INTRODUCTION:Misophonia is a disorder in which certain sounds (known as triggers) cause a negative and often overwhelming emotional response. Common triggers include human-produced and repetative sounds such as chewing and tapping. The extent to which this response is modulated by task focus - such as whether a sound is attended or not - is largely unknown. Similarly, the extent to which these responses are specific to triggers or found, to some degree, for a wider range of stimuli is unclear. METHODS:In this study, two groups (misophonics, controls) engage in a visuo-motor task during the presence of irrelevant sounds (misophonic triggers, unpleasant sounds, neutral sounds) whilst the effects of distraction (poorer performance in the visuo-motor task) and psychophysiological responsiveness (heart and skin conductance) are measured. RESULTS:The results show that misophonic triggers elicit more distraction than other sounds (for people with misophonia), but this is set against a backdrop of an overall tendency for people with misophonia to be more distracted by all sounds. We found no differences in skin conductance, but significant group differences in heart rate and heart rate variability across both sounds and silence. CONCLUSIONS:These findings suggest that misophonia is linked to trait-like differences in attentional style and emotional regulation.

INTRODUCTION:Misophonia is a newly recognised sound sensitivity disorder with clinically significant symptoms affecting up to 18% of the population. It is characterised by extreme negative reactions to specific sounds which are often repetitive and generated by the human oral-nasal tract (eg, sniffing and eating sounds). Although misophonia currently has no standard treatment, research suggests that transcutaneous auricular vagus nerve stimulation (taVNS) holds promise therapeutically. This study aims to investigate both the effects of 4 weeks taVNS (compared with sham) on misophonia and related symptoms as well as its underlying neurophysiological mechanisms. To our knowledge, this is the first trial on taVNS in misophonia. METHODS AND ANALYSIS:This is a single-centre double-blind sham-controlled trial in which 60 participants with clinically significant misophonia are randomly allocated in a 1:1 ratio to receive taVNS or sham stimulation. The intervention will be self-administered over 4 weeks (two times per day for 30 mins each). The primary efficacy outcome is self-reported misophonia severity with secondary outcomes, including mental health and audiological symptoms. In addition, all participants will undergo preintervention and postintervention testing, including MRI and physiology to investigate neurophysiological mechanisms underlying taVNS effects. ETHICS AND DISSEMINATION:The study has been approved by the Brighton and Sussex Medical School ethics board (ER/GLP28/4). Results will be submitted for publication in peer-reviewed journals. Data will be anonymised and made available for sharing after completion of the study. TRIAL REGISTRATION NUMBER:This trial is registered in ISRCTN; ISRCTN79500062.

Empathy is multifaceted, involving sharing and understanding the emotional and mental states of others. This study investigated the factor structure of the English-language version of the Empathy Quotient for Children (EQ-C; Auyeung et al., 2009), an empathy measure previously well-validated only as a global scale. We aimed to compare children with and without educational differences (i.e., Special Educational Needs Disabilities, SEND), and explored associations between empathy and sensory sensitivities across the whole sample. Based on responses from 680 parents, we analysed data from English-speaking children aged 6–12 years, via a series of factor analyses using polychoric correlation matrices and bass-ackward analysis. Empathy domain profiling for children with SEND status (versus children without SEND status) was investigated as group differences (t tests). Sensory sensitivities were examined via associations (correlation) and net effects (regression). We identified an optimal four-factor solution (emotional empathy, social-cognitive empathy, negative interactions, antisocial behaviours), and robust higher order one-, two- and three-factor models. Children with SEND status displayed empathy differences across all four empathy domains (all p < .001). Children with greater sensory sensitivities displayed significant differences for social-cognitive empathy and negative interactions only (both p < .001). We demonstrated the potential utility of the English-language EQ-C as a domain-level measure of empathy. Our paper discusses how the domains align with traditional emotional and cognitive dimensions in adults and cross-culturally. Our empathy profiles can be used alongside global empathy measures for different groups of children, with and without educational differences and sensory sensitivities.

[This corrects the article DOI: 10.1016/j.lanepe.2024.101038.].

