Consensus Definition of Misophonia: A Delphi Study

Susan E Swedo, David M Baguley, Damiaan Denys, Laura J Dixon, Mercede Erfanian, Alessandra Fioretti, Pawel J Jastreboff, Sukhbinder Kumar, M Zachary Rosenthal, Romke Rouw, Daniela Schiller, Julia Simner, Eric A Storch, Steven Taylor, Kathy R Vander Werff, Cara M Altimus, Sylvina M Raver, Susan E Swedo, David M Baguley, Damiaan Denys, Laura J Dixon, Mercede Erfanian, Alessandra Fioretti, Pawel J Jastreboff, Sukhbinder Kumar, M Zachary Rosenthal, Romke Rouw, Daniela Schiller, Julia Simner, Eric A Storch, Steven Taylor, Kathy R Vander Werff, Cara M Altimus, Sylvina M Raver

Abstract

Misophonia is a disorder of decreased tolerance to specific sounds or their associated stimuli that has been characterized using different language and methodologies. The absence of a common understanding or foundational definition of misophonia hinders progress in research to understand the disorder and develop effective treatments for individuals suffering from misophonia. From June 2020 through January 2021, the authors conducted a study to determine whether a committee of experts with diverse expertise related to misophonia could develop a consensus definition of misophonia. An expert committee used a modified Delphi method to evaluate candidate definitional statements that were identified through a systematic review of the published literature. Over four rounds of iterative voting, revision, and exclusion, the committee made decisions to include, exclude, or revise these statements in the definition based on the currently available scientific and clinical evidence. A definitional statement was included in the final definition only after reaching consensus at 80% or more of the committee agreeing with its premise and phrasing. The results of this rigorous consensus-building process were compiled into a final definition of misophonia that is presented here. This definition will serve as an important step to bring cohesion to the growing field of researchers and clinicians who seek to better understand and support individuals experiencing misophonia.

Keywords: consensus building; emotional dysregulation; medical definitions; misophonia; misophonia triggers; sensory sensitivities; sound sensitivity (auditory sensitivity).

Conflict of interest statement

The authors declare that this study received funding from the REAM Foundation (grant number 7894 to the Milken Institute Center for Strategic Philanthropy). The funder was not involved in the study design, collection, analysis, interpretation of data, the writing of this article, or the decision to submit it for publication.

Copyright © 2022 Swedo, Baguley, Denys, Dixon, Erfanian, Fioretti, Jastreboff, Kumar, Rosenthal, Rouw, Schiller, Simner, Storch, Taylor, Werff, Altimus and Raver.

Figures

FIGURE 1
FIGURE 1
A modified Delphi process was employed to develop a misophonia consensus definition. In four rounds of voting, a Misophonia Consensus Committee (MCC), comprised of subject-matter experts, evaluated potential definitional statements about misophonia. Each round of voting differed in its intended purpose, what information the Committee relied on to make its determinations, and/or the format of voting.
FIGURE 2
FIGURE 2
Methodology and results of a modified Delphi method to develop a consensus definition of misophonia. Through four rounds of evaluation and voting on potential definitional statements that were extracted from the published scientific literature, a committee of experts developed a consensus definition of misophonia.

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