experienced psychiatrist and were screened with an adapted version of the Y-BOCS, HAM-D, HAM-A, SCL-90 and SCID II. The misophonia patients shared a similar pattern of symptoms in which an auditory or visual stimulus provoked an immediate aversive physical reaction with anger, disgust and impulsive aggression. The intensity of these emotions caused subsequent obsessions with the cue, avoidance and social dysfunctioning with intense suffering. The symptoms cannot be classified in the current nosological DSM-IV TR or ICD-10 systems.

CONCLUSIONS: We suggest that misophonia should be classified as a discrete psychiatric disorder. Diagnostic criteria could help to officially recognize the patients and the disorder, improve its identification by professional health carers, and encourage scientific research.

RevDate: 2013-01-04
CmpDate: 2013-05-16

Zhu X, Zhang J, M Li (2012)

[Decreased sound tolerance and tinnitus].

Lin chuang er bi yan hou tou jing wai ke za zhi = Journal of clinical otorhinolaryngology, head, and neck surgery, 26(19):909-912.

Decreased sound tolerance includes hyperacusis and/or misphobia (phonophobia). As a commonly subjective symptom, tinnitus is defined to be a sound perceived in the ear or head without corresponding sound or electrical stimulus in the surrounding environment. It is usually occurred with or without hearing loss or harmful psychic reaction, which includes dyssomnia, annoy, rage, anxiety, depress, hard to concentrate, etc. Frequently, tinnitus is accompanied by decreased sound tolerance, while this text is aimed to review the correlated concepts of decreased sound tolerance,and focus on the hyperacusis which is a more common symptom.

RevDate: 2018-12-02
CmpDate: 2015-06-23

Wu T, C Mohan (2012)

Lupus nephritis - alarmins may sound the alarm?.

Arthritis research & therapy, 14(6):129.

A growing body of literature has documented the elevated levels of the alarmin HMGB1 in lupus skin and serum. Two recent reports highlight the increased expression of HMGB1 in lupus nephritis, within the diseased kidneys or in the urine. Taken together with previous reports, these findings suggest that the interaction of HMGB1 with a variety of receptors, including receptor for advanced glycation end products (RAGE) and Toll-like receptors, might play a role in the pathogenesis of lupus nephritis. These studies introduce urinary HMGB1 as a novel biomarker candidate in lupus nephritis. Whether alarmins would be effective in sounding the alarm at the incipience of renal damage remains to be ascertained.

RevDate: 2012-03-14
CmpDate: 2012-04-16

Schwartz P, Leyendecker J, M Conlon (2011)

Hyperacusis and misophonia: the lesser-known siblings of tinnitus.

Minnesota medicine, 94(11):42-43.

Hyperacusis (decreased sound tolerance) and misophonia (fear of sound) are two conditions about which little is known. Consequently, physicians often struggle when they encounter patients who are affected by them. This article attempts to educate the medical community about hyperacusis and misophonia, both of which can have devastating effects on the lives of patients, and ways to manage them.

RevDate: 2012-02-21
CmpDate: 2012-09-17

Erickson MA, Niehoff ML, Farr SA, et al (2012)

Peripheral administration of antisense oligonucleotides targeting the amyloid-β protein precursor reverses AβPP and LRP-1 overexpression in the aged SAMP8 mouse brain.

Journal of Alzheimer's disease : JAD, 28(4):951-960.

