A Common Human Problem Has a Name: Misokinesia

Misokinesia is a psychological phenomenon that is defined as a strong negative affective or emotional response to the sight of someone else’s small and repetitive movements, such as seeing someone mindlessly fidgeting with a hand or foot. Among those who regularly experience misokinesia, there is a growing recognition of the challenges that it presents, as evidenced by blossoming on-line support groups. Yet surprisingly, scientific research on the topic is lacking. This article is novel in systematically examining whether misokinesia exists in the non-clinical population and if there are observable individual variability in the intensity or extent of reported misokinesia sensitivity in the general population. Across three studies that included 4100 participants, we confirmed the existence of misokinesia as a phenomenon in a non-clinical population, with approximately one-third of our participants self-reporting some degree of misokinesia sensitivity to the repetitive, fidgeting behaviors of others as encountered in their daily lives. Moreover, variability in the range of misokinesia sensitivities showed that the negative social-affective impacts that one experiences may grow with age. This study shows that a large population of the public may be suffering from something that has received little formal recognition.

Misokinesia -or the 'hatred of movements' -is a psychological phenomenon that is defined as a strong negative affective or emotional response to the sight of someone else's small and repetitive movements, such as seeing someone mindlessly fidgeting with a hand or foot 1 . Among those who regularly experience misokinesia, there is a growing recognition of the challenges that it presents, as evidenced by blossoming on-line support groups. Yet surprisingly, scientific research on the topic is lacking. In fact, as late as January 24, 2021, searches for the term "misokinesia" on Web of Science (in all databases) returned no hits, either in the title of a paper or as a listed topic. Given this literal absence of scientific insight, the goal of our work presented here was to begin building an empirical foundation for understanding misokinesia and its social impacts.
If misokinesia has yet to be the topic of a scientific report, however, it does get an occasional mention in research articles. In particular, it receives passing recognition as a visual analog to misophonia 2 , a psychological condition that has been receiving scientific attention and is defined by aversive emotional responses to human-produced sounds like chewing and lip-smacking 3 . Within the limited but expanding misophonia literature, one peer-reviewed study has in fact objectively reported on the prevalence of misokinesia, which was found to be 11.9% (or 5 patients) out of a 42 patient sample recruited from a hospital website for misophonia sufferers 4 . Nevertheless, the sample in this study was small, and it was restricted to a clinical population of individuals who were actively seeking support for their misophonia sensitivity. Whether misokinesia can occur in the absence of misophonia, whether it's reliably reported in non-clinical (or more general) populations, and whether there may be individual variability in the intensity or extent of reported misokinesia sensitivities are basic and critical -but currently unanswered -questions.
As such, our aim in the set of studies reported here was to begin addressing these and related questions. Our approach involved three empirical steps. We first conducted an initial pilot study to assess whether misokinesia sensitivities would be reliably reported in a large sample of university undergraduates, based on a simple yes/no answer to a question asking about seeing fidgeting movements in others. Confirming many individuals do report such sensitivities, we then conducted a study in a university undergraduate sample to confirm prevalence rates. This first study assessed individual variability in reported impacts of misokinesia sensitivities, and determined whether misokinesia sensitivities may co-occur with altered visual attentional performance. Finally, we conducted a second study to assess prevalence rates and individual variability in misokinesia sensitivities in a more general, nonuniversity population. In all three studies we included assessments of misophonia sensitivities in order to inform on the question of co-morbidity between misokinesia and misophonia. The end result is what we believe to be the first in-depth scientific exploration of what is a surprisingly common human phenomenon -a difficulty being in the visual presence of others who are fidgeting.

