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Let’s Not Confuse Misophonia and Sensory Processing Disorder – Part 2
Let’s Not Confuse Misophonia and Sensory Processing Disorder – Part 1
August 2, 2016Personal Story – Developing Misophonia
August 14, 2016Let’s Not Confuse Misophonia and Sensory Processing Disorder – Part 2
In my last post I described several differences between SPD and misophonia that makes them distinctly different conditions. But the biggest difference is between SPD stimuli and misophonia trigger stimuli. The two conditions have, by the basic definitions of the disorders, mutually exclusive trigger stimuli.
Auditory Trigger Stimuli: SPD triggers are 
volume based. Loud sounds such as a vacuum cleaner, toilet, loud toy, fireworks, etc. Misophonia triggers are content related and soft sounds. Examples include the sound of someone breathing, father chewing, soft sound of music through walls, typing, sniffing, etc. Therefore, auditory triggers for SPD and misophonia are almost exactly the opposite. SPD triggers are loud and do not depend on the content or source of the sound. Misophonia triggers are soft sounds which must have specific content/meaning. This alone indicates that SPD and misophonia are defined as distinctively different conditions.
Visual Trigger Stimuli: As with auditory triggers, visual triggers are based on the intensity of the trigger for SPD vs. the specific image for misophonia. SPD triggers include bright lights and fluorescent lights. Misophonia visual triggers include such things as seeing a person chew gum, bouncing their leg, or pointing with one finger. Again, misophonia triggers are low intensity with specific meaning/content/context, and SPD triggers are high intensity.
Tactile Trigger Stimuli: SPD sufferers are often very sensitive to touch, such as tight shoes, clothes tags, being touched by another person, or certain textures. Tactile sensitivity is very common with SPD, but tactile triggers are almost non-existent for misophonia.
It is just my guess that the individuals who are claiming that misophonia is a form of SPD are well-meaning individuals who are trying to get more research and public awareness for SPD. I think they truly believe these conditions are related. There was even a peer review journal article by academic researchers (Sensory Intolerance: Latent Structure and Psychopathologic Correlates by Taylor, et al., 2014), which called misophonia “auditory sensory intolerance” and suggested it should be a form of SPD. But in their SPD study survey, participants were asked to rate their tactile intolerance by responding to the statement, “I am very bothered by certain tactile sensations, such as clothing textures or tightness; substances that feel sticky, greasy, or wet, or activities like haircuts or cutting my nails.” Auditory intolerance was assessed by the item, “I am very bothered by certain auditory sensations, such as the sound of alarms, sirens, appliances, or background noises like people talking or ticking clocks.” Clearly these measures would not be used for assessment of severity of misophonia.
When we reviewed this journal article while preparing the manuscript of Misophonia Phenomenology, Impact, and Clinical Correlates, we noted that the Taylor article “investigated sensory intolerance to tactile stimuli and to loud or constant auditory stimuli.” We concluded that “this definition is inconsistent with the description of typical trigger sounds in the misophonia literature (Edelstein et al., 2013; Jasterboff & Jasterboff, 2014; Schröder et al., 2013).
Comparing misophonia and SPD is like comparing influenza and malaria. Symptomatically, both cause high fever and make you feel horrible. But one is a viral infection and the other bacterial. The treatment is completely different.
My heart goes out to anyone who has either of these conditions, and especially to those who are suffering from both. But please, for the sake of both SPD and misophonia research, management, and treatment, let’s be clear that they are distinctively different conditions. Misophonia can learn from SPD research, and SPD can learn from misophonia research, but I do not consider them to be forms of a larger, similar condition of sensory intolerance. I wish success and progress to those researching SPD, and we (and others) will push forward with research on misophonia. May we all be successful in our valiant efforts to help those with either or both of these conditions.
11 Comments
I mean… I have both SPD AND misophonia/misokinesia/misotactilia.
Maybe many people who have misophonia don’t also experience the tactile side of things, but I know I’m one, at least. There are others, too. I’ve spoken to them. I’m also autistic, as are most of the other people who experience this ugly miso-trifecta.