This study examined the concentrations of excitatory and inhibitory neurotransmitters (glutamate and GABA respectively) in two regions of interest (auditory and insular cortices) and a control region (visual cortex) to test the hypothesis that decreased sound tolerance would be linked to increased cortical excitability (more glutamate and/or less GABA). Misophonia (negative emotional responses to specific sounds) and hyperacusis (finding sounds atypically loud) were separately considered and key comorbidities excluded (tinnitus, migraine, autism). A MEGA-PRESS sequence was used for auditory cortex to optimise the detection of GABA. We found no significant group differences in neurotransmitter in any region and pre-registered Bayesian analyses suggested that these are sensitive null results. These findings argue against the idea that decreased sound tolerances are linked to neurochemically-driven differences in excitation/inhibition.

Misophonia is a sound sensitivity disorder characterised by strong negative reactions to specific sounds (e.g., chewing). Previous studies have suggested a link between social judgements and misophonia, in that misophonia arises not simply from auditory/acoustic processing but also from how an individual interprets the meaning of trigger sounds within their social world. In our study, we experimentally manipulated our participants’ social perceptions of various people making sounds, to explore its impact on misophonia. In reverse, we also examined how sounds influenced misophonics’ social evaluations of those same individuals, revealing a bidirectional relationship between sound intolerance and social cognition. We found that social judgements affected the aversiveness of trigger sounds, since sounds were judged as more aversive if they came from people who had been depicted as socially negative. We also found that—when no sounds were present—social judgements made by people with misophonia were entirely typical (i.e., no different from controls). Finally, misophonics perceived people as less pleasant if they produced noisy eating sounds, and these differences were especially apparent if prior perceptions of those people were positive. Together, our findings suggest that unpleasant sounds are harder to tolerate for misophonics when they come from unlikeable individuals, and that even highly likeable people can be judged more harshly if they produce trigger sounds.

Background Children whose parents have anxiety problems are at increased risk of developing anxiety themselves. Parenting behaviors are a contributing factor to intergenerational transmission. Interventions which seek to limit anxiogenic parenting behaviors have shown potential in reducing anxiety in offspring but are not widely accessible. This prevention trial aimed to establish the effectiveness of an unguided modular online intervention for highly anxious parents in preventing anxiety in their children. Methods A parallel group, block-randomised controlled trial of unblinded participants in a 1:1 ratio was conducted to compare efficacy of the online course compared to a no-intervention control. The intervention comprised 8 modules, of approximately 20 min each, and participants progressed through the course at their own pace. The study was conducted entirely online with a self-referred UK-based community sample of parents (child 2-11 years) with substantial anxiety. The primary outcome measure was change in parent-reported child anxiety, as measured by the Spence Children's Anxiety Scale-Parent Report (SCAS-P) or Spence Pre-School Anxiety Scale-Parent Report (Preschool SCAS). Secondary outcomes were child internalising, externalising, and attentional symptoms (Pediatric Symptom Checklist), and parent anxiety (SCARED-Adult). Analyses using complete case analysis following intention to treat principles investigated intervention effects at 6 months (primary analysis) and additionally at 9 to 25-months' follow-up. Trial registration: ClinicalTrials.GovNCT04755933, https://clinicaltrials.gov/ct2/show/NCT04755933. Findings 1811 participants (intervention = 900; control = 911; 92.7% (1677/1810) female; 85.3% (1535/1800) White-British; 66.8% (1201/1799) university educated). Participant retention (based on primary outcome completion) at T2 (6-months post consent) was 67.6% overall (n = 1224) and substantially lower in the intervention arm 57.3% ((516/900) control = 77.8% (708/910)). Child anxiety was lower in the intervention group compared to control at 6-month follow-up (adjusted effect size estimate -0.15 (95% CI: -0.23 to -0.08, p < 0.001). There was very strong evidence that those in the intervention arm had lowered child anxiety (standardised SCAS score) compared to the control arm, with an effect size (Cohen's d) of -0.16 (95% CI: -0.23 to -0.08, p < 0.001). The difference in standardised Spence Child Anxiety Scale score between the arms was -0.15 standard deviations. On the original scales for SCAS-P (0-114) and Preschool SCAS (0-112), this corresponds to a reduction of -2.38 (95% CI: -3.59 to -1.16) and -2.68 (95% CI: -4.05 to -1.31), respectively. No reported harms. Interpretation A clinically unsupported online intervention designed for parents with high levels of anxiety is effective in reducing anxiety and internalising symptoms in their children, and also anxiety in parents. Given the low resource intensity of this intervention, and the positive effects reported here, these findings suggest it has promise in limiting the intergenerational transmission of severe anxiety.

