(PS9-59) Characterization of Misophonia Compared with Clinical Emotion Dysregulation: Racial Differences in Physiological and Self-reported Measures

Misophonia is characterized by intense emotional reactivity to repetitive sounds, such as chewing or tapping. While prior research has linked misophonia to emotional dysregulation, the role of demographic factors, particularly race, in shaping misophonia severity and physiological responses remains understudied. This study examined differences in misophonia severity, physiological reactivity, and emotion regulation between White and Non-White individuals, as well as between those with misophonia and individuals with emotion dyregulation.

Two studies were conducted. Study 1 assessed misophonia severity in 116 participants (86 with misophonia, 30 with emotion regulation deficits; 76.5% White) using the Misophonia Questionnaire (MQ) and the impairment subscale of Duke Misophonia Questionnaire (DMQ). Study 2 examined physiological and emotion regulation differences in 58 participants (28 with misophonia, 30 clinical adults with high emotion dysregulation; 75.4% White), including high-frequency heart rate variability (HFHRV) and skin conductance level (SCL) before, during, and after a stressful task; as well as self-reported emotion regulation, Emotion Regulation Questionnaire (ERQ) at intake visit. Analyses included independent and Welch’s t-tests to compare misophonia severity, physiological responses, and emotion regulation across racial and study arms. Linear regression models examined race and emotion regulation strategies as predictors of physiological outcomes, with moderation analyses examining whether race influences the relationship between emotion regulation strategies and autonomic reactivity.

Study 1 found no significant racial differences in MQ symptoms subscale scores (M_white = 8.5 vs. M_non-white = 6.5, p = 0.11) and misophonia impairment (M_white = 21.4 vs. M_non-white = 16.7, p = 0.23). In Study 2, the regression analyses revealed that race significantly predicted arousal as measured using SCL (p = 0.03) at baseline, but not in other variables. Moderation analysis showed that race significantly moderated the relationship between emotional reappraisal and HFHRV during a task involving listening to aversive sounds, 40% of which were misophonic (p = 0.04). Comparisons between misophonia and the clinical control group showed no significant differences in physiological reactivity during the stressful task or self-reported emotion regulation.

While race and emotion regulation may interact to shape physiological responses, misophonia severity and autonomic reactivity were not strongly differentiated by race or diagnostic group. Given the overrepresentation of White adults in this study, larger studies with better representation should be conducted to examine racial differences in misophonia. Future research should explore how stress, cultural factors, and individual differences in emotional processing contribute to variability in misophonia, guiding equitable interventions that address diverse needs.