The senescence accelerated mouse-prone 8 (SAMP8) mouse model of Alzheimer's disease has a natural mutation leading to age-related increases in the amyloid-β protein precursor (AβPP) and amyloid-β (Aβ) in the brain, memory impairment, and deficits in Aβ removal from the brain. Previous studies show that centrally administered antisense oligonucleotide directed against AβPP can decrease AβPP expression and Aβ production in the brains of aged SAMP8 mice, and improve memory. The same antisense crosses the blood-brain barrier and reverses memory deficits when injected intravenously. Here, we give 6 μg of AβPP or control antisense 3 times over 2 week intervals to 12 month old SAMP8 mice. Object recognition test was done 48 hours later, followed by removal of whole brains for immunoblot analysis of AβPP, low-density lipoprotein-related protein-1 (LRP-1), p-glycoprotein (Pgp), receptor for advanced glycation endproducts (RAGE), or ELISA of soluble Aβ(40). Our results show that AβPP antisense completely reverses a 30% age-associated increase in AβPP signal (p < 0.05 versus untreated 4 month old SAMP8). Soluble Aβ(40) increased with age, but was not reversed by antisense. LRP-1 large and small subunits increased significantly with age (147.7%, p < 0.01 and 123.7%, p < 0.05 respectively), and AβPP antisense completely reversed these increases (p < 0.05). Pgp and RAGE were not significantly altered with age or antisense. Antisense also caused improvements in memory (p < 0.001). Together, these data support the therapeutic potential of AβPP antisense and show a unique association between AβPP and LRP-1 expression in the SAMP8 mouse.

RevDate: 2019-02-25
CmpDate: 2011-05-27

Anonymous (2011)

Fear of the yawning mother: a case study of misophonia.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 19(1):88.

RevDate: 2019-02-05
CmpDate: 2010-10-19

Kupniewska-Kozak A, Gospodarska E, M Dadlez (2010)

Intertwined structured and unstructured regions of exRAGE identified by monitoring hydrogen-deuterium exchange.

Journal of molecular biology, 403(1):52-65.

Receptor for advanced glycation end products (RAGE) is a multiligand receptor that is engaged in many pathological processes. Potentially beneficial modification of its activity requires sound knowledge of its structural properties. However, up to now, only the structures of its separated domains have been published or deposited in databases. In this work, we used hydrogen-deuterium exchange and mass spectrometry to gain insight into the structural properties of exRAGE (extracellular region of RAGE)--the full extracellular part of the protein. The present work indicates the common and disparate features of full exRAGE as compared to the structural models of its separate domains. The highlight of the present study is the contrasting behavior of the different regions of the protein, with the protected regions neighboring fully exposed parts especially in the N-terminal V domain.

RevDate: 2011-03-10
CmpDate: 2010-04-28

Collins N (2010)

Fear of the yawning mother: a case of misophonia.

Australasian psychiatry : bulletin of Royal Australian and New Zealand College of Psychiatrists, 18(1):71-72.

RevDate: 2010-02-01
CmpDate: 2010-03-19

Sztuka A, Pospiech L, Gawron W, et al (2010)

DPOAE in estimation of the function of the cochlea in tinnitus patients with normal hearing.

Auris, nasus, larynx, 37(1):55-60.

OBJECTIVE: The most probable place generating tinnitus in the auditory pathway is the outer hair cells (OHCs) inside the cochlea. Otoacoustic emissions are used to assess their activity. The objective of the investigation was to measure the features of distortion product otoacoustic emissions (DPOAE) in a group of tinnitus patients without hearing loss, estimate the diagnostic value of the parameters for the analysis of cochlear function in the patients, emphasizing those most useful in localizing tinnitus generators, and determine the hypothetical influence of hyperacusis and misophony on DPOAE parameters in tinnitus patients.

PATIENTS AND METHODS: The material consisted of 44 patients with tinnitus and without hearing loss. In the control group were 33 patients without tinnitus with the same state of hearing. The tinnitus patients were divided into three subgroups: those with hyperacusis, those with misophonia, and those with neither. After collecting medical history and performing clinical examination of all the patients, tonal and impedance audiometry, ABR, and discomfort level were evaluated. Then DPOAE were measured using three procedures. First the amplitudes of two points per octave were assessed, second the "fine structure" method with 16-20 points per octave (f2/f1=1.22, L1=L2=70 dB), and the third procedure included recording the growth function in three series for input tones of f2=2002, 4004, and 6006Hz (f2/f1=1.22) and L1=L2 levels increasing by increments of 5 dB in each series.