OBJECTIVE:It is thought that decreased sound tolerance can be subdivided into distinct types including misophonia (involving specific trigger sounds) and hyperacusis (broader in profile). However, there are few established methods for differentially assessing these disorders and this is complicated by the fact that some measures (e.g. the HQ Hyperacusis Questionnaire) were developed before the concept of misophonia was accepted. DESIGN/STUDY SAMPLE:We took a group of N = 119 participants with misophonia (varying in severity) and asked them about the presence of hyperacusis (based on a scoping review definition). RESULTS:Scores for some items on the HQ were correlated with scores for misophonia severity (e.g. social impact of sound) and others with scores for hyperacusis (e.g. ability to concentrate in noise). Similarly, some trigger sounds were more indicative of hyperacusis (e.g. dishes being stacked) and others were more indicative of misophonia in the absence of hyperacusis (e.g. chewing). CONCLUSIONS:These double dissociations provide compelling evidence for separable forms of sound intolerance. Moreover, our research suggests that a single-item question about hyperacusis is associated with other characteristics of hyperacusis, even when assessed 18 months later.

Phenomenological control is the ability to alter experience according to goals, measured by responses to imaginative suggestion. The capacity to create vivid mental imagery has been thought to contribute to generation of experiences following suggestions during hypnosis, but evidence is mixed. Moreover, no study has yet investigated this link outside of hypnosis. Across two studies (n = 639 and n = 66), we tested the relationship between imagery vividness and both non-hypnotic and hypnotic imaginative suggestion scales. Our samples included, for the first time, people lacking voluntary imagery (aphantasics). We also assessed this relationship following commonly used approaches to studying aphantasia (direct recruitment of self-reported aphantasics), versus those designed to minimize demand characteristics effects. We observed a weak positive relationship between imagery vividness and phenomenological control, with aphantasics being slightly lower in this trait than non-aphantasics. However, this effect was exaggerated among self-reported aphantasics, who scored lower on phenomenological control than samples experiencing imagery as well as aphantasics assessed via single-blind procedure. Our results have been certified as computationally reproducible by an independent statistician. We conclude that, while imagery may contribute to responding to imaginative suggestions, it is crucial to follow single-blind recruitment to reduce the effect of demand characteristics.

The contemporary definition of mental imagery is characterized by two aspects: a sensory representation that resembles, but does not result from, perception, and an associated subjective experience. Neuroimaging demonstrated imagery-related sensory representations in primary visual cortex (V1) that show striking parallels to perception. However, it remains unclear whether these representations always reflect subjective experience or if they can be dissociated from it. We addressed this question by comparing sensory representations and subjective imagery among visualizers and aphantasics, the latter with an impaired ability to experience imagery. Importantly, to test for the presence of sensory representations independently of the ability to generate imagery on demand, we examined both spontaneous and voluntary imagery forms. Using multivariate fMRI, we tested for decodable sensory representations in V1 and subjective visual imagery reports that occurred either spontaneously (during passive listening of evocative sounds) or in response to the instruction to voluntarily generate imagery of the sound content (always while blindfolded inside the scanner). Among aphantasics, V1 decoding of sound content was at chance during voluntary imagery, and lower than in visualizers, but it succeeded during passive listening, despite them reporting no imagery. In contrast, in visualizers, decoding accuracy in V1 was greater in voluntary than spontaneous imagery (while being positively associated with the reported vividness of both imagery types). Finally, for both conditions, decoding in precuneus was successful in visualizers but at chance for aphantasics. Together, our findings show that V1 representations can be dissociated from subjective imagery, while implicating a key role of precuneus in the latter.