PILOT STUDY
The goal of our initial pilot study was to identify a basic prevalence rate for misokinesia in a non-clinical undergraduate population, including its prevalence within each sex and its rate of co-morbidity with misophonia. A total of 2751 individuals (ages 17 -66; Median = 20, SD = 3.27; 2028 female, 701 male, 3 trans-gender, 19 declined to identify) were recruited through the Human Subject Pool (HSP) on-line study recruitment portal for students enrolled in undergraduate courses in the Department of Psychology at the University of British Columbia (UBC). All participants provided informed consent prior to participation and were reimbursed 0.5 extra course credits. All protocols were approved by the UBC Behavioural Research Ethics Board, and all methods were performed in accordance with the relevant guidelines and regulations.
Our pilot study involved administering on an on-line questionnaire that asked two yes/no questions. The first question was used to assess misokinesia prevalence in our For the misokinesia question, a total of 1053 students (or 38.3%) responded yes, while for the misophonia question, a total of 1406 students (or 51.1%) responded yes. In terms of co-morbidity rates, a total of 872 students (or 31.7%) reported yes for both questions. In terms of misokinesia rates within each sex, a total of 874 females (or 43.1%) and 173 males (or 24.7%) responded yes to the misokinesia question. In terms of misophonia rates within each sex, a total of 1118 females (or 55.1%) and 280 males (or 39.9%) responded yes to the misophonia question.
Taken together, our findings suggest that misokinesia sensitivities extend to nonclinical populations, as more than one-third of our undergraduate sample reported experiencing some level of misokinesia problems. Moreover, the numerically higher rate reported for females vs. males, and the reported level of co-morbidity with misophonia sensitivities parallel rates previously reported in a clinical population 4 , results which provide a measure of normative validity for our pair of assessment question. Given these initial confirmatory results, we then designed a study to not just confirm these initial prevalence rates, but to extend them in two critical ways -by examining individual variability in the strength and/or extent of reported misokinesia sensitivities in an undergraduate population, and by investigating whether misokinesia sensitivities may be associated with heightened visual-attentional sensitivities.

STUDY 1
First, in terms of assessing individual variability in misokinesia sensitivities, presently there are no validated misokinesia assessment instruments. However, Dozier 3 developed the Misophonia Assessment Question (MpAQ) to appraise the degree to which an individual experiences negative thoughts, feelings, and emotions regarding misophonic sounds. In Study 1, we thus adapted the MpAQ to ask about visual rather than auditory issues, thereby creating the Misokinesia Assessment Questionnaire (MkAQ) to assess the degree to which an individual experiences negative thoughts, feelings, and emotions regarding misokinesic visual stimuli. In so doing, this had the additional benefit of allowing for a more direct comparison of misokinesia and misophonia sensitivities both within and between individuals.
Second, as a visual issue defined by a heightened salience for repetitive or fidgetingbased movements, we wanted to examine the possible cognitive correlates of misokinesia, or cognitive mechanisms that may contribute to the condition. In particular, could misokinesia be associated with either an increased inability to ignore distracting stimuli in the visual periphery, or an increased susceptibility of reflexively orienting visual attention to peripheral visual events? Given anecdotal reports of misokinesia as a subjectively experienced phenomenon (e.g., people commonly report a heightened attention to the fidgeting movements of others), either or both of these possibilities may be plausible. If so, it would suggest that misokinesia may be understood, at least in part, as an attention-related phenomenon.
Accordingly, Study 1 included two different behavioral assessments of visual attentional performance. One was a modified distractor interference paradigm, where participants performed a simple target detection task at fixation while ignoring brief kineticbased distractors in the visual periphery; this was used to assess the ability of participants to inhibit peripheral attentional orienting. The other was a traditional reflexive attentional cuing paradigm, where participants performed a spatially-cued target detection task in the visual periphery 5 ; this was used to assess the magnitude of participants' peripheral attentional orienting. If misokinesia is associated with altered visual attentional responsivity, it predicted that there should be a correlation between the degree of misokinesia sensitivity (as indexed by the MkAQ) and performance in these two behavioral attentional assessments. In other words, individuals that are more bothered by visual distractions in their daily lives were predicted to show evidence of greater distractor interference and/or stronger orienting responses to peripheral attentional cues, relative to those not reporting misokinesia sensitivities.