Just to make a note for those curious. And, also ’cause the statement that people with misphonia don’t ever experience similar issues with tactile situations. I ABSOLUTELY do. My husband bouncing his leg next to me, enough that I can feel the brush of his jeans against my leg, or the shifting of his chair…makes me insane. And, the misokinesia aspect makes it way worse. Seeing it AND feeling it make me feel physically ill, my skin crawls, I snap in irritability. “JUST…please. Stop that, please.”
It exists, okay?
First, it is more common to consider misophonia a trigger with auditory, visual, and tactile triggers (and others). What you described seems to be misophonia, and not SPD. SPD is generally considered a genetic condition, which does not require experience to develop, where misophonia triggers develop through experience with the stimulus. But as you said, tactile misophonia triggers do exist, asyou described. I agree.
Haha, I’m only four years late to this reply. But, yeah. I’m not sure how misophonia is developed if it’s not based out of sensitivity of some sort. It’s not rational, it’s not something that can be controlled — it simply is, and one must simply deal. We can only control our outward reaction to it and, sometimes?…we can’t even control that. I remember being in a therapist’s office and there was a string or something hanging from the a/c vent. It kept blowing and it was erratic, unpredictable, and always in my peripheral unless I actively looked down the whole time. The therapist could tell I was agitated and asked me about it. I’d been spending all of my spoons trying to keep it together and speak, but that was all it took for me to explode. “MAYBE YOU SHOULD CHECK TO SEE IF THERE ARE VISUAL DISTRACTIONS LIKE THAT STRING UP THERE THAT’S DRIVING ME INSANE, PLEASE AND THANK YOU.”
I didn’t even manage to stay in the office after that. I stormed out and never went back. It was bad. Thankfully, I don’t usually have reactions that outwardly strong, but good lord does it test me.
Very interesting article – thanks
I’m probably very late replying to this article, not sure because I can’t see the publication date on mobile. But I just want to point out that tactile triggers are definitely existent for some people with misophonia. This still seems to support your point overall though, because people with SPD presumably experience increased sensitivity to all types of touch, whereas people with misophonia (or ‘misotactilia’ as one person dubbed it) are bothered by specific sensations like repeated touches, soft sensations or unexpected contact with a stranger.
Hi Tom! Are you aware of any research that discusses misophonia being a genetic condition? I have it and so do two out of three of my siblings. My nephew also just started showing signs and we’re all searching for what to do… Thanks!
There is no research on the genetic vs. environmental contributrions of misophonia. Remember that families share both genes and the environment. Children that are may be sensitive to the feelings of others, or may be strong-willed. Anxiety and depression also seem to contribute to the likelihood that a person will develop misophonia. All of these have both genetic and environmental factors.
Please note, however, that it takes experience with a stimulus to develop a misophonic response to that stimulus.
I still feel they are related if a person has both then it’s because they are connected and it’s neurological. You talk about the spd over stimulation but what about under responsive…..so spd is not loud for under responsive only for over responsive. Maybe a person has one or both. Misophonia is soft sounds yes but altogether it’s a sensitivity to sound. And a distraction.
I know there are people who disagree with me on this point. Everyone is allowed to have their views. The biggest difference to me is that (from all my experience, research, and reading research of others) misophonia is a conditioned (learned) response disorder, and SPD is mostly a genetically caused condition. I suggest you read the “Personal Story – Developing Misophonia”. Misophonia is very different that SPD, but if a person has both SPD and misophonia, I see that they seem to be related.
I think you can keep drilling down and find differences that are distinct from one another. I have been driven to extremes because of misophoniaa since early childhood Auditory trigger stimulae and tactile issues are increasing in their clam our. I have immense trouble living with people and animals. I find repeated movements from others get to me. I have been diagnosed as OCD and it’s a relief finding that all these are real and acknowledged by some. Ideally I need to live alone and in silence. To cope I try to switch off but it turns me silent and requires serious will power to stay contained. Temper flashes are ever present but mostly under control. I have read your articles and understand the differences ad you define them, however notwithstanding that the stimulae may be different the underlying result is very similar and aggravated by the multiple sources. There must be a connection within that responds similarly.
Very clear and well stated.