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Id 5f0dea96-5258-4bdb-bc09-f20febb3fc51

Year 2023

Abstract

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purpleRed

Aliases

(Mattson et al., 2023)

Import Date 01-24-2026

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Dv Authors Seth A. Mattson, Johann D'Souza, Katharine D. Wojcik, Andrew G. Guzick, Wayne K. Goodman, Eric A. Storch,

Dv Initial Source Misophonia MOCMisophonia

Dv Status #status/Bare-bones-review

Dv Limitations • Scarcity of RCTs and high reliance on case studies. • Small sample sizes, heterogeneity in interventions and outcome measures. • Lack of consensus on diagnostic criteria and standard outcome metrics. • Predominant use of self-report; clinician-administered scales underutilized.

Dv Future Directions • Develop and test mechanism-based treatment protocols with stakeholder input. • Conduct dismantling studies to isolate effective components. • Replicate promising interventions in independent samples. • Improve measurement tools (validity, clinician-administered scales). • Expand research on third-wave and pharmacological treatments.

Dv Relevance • a literature review of treatment approaches to Misophonia up to 2023 • found a lot of what we already expected, with CBT being the most used and successful. they also discuss CBT with exposure to mixed results. • a good source for spinning someone up on the (as of this article) current treatment attempts.

•

A systematic review of treatments for misophonia

Status:: #status/Bare-bones-review

Metadata

Item Type: #journalArticle
Authors:: Seth A. Mattson, Johann D'Souza, Katharine D. Wojcik, Andrew G. Guzick, Wayne K. Goodman, Eric A. Storch,
Date Added: May 12, 2023
URL: https://linkinghub.elsevier.com/retrieve/pii/S2468171723000054
DOI: 10.1016/j.pmip.2023.100104
Cite Key: mattsonSystematicReviewTreatments2023
Tags:: #Bare-bones-review-🦴 , #Misophonia, #literature-review, #treatment, #CBT, #assessment,
PDF Attachments

Abstract


Background/Purpose	Background- • Misophonia was first formally named in 2002 and typically presents in childhood/adolescence. • Triggers are most often oral/nasal sounds (e.g., chewing, breathing), producing intense emotional and autonomic reactions. • Common comorbidities include depression, anxiety, OCD, ADHD, autism, and suicidality. • Functional neuroimaging implicates hyperconnectivity between auditory and motor circuits (e.g., anterior insula). • Despite increasing recognition, treatment research is in early stages and lacks methodological rigor. Purpose- • To systematically review all peer-reviewed treatments specifically targeting misophonia symptoms. • Identify the effectiveness of different treatment modalities and assess trends in the literature to inform clinical practice and future research.
Participants/samples	• 33 studies included: 1 RCT, 1 open-label trial, and 31 case studies/series. • Wide age range and diverse comorbidity profiles. • Inclusion required English-language full-text studies focusing on misophonia as a primary or secondary treatment target.
Measures	N/A
Procedures	N/A
Results	• CBT: • Most studied and most effective across modalities. • RCT by Jager et al. (2020): group CBT led to a 9.7-point AMISOS-R reduction (d = 1.97); 37% were treatment responders. • Open-label trial: 90 patients, 48% with ≥30% reduction in A-MISO-S. • CBT with exposure therapy: • Mixed outcomes; some show strong benefit, others show no change. • Exposure integrated into broader CBT or as graded/inhibitory learning models. • One case (Dover & McGuire): 70% symptom reduction, 75% reduction in family accommodation behaviors. • Third-wave therapies: • ACT and DBT showed positive outcomes in isolated cases, targeting emotion regulation and acceptance. • Example: DBT led to A-MISO-S reduction from 22 to 10 over 7 weeks. • TRT: • Jastreboff studies showed ~86% self-reported improvement. • One case showed AMISOS-R decrease from 17 to 6 after 28 weeks. • Pharmacotherapy: • SSRIs (fluoxetine, sertraline, escitalopram) yielded partial to full remission in some cases. • Propranolol reduced autonomic arousal symptoms (e.g., A-MISO-S drop from 15 to 2). • Risperidone improved symptoms in a child with autism. • Methylphenidate combined with CBT helped in ADHD comorbidity.
Discussion/Limits	Conclusion- • CBT, especially group-based, is the most promising treatment, with moderate to large effect sizes in the RCT. • The field lacks clarity on which components (e.g., exposure, relaxation, cognitive reappraisal) are most effective. • Exposure-based approaches may benefit from inhibitory learning models rather than habituation. • Preliminary evidence supports ACT, DBT, and pharmacological interventions in specific contexts.
Limitations::	• Scarcity of RCTs and high reliance on case studies. • Small sample sizes, heterogeneity in interventions and outcome measures. • Lack of consensus on diagnostic criteria and standard outcome metrics. • Predominant use of self-report; clinician-administered scales underutilized.
Future Directions::	• Develop and test mechanism-based treatment protocols with stakeholder input. • Conduct dismantling studies to isolate effective components. • Replicate promising interventions in independent samples. • Improve measurement tools (validity, clinician-administered scales). • Expand research on third-wave and pharmacological treatments.
Relevance::	• a literature review of treatment approaches to Misophonia up to 2023 • found a lot of what we already expected, with CBT being the most used and successful. they also discuss CBT with exposure to mixed results. • a good source for spinning someone up on the (as of this article) current treatment attempts.

key terms

Misophonia – A condition marked by decreased tolerance to specific auditory stimuli (“triggers”) leading to intense negative emotional, physiological, and behavioral reactions, including anger, disgust, anxiety, and autonomic arousal.
Cognitive Behavioral Therapy (CBT) – A psychological intervention aiming to restructure maladaptive thought patterns and behaviors; in misophonia, often includes counter-conditioning, task concentration, and arousal reduction.
Counter-conditioning – A behavioral technique where a negative trigger (e.g., chewing sound) is paired with a positive stimulus to elicit a new, more adaptive emotional response.
Exposure Therapy – A behavioral technique involving gradual exposure to feared or avoided stimuli to reduce associated distress; in misophonia, used to reduce reactivity to trigger sounds.
Third-wave behavioral therapies – Therapies like Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT) that emphasize mindfulness, acceptance, and values-based action.
Tinnitus Retraining Therapy (TRT) – A therapy involving sound exposure and habituation, adapted for misophonia to reduce distress toward trigger noises.
Amsterdam Misophonia Scale (A-MISO-S) – A clinician-administered scale modeled on the Y-BOCS to measure misophonia severity.
AMISOS-R – Revised self-report version of the A-MISO-S with improved psychometric properties.
CGI-I – Clinical Global Impression-Improvement scale, a one-item measure assessing clinician-rated improvement over time.

my engagement notes

my questions

my comments

Bookmarks

bookmark for Cognitive-Behavioral therapy (page 5)
bookmark for CBT with exposure therapy (page 5)
bookmark for talking about “Third-Wave” therapy approaches (page 9)
bookmark for Pharmacotherapy (page 9)

reading notes

Heterogeneity in Treatment Responses

Interventions worked variably depending on symptom severity, age, comorbidities, and modality (e.g., virtual vs. in-person).

Importance of Family Involvement

Several successful protocols incorporated family education or behavioral coaching (e.g., parent management training).

Need for Stakeholder Engagement

Authors emphasize participatory research approaches to improve real-world implementation and ecological validity.

zettelkasten

Mattson 2023 on CBT and treatment outcomes in Misophonia