Participants
A total of 689 individuals were recruited through the UBC HSP on-line study recruitment portal; this number was based on our recruitment goal of running as many participants as possible during the fall, 2019 semester at UBC. Data from 39 of these participants were excluded for either leaving the MkAQ or MpAQ incomplete, or not completing the behavioural task, leaving a final sample of 650 individuals (514 females, 124 males, 2 non-binary, 1 agender, 9 declined to answer; the age range was 18-44, with 594 between the ages of 18-24, 28 between the ages of 25-34, 4 between the ages of 35-44, and 24 who declined to answer). All participants provided informed consent prior to participation, self-reported as free of neurological problems, including no reports of head injuries resulting in loss of consciousness for over 5 minutes, or stroke, meningitis, and/or seizures, were fluent in English and had normal range vision (with or without corrective lenses), and received 0.5 extra course credits. All protocols were approved by the UBC Behavioural Research Ethics Board, and all methods were performed in accordance with the relevant guidelines and regulations.

Procedures
After arriving at the laboratory and giving informed consent, each participant performed two behavioral tasks, as described below. Following completion of these tasks, they then filled out a set of questionnaires and were debriefed on our study. Total testing time took approximately 0.5 hours.

Questionnaires
Participants filled out four online questionnaires in total through Qualtrics: A basic demographics form, the MkAQ (see Supplementary Methods), the MpAQ 3 , and the State and Trait Anxiety Inventory 6 ; however, the latter was collected for use in a different study and thus an analysis of those findings are not included below.

Behavioural Tasks
Two different attentional assessments were included in Study 1 -a distractor interference task, and a reflexive attentional cuing task. All 650 participants completed both, with the distractor task always performed first. However, as described below, we employed two different versions of the attentional cuing tasks, one that used a kinetic-based peripheral visual cue and the other that used a more canonical "flash" as a visual cue 5 . We included this manipulation of cue type to examine whether misokinesia sensitivities may be associated with a particular sensitivity to kinetic-based visual events; cue-type was manipulated between-subjects, with participants run in the first half of the semester performing the "kinetic" version of the attentional cuing task, and participants run in the second half of the semester performing the more traditional "flash" version of the attentional cuing task. For all behavioral tasks, at the beginning of each session, the participants performed practice trials and were given the opportunity to ask the experimenter any clarifying questions. Accuracy and speed of response were emphasized equally to the subjects. The viewing distance for all participants was kept at 57 cm from the centre of the computer screen.

Distractor Interference Task
This was a target detection task that required making speeded button presses whenever a target stimulus was presented at fixation; trial sequences and timings are shown in Figure 1. Two boxes, one to the left and one to the right of the fixation cross, remained on-screen throughout the trial block. These peripheral boxes were demarcated by the outlines of 4.28 ° square boxes and were located 7.68 ° to the centre fixation cross (0.74 °). The target stimulus consisted of three 0.7° horizontal sine wave grating lines inside a square box of 2.81°, and was presented at the fixation cross; participants responded to the target onset with a buttonpress (spacebar) using their right index finger when the target stimulus appeared. On distractor-present trials (66.6% of trials), one of the peripheral boxes was briefly "wiggled" just prior to the onset of the target (i.e., the orientation of the box was briefly rotated by 15° clockwise and then back to its original orientation, as a kinetic-based visual distraction). On distractor-absent trials (33.3% of trials), the target was presented without a preceding box distractor-present, 12 distractor-absent), with the distractor-present trials equally split (but randomly varying) between a "wiggle" of the left vs. right boxes.

