Talk:Misophonia

Wiki Education assignment: WikiMed Fall 2024

This article was the subject of a Wiki Education Foundation-supported course assignment, between 28 October 2024 and 22 November 2024. Further details are available on the course page. Student editor(s): DoubleDoctorZack (article contribs). Peer reviewers: Azwilliams55.

— Assignment last updated by Wendyxieyang (talk) 06:55, 22 November 2024 (UTC)

Hey folks, exciting stuff hopefully to come here. Clearly this page has quite a history, and I happen to have done my PhD on misophonia (https://ir.vanderbilt.edu/items/a9e54a3e-61db-467b-b2cf-2eb0e9f8b977), so I genuinely have quite a lot to add here as someone that's been in the field of misophonia research for a bit and has attended three years of Misophonia Research Fund funded investigator meetings (sidebar: we should probably make a page for the misophonia research fund [1], as the major [read: only] org funding research on misophonia, with $10M in grants funded to date). Though there's clearly been a lot of COI and self-promotion on this page to date, that's definitely not my goal here—I'm really trying to "clean up" the page and improve the quality of information on misophonia that people are being exposed to here on Wikipedia. I'll probably self-cite once or twice (because I have published relevant works, but you know from the link above who I am, and I'll certainly disclose that when I do self-cite), but the goal here isn't really to self-promote (as much as to promote misophonia itself as a legitimate condition and ensure that patients and providers have accurate and evidence-based information). If anything, I'd love to make misophonia a featured article one day, just for the awareness!

Please do feel free to reply here or ping me on my talk page if you find any of my edits problematic, do find me conflicted in some way (e.g., take issue with my citations), or want to discuss any of my (soon-to-be extensive) revisions to this article. I certainly don't want this to be "Zack's take on misophonia." DoubleDoctorZack (talk) 06:00, 30 October 2024 (UTC)

Adding Photo to Infobox - Ideas?

Hi folks. One of the edits I'd love to see made to this page is not having a pictureless infobox. I don't have a strong preference as to what that picture has to be (as long as it represents misophonia in some way), but I attempted to make something yesterday that was then taken down by another editor today. That picture is shown below for reference (disclaimer: generative AI created the base picture, which I then modified; I do have decent digital art and photo-editing skills/software but not infinite free time to animate my own characters, etc.). I'm not gonna lie, I'm a little bummed about this turn of events, given the amount of time I actually took to make what I thought was my first meaningful contribution to the page (and as someone with a PhD in this area, I have plenty more where that came from), but instead of simply trying again, I thought I'd ask the other people who care about editing this page what they actually want to see in an infobox photo (alternatively, give me a good argument as to why this page should not have one, but I haven't seen that yet). Essentially, I'm taking requests, so please let me know what I can try to make here.

DoubleDoctorZack (talk) 19:59, 30 October 2024 (UTC)

Sorry to hear that you're discouraged! To give an actual style guide link, my view in removing it was that MOS:LEADIMAGE says that it should be the type of image used for similar purposes in high-quality reference works, and I wouldn't expect to see a humorous cartoon in a medical reference work.

From what I've seen around Wikipedia, most medical articles about non-visible conditions seem happy to run without a lead image, where there is no obvious physical condition to photograph and no visual representations in the literature (or, at a push, in pre-existing art). Checking a few, the only original artwork I've found is at dyslexia, where a silhouetted child draws some letters incorrectly. Perhaps something like that could work here (a silhouette with fingers in ears against a simple background of a restaurant?), but I'm not sure it's that necessary. --Belbury (talk) 20:19, 30 October 2024 (UTC)

That makes sense, thanks for the guidance. I was sort of going off of depictions I had found on other misophonia resources (which, frankly, had at times been humorous). For a more serious way of depicting misophonia, one could explore https://www.soquiet.org/, arguably the most prominent misophonia patient advocacy org (also a page I'm meaning to make at some point). But to your suggestions, I Midjourney'd a couple "silhouette pics" that I thought might be reasonable, and here's the one I liked the most. Let me know your thoughts (and others may feel free to chime in).

