Transdiagnostic and clinical predictors of longitudinal misophonia symptoms.

Introduction: Anxiety sensitivity (AS) and distress tolerance (DT) are emotional-vulnerability factors driving emotion dysregulation. AS and DT may amplify misophonia. Research examining transdiagnostic factors predicting misophonia is largely cross-sectional. We examined relations between AS, DT, and longitudinal misophonia symptoms, adjusting for clinical variables. Methods: Fifty-eight individuals recruited from soQuiet endorsing clinical misophonia symptoms completed baseline and daily surveys 3x daily for 30 days. Results: Bivariate analyses suggested baseline AS was associated with elevated longitudinal misophonia symptoms during and not during triggers, while baseline DT was associated with higher misophonia symptoms during triggers. Baseline AS, momentary emotion dysregulation, and baseline misophonia were predictors of longitudinal misophonia during triggers, adjusting for momentary emotion dysregulation, baseline misophonia, and baseline obsessions and compulsions. An alpha correction suggested an attenuated AS effect. Null effects for DT may be explained by analyses supporting emotion dysregulation as a mediator of the relation between DT and misophonia. Effects of obsessive-compulsive symptoms were null. Discussion: Results inform longitudinal relations between transdiagnostic factors and misophonia. A predominant limitation is sample homogeneity. Misophonia symptom fluctuations appear contextualized, likely impacted by environmental and emotional-vulnerability factors. Results inform ongoing advancements to misophonia assessment and, pending further investigation, clinical interventions targeting malleable transdiagnostic factors.