Attentional Cuing Task
This was a target detection task that required making speeded button presses whenever a target stimulus was presented at a peripheral location either to the left or right of fixation; trial sequences and timings were adapted from Handy, Jha and Mangun 7 and are shown in Figures 2 and 3. Two boxes, one to the left and one to the right of the fixation cross, remained on-screen throughout the trial block. Participants responded with a buttonpress (spacebar) using their right index finger when the target stimulus appeared on the screen. In the short-delay condition, the target was presented following a peripheral cue. In the long-delay condition, the peripheral cue was followed by a second (central) cue presented at fixation see 7 . In the version of the task that used a kinetic-based attentional cue, we employed the same box "wiggle" as described above for the distractor interference task ( Figure 2); in the version of the task that used a more canonical "flash" as an attentional cue, the outline of one of the boxes was briefly thickened ( Figure 3).  Our analyses focused on three a priori issues of interest -confirming a basic prevalence rate for misokinesia sensitivities in our non-clinical undergraduate sample, establishing a distribution of individual variability in the strength or magnitude of misokinesia sensitivity within our sample, and establishing whether misokinesia sensitivity is associated with altered visual attentional performance, relative to those not reporting misokinesia sensitivities.

Prevalence and Variability
Our assessment of prevalence was based on the MkAQ. Mirroring analysis of the In terms of misokinesia rates, a total of 392 students (or 60.3%) reported a sum score of 2 or more on the MkAQ, while in terms of misophonia rates, a total of 460 students (or 70.8%) reported a sum score of 2 or more on the MpAQ. In terms of co-morbidity rates, a total of 246 students (or 37.8%) reported a sum score of 2 or more on both questionnaires. In terms of misokinesia rates within each sex, a total of 320 females (or 62.3%) and 62 males (or 50.0%) reported a sum score of 2 or more on the MkAQ. In terms of misophonia rates within each sex, a total of 366 females (or 71.2%) and 83 males (or 66.9%) reported a sum score of 2 or more on the MpAQ.
To assess individual variability in the strength or magnitude of misokinesia sensitivities, we first plotted the MkAQ sum scores as a frequency histogram ( Figure 4). As can be seen, scores were positively skewed, with a majority of participants reporting a sum score of 5 or less. More specifically, 258 participants (or 39.7%) had a sum score of 0 or 1 (or what was defined above as no/minimal misokinesia sensitivity), 192 participants (or 29.5%) had a sum score of 2-5, and 200 participants (or 30.8%) had a sum score of 6 or higher; these groupings we then labeled as "no misokinesia" (or noM), "low misokinesia" (or lowM), and "high misokinesia" (or hiM) for subsequent analyses.

Attentional Performance
Our goal in analyzing the performance data was to examine whether attentional performance systematically varies with misokinesia sensitivity. Because the range of MkAQ sum scores was so positively skewed (Figure 4), rather than use a correlational approach to performance analyses, we treated misokinesia as a between-group factor based on the classification above --noM, lowM, and hiM -and interrogated the data using repeatedmeasures analyses of variance (ANOVAs).

Distractor Interference Task
All 650 participants completed the distractor interference task. Mean reaction times (RT) and accuracy data (d' and beta) are presented in Table 1 as a function of trial type (distractor-present, distractor-absent) and group (noM, lowM, and hiM). Participants appeared to be faster and more accurate in responding on distractor-present vs. distractor absent trials, an effect that did not seem to vary as a function of misokinesia group. We  Table 1 Mean reaction time, d' and beta across subjects for the distractor interference task in Study 1, as a function of cue condition and MkAQ scores (noM = a sum score of 0 or 1 lowM = a sum score of 2-5, hiM = a sum score of 6 or higher).  Table 2 as a function of trial type (validly-cued vs. invalidly-cued), cue-target delay (long or short), and group (noM, lowM, and hiM). It appeared that responses were faster on invalidly-cued trials compared to validlycued trials, and also during long cue-target delay relative to short cue-target delay trials. Both of these effects, however, did not seem to vary as a function of misokinesia groups. We show any group differences (F (2,165) = 1.36, p = .26). We had post-hoc power of 5% for observing our null between groups effect ( 2 = .016).

