Abstract
Misophonia has been characterized as intense negative reactions to specific trigger sounds (often orofacial sounds like chewing, sniffling, or slurping; Swedo et al., 2021). However, recent research suggests high-level, contextual, and multisensory factors are also involved (Kumar et al., 2021; Edelstein et al., 2020). We recently demonstrated that neurotypicals’ negative reactions to aversive sounds (e.g., nails scratching a chalkboard) are attenuated when the sounds are synced with positive attributable visual sources (PAVS; e.g. tearing a piece of paper; Samermit, Saal, & Davidenko, 2019). To assess whether this effect generalizes to misophonic triggers, we produced 39 12-second video clips depicting common triggers (original video sources, OVS) and constructed a corresponding set of PAVS synchronized with those trigger sounds. Based on Experiment 1 (N=34), we selected the 20 PAVS with the best audiovisual match ratings. In Experiment 2 (N=102), participants judged the pleasantness/unpleasantness of these 20 trigger sounds paired with both PAVS and OVS contexts (counterbalanced, pseudo-randomized order), after which they completed the Misophonia Questionnaire (Wu et al., 2014). We found a robust attenuating effect of PAVS videos on the unpleasantness of trigger sounds: sounds were rated as significantly more pleasant when paired with PAVS (M=2.87) than OVS videos (M=2.34; difference: 0.52; paired t(101)=14.9, <0.00001), replicating Samermit et al. (2019) with misophonic trigger sounds. Moreover, this attenuating effect was positively correlated with self-reported severity of misophonia symptoms (r=0.28, p=0.004); individuals with higher misophonia severity (7+ on a 15-point scale) saw a larger PAVS-OVS difference (M=0.66) compared to those with lower severity (M=0.47; unpaired t(100)=2.62, p=0.01). Our results demonstrate the power of visual stimuli to modulate misophonic responses and suggest a promising avenue for therapeutic research.