(PS9-65) Intolerance of Uncertainty is Associated with Severity of Misophonia Symptoms

Abstract Text:

Background: Misophonia is a recently characterized disorder of decreased tolerance to sounds, known as triggers, that result in affective (e.g., anger, disgust), physiological (e.g., increased tension, increased heart rate), and behavioral (e.g., avoidance, agitation) responses (Swedo et al., 2022). Although studies have started to identify psychological processes that contribute to misophonia, much remains unknown. Intolerance of uncertainty is a transdiagnostic mechanism central to many disorders that commonly co-occur with misophonia such as obsessive-compulsive personality disorder, generalized anxiety disorder, and obsessive-compulsive disorder (McEvoy et al., 2019; Rosenthal et al., 2022). Intolerance of uncertainty increases susceptibility to negative affect due to increased arousal and need for predictability (Einstein, 2014), which is particularly relevant as individuals with misophonia experience high rigidity and need for control (Cowan et al., 2024; McKay et al., 2018). Currently, research has yet to investigate intolerance of uncertainty in individuals with misophonia. We hypothesized that individuals with misophonia would report higher intolerance of uncertainty compared to subclinical and non-clinical participants. We also hypothesized that higher intolerance of uncertainty would be associated with greater misophonia severity, after accounting for relevant covariates.

Method: Undergraduate students at a southeast university (N = 1,719; 75.1% female) completed self-report measures. Misophonia status (i.e., clinical, subclinical, nonclinical) was determined by the Duke-Vanderbilt Misophonia Screening Questionnaire (DVMSQ; Williams et al., 2023). The misophonia group (n = 103; 6%) met all diagnostic criteria, the subclinical group (n = 144; 8.4%) met all criteria except functional impairment, and the nonclinical group did not meet any criteria for misophonia (n = 1466; 85.6%). Participants also completed self-report questionnaires to measure symptoms of depression, anxiety and stress (DASS-21; Lovibond & Lovibond, 1995) and intolerance of certainty (IUS-SF; Carleton et al., 2007).

Results: As expected, intolerance of uncertainty was highest among individuals with misophonia (M = 38.17, SD = 10.44) compared to those with subclinical (M = 34.66, SD = 10.00) and nonclinical groups (M = 30.60; SD = 9.89; F[2, 1697] = 36.14, p < .001). Next, a hierarchical linear regression analysis was conducted (Total Model R2 = .14, p < .001) and revealed intolerance of uncertainty accounted for an additional 5.7% of the variance in misophonia symptom severity, after accounting for depression, anxiety, and stress symptoms.

Discussion: This study expands knowledge on misophonia by showing that greater intolerance of uncertainty was uniquely associated with worse misophonia. Additional research is needed to fully understand the role of intolerance of uncertainty in the maintenance and treatment of misophonia. To date, there are few studies evaluating treatments for misophonia; however, treatment targeting intolerance of uncertainty has shown large therapeutic effects in anxiety-related disorders (Miller & McGuire, 2023), suggesting this may be a viable direction for future misophonia work.