RESULTS AND CONCLUSIONS: Hyperacusis was found in 63% and misophonia in 10% of the tinnitus patients with no hearing loss. DPOAE amplitudes in recordings with two points per octave and the fine structure method are very valuable parameters for estimating cochlear function in tinnitus patients with normal hearing. Function growth rate cannot be the only parameter in measuring DPOAE in tinnitus patients, including subjects with hyperacusis and misophonia. The markedly higher DPOAE amplitudes in the group of tinnitus patients without hearing loss suggest that tinnitus may be caused by increased motility of the OHCs induced by decreasing efferent fiber activity, and not by OHC failure. Hyperacusis significantly increases the amplitude of DPOAE in tinnitus patients with no hearing loss.

RevDate: 2015-10-29
CmpDate: 2007-04-05

Sztuka A, Pośpiech L, Gawron W, et al (2006)

[DPOAE in tinnitus patients with cochlear hearing loss considering hyperacusis and misophonia].

Otolaryngologia polska = The Polish otolaryngology, 60(5):765-772.

UNLABELLED: The most probable place generating tinnitus in auditory pathway are outer hair cells (OHC) inside cochlea. To asses their activity otoacoustic emission is used. The goal of the investigation was estimation the features of otoemission DPOAE in groups with tinnitus patients with cochlear hearing loss, estimation of diagnostic value of DPOAE parameters for analysis of function of the cochlea in investigated patients emphasizing DPOAE parameters most useful in localizing tinnitus generators and estimation of hypothetic influence of hyperacusis and misophony on parameters of DPOAE in tinnitus patients with cochlear hearing loss. The material of the study were 42 tinnitus patients with cochlear hearing loss. In the control group there were 21 patients without tinnitus with the same type of hearing loss. Then tinnitus patients were divided into three subgroups--with hyperacusis, misophony and without both of them, based on audiologic findings.

METHOD: after taking view on tinnitus and physical examination in all the patients pure tone and impedance audiometry, supratreshold tests, ABR and audiometric average and discomfort level were evaluated. Then otoemission DPOAE was measured in three procedures. First the amplitudes of two points per octave were assessed, in second--"fine structure" method-- 16-20 points per octave (f2/f1 = 1.2, L1 = L2 = 70 dB). Third procedure included recording of growth rate function in three series for input tones of value f2 = 2002, 4004, 6006 Hz (f2/f1= 1.22) and levels L1=L2, growing by degrees of 5dB in each series.

RESULTS: DPOAE amplitudes in recording of 2 points per octave and fine structure method are very valuable parameters for estimation of cochlear function in tinnitus patients with cochlear hearing loss. Decreasing of DPOAE amplitudes in patients with cochlear hearing loss and tinnitus suggests significant role of OHC pathology, unbalanced by IHC injury in generation of tinnitus in patients with hearing loss of cochlear localization. DPOAE fine structure provides us the additional information about DPOAE amplitude recorded in two points per octave, spreading the amount of frequencies f2, where differences are noticed in comparison of two groups--tinnitus patients and control. Function growth rate cannot be the only parameter in estimation of DPOAE in tinnitus patients with cochlear hearing loss, also including subjects with hyperacusis and misophony. Hyperacusis has important influence on DPOAE amplitude, increases essentially amplitude of DPOAE in the examined group of tinnitus patients.

RevDate: 2006-06-12
CmpDate: 2006-12-04

Veale D (2006)

A compelling desire for deafness.

Journal of deaf studies and deaf education, 11(3):369-372.

A case is described of a patient who has a compelling and persistent desire to become deaf. She often kept cotton wool moistened with oil in her ears and was learning sign language. Living without sound appeared to be a severe form of avoidance behavior from hyperacusis and misophonia. She had a borderline personality disorder that was associated with a poor sense of self. Her desire to be deaf may be one aspect of gaining an identity for herself and to compensate for feeling like an alien and gaining acceptance in the Deaf community. Will a compelling desire for deafness ever become a recognized mental disorder one day for which hearing patients may be offered elective deafness after a period of assessment and living like a deaf person? Those working in the field of deafness should be aware that individuals may occasionally be seeking elective deafness or self-inflicting deafness to obtain a hearing aid.

