The proximal and distal causes of misophonia

In this viewpoint article, I describe two ways-not mutually exclusive-in which the causes of misophonia can be understood. These draw on the distinction between proximal and distal causation. The proximal causes of misophonia relate to the brain circuitry which underpin misophonic reactions (e.g., stimulus evaluation leading to negative affective response). The distal causes seek to explain why this atypical reaction (/atypical brain circuitry) develops in some people and not others. For proximal causes there is a tight correspondence between the definition and mechanisms of misophonia, whereas for distal causes this definition-mechanism coupling is likely to be far looser (e.g., transdiagnostic vulnerability factors that are not specific to misophonia).