User:Myfyrwraigbangor/sandbox

Mechanisms
Little has been proven to be behind the mechanisms of misophonia, however recent research has highlighted multiple possible explanations. Participants in one study displayed heightened skin conductance responses to auditory stimuli when compared to the typically developed control group. This suggests that misophonia as a disorder produces numerous distinct autonomic effects not seen in the typical population.

Misophonia and tinnitus have both been proposed to be associated with a hyperconnectivity, or an enhanced version of the functional links between the limbic system and the auditory system. In other words, the connections between the auditory system and the limbic system are too strong. It is believed that both the peripheral (outer) and central parts of the auditory system are involved .The symptoms displayed by people with misophonia can consist of, or include, increased blood pressure, heart rate, heightened body temperature, sweaty palms, or a feeling of fullness in the nose to name but a few. More severe symptoms include physical pain, difficulty breathing, and sleep and digestion. These symptoms are all characteristics associated with an overstimulation of the individual’s autonomic nervous system (ANS), as is seen in anxiety and panic disorders. Misophonic responses also are reported to be worse when the individual is in a situation from which they feel they cannot get away, such as school, car journeys (and some forms of public transport; planes, trains), and sometimes at home, especially if the individual is younger. This supports the stance that misophonia produces similar responses to anxiety and panic disorders. Another indication that misophonia is associated with the ANS is that some participants reported that they felt that caffeine intensified their reactions towards their triggers, and alcohol reduced their reactions to the same triggers.

Diagnosis
Due to the recentness of the emergence of misophonia as its own disorder, there is very little proven research on the diagnosis of misophonia, and therefore no agreement on how practitioners should diagnose it. Pure misophonia has been found to cause discomfort at 30-120 decibels using a loudness discomfort level (LDL) test. This range is too broad for any definitive diagnosis to be able to be drawn from LDL. Although some argue that misophonia should be a classified as a new psychiatric disorder, when analysing a typical population rather than a sample of psychiatric patients, only 2.2% of the typical sample showed signs of any psychiatric disorder.

Management
As aforementioned, misophonia potentially has physiological underpinning mechanisms. However, there is some research to indicate that it also has an element of a disorder of emotion processing. This fits in with one of the current methods of managing misophonia; cognitive behavioural therapy (CBT). As some sufferers show a potent attributional component in that they show stronger reactions towards those that are closest to them, while if strangers are producing the trigger sounds, the response is not as severe.

Case Study
One case study attempted to treat one participant named Liz with a three-component version of CBT. The researcher aimed to disrupt Liz’s pattern of reacting negatively to triggers, to change her coping strategies, and to decrease her stress levels after a trigger. The first component was to address Liz’s reactions, and this used a cognitive method. Utilising a behavioural component, they hoped to address the coping strategies; to change them from avoidance and lashing out to more helpful strategies. Finally, the physiological was used to try and recalibrate how her body reacted to the triggers.

At the end of the therapy, Liz still found any chewing sounds unpleasant, however the triggers that once made her react with anger were gone, and her social and work life were no longer impaired. After four months, Liz went for a check-up test and no signs of relapse were present. Although this is promising research, it is only one participant, and further research is necessary to expand on the knowledge on the topic.