MERGE: Misophonia and emotion regulation in a guided experience sampling study

BACKGROUND: Increased sensitivity and reactivity to contextualized sound triggers is the defining feature of misophonia. Emotion regulation (ER) fluctuates at a momentary level, is a malleable misophonia risk factor, and characterizes maladaptive cognitive, affective, and behavioral responses to aversive stimuli in individuals with misophonia. As misophonia symptom expression varies due to context (e.g., sound exposure), it is likely that misophonia also fluctuates momentarily. Understanding real-time associations between momentary ER and misophonia symptoms would help 1) better characterize misophonia and 2) inform an understanding of misophonia symptoms, symptom trajectories, and tailored interventions; yet, experience sampling studies of misophonia are limited. METHOD: Interval- and event-contingent ecological momentary assessment methods measured misophonia, ER strategies (techniques to manage emotions), and ER abilities (capacity to manage emotions) over a 30-day period three times per day to capture ER and misophonia during and outside of triggers. Sixty individuals screening positive for misophonia were recruited, and participants completed ∼3000 momentary surveys. RESULTS: Intraclass correlation coefficients suggested between 23-52% of individual variability in momentary misophonia, ER abilities, and ER strategies was due to momentary-level changes. In multilevel models, within- and between-individual domains of ER strategies and abilities were related to misophonia both during and not during triggers, controlling for: 1) time since most recent trigger and 2) trigger anticipation for individuals not endorsing a current trigger. DISCUSSION: Results suggest meaningful individual variability in misophonia, ER strategies, and ER abilities. Findings will inform follow-on just-in-time adaptive interventions targeting momentary misophonia variability.