BackgroundThe use of a second informant (co-respondent) is a common method of identifying potential bias in outcome data (e.g., parent-report child outcomes). There is, however, limited evidence regarding methods of increasing response rates from co-respondents. The use of financial incentives is associated with higher levels of engagement and follow-up data collection in online surveys. This study investigated whether financial incentives paid to index participants in an online trial of a parenting-focused intervention, would lead to higher levels of co-respondent data collection.MethodsA study within a trial (SWAT) using a parallel group RCT design. Participants in the host study (an RCT of an online intervention) were randomised into one of two SWAT arms: received/did not receive a £15 voucher when referred co-respondent completed baseline measures. Primary outcome was completion (No/Yes) of Spence Children's Anxiety Scale (SCAS or SCAS-Pre) at baseline. Additional analysis explored impact of incentives on data quality.ResultsIntention to treat analysis of 899 parents (183 co-respondents) in the no-incentive arm, and 911 parents (199 co-respondents) in incentive arm. Nomination of co-respondents was similar between incentive arms. The RR for the incentive arm compared to the no incentive arm was 1.13 (95% CI: 0.91 to 1.41, p = 0.264) indicating that incentives did not impact completion of outcomes by consented co-respondents. There were no indications of different data quality between arms.DiscussionThe finding that payment of financial incentives to index participant does not lead to greater levels of co-respondent outcome completion suggests that careful consideration should be made before allocating resources in this way in future trials.Trial registrationThe host study was registered at Study Record | ClinicalTrials.gov and the SWAT study was registered in the SWAT Store | The Northern Ireland Network for Trials Methodology Research (qub.ac.uk): SWAT number 143: Filetoupload,1099612,en.pdf (qub.ac.uk).

Synaesthesia has often been linked to an artistic or creative temperament, but the nature of this link (and, hence, the possible underpinning mechanisms) are poorly understood. This study focusses primarily on people with synaesthesia who have visual experiences, including color, that are induced by music. We determine how this impacts their musical preferences and musical sophistication using previously validated self-report measures and contrast them against non-synaesthetes and synaesthetes with non-musical types. Our data show that people with music-color synaesthesia gravitate toward certain genres (e.g., Reflective and Complex) and show more active engagement with music relative to controls and other synaesthetes. However, synaesthesia as a whole is also linked to greater musical sophistication (e.g., perceptual abilities). A second study examines in detail the nature of associations from musical notes to colors in synaesthetes relative to non-synaesthetes. Synaesthetes have a distinctive way of associating colors with notes: They are more consistent over time, show a more sensitive pitch-luminance correspondence, and have a distinctive color palette (e.g., more browns, fewer greens). These indicative features can be used to determine the presence of this form of synaesthesia.

There is considerable interest in understanding the developmental origins and health implications of individual differences in brain structure and function. In this pre-registered study we demonstrate that a hidden subgroup within the general population-people with synesthesia (e.g. who "hear" colors)-show a distinctive behavioral phenotype and wide-ranging differences in brain structure and function. We assess the performance of 13 different brain-based biomarkers (structural and functional MRI) for classifying synesthetes against general population samples, using machine learning models. The features in these models were derived from subject-specific parcellations of the cortex using the Human Connectome Project approach. All biomarkers performed above chance with intracortical myelin being a particularly strong predictor that has not been implicated in synesthesia before. Resting state data show widespread changes in the functional connectome (including less hub-based connectivity). These brain-based individual differences within the neurotypical population can be as large as those that differentiate neurotypical from clinical brain states.

Misophonia is a sound sensitivity disorder characterized by a strong aversion to specific sounds (e.g., chewing). Here we present the Sussex Misophonia Scale for Adults (SMS-Adult), within an online open-access portal, with automated scoring and results that can be shared ethically with users and professionals. Receiver operator characteristics show our questionnaire to be "excellent" and "good-to-excellent" at classifying misophonia, both when dividing our n = 501 adult participants by recruitment stream (self-declared misophonics vs. general population), and again when dividing them with by a prior measure of misophonia (as misophonics vs. non-misophonics). Factor analyses identified a five-factor structure in our 39 Likert-type items, and these were Feelings/Isolation, Life consequences, Intersocial reactivity, Avoidance/Repulsion, and Pain. Our measure also elicits misophonia triggers, each rated for their commonness in misophonia. We offer our open-access online tool for wider use (www.misophonia-hub.org), embedded within a well-stocked library of resources for misophonics, researchers, and clinicians.

