Positive Attributable Visual Sources Attenuate the Impact of Trigger Sounds in Misophonia

Misophonia is characterized by strong negative reactions to everyday sounds, such as chewing, slurping or breathing, that can have negative consequences for daily life. Here, we investigated the role of visual stimuli in modulating misophonic reactions. We recruited 26 misophonics and 31 healthy controls and presented them with 26 sound-swapped videos: 13 trigger sounds paired with the 13 Original Video Sources (OVS) and with 13 Positive Attributable Visual Sources (PAVS). Our results show that PAVS stimuli significantly increase the pleasantness and reduce the intensity of bodily sensations associated with trigger sounds in both the misophonia and control groups. Importantly, people with misophonia experienced a larger reduction of bodily sensations compared to the control participants. An analysis of self-reported bodily sensation descriptions revealed that PAVS-paired sounds led participants to use significantly fewer words pertaining to body parts compared to the OVS-paired sounds. We also found that participants who scored higher on the Duke Misophonia Questionnaire (DMQ) symptom severity scale had higher auditory imagery scores, yet visual imagery was not associated with the DMQ. Overall, our results show that the negative impact of misophonic trigger sounds can be attenuated by presenting them alongside PAVSs.