DoubleDoctorZack (talk) 05:42, 4 November 2024 (UTC)

No to both. As far as I am concerned, the only time it is ever appropriate to have an AI-generated image in an encyclopedia is if the topic of discussion is that image, such as File:Trump’s arrest (2).jpg being discussed in the article Deepfake. Otherwise, having no image is better than having an AI image, because AI images are not accurate, and this is supposed to be an educational resource. Those two things are in conflict with one another. The Squirrel Conspiracy (talk) 08:22, 4 November 2024 (UTC)

That's fair, and I can understand that rationale. Assuming it were actually my own work, how would people feel about a picture of common triggers (mouth chewing, nose sniffing, pen clicking, etc.) as the infobox pic? Again these would be animated/cartoonish as this is what I can actually produce as a digital artist. DoubleDoctorZack (talk) 08:40, 4 November 2024 (UTC)

Major rewrites coming in near future

Hi misophonia talk page folks! First off, thanks to those who have engaged with me thus far on my journey to significantly improve this page. I've done some significant digging into the misophonia literature and also studied up on the wikipedia style guides (especially WP:MEDRS and WP:SELFCITE), and I think I'm ready to take a crack at really editing the content of the page in most of the sections, sourcing out the sections with better sources (read: secondary sources whenever possible per WP:MEDRS, though I do think there are a couple primary sources I'd like to keep/see here like references to specific measurement tools [or their respective validation studies] in a section I want to make about assessing misophonia symptoms), and removal of sections/text that is based almost entirely on primary sources (again, this is in line with the WP:MEDRS guidelines).

I also plan to eventually find an infobox picture that works, which I think I will actually commission from a well-known misophonia advocate (if he's okay being the "face" of misophonia, that is). It's fairly hard to argue that a real picture of a real person with misophonia, wearing earphones and a t-shirt that has something to do with misophonia is a bad picture of misophonia for an encyclopedia entry on misophonia. The rest of the infobox will also eventually be filled out with some well-sourced claims, of which I have plenty ready to go!

One thing to also note is that when editing this page, I will inevitably be encountering some of my own published research (I am Zachary J. Williams; here's my NCBI mybibliography). I'd also like to note that my work was already cited in the article before I got here and I actually removed what I thought was a bad citation of it (lol). Given how small of a field this is (and the fact that I believe I've contributed meaningfully to it in ways that certain other researchers haven't, like describing overlaps with autism) I may nevertheless want to sparingly add a citation or two to a paper of mine elsewhere in the article (that I'll happily declare and note for the talk page). Hopefully, with the amount that I'm changing the article (and citing other researchers' work, of which I have 20+ secondary sources lined up that I didn't author), nobody is going to accuse me of unfairly promoting my own scholarship on this page (but please comment here and let me know what you think—I'm genuinely trying to do the right thing here, and if anyone finds my edits to be problematic, let's talk about it.

Articles most likely to be (self)-cited at some point:

• Decreased sound tolerance in autism: understanding and distinguishing between hyperacusis, misophonia, and phonophobia(includes operational criteria for misophonia my research group used for diagnostic purposes, as well as a way to actually give an ICD code when "diagnosing" misophonia clinically; audiologists reading the magazine really liked this article!)

• A review of decreased sound tolerance in autism: Definitions, phenomenology, and potential mechanisms (very comprehensive review article [it's an early version of chapter 1 of my dissertation that I used for my PhD qualifying exam on this topic] that at the time collated all known information on the overlap of autism and decreased sound tolerance conditions, misophonia included and still remains the authoritative secondary source on autism and DST [though the dissertation chapter is updated and technically better, I don't know if it would fly as a WP source]).