Table 2
Mean reaction time across subjects for the attentional cuing task (kinetic cue) in Study 1, as a function of cue condition, cue-target delay, and MkAQ scores (noM = a sum score of 0 or 1 lowM = a sum score of 2-5, hiM = a sum score of 6 or higher).

Attentional Cuing Task --Flash Cue
A subset of 498 participants were run in this task; data from 38 participants were excluded for leaving the questionnaires incomplete, not finishing the behavioural task, or having a high number of false alarms (3+ in either the short-or long-delay condition), resulting in a final sample of 460 participants (N = 356 females, 100 males, 1 non-binary, 3 declined to respond; ages 18 -44). Mean RTs are presented in Table 3 as a function of trial type (validly-cued vs. invalidly-cued), cue-target delay (long or short), and group (noM, lowM, and hiM). Responses appeared to be faster in on invalidly-cued trials compared to validly-cued trials, and also during long cue-target delay relative to short cue-target delay trials. However, response patterns did not appear to vary as a function of group. We confirmed this data pattern via a mixed model ANOVA with within-subject factors of trial type and cue-target delay, and between-subject factor of group. We found significant main effect of cue (F (1,457) = 757.59, p < 0.001, 2 = 0.62), cue-target delay (F (1,457) = 216.95, p < 0.001, 2 = 0.32), and a significant interaction of cue and cue-target delay conditions (F 1,457) = 694.61, p < 0.001, 2 = 0.60). However, we failed to show any group differences (F 2,457) = 0.25, p=.78). We had post-hoc power of 5% for observing our null between groups effect ( 2 = .001).

Table 3
Mean reaction time across subjects for the attentional cuing task (flash cue) in Study 1, as a function of cue condition, cue-target delay, and MkAQ scores (noM = a sum score of 0 or 1 lowM = a sum score of 2-5, hiM = a sum score of 6 or higher).

DISCUSSION
Our goals in Study 1 were three-fold. First, we wanted to confirm the general prevalence rate for misokinesia in a second student-aged sample. In that regard, we found that almost one-third of our participants had a sum score of 6 or more on the MkAQ, a rate not inconsistent with the 38.3% of participants from our pilot study who reported yes to the question of whether they had visual sensitivities to fidgeting and like behaviors. sensitivities. This suggests that misokinesia is not necessarily a binary phenomenon in terms of symptomology, but rather, the impacts experienced by individuals can widely differ in breadth and/or intensity.
Finally, from a cognitive perspective, we wanted to determine whether misokinesia could be associated with either an increased inability to ignore distracting stimuli in the visual periphery, and/or an increased susceptibility of reflexively orienting visual attention to peripheral visual events. However, in all three behavioural tasks we found no evidence to support either possibility. In our distractor interference paradigm, target responses were actually faster and more accurate on distractor-present trials across all three groups, relative to distractor absent trials. This suggests that far from distracting attention away from the target's location at fixation, the distractor served as a reliable temporal warning cue as to the target's pending presentation. Likewise, in both versions of the reflexive attentional orienting paradigm, there were again no between-group differences observed. While overall attentional cuing effects were absent at the short cue-target delay (i.e., we did not show behavioral evidence of increased attention at the cued location in the visual periphery), target responses at the long cue-target delay were significantly faster at the uncued (vs. cued) peripheral location, an effect consistent with inhibition of return (or IOR; 5 ). IOR is normative at long cue-target delays in reflexive orienting paradigms e.g., 7 , suggesting that both our orienting tasks were in fact influencing reflexive visual attentional mechanisms at least to some degree. More importantly though, there were again no significant between-group differences observed. As such, while it may remain to further probe potential attentional correlates of misokinesia, our initial evidence is consistent with the conclusion that reflexive visual attentional mechanisms may not make substantive contributions to misokinesia.

