Relationships of misophonia with reinforcement sensitivity theory systems, cognitive emotion regulation strategies and perfectionism

Misophonia is a disorder characterized by decreased tolerance to specific sounds (e.g. sounds of eating) typically produced by other people, and may negatively affect individuals' lives in numerous domains. However, it is underexplored and not included in psychiatric diagnostic classification systems. Identifying the associated traits appears to be crucial for gaining insight into the underlying mechanisms of the aforementioned disorder. In this study, the relationship between misophonia and reinforcement sensitivity theory systems, cognitive emotion regulation strategies, and perfectionism were examined. Accordingly, the Misophonia Questionnaire, Reinforcement Sensitivity Questionnaire, Short Almost Perfect Scale and Cognitive Emotion Regulation Questionnaire were used. Misophonia levels that can be considered clinically significant were detected in 22% of the participants (N=322). Moreover, it was observed that the level of misophonia was higher in women than in men and in those with a history of psychological disturbances requiring treatment than in those without a history of psychological disturbances. Positive correlations were found between misophonia and behavioral inhibition, flight and freeze responses which are components of the fight-flight-freeze system, standards and discrepancy dimensions of perfectionism, maladaptive cognitive emotion regulation strategies (self-blame, blaming others, rumination, catastrophizing) and some adaptive cognitive emotion regulation strategies (refocus on planning, acceptance). Furthermore, it was observed that maladaptive perfectionists had a higher levels of misophonia than both adaptive perfectionists and non-perfectionists. When the variables of gender and history of psychological disturbance were controlled, behavioral inhibition and discrepancy (representing the maladaptive side of perfectionism) were found to be significant predictors of misophonia. Keywords: misophonia, behavioral inhibition, fight-flight-freeze, maladaptive perfectionism, cognitive emotion regulation