Misophonia Symptoms Severity is Attributed to Impaired Flexibility and Heightened Rumination

Abstract Misophonia is a disorder involving sensitivity to certain sounds and related stimuli. Here, we explore the relationship between misophonia and affective flexibility, which describes cognitive shifting abilities in the face of emotion-evoking stimuli. Previous evidence suggests impaired subjective cognitive flexibility in misophonia, but this relationship has not been confirmed behaviourally or in emotionally-salient contexts. The secondary aim of this study is to test the potential association between misophonia and cognitive flexibility, building upon findings from previous research. The third objective is to examine the relationship between misophonia and rumination, a maladaptive cognitive process characterized by repetitive negative thinking and linked to both cognitive and affective inflexibility. One hundred and forty participants completed the recently developed Memory and Affective Flexibility Task (MAFT), designed to assess affective flexibility, as well as a battery of self-report measures to evaluate misophonia severity, cognitive flexibility and rumination. Results suggested an inverse relationship between affective flexibility as measured by switch accuracy, but not reaction time, and misophonia severity. Cognitive flexibility was also inversely associated with misophonia severity, but notably did not attribute to task-based affective flexibility, suggesting two independent constructs both involved in misophonia manifestation. Rumination associated positively with misophonia severity and inversely with cognitive flexibility, but not affective flexibility. Taken together, these findings highlight a unique cognitive profile of misophonia, characterized by rigidity at the psychological level through cognitive inflexibility and rumination, as well as at the executive-function level in terms of affective switching difficulties.