• Development and Initial Validation of the Duke Misophonia Questionnaire (I was just the psychometrician on this study, but I still authored it; the DMQ is a major measure in the field and should be cited in any "symptom measurement" section)

• Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The Duke-Vanderbilt Misophonia Screening Questionnaire (this was actually the paper that was here when I arrived, but I still think it's relevant to any "symptom measurement" section; the paper also describes the prevalence I found in the autistic population in my dissertation work).

Anyways, I hope that folks aren't too taken aback if they come back to the misophonia page and see a very different entry in a couple days to weeks. I'd rather have discussion in the comments here than a ton of edit wars and reversions, but I've also gotten a few other interested people in the misophonia research community now working on this project with me (again, with the shared goal of making sure the information here is actually of good quality of patients, scientists, etc.), and if things do get out of hand, we aren't above seeking a page lock of some level to ensure that it stays that way. DoubleDoctorZack (talk) 21:34, 8 November 2024 (UTC)

As a note, I've also gone ahead and (as a precaution) added myself as a "COI editor" (in the section along with certain other misophonia researchers who've contributed like Jo Brout, Mercede Erfanian, etc.). Note that I have yet to self-cite and plan to change that section to reflect when I have, but I want people in the mean time to be aware that I am at least planning to do so. Not sure if this actually requires a neutral editor to review all of my non-self-cited contributions up to that point (please feel free—I'd like to think they're genuinely unbiased, meaningful, and high-quality, but I write peer-reviewed papers for a living, so I'm used to other people taking a second pass at my work). Also, feel free to comment here if you do take issues with any of my edits, and I'm more than happy to have a conversation about any of the substantive content. Again, I don't actually have stated goals other than improving the quality of the general information on the page (potentially all the way to featured article level) and making sure that readers (primarily patients, clinicians, and researchers) actually get a good evidence-based picture of misophonia! DoubleDoctorZack (talk) 19:43, 10 November 2024 (UTC)

General info

Whose work are you reviewing?

DoubleDoctorZack

Link to draft you're reviewing

Misophonia

Link to the current version of the article (if it exists)

Misophonia

Evaluate the drafted changes

This article was rated B-class before editing began.

Lead

• Has the Lead been updated to reflect the new content added by your peer?
  • Yes, although it appears much of the lead is stand-alone information rather than a brief review of information below. For example, the statement "But the three highest-quality studies (i.e., those that used probability-based sampling methods) estimated that 4.6–12.8% of adults may have misophonia that rises to the level of clinical significance." is in the introduction but not revisited in the Epidemiology section. The lead could perhaps be tightened up by keeping information more minimal and moving expanded information to the epidemiology section. I also wonder if maybe you just hadn't reached the Epidemiology section you clearly did a ton of work on this article and it was a very ambitious choice.
  • Just a reminder that the medicine style guide recommends not describing the design of studies; it would be important to only call them 'highest-quality studies' if another source deems them that, not individual scientific opinion.
• Does the Lead include an introductory sentence that concisely and clearly describes the article's topic?
  • Yes, although the second sentence is also necessary for context (I think that is alright though)
• Does the Lead include a brief description of the article's major sections?
  • The lead contains information from each of the major sections but perhaps not a succinct summary
• Does the Lead include information that is not present in the article?
  • Yes, one example is provided above
• Is the Lead concise or is it overly detailed?
  • I would argue it is overly detailed and suggest moving information below. For example, the sentence "Misophonic reactions can be triggered be many different auditory, visual, and audiovisual stimuli." and just brief examples can be given there, removing the rest of the paragraph and covering it in signs and symptoms (which you do). I think the Gout article has a nice guide for length. I don't think you're far off, I just think it's a bit more dense than recommended in the style guide.

Content

• Is the content added relevant to the topic?
  • Yes
• Is the content added up-to-date?
  • Yes
• Is there content that is missing or content that does not belong?
  • Adaptations for school-age children are covered in the lead but I wonder if that could be better served in its own section. I also think the S-Five model requires justification of its inclusion. I like the inclusion of other terminology people may run into.