STUDY 2
While our findings from Study 1 suggest that misokinesia is not associated with altered patterns of attentional performance, we did confirm the original results from our pilot study demonstrating that misokinesia is prevalent in the general population -approximately 1 in 3 participants in our two studies reported some level of sensitivity. Further, we found that for those experiencing misokinesia sensitivities, there is a high degree of individual variability in how those sensitivities are manifest or impact their daily lives. Given these conclusions regarding prevalence, we wanted to conduct a second study with the explicit goal of expanding our assessment of misokinesia prevalence in the general population, and in particular, expanding it beyond a relatively young, student-aged sample. More specifically, our aims in this final study were two-fold. First, we wanted to determine whether our estimate of an approximately 33% prevalence rate for misokinesia would hold in an older, more demographically diverse sample, and second, we wanted to examine whether individual variability in this sample would show a similar frequency distribution in reported misokinesia sensitivities as to what we found in Study 1 in our student-age sample. participation. In terms of procedures, we replicated two aspects of our earlier studies: (1) we asked participants the two questions described above in our pilot study, to assess whether they had problems related to misokinesia and/or misophonia, and (2) participants completed the four questionnaires (demographics, MkAQ, MpAQ, State and Trait Anxiety Inventory) described above in Study 2; again, the anxiety measures were used for a separate study.

RESULTS
For our misokinesia question, a total of 275 participants (or 35.9%) responded yes, while for our misophonia question, a total of 325 participants (or 42.5%) responded yes. In terms of co-morbidity rates, a total of 195 participants (or 25.5%) reported yes for both questions. In terms of misokinesia rates within each sex, a total of 93 females (or 38.1%) and 182 males (or 35.3%) responded yes to the misokinesia question, while a total of 169 females (or 69.3%) and 395 males (or 76.6%) reported a sum score of 2 or more on the MkAQ. In terms of misophonia rates within each sex, a total of 120 females (or 49.2%) and 204 males (or 39.5%) responded yes to the misophonia question, while a total of 188 females (or 77.1%) and 397 males (or 76.9%) reported a sum score of 2 or more on the MpAQ.
To assess individual variability in the strength or magnitude of misokinesia sensitivities, as per Study 1 we first plotted the MkAQ sum scores as a frequency histogram ( Figure 4) and subdivided participants into three groups --noM, lowM, and hiM. As can be seen in Figure 4,

DISCUSSION
We had two goals in Study 2. First, we wanted to assess the prevalence rate for misokinesia in a non-student, non-clinical population, and we found that approximately onethird (35.9%) of the respondents reported experiencing some level of misokinesia sensitivity in their lives. This percentage is consistent with the prevalence rate found in our pilot study that also used a binary-choice question for assessing misokinesia prevalence. If we apply the same measure of prevalence rate as in Study 1 -the percentage of participants having a sum score of 6 or more -the prevalence rate nearly doubles (67.3%). While we discuss these differences between measures in our general discussion below, the more central point remains that misokinesia sensitivities were indeed found to be prevalent in a non-studentbased sample from the general population.
Second, we wanted to examine the distribution of misokinesia sensitivities in a nonstudent, non-clinical sample. In that regard, we found that there was a significant difference between the frequency distributions from Studies 1 and 2, with the latter showing a more bimodal pattern and higher percentage of participants falling in the hiM category, relative to the former. Why might this be? Demographically, the MTurk-based sample in Study 2 was older than our student-aged sample from Study 1, and contained a higher percentage of male participants. There were also clear differences in the distribution of ethnicities between the two participant samples, as can be seen in Table 4. Below we discuss how these demographic factors may help to explain the observed differences in frequency distributions of misokinesia sensitivities.

