Abstract Individuals with misophonia present with sensitivity to selective sounds and, may experience negative psychological and physiological reactions when exposed to triggers. Previous studies ...have examined the clinical correlates and phenomenology of misophonia; however, further research is warranted to extend findings beyond samples from Western cultures. Accordingly, this study investigated the incidence and phenomenology of misophonia in a sample of Chinese college students ( N =415; M age =19.81; SD =1.16) through the use of self-report measures. Approximately 6% of the sample exhibited clinically significant misophonia symptoms with associated impairment. In addition, misophonia symptoms were associated with impairment across work, school, social, and family domains. Medium to strong relationships were observed with general sensory sensitivities, obsessive-compulsive, anxiety, and depressive symptoms. Anxiety significantly mediated the relationship between misophonia and anger outbursts. This study indicates that symptoms of misophonia are common and directly associated with multiple domains of psychopathology.
Adjunctive strategies that effectively incorporate adolescents’ developmental needs may augment the therapeutic benefits of cognitive behavioral therapy (CBT) for adolescents with attention deficit ...hyperactivity disorder (ADHD). This preliminary study evaluated a combined CBT and music-based treatment designed to enhance emotion-regulation skills in adolescents with ADHD. Utilizing a single-case experimental design, eight adolescents with ADHD were assigned to a 3-week baseline assessment phase followed by 12 weekly individual sessions of treatment and a 2-month follow-up phase. The intervention was effective in reducing the core symptoms of ADHD, such that, participants showed an increase in adaptive emotion-regulation strategies (cognitive reappraisal) and decrease in maladaptive emotion-regulation strategies (expressive suppression). The intervention was also found to be highly acceptable to participants. The findings provide initial support for combining standard CBT with music-based treatment designed to enhance emotion-regulation skills, and add to the growing body of literature showing that adjunctive strategies can augment the therapeutic benefits of CBT for adolescents with ADHD.
Background
Cognitive‐behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are recommended treatments for pediatric obsessive‐compulsive disorder (OCD), but their relative efficacy and ...acceptability have not been comprehensively examined. Further, it remains unclear whether the efficacy of in‐person CBT is conserved when delivered in other formats, such as over telephone/webcam or as Internet‐delivered CBT (ICBT).
Methods
PubMed, PsycINFO, trial registries, and previous systematic reviews were searched for randomized controlled trials (RCTs) comparing CBT (in‐person, webcam/telephone‐delivered, or ICBT) or SRIs with control conditions or each other. Network meta‐analyses were conducted to examine efficacy (post‐treatment Children's Yale‐Brown Obsessive Compulsive Scale) and acceptability (treatment discontinuation). Confidence in effect estimates was evaluated with CINeMA (Confidence in Network Meta‐Analysis).
Results
Thirty eligible RCTs and 35 contrasts comprising 2,057 youth with OCD were identified. In‐person CBT was significantly more efficacious than ICBT, waitlist, relaxation training, and pill placebo (MD range: 3.95–11.10; CINeMA estimate of confidence: moderate) but did not differ significantly from CBT delivered via webcam/telephone (MD: 0.85 −2.51, 4.21; moderate), SRIs (MD: 3.07 −0.07, 6.20; low), or the combination of in‐person CBT and SRIs (MD: −1.20 −5.29, 2.91; low). SRIs were significantly more efficacious than pill placebo (MD: 4.59 2.70, 6.48; low) and waitlist (MD: 8.03 4.24, 11.82; moderate). No significant differences for acceptability emerged, but confidence in estimates was low.
Conclusions
In‐person CBT and SRIs produce clear benefits compared to waitlist and pill placebo and should be integral parts of the clinical management of pediatric OCD, with in‐person CBT overall having a stronger evidence base. The combination of in‐person CBT and SRIs may be most efficacious, but few studies hinder firm conclusions. The efficacy of CBT appears conserved when delivered via webcam/telephone, while more trials evaluating ICBT are needed.
Misophonia is a disorder of decreased tolerance to specific sounds or their associated stimuli that has been characterized using different language and methodologies. The absence of a common ...understanding or foundational definition of misophonia hinders progress in research to understand the disorder and develop effective treatments for individuals suffering from misophonia. From June 2020 through January 2021, the authors conducted a study to determine whether a committee of experts with diverse expertise related to misophonia could develop a consensus definition of misophonia. An expert committee used a modified Delphi method to evaluate candidate definitional statements that were identified through a systematic review of the published literature. Over four rounds of iterative voting, revision, and exclusion, the committee made decisions to include, exclude, or revise these statements in the definition based on the currently available scientific and clinical evidence. A definitional statement was included in the final definition only after reaching consensus at 80% or more of the committee agreeing with its premise and phrasing. The results of this rigorous consensus-building process were compiled into a final definition of misophonia that is presented here. This definition will serve as an important step to bring cohesion to the growing field of researchers and clinicians who seek to better understand and support individuals experiencing misophonia.
