Expanding What a Trigger Sound Is in Misophonia Research

Dr. Heather Hansen

Source: Used with permission of Heather Hansen

What makes a misophonia researcher stand out? The best researchers are both creative and rigorous. They understand multiple facets of misophonia and view the disorder in the context of the whole body of misophonia research. They are empathic toward the individuals they study, and their families. Dr. Heather Hansen is all of these things, and it doesn't hurt that she also has misophonia! Read along to find out about her game-changing findings across three misophonia studies.

Jennifer Brout: Thank you for agreeing to do this interview, Heather. I am really excited to hear about your work, but first would you tell me a little bit about yourself? Why are you interested in researching misophonia?

Heather Hansen: Thanks…I am a misophonia sufferer myself. I discovered it in my teen years, but at the time it didn’t yet have a name. Of course, I thought I was the only one dealing with it.

JB: Tell me about how you felt when you first heard the name “misophonia?”

HH: It was around 2012 and misophonia was on a 20/20 news segment. This was the first time I learned that my experiences had a name. I came to understand that there was very little research on the disorder, and I thought well…then I will do it myself!

JB: That is very impressive!

HH: I did my undergraduate in psychobiology at UCLA and my graduate training at Ohio State. At the time there were some published misophonia papers, but I did have to convince my advisors that misophonia was a real disorder worthy of study.

JB: So, tell me a little bit about your research! Tell me about the 2021 paper that was published in the Journal of Clinical Psychology. To me, this paper is extremely important because across so many studies trigger sounds have been exclusively described as only mouth and nasal sounds (emanating from people). Your paper debunked that.

HH: Yes, oral/nasal sounds had always been the focus of research, but I felt that reactivity to other sounds deserved investigation. So, I surveyed participants as to whether human‐produced oral/nasal sounds were more aversive than human‐produced non-oral/nasal sounds and non‐human/nature sounds. As it turns out, sounds from each category were rated as significantly aversive.

JB: Heather, would you tell me more specifically about some of the other sounds you found were triggering?

HH: Sure. Sounds like typing or pen-clicking – things you can “blame” a person for doing but don’t involve the mouth or nose. Also sounds that come from animals, like a dog lapping water, or sounds like water dripping or ice floating in a glass – all more aversive in misophonia.

JB: Very interesting! Then in your next study, you added neural evidence for non-orofacial triggers in misophonia. Please tell me about that.

HH: We worked off a prior study [1]that showed increased connectivity in misophonia between both auditory cortex [part of the brain where auditory information is processed] and the insula [part of the brain that helps orient attention and is important to interpreting emotion] with parts of motor cortex thought to control orofacial movement. In our study, we found that auditory and insula connectivity extended to motor areas responsible for finger movement, too.

JB: So, the greater connectivity is not specific to the area associated with orofacial movement, but instead extends to other areas of the motor cortex?

HH: Yes, exactly. And not only other areas of motor cortex, but also areas of sensory cortex, too.

JB: So, what is the main takeaway from this study?

HH: I think explaining misophonia as a hyperconnectivity of orofacial motor cortex is incomplete. If we’re going to figure out the neural markers of misophonia, we need to keep looking at non-orofacial regions and non-motor regions, too.

JB: So, this leads me to your latest research! Tell me what you did and what you found.

HH: Well, we know from several other studies as well as anecdotal reporting that when people with misophonia are exposed to triggers, attention and cognition is negatively impacted. I wanted to test this more stringently, and incorporate social judgement, too. Using a control group and a misophonia group, we showed participants faces that were paired with auditory stimuli (trigger sounds, control sounds, and quiet) while completing a simple cognitive task (which was to identify gender), after which participants also rated their level of sound discomfort. Next, we showed the participants the same faces along with new ones and asked them to tell us whether they remembered the face and how likeable they found the face.

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JB: I see. Please go on.

HH: The participants with misophonia reported higher levels of discomfort for both oral and non-oral trigger sounds, they were slower to perform the original cognitive task (identifying gender) when trigger sounds were playing, and here is the most interesting part, they rated the faces they remembered as being paired with trigger sounds as less likeable than controls did.

JB: So, this supports that cognition is impaired when those with misophonia are faced with triggers, including possibly facets of attention and memory.

HH: Yes, it’s evidence that cognition may be impaired, but also demonstrates that social judgement is negatively impacted by trigger sounds, too.

JB: Would you say a little bit about how this study informs future research?

HH: This study highlights individual differences in the experience of misophonia – both in the specific sounds that are rated as aversive (which is why we encourage individualized approaches to trigger categories in future research) and in memory performance, with some individuals remembering faces paired with trigger sounds better and others worse. Does this mean different subtypes of misophonia exist? Stay tuned!

JB: I certainly will! Heather, thank you so very much for the important work you are doing. I understand that recently you have also become Director of the Misophonia Research Network at SoQuiet. Would you tell me some of your plans/goals?

HH: Absolutely! I’m honored to step into this role. My goal is to continue to create a space for researchers to connect with other misophonia professionals, initiate collaborations, troubleshoot problems, share resources, and ultimately advance the field so we can all better understand misophonia.

JB: Thank you again! I look forward to your future work!

[1] In the Motor Basis of Misophonia (Kumar Et al. 2021) researchers found greater connectivity between both the auditory and visual cortex with the ventral premotor cortex (responsible for orofacial movements) at rest and during sound perception, and stronger activation of the orofacial motor area in response to trigger sounds.