Questions That often Arise Regarding Misophonia
Nature versus Nurture?
The distinction nature versus nurture (which is inexorably entwined with the “conditioned versus constitutional paradigm”) is a dated model in genetics. The interaction of genes and the environment is known to be more amorphous and less distinguishable than previously thought. The field of epigenetics demonstrates that genes may be turned on or off according to environmental factors. This idea renders for example, "age of onset" as a way to distinguish between disorders as less important.
People Noises versus Repetitive Noises
An important issue arising out of this relatively rigid use of the nature versus nurture idea relates to conflation between types of sounds that may cause the emotional and behavioral response noted in misophonia with the people from whom these sounds emanate. As the Jastreboff’s (2001) originally suggested, misophonia sufferers aversively react to pattern-based sounds. While many of these sounds are person-oriented (e.g. chewing, coughing, sneezing, etc.) many are not (e.g. pencil tapping, basketball bouncing, typing on a keyboard, etc.). The Jastreboff’s hypothesized that negative cognitive association between these particular types of sounds and the misophonia sufferer had occurred, and could possibly be retrained. Yet, they did not suggest that only “people” or “body noises” were the cause of the aversive reactivity.
This idea has become somewhat confused in the emerging literature. We do not yet know the physical or acoustic basis for the sounds people with misophonia respond to, nor do we know if all people with misophonia react to the same sounds or how many of the same sounds people react to, etc.
One very important distinction that the Jastreboff's made is between the physical pain people with hyperacusis experience upon exposure to loud sounds versus the autonomic nervous system arousal those with misophonia experience upon presentation of repetitive, pattern-based auditory stimuli.