Objective
Individuals with misophonia display extreme sensitivities to selective sounds, often resulting in negative emotions and subsequent maladaptive behaviors, such as avoidance and anger ...outbursts. While there has been increasing interest in misophonia, few data have been published to date.
Method
This study investigated the incidence, phenomenology, correlates, and impairment associated with misophonia symptoms in 483 undergraduate students through self‐report measures.
Results
Misophonia was a relatively common phenomenon, with nearly 20% of the sample reporting clinically significant misophonia symptoms. Furthermore, misophonia symptoms demonstrated strong associations with measures of impairment and general sensory sensitivities, and moderate associations with obsessive‐compulsive, anxiety, and depressive symptoms. Anxiety mediated the relationship between misophonia and anger outbursts.
Conclusion
This investigation contributes to a better understanding of misophonia and indicates potential factors that may co‐occur and influence the clinical presentation of a person with misophonia symptoms.
Family accommodation in obsessive–compulsive disorder (OCD) is characterized by myriad behaviors, such as modifying family routines, facilitating avoidance, and engaging in compulsions to reduce ...obsessional distress. It has been linked to various deleterious outcomes including increased functional impairment and poorer treatment response for OCD. Although extant literature suggests a linear relationship between family accommodation and OCD symptom severity, the magnitude and statistical significance of this association has been inconsistent across studies, indicating that moderators may be influencing this relationship. The present study examined this relationship using meta-analytic techniques, and investigated sample-dependent (age, gender, comorbid anxiety/mood disorders) and methodological (administration method and number of items used in family accommodation measure, informant type, sample size, publication year) moderators. Forty-one studies were included in the present meta-analysis, and the overall effect size (ES) for the correlation between family accommodation and OCD symptom severity was moderate (r=.42). Moderator analyses revealed that the number of items on the family accommodation scale moderated the ES. No other sample-dependent or methodological characteristics emerged as moderators. In addition to being the first systematic examination of family accommodation moderators, these results highlight the moderate relationship between family accommodation and OCD severity that is influenced by measurement scales. Findings may be used to guide clinical care and inform future investigations by providing a more nuanced understanding of family accommodation in OCD.
•This meta-analysis synthesized an overall effect size (ES) across 41 studies.•The ES for family accommodation and OCD symptom severity was r=.42.•This is the first meta-analysis to examine purported moderators of this ES.•The number of items used in the family accommodation measures moderated the ES.•Despite adequate power, no sample-dependent variables significantly moderated the ES.
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.
Professional organizations and expert consensus recommend the use of exposure‐based cognitive‐behavioral therapy (CBT) to treat pediatric obsessive‐compulsive disorder (OCD), but a sizable proportion ...of clinicians possess hesitancy regarding the use of exposures in treatment. Most notably, this hesitancy relates to concerns about negative patient and parent reactions to exposures. Accordingly, we examine three commonly reported clinician concerns regarding negative patient/parent reactions (e.g. treatment attrition, therapeutic relationship, and treatment satisfaction) among youths receiving exposure‐based CBT compared to a nonexposure‐based treatment. Based on our findings, there is no empirical support that exposure‐based CBT precipitates adverse consequences in treatment (e.g. treatment attrition, poor therapeutic relationship, low treatment satisfaction) relative to nonexposure‐based interventions. These results corroborate existing OCD expert recommendations for the use of exposure‐based CBT and provide information to mitigate clinicians’ concerns about the potentially iatrogenic impact of exposures when treating pediatric OCD. We briefly present best practice recommendations for implementing exposure‐based CBT in pediatric OCD patients.
Clinical guidelines recommend exercise as a core treatment for knee or hip osteoarthritis (OA). However, how its analgesic effect compares to analgesics, for example, oral non-steroidal ...anti-inflammatory drugs (NSAIDs) and paracetamol-the most commonly used analgesics for OA, remains unknown.
Network meta-analysis.
