Exacerbation of paranoia-like thoughts following exposure to common misophonia trigger sounds

Paranoia-like thoughts refer to heightened suspicions and unfounded beliefs about being watched or persecuted by others. Recent research has found a significant correlation between misophonia symptoms, a form of decreased sound tolerance, and paranoia-like thoughts, both of which are linked to heightened negative emotions in clinical and non-clinical populations. Notably, it has been observed that misophonia may also be associated with the tendency to attribute hostile intent to those producing triggering sounds, a feature consistent with paranoid ideation (i.e., perceptions of intentional harm). However, existing research is based on correlational data, limiting causal inference. Therefore, an online study involving a non-clinical sample (N = 487) employed an experimental approach to examine the relationship between misophonia symptoms, negative emotional response, and paranoia-like thoughts. Participants were randomly assigned to one of four task conditions, each related to exposure to different stimulus types: orofacial human-produced sounds, non-human sounds, sounds without visual context, or visuals devoid of sound. The results of mixed model ANOVA and mediation analysis revealed that exposure to common misophonia trigger sounds with a human-related visual context slightly, but not significantly, raised the levels of paranoia-like thoughts. However, it did lead to a significant increase in negative emotions, which, in turn, proved to be a significant mediator of an increase in paranoia-like thoughts. Conversely, exposure to non-human sounds or to only audio/visual stimuli either decreased both negative emotions and paranoia-like thoughts or showed no significant change. This emphasized the role of context and the involvement of negative emotional response to human-made sounds in amplifying paranoia-like thoughts. Importantly, this effect was observed in individuals who do not meet the provisional diagnostic criteria for misophonia, suggesting that symptoms of misophonia may extend beyond clinical diagnoses, with milder manifestations potentially being present within the general population.