Early maladaptive schemas and misophonia: Incremental contributions beyond personality traits and general psychopathology

Misophonia is a sound sensitivity disorder characterized by heightened emotional, physiological, and behavioral reactions to specific auditory stimuli. Although prior research has linked misophonia to maladaptive personality traits and internalizing symptoms, the role of early maladaptive schemas (EMSs) remains underexplored. The present study examined the associations between misophonia severity, EMSs, personality trait domains, and psychological symptoms, and tested whether EMSs accounted for incremental variance beyond these factors. A total of 144 adults (72 with misophonia and 72 matched controls) completed self-report measures of misophonia, EMSs, personality traits, depression, and anxiety. Misophonia severity was positively associated with most EMSs, as well as with negative affectivity, detachment, psychoticism, and symptoms of depression and anxiety. Individuals with misophonia reported significantly higher levels across all EMSs, personality domains, and psychological symptoms compared to controls. Regression analyses indicated that several EMSs predicted misophonia severity, with Entitlement and Emotional Inhibition emerging as the strongest independent predictors. In a hierarchical regression model, EMSs accounted for additional variance beyond personality traits and psychological symptoms. In the final model, Entitlement and Negative Affectivity remained significant predictors. These findings support a hierarchical framework in which personality trait domains reflect a broad dispositional vulnerability, whereas EMSs represent more specific cognitive-emotional processes that may shape the appraisal and perceived meaning of trigger sounds. Targeting EMSs may enhance psychological interventions by addressing maladaptive appraisals and emotional regulation difficulties underlying misophonic responses.