Transdiagnostic cognitive behavioral therapy for misophonia in youth: Methods for a clinical trial and four pilot cases

Lewin, Adam B.; Dickinson, Sarah; Kudryk, Kelly; Karlovich, Ashley R.; Harmon, Sherelle L.; Phillips, Dominique; Tonarely, Niza A.; Gruen, Rinatte; Small, Brent J.; Ehrenreich–May, Jill

doi:10.1016/j.jad.2021.04.027

Cited by 31 publications

(29 citation statements)

References 38 publications

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“…Specifically, misophonia has been found to be associated with anxiety, depression, and personality disorder symptoms, with anxiety as a mediator between personality disorder symptoms and misophonia (Cassiello-Robbins et al, 2021). As such, different forms of cognitive behavioral therapy, including transdiagnostic and counterconditioning approaches (Schröder et al, 2017;Lewin et al, 2021), and inhibitory learning approaches (Frank and McKay, 2019) that address emotional responses and contextual factors around a trigger stimulus-response pairing have shown some promising results. As the field continues to learn more about misophonia, it is possible that these clinical approaches may be complemented by the cross-sensory remapping approach we introduced here.…”

Section: Discussionmentioning

confidence: 99%

Development and Evaluation of a Sound-Swapped Video Database for Misophonia

et al. 2022

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Misophonia has been characterized as intense negative reactions to specific trigger sounds (often orofacial sounds like chewing, sniffling, or slurping). However, recent research suggests high-level, contextual, and multisensory factors are also involved. We recently demonstrated that neurotypicals’ negative reactions to aversive sounds (e.g., nails scratching a chalkboard) are attenuated when the sounds are synced with positive attributable video sources (PAVS; e.g., tearing a piece of paper). To assess whether this effect generalizes to misophonic triggers, we developed a Sound-Swapped Video (SSV) database for use in misophonia research. In Study 1, we created a set of 39 video clips depicting common trigger sounds (original video sources, OVS) and a corresponding set of 39 PAVS temporally synchronized with the OVS videos. In Study 2, participants (N = 34) rated the 39 PAVS videos for their audiovisual match and pleasantness. We selected the 20 PAVS videos with best match scores for use in Study 3. In Study 3, a new group of participants (n = 102) observed the 20 selected PAVS and 20 corresponding OVS and judged the pleasantness or unpleasantness of each sound in the two contexts accompanying each video. Afterward, participants completed the Misophonia Questionnaire (MQ). The results of Study 3 show a robust attenuating effect of PAVS videos on the reported unpleasantness of trigger sounds: trigger sounds were rated as significantly less unpleasant when paired with PAVS with than OVS. Moreover, this attenuating effect was present in nearly every participant (99 out of 102) regardless of their score on the MQ. In fact, we found a moderate positive correlation between the PAVS-OVS difference and misophonia severity scores. Overall our results provide validation that the SSV database is a useful stimulus database to study how misophonic responses can be modulated by visual contexts. Here, we release the SSV database with the best 18 PAVS and 18 OVS videos used in Study 3 along with aggregate ratings of audio-video match and pleasantness (https://osf.io/3ysfh/). We also provide detailed instructions on how to produce these videos, with the hope that this database grows and improves through collaborations with the community of misophonia researchers.

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Section: Discussionmentioning

confidence: 99%

Development and Evaluation of a Sound-Swapped Video Database for Misophonia

et al. 2022

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“…Determining the relationships of these emotional processes with misophonia can help clarify intervention targets for clinicians and treatment researchers. This clarification is important, as there are currently no evidencebased interventions designed for adults with misophonia, and few randomized trials have been conducted [17,18]. Further, despite empirical evidence that mood and anxiety disorders cooccur with misophonia [6,14,15], investigation of misophonia thus far has not controlled for depression and anxiety symptoms.…”

Section: Introductionmentioning

confidence: 99%

Examining emotional functioning in misophonia: The role of affective instability and difficulties with emotion regulation

et al. 2022

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Misophonia is a newly described condition characterized by sensory and emotional reactivity (e.g., anxiety, anger, disgust) to repetitive, pattern-based sounds (e.g., throat clearing, chewing, slurping). Individuals with misophonia report significant functional impairment and interpersonal distress. Growing research indicates ineffective coping and emotional functioning broadly (e.g., affective lability, difficulties with emotion regulation) are central to the clinical presentation and severity of misophonia. Preliminary evidence suggests an association between negative emotionality and deficits in emotion regulation in misophonia. Still, little is known about (a) the relationships among specific components of emotional functioning (e.g., emotion regulation, affective lability) with misophonia, and (b) which component(s) of misophonia (e.g., noise frequency, emotional and behavioral responses, impairment) are associated with emotional functioning. Further, despite evidence that mood and anxiety disorders co-occur with misophonia, investigation thus far has not controlled for depression and anxiety symptoms. Examination of these relationships will help inform treatment development for misophonia. The present study begins to disambiguate the relationships among affective lability, difficulties with emotion regulation, and components of misophonia. A sample of 297 participants completed questionnaires assessing misophonia, emotional functioning, depression, anxiety, and COVID-19 impact. Findings indicated that misophonia severity was positively associated with each of these constructs with small to medium effect sizes. When controlling for depression, anxiety, and COVID-19 impact, results from this preliminary study suggest that (a) difficulties with emotion regulation may be correlated with misophonia severity, and (b) misophonic responses, not number of triggers or perceived severity, are associated with difficulties with emotion regulation. Overall, these findings begin to suggest that emotion regulation is important to our understanding the risk factors and treatment targets for misophonia.

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“…In general, different studies have presented cases subjecting misophonic patients to different cognitive-behavioral therapy plans, using, for example, principles of exposure and response prevention [ 71 , 92 , 95 , 96 ]. Moreover, separate analyses have been performed for patients with tinnitus, hyperacusis, and misophonia [ 96 , 97 ].…”

Section: Results Of the Bibliographic Researchmentioning

confidence: 99%

Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field

Ferrer-Torres

2022

IJERPH

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Misophonia is a scarcely known disorder. This systematic review (1) offers a quantitative and qualitative analysis of the literature since 2001, (2) identifies the most relevant aspects but also controversies, (3) identifies the theoretical and methodological approaches, and (4) highlights the outstanding advances until May 2022 as well as aspects that remain unknown and deserve future research efforts. Misophonia is characterized by strong physiological, emotional, and behavioral reactions to auditory, visual, and/or kinesthetic stimuli of different nature regardless of their physical characteristics. These misophonic responses include anger, general discomfort, disgust, anxiety, and avoidance and escape behaviors, and decrease the quality of life of the people with the disorder and their relatives. There is no consensus on the diagnostic criteria yet. High comorbidity between misophonia and other psychiatric and auditory disorders is reported. Importantly, the confusion with other disorders contributes to its underdiagnosis. In recent years, assessment systems with good psychometric properties have increased considerably, as have treatment proposals. Although misophonia is not yet included in international classification systems, it is an emerging field of growing scientific and clinical interest.

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Transdiagnostic cognitive behavioral therapy for misophonia in youth: Methods for a clinical trial and four pilot cases

Cited by 31 publications

References 38 publications

Development and Evaluation of a Sound-Swapped Video Database for Misophonia

Development and Evaluation of a Sound-Swapped Video Database for Misophonia

Examining emotional functioning in misophonia: The role of affective instability and difficulties with emotion regulation

Misophonia: A Systematic Review of Current and Future Trends in This Emerging Clinical Field

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