PubMed, Embase, Scopus, Cochrane Library and Web of Science from database inception to January 2022.
Randomised controlled trials (RCTs) comparing exercise therapy with oral NSAIDs and paracetamol directly or indirectly in knee or hip OA.
A total of n=152 RCTs (17 431 participants) were included. For pain relief, there was no difference between exercise and oral NSAIDs and paracetamol at or nearest to 4 (standardised mean difference (SMD)=-0.12, 95% credibility interval (CrI) -1.74 to 1.50; n=47 RCTs), 8 (SMD=0.22, 95% CrI -0.05 to 0.49; n=2 RCTs) and 24 weeks (SMD=0.17, 95% CrI -0.77 to 1.12; n=9 RCTs). Similarly, there was no difference between exercise and oral NSAIDs and paracetamol in functional improvement at or nearest to 4 (SMD=0.09, 95% CrI -1.69 to 1.85; n=40 RCTs), 8 (SMD=0.06, 95% CrI -0.20 to 0.33; n=2 RCTs) and 24 weeks (SMD=0.05, 95% CrI -1.15 to 1.24; n=9 RCTs).
Exercise has similar effects on pain and function to that of oral NSAIDs and paracetamol. Given its excellent safety profile, exercise should be given more prominence in clinical care, especially in older people with comorbidity or at higher risk of adverse events related to NSAIDs and paracetamol.CRD42019135166.
This meta-analysis examined treatment efficacy, treatment response, and diagnostic remission effect sizes and moderators of D-cycloserine-augmented exposure treatment in randomized controlled trials ...(RCTs) of individuals with anxiety disorders, obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD).
The terms D-cycloserine AND randomized controlled trial were used to search the PubMed (1965-May 2015), PsycINFO, and Scopus databases for randomized placebo-controlled trials of D-cycloserine-augmented exposure therapy for anxiety disorders, OCD, and PTSD.
Clinical variables and effect sizes were extracted from 20 RCTs (957 participants). A random-effects model calculated the effect sizes for treatment efficacy, treatment response, and diagnostic remission using standardized rating scales. Subgroup analyses and meta-regression were used to examine potential moderators.
A small, nonsignificant benefit of D-cycloserine augmentation compared to placebo augmentation was identified across treatment efficacy (g = 0.15), response (risk ratio RR = 1.08), and remission (RR = 1.109), with a moderately significant effect (P = .03) for anxiety disorders specifically (g = 0.33). At initial follow-up assessments, a small, nonsignificant effect size of D-cycloserine augmentation compared to placebo was found for treatment efficacy (g = 0.21), response (RR = 1.06), and remission (RR = 1.12). Specific treatment moderators (eg, comorbidity, medication status, gender, publication year) were found across conditions for both acute treatment and initial follow-up assessments.
D-Cycloserine does not universally enhance treatment outcomes but demonstrates promise for anxiety disorders. Distinct treatment moderators may account for discrepant findings across RCTs and disorders. Future trials may be strengthened by accounting for identified moderators in their design, with ongoing research needed on the mechanisms of D-cycloserine to tailor treatment protocols and maximize its benefit.
Pediatric obsessive-compulsive disorder (OCD) is associated with deleterious familial effects; caregivers are often enmeshed in the disorder and can experience considerable burden and decreased ...quality of life (QoL). Consequently, this study examined burden and QoL in caregivers of youth with OCD enrolled in an intensive outpatient or partial hospitalization program.
The relationships between caregiver QoL and burden and the following variables were investigated: OCD symptom severity, functioning (youth functional impairment, general family functioning), family (family accommodation, parental relationship satisfaction, positive aspects of caregiving), and comorbid psychopathology (caregiver anxiety and depressive symptoms, youth internalizing and externalizing behaviors). Seventy-two child and caregiver dyads completed clinician- and self-rated questionnaires.