RevDate: 2006-03-03
CmpDate: 2007-08-16

Jastreboff PJ, MM Jastreboff (2006)

Tinnitus retraining therapy: a different view on tinnitus.

ORL; journal for oto-rhino-laryngology and its related specialties, 68(1):23-9; discussion 29-30.

Tinnitus retraining therapy (TRT) is a method for treating tinnitus and decreased sound tolerance, based on the neurophysiological model of tinnitus. This model postulates involvement of the limbic and autonomic nervous systems in all cases of clinically significant tinnitus and points out the importance of both conscious and subconscious connections, which are governed by principles of conditioned reflexes. The treatments for tinnitus and misophonia are based on the concept of extinction of these reflexes, labeled as habituation. TRT aims at inducing changes in the mechanisms responsible for transferring signal (i.e., tinnitus, or external sound in the case of misophonia) from the auditory system to the limbic and autonomic nervous systems, and through this, remove signal-induced reactions without attempting to directly attenuate the tinnitus source or tinnitus/misophonia-evoked reactions. As such, TRT is effective for any type of tinnitus regardless of its etiology. TRT consists of: (1) counseling based on the neurophysiological model of tinnitus, and (2) sound therapy (with or without instrumentation). The main role of counseling is to reclassify tinnitus into the category of neutral stimuli. The role of sound therapy is to decrease the strength of the tinnitus signal. It is crucial to assess and treat tinnitus, decreased sound tolerance, and hearing loss simultaneously. Results from various groups have shown that TRT can be an effective method of treatment.

RevDate: 2019-09-14
CmpDate: 1997-08-14

Counter SA, Olofsson A, Grahn HF, et al (1997)

MRI acoustic noise: sound pressure and frequency analysis.

Journal of magnetic resonance imaging : JMRI, 7(3):606-611.

The large gradient coils used in MRI generate, simultaneously with the pulsed radiofrequency (RF) wave, acoustic noise of high intensity that has raised concern regarding hearing safety. The sound pressure levels (SPLs) and power spectra of MRI acoustic noise were measured at the position of the human head in the isocenter of five MRI systems and with 10 different pulse sequences used in clinical MR scanning. Each protocol, including magnetization-prepared rapid gradient echo (MP-RAGE; 113 dB SPL linear), fast gradient echo turbo (114 dB SPL linear), and spin echo T1/2 mm (117 dB SPL linear), was found to have the high SPLs, rapid pulse rates, amplitude-modulated pulse envelopes, and multipeaked spectra. Since thickness and SPL were inversely related, the T1-weighted images generated more intense acoustic noise than the proton-dense T2-weighted measures. The unfiltered linear peak values provided more accurate measurements of the SPL and spectral content of the MRI acoustic noise than the commonly used dB A-weighted scale, which filters out the predominant low frequency components. Fourier analysis revealed predominantly low frequency energy peaks ranging from .05 to approximately 1 kHz, with a steep high frequency cutoff for each pulse sequence. Ear protectors of known attenuation ratings are recommended for all patients during MRI testing.

RevDate: 2015-11-19
CmpDate: 1995-04-05

Burland JA (1994)

Splitting as a consequence of severe abuse in childhood.

The Psychiatric clinics of North America, 17(4):731-742.

