Selective Sound Sensitivity Syndrome

Selective Sound Sensitivity Syndrome is also known as misophonia or sound-rage. It is a disorder of decreased tolerance to specific sounds or their associated stimuli, or cues. These cues, known as "triggers", are experienced as unpleasant or distressing and tend to evoke strong negative emotional, physiological, and behavioral responses that are not seen in most other people.

Negative reactions to these trigger sounds range from annoyance to anger, with possible activation of the fight-or-flight response. The responses do not seem to be elicited by the loudness of the sound, but rather by its specific pattern or meaning to the hearer. Triggers are commonly repetitive stimuli and are primarily, but not exclusively, related to the human body, such as chewing, eating, smacking lips, slurping, coughing, throat clearing, sniffing, and swallowing.

Once a trigger stimulus is detected, people with Selective Sound Sensitivity Syndrome may have difficulty distracting themselves from the stimulus, and may experience suffering, distress, and/or impairment in social, occupational, or academic functioning.

The expression of symptoms varies, as does the severity, which ranges from mild (anxiety, discomfort, and/or disgust) to severe (rage, anger, hatred, panic, fear, and/or emotional distress). Some people with Selective Sound Sensitivity Syndrome are aware that their reactions triggers are disproportionate to the circumstances.

Symptoms are typically first observed in childhood or early adolescence. Selective Sound Sensitivity Syndrome is probably a symptomatic manifestation of an underlying (other) psychiatric disorder, including mood disorders, anxiety disorders, ADHD, OCD, depressive disorders, and autism[1][2]. Its mechanism is also not yet fully understood, but it appears that it may be caused by a dysfunction of the central nervous system in the brain.

In 2022, clinical and scientific leaders convened to create a consensus definition of Selective Sound Sensitivity Syndrome agreeing that it is a disorder of decreased tolerance to specific sounds and their associated stimuli[3].

Health care providers generally try to help people cope with misophonia by recognizing what the person is experiencing and working on coping strategies.

[1] Cavanna, Seri: Misophonia: current perspectives in Neuropsychiatric Disease and Treatment – 2015. See here.
[2] Guzick et al: Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia in Journal of Affective Disorders – 2023. See here.
[3] Swedo et al: Consensus Definition of Misophonia: A Delphi Study in Frontiers in Neuroscience – 2022. See here.