GENERAL DISCUSSION
Our findings reported here represent what to the best of our knowledge is the first systematic examination of misokinesia and its prevalence in non-clinical populations. Across three studies that collectively sampled over 4100 individuals, we found that approximately one-third self-reported some degree of misokinesia sensitivity to the repetitive, fidgeting behaviors of others as encountered in their daily lives. These results support the conclusion that misokinesia is not a phenomenon restricted to clinical populations, but rather, is a basic and here-to-fore under-recognized social challenge shared by many in the wider, general population. But beyond simply confirming misokinesia as a common and non-clinical phenomenon, our set of studies inform on several further questions that help to begin building a deeper scientific understanding of this visual-social sensitivity.
First, is misokinesia always co-morbid with misophonia? Our findings suggest not.
While co-morbidity rates exceeded 25% in each of our three population samples, we also consistently found a percentage of individuals reporting misokinesia sensitivities in the absence of any misophonia sensitivities. And consistent with the original prevalence report of Schröder, Vulink and Denys 4 in a small clinical population, we also consistently found a percentage of individuals reporting misophonia but not misokinesia sensitivities. Taken together, this pattern of co-occurrence between the two phenomena suggests that while they are often experienced together in an individual, misokinesia itself is not simply a comorbidity or visual analog of misophonia; for some individuals the challenge of seeing others fidget is experienced in the absence of any corresponding auditory-social correlates. in fact be associated with altered visual-attentional function, but either (1) the paradigms used in our study were not valid assessments of these attentional correlates, or (2) individuals with misokinesia sensitivities may be well-practiced at controlling visual attention in a top-down manner as a compensatory strategy for mitigating their discomfort, strategies that could mask attentional correlates of the condition. On the other hand, given that misophonia has been strongly associated with altered affective reactivity to trigger sounds, it could also be the case that misokinesia does not involve altered attentional functioning, and instead, it too may be more tied to heightened affective reactivity to visual triggers. These now become important questions to begin pursuing if we are to build a neurocognitive understanding of the phenomenon.
Our performance results also raise several additional considerations that shed additional light on how to advance research on misokinesia. First, the MkAQ emphasized social/clinical impacts rather than providing a clear accounting of the more immediate, subjective effects of misokinesia. More specifically, the questions in the MpAQ -on which the MkAQ was based -focus on the emotional impacts of misophonia and address possible social problems that can arise for those who experience the phenomenon. As the MpAQ was designed based on clinical interviews conducted by an audiologist 9 , it is possible that merely adapting the questionnaire for studying misokinesia did not capture actual misokinesia symptoms as they occur when in the presence of a visual trigger. The MkAQ, thus, does not measure subjective experiences of triggers, responses, or coping mechanisms, and this could again help to explain our null attentional performance results. Namely, if misokinesia sensitivity is predicated on visual-emotional symptoms when dealing with an actual trigger stimulus rather than the social-emotional impacts of having to manage possible exposures to trigger stimuli (as captured by the MkAQ), it could reveal possible between-group differences in attentional performance that are obscured when grouping is based on socialemotional impacts as per Study 1.
Second, it is also important to note that the key stimulus used in our attentional paradigm --the kinetic movement of the peripheral boxes --may not have been an effective distractor/cue, for individuals with misokinesia. That is, the kinetic movement of the peripheral boxes may not have been a valid proxy for human fidgeting, or the kinds of stimuli that are visual triggers in misokinesia. This possibility is certainly consistent with what is known about the nature of processing within visual cortex. The so-called ventral visual stream that underpins visual object processing bifurcates into areas that respond to animate vs. inanimate objects e.g., 10 , and numerous neuroimaging studies have confirmed that while ventrolateral visual brain regions are activated by animate objects, it is more ventromedial regions that are activated by inanimate objects e.g., [11][12][13][14] . This functional dissociation raises the question of whether misokinesia could be specifically associated with altered attentional sensitivity to either animate objects in general, or perhaps even more selectively, to human movements exclusively.
In conclusion, despite these important unanswered questions, our data firmly establish that misokinesia is indeed prevalent in the non-clinical population, and that many people may be suffering from something that has received little formal recognition. And as our findings suggest, the negative social-affective impacts of misokinesia may in fact grow with age. Yet while our findings highlight a number of pressing questions to address going forward, the end result here is that we have confirmed something long under-appreciated about the human condition -we don't just frequently fidget, but as well, many of us are challenged by being in the visual presence of others who are doing so.