Clinical data suggest that Kernberg's description of splitting as a defense mechanism is useful in conceptualizing the psychological consequences of abuse in childhood in certain patients. The splitting in these patients is similar to his description of splitting in borderline patients in that it compartmentalizes and sequesters certain overwhelming and painful ego states accompanying negative introjects of the betraying primary object and the betrayed self. These sequestered introjects, furthermore, act as automatons, generating behaviors that arbitrarily re-enact their content even though the patient remains consciously unaware of their historical meaning. Another consequence of the sequestration of these traumatic introjects is that their affects retain their initial power and primitive quality, unmodulated by the usual homogenizing process that is a part of the synthesis of part-object introjects into whole-object introjects; the sequestration, therefore, often painful in itself, must nevertheless be rigidly maintained lest traumatic anxiety in the face of overwhelming affects be re-experienced. Shengold calls the sequence of events that results in this brittle but stubborn painful constriction of the personality "soul murder." He borrowed the phrase from Freud who used it to refer to what Schreber had suffered at the hands of his sadistic father. That phrase--"soul murder"--may sound melodramatic, but it powerfully conveys what these patients communicate of their experience of themselves. As with Kernberg's patients, the defensive splitting serves to protect the positive introjects. These patients fear their negative introjects, even more than they feel uncomfortable about the split. They fear their desperate rage will destroy their love objects, and leave them feeling abandoned and hating themselves. As one of my patients put it: "I fear that my destructive anger will leave me all alone in a sea of rubble of my own making." In the transference, he feared destroying me and our positive bond. In these cases it would seem that the turning to splitting occurred at a later age than it does with Kernberg's borderline patients. His proposition is that the developmentally normal "splitting," related to the undifferentiation of the infantile ego, persists as a defensive splitting, perhaps as a consequence of a consistently derailed mother-child dialogue; whereas in my patients it would seem that the normal developmental splitting had waned as ego differentiation proceeded, but that in the face of overwhelming traumata at perhaps 3 or 4 years of age, the primitive defense was invoked regressively.(ABSTRACT TRUNCATED AT 400 WORDS)

RevDate: 2016-10-18
CmpDate: 1994-10-19

Graeff FG (1994)

Neuroanatomy and neurotransmitter regulation of defensive behaviors and related emotions in mammals.

Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas, 27(4):811-829.

1. There is suggestive evidence that the septo-hippocampal system and the amygdala are involved in risk assessment behavior, a response to potential threat possibly related to anxiety. In addition, experimental results have been reported implicating the medial hypothalamus in coordinated escape, while the periaqueductal gray matter (PAG) and the median raphe nucleus serotonergic projection to the hippocampus seem to mediate freezing. The latter defensive behaviors are evoked by distal danger stimuli and may be viewed as manifestations of fear. Finally, there is a sound body of evidence indicating that the PAG commands primitive fight or flight reactions elicited by proximal threat, acute pain or asphyxia. These defense reactions may be related to rage and panic, respectively. In contrast, the lateral septal area and the bed nucleus of the stria terminalis have been shown to exert tonic inhibitory influence on defense. 2. Experimental evidence indicates that gamma-aminobutyric acid (GABA) tonically inhibits defensive behavior in the amygdala, hypothalamus and the PAG, an effect opposed by excitatory amino acids. Among monoamines, serotonin (5-HT) has been suggested to facilitate anxiety in the amygdala while inhibiting panic in the PAG. The role of noradrenaline in defense is less clear, although hypotheses implicating the locus coeruleus in anxiety and panic have been suggested. Among peptides, corticotropin-releasing factor (CRF) acting as a central neurotransmitter is thought to mediate behavioral and physiological effects of acute stress, while opioid peptides have been shown to inhibit defense in the amygdala and in the dorsal PAG. Finally, acetylcholine seems to facilitate defensive behavior in the hypothalamus and the PAG.

RevDate: 2006-11-15
CmpDate: 1985-05-01

Oniani TN, NG Nachkebiia (1985)

[Effect of electrocoagulation of the septum on the behavior and memory of the cat].

Zhurnal vysshei nervnoi deiatelnosti imeni I P Pavlova, 35(1):17-24.

Lesion effects of various areas of the septum on general behaviour, learning and memory were studied in cats. It appeared that electrocoagulation of the medial septum alone leading to the disappearance of the hippocampal theta rhythm does not result in the development of the septal syndrome signs; does not disturb the normal structure of the sleep-wakefulness cycle; does not delay the elaboration of instrumental alimentary reflexes (to approach two feeders) or their extinction, but does entirely disturb the delayed responses to conditioned stimuli. In cases when lesion involves also the lateral septum, it produces the development of all signs of the septal syndrome (hyperemotionality, hyperactivity, rage, hyperphagia, etc.), disturbance of the normal structure of the sleep-wakefulness cycle, delay of both the elaboration and extinction of instrumental alimentary reflexes, disturbance of pre-elaborated conditioned reactions with sound discrimination, entire disturbance of conditioned delayed responses. On the basis of these data, the specific significance of hippocampal theta-rhythm in the organization of learning and memory is rejected, and a more important role is attributed to the descending regulatory influence exerted by the hippocampus and other archipaleocortical structures on the activating and motivatiogenic structures of mesodiencephalon.

