Adverse Childhood Experiences and Misophonia: The Empathy Link

A 2026 study from Sakarya University in Türkiye provides a new perspective on misophonia, framing it as a condition with developmental and emotional roots. The research, led by Sevgi Koroglu Gokbel and Gülgün Durat, found that emotional empathy plays a key role in connecting adverse childhood experiences to the intensity of misophonic reactions.

The Study: Connecting Developmental Past and Auditory Present

The research team conducted an online survey between September and November 2025. They recruited 369 adults who met established diagnostic criteria for misophonia. To measure the variables, they used three validated tools: the Adverse Childhood Experiences (ACE) Scale, the emotional empathy subscale of the Cognitive and Emotional Empathy Scale, and the Misophonia Scale.

Using structural equation modeling—a statistical technique for testing complex relationships—they analyzed the direct and indirect links between childhood adversity, emotional empathy, and misophonia severity. The model’s fit to the data was strong, indicating the proposed relationships were well-supported.

Emotional Empathy as a Mediating Link

The results showed a clear chain of association. First, participants who reported more adverse childhood experiences—such as abuse, neglect, or household dysfunction—tended to have higher scores on emotional empathy. The statistical relationship was significant (β = 0.272, p = 0.001).

Second, higher emotional empathy was significantly associated with more severe misophonia symptoms. The mediation analysis revealed that emotional empathy acts as a partial mediator. This means childhood adversity both directly influences misophonia and does so indirectly by heightening emotional empathy. The indirect pathway through empathy accounted for approximately 25% of the total effect.

What Does “Emotional Empathy” Mean in This Context?

Emotional empathy, sometimes called affective empathy, refers to the capacity to automatically feel and share the emotions of others. It is distinct from cognitive empathy, which involves understanding another person’s perspective intellectually. The study suggests that individuals with misophonia may have a heightened, potentially dysregulated, capacity for this type of emotional resonance. The authors propose that adverse early experiences may sensitize this emotional system, making individuals more reactive not just to social and emotional cues, but also to specific, often human-generated, trigger sounds.

Implications for Understanding and Treatment

This study challenges a view of misophonia as solely a disorder of auditory processing or sound tolerance. Instead, it positions the condition within a framework of developmental psychopathology and emotional regulation.

The practical implication is that treatment focusing only on the trigger sounds—through sound therapy or masking—may have limited success for some individuals. The findings point to the potential benefit of integrating therapeutic approaches that address underlying emotional patterns. This could include therapies aimed at trauma processing, emotion regulation skills, and managing empathic hypersensitivity. For instance, Cognitive Behavioral Therapy for misophonia could be adapted to specifically work with the emotional responses linked to empathy and past experiences.

This research aligns with a broader understanding of how early life stress can shape sensory and emotional processing in related conditions. For example, the concept of increased central gain in hyperacusis describes a neural amplification process that can be influenced by stress and emotional state. Similarly, the link between chronic headache and hyperacusis highlights shared brain mechanisms for pain and sound sensitivity, which can also be affected by developmental history.

A New Direction for Misophonia Research

The cross-sectional design of this study means it can show association, not causation. Longitudinal research is needed to confirm if childhood adversity leads to heightened empathy, which in turn increases the risk for misophonia. Nevertheless, the work by Koroglu Gokbel and Durat opens a vital new avenue for investigation.

It suggests that assessing a patient’s developmental history and emotional empathy profile could become a valuable part of a comprehensive misophonia evaluation. Future studies could explore whether therapeutic interventions that successfully reduce misophonia distress also lead to measurable changes in emotional empathy or in the processing of adverse childhood memories.

By identifying emotional empathy as a mediating factor, this research adds depth to our model of misophonia. It moves the conversation beyond the ear and into the intertwined realms of life history, emotional brain development, and sensory-emotional integration.

Source: Koroglu Gokbel S, Durat G. The mediating role of emotional empathy in the relationship between adverse childhood experiences and misophonia: a structural equation modeling. Front Psychol. 2026;17:1771797. doi:10.3389/fpsyg.2026.1771797. PMID: 42199284.