ABSTRACTAutistic traits are found throughout the general population, but their link to creative attributes has received little attention in childhood populations. In adults, autistic traits are linked to both creative benefits and disadvantages, moderated by the autistic trait and the creative domain under investigation. The current study investigates the link between autistic traits and creative attributes (creative personality traits, creative talent, creative artistic choices) in children aged 10–14 years. Autistic traits were measured using the Adolescent‐AQ, both globally (AQ‐Total) and for individual subscales (AQ‐Attention to detail, AQ‐Imagination, and “AQ‐Core”, i.e., combining AQ‐Social skills, AQ‐Attention switching, AQ‐Communication). Using child and parent reports, data from 149 children revealed an association between autistic traits and creative personality traits (both positive and negative) while also showing a (weaker) relationship with creative artistic choices. Global and core autistic symptoms negatively predicted creative personality traits. At the same time, AQ‐Imagination predicted lower creative attributes across nearly all creative domains. Finally, and in contrast, AQ‐Attention to detail positively predicted a number of creative attributes (i.e., creative personality traits, creative talent). Our results show how autistic traits map to a range of creative attributes, across children in the general population.

Several studies have investigated the relationship between autism-linked traits and creativity in adults across the general population, but far fewer in developmental populations. Here we examined how creativity in children is linked to the autism-linked traits of empathy (i.e. ability to understand and engage with another's emotions and feelings) and sensory sensitivities (i.e. over/under-responding to incoming sensory stimuli). Our study collected data from 659 children aged 6-12, treating autism-linked traits as global and domain level features. We collected two sets of creativity data, focussing on a personality trait associated with creativity (Openness to experience; with two facets of Ideas and Aesthetics) and engagement in creative activities (with two facets of Performance and Art). After controlling for age and gender, our global measure of empathy predicted all four creativity outcomes, especially Ideas (strongly linked to curiosity, inventiveness and idea generation). Similarly, children with greater Emotional empathy displayed more creative across all four creativity outcomes, particularly creative activities (Performance, Art). Social-cognitive empathy was associated with both Openness facets, particularly Ideas. Finally, we found that sensory sensitivities predicted several trivially-size effects. Our study contributes to a broader understanding of how autism-linked traits in the general population interact with features of creativity in children.

Autonomous Sensory Meridian Response (ASMR) is a multisensory experience most often associated with feelings of relaxation and altered consciousness, elicited by stimuli which include whispering, repetitive movements, and close personal attention. Since 2015, ASMR research has grown rapidly, spanning disciplines from neuroscience to media studies but lacking a collaborative or interdisciplinary approach. To build a cohesive and connected structure for ASMR research moving forwards, a modified Delphi study was conducted with ASMR experts, practitioners, community members, and researchers from various disciplines. Ninety-eight participants provided 451 suggestions for ASMR research priorities which were condensed into 13 key areas: (1) Definition, conceptual clarification, and measurement of ASMR; (2) Origins and development of ASMR; (3) Neurophysiology of ASMR; (4) Understanding ASMR triggers; (5) Factors affecting the likelihood of experiencing/eliciting ASMR; (6) ASMR and individual/cultural differences; (7) ASMR and the senses; (8) ASMR and social intimacy; (9) Positive and negative consequences of ASMR in the general population; (10) Therapeutic applications of ASMR in clinical contexts; (11) Effects of long-term ASMR use; (12) ASMR platforms and technology; (13) ASMR community, culture, and practice. These were voted on by 70% of the initial participant pool using best/worst scaling methods. The resulting agenda provides a clear map for ASMR research to enable new and existing researchers to orient themselves towards important questions for the field and to inspire interdisciplinary collaborations.