Tone and Balance

• Is the content added neutral?
  • A neutral tone is maintained, however I wonder if there is more controversy that has not been addressed given the condition is not recognized by the DSM. However, I am not a content expert.
• Does the content added attempt to persuade the reader in favor of one position or away from another?
  • No; I think the tone maintained is excellent.

Sources and References

• Is all new content backed up by a reliable secondary source of information?
  • Many of the sources added do not appear to be secondary (i.e. reviews or meta-analyses); there are over 100 so I didn't go through them all but here are a small number of examples:
    • Case Reports Cited: "Suicidal misophonia: a case report", "A Little Known Topic Misophonia: Two Case Reports", "Misophonia: physiological investigations and case descriptions"
    • Cohort Studies Cited: "Misokinesia is a sensitivity to seeing others fidget that is prevalent in the general population", "A nomological network for misophonia in two German samples using the S-Five model for misophonia", "Listening to People with Misophonia: Exploring the Multiple Dimensions of Sound Intolerance Using a New Psychometric Tool, the S-Five, in a Large Sample of Individuals Identifying with the Condition", "Clinical characteristics, impairment, and psychiatric morbidity in 102 youth with misophonia", "The Motor Basis for Misophonia"
    • Epi Studies: "The Prevalence and Severity of Misophonia in a UK Undergraduate Medical Student Population and Validation of the Amsterdam Misophonia Scale", "Prevalence, phenomenology, and impact of misophonia in a nationally representative sample of U.S. adults", "Prevalence and clinical correlates of misophonia symptoms in the general population of Germany"
  • Although all of these studies do include an introduction which reviews the literature, I think they are pretty explicitly against the style guidelines to include. I think citing 30 primary articles isn't justified in this case where review articles do exist, given Wikipedia is so strict. I think this is currently a major weakness of the article. I know you didn't add many of these and probably don't have time to change them, but it may be something to consider working towards if you choose to continue working on the article.
• Does the content accurately reflect what the cited sources say? (You'll need to refer to the sources to check this.)
  • Too many citations to adequately review. However, they do appear accurately reflected based on the few I chose.
• Are the sources thorough - i.e. Do they reflect the available literature on the topic?
  • Yes
• Are the sources current?
  • Yes; many new review articles included
• Check a few links. Do they work?
  • All the links I checked work
• Other
  • There are parts that you didn't get to that are against the style guidelines that you may want to consider in the future, however again this article is a huge undertaking and you already did a bunch. i.e. "The University of Nottingham conducted a study of misophonia in one sample of undergraduate medical students" goes against the style guideline of not describing studies.

Organization

Guiding questions:

• Is the content added well-written - i.e. Is it concise, clear, and easy to read?
  • Yes, I think the writing is fantastic! It is very easy to follow and lays out the issue well. I do think the introduction to the S- five model is a bit confusing due to lack of importance about the S-five model. Additionally "Cognitive and behavioral reactions to misophonic triggers" is a bit confusing that you're getting at the patient's reaction. It may be helpful to clarify a bit here and explain the importance of the S-five model, or delete the reference to the model if the information is not broadly applicable.
• Does the content added have any grammatical or spelling errors?
  • No
• Is the content added well-organized - i.e. broken down into sections that reflect the major points of the topic?
  • I think so; the layout is very easy to follow and well done.

Images and Media

• I remember you saying you're working on getting an image for the page-- that will be a nice addition!

Overall Impressions

This article was listed as B but I think it's a fair argument to say it actually started as a C based on areas that you did not edit which violate style guidelines in ways that would take significant effort to improve. I think it remains a C, based largely on the issues with the citations (using the B-class criteria for comparison). I think the lead section could use a bit of improvement as well, but otherwise I feel the rest of the B-class criteria are met. You have clearly put a tremendous amount of effort into this article and I think you should be proud of what you have done. I think your additions absolutely improve understanding of the topic.

