Real-time emotional responses to trigger sounds in misophonia: An ecological momentary assessment study

Although misophonia is characterized by intense negative emotional responses, the temporal dynamics of these experiences in naturalistic settings are poorly understood. This study utilized ecological momentary assessment (EMA) to characterize the real-time emotional experiences of adults with misophonia outside of laboratory settings. Forty adults with misophonia completed EMA surveys for 10 days. Results indicated that trigger sounds elicited significant elevations in negative emotions, particularly irritability and anger, compared to non-trigger periods. Although most emotional responses subsided substantially within 1 h, recovery patterns and the intensity of reactivity (e.g., hostility, disgust) varied considerably across individuals. Greater emotional reactivity was associated with higher baseline negative affect, greater misophonia severity, and co-occurring psychopathology. To our knowledge, this is the first EMA study to detail real-time emotional patterns in misophonia. Findings provide novel insights into the moment-to-moment experience of the disorder and highlight key individual differences that may inform personalized interventions targeting emotional reactivity.