Components of caregiver QoL correlated with caregiver-rated functional impairment, family accommodation, youth externalizing behaviors, and caregiver psychopathology. Aspects of caregiver burden correlated with child OCD symptom severity, functional impairment related to OCD, as well as caregiver and child comorbid psychopathology. Caregiver depressive symptoms predicted caregiver QoL, and caregiver depressive symptoms and child externalizing symptoms both predicted caregiver burden. Caregiver burden did not mediate the relationship between obsessive-compulsive symptom severity and caregiver QoL.
Ultimately, elucidating factors associated with increased caregiver burden and poorer QoL is pertinent for identifying at-risk families and developing targeted interventions.
To develop and examine the psychometric properties of the Children's Yale-Brown Obsessive-Compulsive Scale Second Edition (CY-BOCS-II) in children and adolescents with obsessive-compulsive disorder ...(OCD).
Youth with OCD (N = 102; age range 7-17 years), who were seeking treatment from 1 of 2 specialty OCD treatment centers, participated in the study. The CY-BOCS-II was administered at an initial assessment, and measures of OCD symptom severity, anxiety and depressive symptoms, behavioral and emotional problems, and global functioning were administered. Inter-rater and test-retest reliabilities were assessed on a subsample of participants (n = 50 and n = 31, respectively) approximately 1 week after intial assessment.
The CY-BOCS-II demonstrated moderate-to-strong internal consistency (α = 0.75-0.88) and excellent inter-rater (intraclass correlation coefficient = 0.86-0.92) and test-retest (intraclass correlation coefficient = 0.95-0.98) reliabilities across all scales. Construct validity was supported by strong correlations with clinician-rated measures of OCD symptom severity and moderate correlations with measures of anxiety symptoms. Exploratory factor analysis showed a 2-factor structure, which was generally inconsistent with its adult counterpart, the Yale-Brown Obsessive-Compulsive Scale Second Edition.
Initial findings support the CY-BOCS-II as a reliable and valid measure of obsessive-compulsive symptoms in youth.
Background: Access to psychosocial services is limited, especially during a pandemic. A Zoom-delivered family-based intervention for adolescents with type 1 diabetes has the potential to enhance ...access to psychosocial services.
Methods: Nine families enrolled in a pilot of a 6-session online (Zoom) intervention for adolescents with type 1 diabetes and their parents during the COVID-19 pandemic. Qualitative and quantitative data were collected via online focus groups and surveys.
Results: Teens’ ages ranged from 12-17 years (M=14.9, SD=1.76) and most self-identified as male (78%). All parents self-identified as female and most families self-identified as non-Hispanic white (78%). Qualitative results revealed that participants found the program to be generally helpful and would recommend the program to others. Perceived benefits included increased parental empathy toward teens, enhanced parental involvement in teens’ diabetes management, and decreased parent-teen conflict. Participants conveyed that these benefits were particularly impactful given increased family contact and tensions related to the COVID-19 pandemic. Identified areas for improvement included adding follow-up group sessions with parents to maintain program impact on parenting over time and to target teens in early adolescence, when family dynamics are more malleable. Quantitative results from paired t-tests of pre-post comparisons revealed no significant differences in teen or parental diabetes distress or depression (all p>0.05), but should be interpreted with caution due to small sample size.
Conclusions: Adolescents with type 1 diabetes and their parents responded positively to this program and found it particularly relevant during the current pandemic. Zoom delivery of these programs may be instrumental in their feasibility, acceptability, and ultimately dissemination in the future.
Disclosure
J. J. Wong: None. M. S. Lanning: None. J. Ngo: None. C. A. Wu: None. S. Hanes: None. H. M. Linzmeyer: None. D. Naranjo: None. K. K. Hood: Consultant; Self; Cecelia Health, Cercacor, LifeScan Diabetes Institute.
Funding
National Institute of Diabetes and Digestive and Kidney Diseases (1K23DK121771-01A1)
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