• Has the content added improved the overall quality of the article - i.e. Is the article more complete?
  • I think the additions to the lead section were informative and very well-written but maybe can be moved elsewhere to trim down the length.
• What are the strengths of the content added?
  • I appreciated better clarity on the array of reactions to the monophonic response.
• How can the content added be improved?
  • I think the biggest issue is the sources used, and deviation from the style guides when referring to studies. I think however this will take a major article overhaul to fix and will be a major undertaking.

Overall, nice work! -Alison Azwilliams55 (talk) 21:07, 18 November 2024 (UTC)

Thanks for the review Alison! This has been extremely helpful, and I've made a number of changes to address your comments thus far. Still a ways to go, but here's what I've done so far:

1. Shortened the lead section at least some (mostly in the section on triggers; moved bits to the symptoms section, cut others), removed judgment of epi articles as "high-quality" (though left probability-based sampling methods, as this is a factual statement about the studies). NB: Have not written epi section yet, though I plan to re-vamp this section at a later time to be more in line with the lead (which I did already write).

2. I do plan to add "accommodations" as part of the treatment section (which I haven't gotten to), but this has been added to the lead section briefly already to note that it is considered a disability and can be served in school with a 504 plan [I felt this was better to add ahead of time for the 3,000-ish people a day who read the article].

3. I revamped the section on the "S-Five model" to clarify that it's factor-analytically based and from a commonly-used questionnaire (that was also used to guide the major epidemiological study of misophonia in the UK conducted to date).

4. Glad that my tone remains neutral. I have plenty of my own biases, though I try to keep them out of the article. Did cut the "high-quality" judgment and will do my best to keep any editorializing about articles to a minimum (though some description of articles' methods may be necessary for the best interpretation of their content; I'm sort of leaning on the final pillar of Wikipedia [that all rules are flexible] here, but hopefully not too hard).

5. Re: sources, the page was actually sourced almost exclusively with primary literature when I started editing, and I've done most of the adding of secondary/tertiary sources myself. I have, however, still added some primary literature when (a) the primary sources are adding information that could not be found in the secondary lit, or (b) the primary source could supplement a similarly-cited secondary source (e.g., 3-4 citations to the same secondary source in a row, but this essentially showed "where in the secondary source" that information came from; sometimes also providing information that was not in the secondary source because the primary source was published after the review termination date, etc.). I do plan to clean out a few more primary sources, especially in the sections I haven't yet edited, but many of the ones in the sections I have edited are there for one of the reasons above and I think can be justified as adding meaningful value to the paper. Moreover, sometimes (as you note), I am actually citing the literature reviews done in the sources rather than the empirical portions of those articles (case reports are particularly common for this, as they tend to be associated with fairly robust literature reviews in a barren literature). Once again, the last pillar of Wikipedia is that rules are flexible, and I feel that with adequate justification for at least some of these sources, they can be maintained in a high-quality article. But I do agree that far more needs to be done to make the article based more strongly on secondary sources (at least in the sections I haven't yet finished editing).

6. I do have an image in the works (I have my model [a misophonia self-advocate out of Duke CMER] and an idea for a pose; she's just in the process of setting it up and getting clearance from her boss on being the face of misophonia on the internet!)

7. Lastly, I definitely want to help with the re-description of the studies in the sections I haven't edited yet (I'll probably delete at least a few of them). Thankfully there is a good bit of secondary lit on prevalence, so I can probably just cite that for some, and then I can once again refer to the population-based studies for prevalence estimates I (and readers) can trust. It's still a very much emerging field, which is one of the reasons I left this part for last (epi was a major part of my PhD, I'll probably at least throw in one self-citation there because few other [any?] people have the hyperacusis/misophonia comorbidity rate in autism as a finding in their studies at this point, and this seems notably higher than in the general population).

Again, thanks for the review. Really appreciate the time and effort you took to do this, and you certainly helped quite a lot in improving the article!

- Zack DoubleDoctorZack (talk) 15:26, 21 November 2024 (UTC)