A qualitative study exploring early experiences of misophonia through firsthand perspectives.

Introduction: Misophonia is characterized by highly aversive affective, physiological, and behavioral responses to specific auditory and related cues. Although research on misophonia has increased in recent years, relatively little is known about onset, course, and maintenance of this disorder. The present study explores early experiences of misophonia through firsthand perspectives with the goal of constructing themes to reflect patterns related to symptom onset, progression, coping, and perceived causal or contextual factors. Methods: Adults residing in the United States who identified as having misophonia completed an online survey that included demographic questions, the Duke Misophonia Questionnaire (DMQ), and a series of open-ended questions about early experiences with misophonia. Responses from 50 participants who completed the survey were analyzed using reflexive thematic analysis to generate patterns of meaning across narratives. Results: A total of seven themes were developed: 1) Concealment, 2) Psychological Distress, 3) Course Variability, 4) Heterogeneity of Misophonic Cues, 5) Coping Mechanisms and Management Strategies, 6) Barriers to Coping, and 7) Theories of Causality. Discussion: Findings highlight the complex and heterogeneous nature of early experiences and are consistent with a biopsychosocial understanding of misophonia in which contextual and individual factors may shape its development and course.