RevDate: 2019-12-10
CmpDate: 1984-06-20

Watkins JG, HH Watkins (1984)

Hazards to the therapist in the treatment of multiple personalities.

The Psychiatric clinics of North America, 7(1):111-119.

It is vitally important that the therapist be cognizant of the dangers inherent in treating some patients with multiple personality disorder. The authors offer sound, detailed advice on every facet of the clinician's interaction with the patient--from keeping on good terms with each ego state to guarding against physical violence and sexual seduction.

RevDate: 2017-02-14
CmpDate: 1982-01-09

Rudolph J (1981)

Aggression in the service of the ego and the self.

Journal of the American Psychoanalytic Association, 29(3):559-579.

With Jay, as with other patients in psychoanalysis, the pathological has shed light on the normal. First, during symbiosis, physical illness markedly disrupted his sense of well-being. He did not develop sufficient reserves of narcissism and instead built up a superabundance of hostile aggression. In the differentiation subphase of separation-individuation, his aggression could not be used constructively in the service of differentiation. In the practicing subphase, still immobilized, he was unable to effect even physical separation, let alone psychic separation. These subphase inadequacies, of course, influenced the character of his rapprochement subphase. With functioning already impaired by earlier subphase experience, continuing emotional pain and frustration affected his ability to negotiate the rapprochement subphase. Missing for Jay were the contributions that an adequate rapprochement subphase furnishes the organizing function of the ego. Not only did the rapprochement subphase fail to correct the inadequacies of the earlier subphases, the failures of rapprochement represented the last and final blow to the development of even a semblance of self- and object constancy, so that borderline pathology was the result. We can follow the progress made by the analysand by his own statements: Early: "I don't have a reserve of self-love to carry me through." Later, "I'm at a stage when I feel I can organize things without great anxiety. Plan things. Going ahead and slipping back sometimes too, but feeling confident." It has been the aim of this paper to show how the most malignant narcissistic rage has been converted into constructive aggression. Despite the greatest intrinsic and environmental odds, this patient, because of his good endowment, and aided by psychoanalysis, succeeded in gradually converting destructive aggression into constructive aggression by amalgamating it with more and more libido. Along with this, he also developed a sound secondary narcissism, so that his prognosis at eighteen years of age is optimistic.

RevDate: 2019-12-10
CmpDate: 1979-11-28

Lomarev MP (1979)

[Conditioned reactions elaborated on the basis of reinforcement by hypothalamic stimulation].

Zhurnal vysshei nervnoi deiatelnosti imeni I P Pavlova, 29(4):715-721.

The possibility of elaboration of conditioned emotional reactions on the basis of the stimulation of the hypothalamus, was studied in cats. Reinforcement of a sound (500 c/s) by electrical stimulation of the hypothalamus, which produced reactions of undirected rage, of fear with avoidance, of food search, led to the formation of a conditioned passive defensive reaction, analogous to that based on pain reinforcement. Elaboration of conditioned emotional reactions were blocked by switching off of the sensorimotor cortex by cold. A conclusion is made that during stimulation of the hypothalamus, the state of fear serves as the reinforcing factor and that the sensorimotor neocortical areas participate in the estimation of biological significance of the conditioned signal.

RevDate: 2009-11-11
CmpDate: 1975-05-10

Schwarz A (1974)

Sound production and associated behavior in a cichlid fish, Cichlasoma centrarchus. I. Male-male interactions.

Zeitschrift fur Tierpsychologie, 35(2):147-156.

RJR Experience and Expertise


Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.


Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.


Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.


Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.


While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.


Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.


Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.


Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.

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