Misophonia is characterized by extreme aversive reactions to certain classes of sounds. It has recently been recognized as a condition associated with significant disability. Research has begun to ...evaluate psychopathological correlates of misophonia. This study sought to identify profiles of psychopathology that characterize misophonia in a large community sample. A total of N = 628 adult participants completed a battery of measures assessing anxiety and anxiety sensitivity, depression, stress responses, anger, dissociative experiences, obsessive-compulsive symptoms and beliefs, distress tolerance, bodily perceptions, as well as misophonia severity. Profile Analysis via Multidimensional Scaling (PAMS) was employed to evaluate profiles associated with elevated misophonia and those without symptoms. Three profiles were extracted. The first two accounted for 70% total variance and did not show distinctions between groups. The third profile accounted for 11% total variance, and showed that misophonia is associated with lower obsessive-compulsive symptoms for neutralizing, obsessions generally, and washing compared to those not endorsing misophonia, and higher levels of obsessive-compulsive symptoms associated with ordering and harm avoidance. This third profile extracted also showed significant differences between those with and without misophonia on the scale assessing physical concerns (that is, sensitivity to interoceptive sensations) as assessed with the ASI-3. Further research is called for involving diagnostic interviewing and experimental methods to clarify these putative mechanisms associated with misophonia.
•Misophonia is a condition characterized by extreme negative emotional reactions to specific sounds.•A large community sample (N=628) were assessed for misophonia severity and other psychopathology variables.•A profile extracted differentiated misophonia individuals from those without, with need for ordering especially distinct.
Misophonia is a complex condition characterized by extreme emotional distress in response to specific sounds or specific visual stimuli. Despite a growing body of clinical and neuroscientific ...literature, the etiology of this condition remains unclear. Hyperarousal, that is, a state of heightened alertness and disinhibition, as a core feature of misophonia is supported by behavioral and neuroimaging literature and might represent a viable clinical target for the development of both behavioral and pharmacological interventions. The aim of this study was to investigate how hyperarousal might be linked to neurocognitive processes associated with vigilance and stimulus discrimination in youth with misophonia.
We compared 72 children and adolescents with misophonia (13.74 ± 2.44 years) (64 % female) and 89 children and adolescents with anxiety (12.35 ± 2.57 years) (58.4 % female) on behavioral and signal detection performance of the immediate memory task (IMT). Anxiety patients were used as a clinical control group to distinguish attentional processes specific for misophonia.
Both groups demonstrated similar behavioral performance, including response rate and reaction time. However, misophonia was associated with elevated stimulus discrimination (d prime), which in turn was positively correlated with the severity of misophonia trigger reports.
Our findings are in line with previous cognitive and neuroimaging studies, and support an arousal-based model of misophonia, where individuals with misophonia experience a state of heightened vigilance, being more aware of stimuli in the environment. Our findings provide a neurocognitive basis for future study of neurochemical imaging that might further progress towards clinical targets.
•Signal detection theory measures can distinguish misophonia from anxiety.•Misophonia is characterized by heightened stimulus discrimination.•Stimulus discriminability was positive correlated with the severity of misophonic trigger phenomenon.
This study examined changes in utilization of mental health services after Hurricane Katrina among children with preexisting conditions who were displaced from their homes in Louisiana disaster ...counties and resettled in Texas.
A retrospective analysis was performed on Medicaid claims data for 101,950 children from 2004 to 2006. Pre-post changes in utilization of mental health services by the displaced children and three control groups were compared. The control groups were children from Louisiana disaster counties who were not displaced, Louisiana children from nondisaster counties, and Texas children enrolled in Medicaid.
The proportion of children who had a prescription fill for psychotropic medication and the average days' supply per child decreased in each group, but the decreases were significantly larger for the displaced group than for the control groups. The decreases in both measures were largest for stimulants and antidepressants, the two most common medication classes. By contrast, changes in the proportion of children with an encounter involving psychiatric services and the average number of psychiatric services encounters per child did not vary systematically across the displaced and control groups.
The contrast between the results for medication utilization and encounters reveals a potential gap in post-Katrina provision of care. Although the findings for encounters indicate that, on average, displaced children did not experience a disruption in provider visits, the medication estimates suggest that they often did not obtain pharmaceutical treatment. Future disaster responses may be improved by addressing logistical impediments faced by disaster victims in filling their prescriptions for psychiatric medications.
PDF
