Association for Behavior Analysis International

The Association for Behavior Analysis International® (ABAI) is a nonprofit membership organization with the mission to contribute to the well-being of society by developing, enhancing, and supporting the growth and vitality of the science of behavior analysis through research, education, and practice.


44th Annual Convention; San Diego, CA; 2018

Event Details

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Symposium #129
Misophonia: A Conditioned Respondent Behavior Disorder
Saturday, May 26, 2018
5:00 PM–5:50 PM
Manchester Grand Hyatt, Coronado Ballroom AB
Area: CBM/PCH; Domain: Translational
Chair: Thomas H. Dozier (Misophonia Institute; Misophonia Treatment Institute)
Discussant: Patrick C. Friman (Boys Town)
CE Instructor: Thomas H. Dozier, M.S.

Misophonia is an understudied but relatively common respondent behavior condition, the effects of which range from annoying to debilitating. Misophonia cannot be classified with DSM or ICD-criteria. Misophonia is known as a condition where commonly occurring innocuous stimuli (e.g. chewing sound) elicit anger and accompanying physiological responses which function as motivating operations for overt aggression and escape. Recent basic research on misophonia as a behavioral phenomenon has identified an immediate physical response (typically a muscle flinch) elicited by misophonic stimuli, which is unique for each person. Although there are some common misophonic stimuli, each person has a unique set of stimuli, which often includes auditory and visual stimuli, but can be any sensory modality. Misophonia is similar to general sensory sensitivity which is common with autism, but the management and intervention for each are quite different. Misophonia was first identified and named by audiologists and has been considered a hearing disorder. Recently misophonia has come to be viewed as an anger disorder and the focus of psychiatrists, psychologists, and neuroscience. Behaviorally, misophonia is a classically conditioned physical respondent phenomenon, and it may be more appropriate to view misophonia as a conditioned behavioral disorder.

Instruction Level: Basic
Keyword(s): classical conditioning, counterconditioning, misophonia, respondent behavior
Target Audience:

Behavior analysts, other professional practitioners, and educators

Learning Objectives: 1. Identify two initial respondent behaviors of the misophonic response. 2. Identify the difference between misophonia and sensory over-responsivity. 3. Identify one intervention to reduce the initial physical response of misophonia.
Phenomenology of Misophonia: A Respondent Physical-Emotional Response Disorder
(Applied Research)
MICHELLE LOPEZ (Alliant International University, San Diego; Misophonia Institute), Thomas H. Dozier (Misophonia Treatment Institute; Misophonia Institute), Kate L. Morrison (Utah State University), Leighton Grampp (Alliant International University, San Diego)
Abstract: Two basic research studies on the phenomenology of misophonia were conducted to document the initial physical response to misophonic stimuli previously reported in cases studies. All participants were developmentally typical adults. One study exposed participants to weak auditory and visual misophonic stimuli, and they reported immediate physical sensations and emotions. All reported immediate physical responses to at least one of their stimuli. The second study used electromyography (EMG) and direct observation of the immediate physical response to misophonic stimuli in three participants. EMG responses were recorded for two participants and an observed physical response (tic-like or muscle flinch) was consistent but different in each participants. Response latency for the EMG measured response was several hundred milliseconds, indicating the responses were elicited reflexes and not general physiological arousal. Overall, results show that misophonic auditory and visual trigger stimuli elicit physical responses in addition to emotional responses. Therefore misophonia should be considered a condition in which otherwise innocuous stimuli elicit specific physical responses unique to the individual and strong emotional responses.

Counterconditioning Intervention for Misophonia

(Service Delivery)
THOMAS H. DOZIER (Misophonia Institute; Misophonia Treatment Institute)

Misophonia behavior patterns often impair multiple life domains, and once developed may persist indefinitely. Two adult participants with misophonia and no comorbid conditions were treated using a adapted counterconditioning intervention which provided a continual positive stimulus and an intermittent, low intensity misophonic stimulus. During the intervention, the participants experienced a physical reflex consisting of a skeletal muscle contraction, which gradually extinguished. Both participants had a large reduction in their misophonia impairment, and maintenance and generalization of the treatment effect. One intervention was a multiple baseline design, providing some empirical support of a functional relation. The intervention for one participant included live and recorded audio sessions. The second intervention utilized an automated stimulus delivery system (an iPhone app) which gave the participant real-time control of the counterconditioning parameters. These cases provide initial support for a counterconditioning treatment for misophonia, and they show that misophonia may include a physical respondent to misophonic stimuli.




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Modifed by Eddie Soh