Properties (9)
Id
b4eb7ebd-44e4-4f00-90d1-b0600e2aedb4
Year
2026
Abstract
Background/Objectives: Given that the evidence-based treatment for pediatric misophonia remains in its early stages, families have developed their own strategies to cope with misophonia-related distress. The control-based model of coping distinguishes between voluntary coping and involuntary responses to stressful events and provides a useful framework for understanding responses to misophonia-related distress. This report sought to characterize the range of coping strategies and involuntary stress responses among youth and families and their associations with misophonia symptom severity to inform novel targets for future family-focused interventions. Methods: Participants were recruited online across the United States and included 85 parents (M = 42.58 years, SD = 6.25) who reported on their children (M = 12.92 years, SD = 2.34) with misophonia symptoms. Parents completed questionnaires about their child’s misophonia symptoms, coping and involuntary stress responses, parent responses to symptoms, perceived effectiveness of approaches, parenting stress, and family functioning. Results: Across misophonia measures, greater primary and secondary control coping were associated with lower misophonia symptom severity (rs = −0.31 to −0.59, ps ≤ 0.004), whereas involuntary engagement and involuntary disengagement were associated with greater symptom severity (rs = 0.29 to 0.60, ps ≤ 0.007). Associations between disengagement coping and symptom severity were less consistent across measures. More frequent parent responses to misophonia were associated with greater misophonia symptom severity across measures (rs = 0.45 to 0.65, ps < 0.001). Conclusions: A range of strategies are utilized by youth and families to manage misophonia-related distress, which have unique connections to misophonia symptom severity. Family-focused interventions may benefit from promoting flexible, collaborative strategy use aimed at reducing impairment, rather than categorizing strategies as uniformly “adaptive” or “maladaptive.”
Cssclasses
- purpleRed
Aliases
- Characterizing How Families Cope with Pediatric Misophonia
- (Pine et al., 2026)
Import Date
11-03-2026
Initial Source
- Misophonia
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Characterizing How Families Cope with Pediatric Misophonia: Youth Coping, Parent Responses, and Associations with Symptom Severity
Status::
Metadata
- Item Type: #journalArticle
- Authors:: Abigail E. Pine, Bruce E. Compas, Joseph F. McGuire,
- Date Added: October 18, 2026
- URL: https://www.mdpi.com/2077-0383/15/20/7986
- DOI: 10.3390/jcm15207986
- Cite Key: pineCharacterizingHowFamilies2026
- Tags:: #Bare-bones-review-🦴, #clinical, #coping, #Misophonia, #parenting, #youth,
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia: Intense emotional, physiological, and/or behavioral responses to specific sounds or associated stimuli, typically beginning in childhood and significantly affecting youth and families. • Treatment limitations: Evidence-based interventions remain limited. CBT shows initial promise but has primarily been studied in adults, with limited RCT evidence. Common techniques include graded exposure, cognitive restructuring, distress tolerance, and mindfulness. • Individual differences: Misophonia-specific characteristics, developmental factors, and family context may limit the uniform application of CBT, leading many families to develop their own coping strategies. • Control-based coping model: Applied to youth experiencing chronic stress, with primary and secondary control coping associated with lower psychopathology and disengagement coping with greater symptoms. Particularly relevant to misophonia given the unpredictability and limited controllability of triggers and reactions. • Parental influence: Parents shape youth coping through reinforcement, modeling, and emotional validation, with family functioning and parenting stress influencing their responses. • Research gap: No prior studies have applied the control-based coping model to misophonia or examined how parental responses support youth coping and stress regulation in this population. Purpose- • Apply the control-based coping model to characterize how youth and families respond to misophonia-related distress, to inform targets for family-focused interventions. • Describe youth responses, parent responses, and parents’ perceived effectiveness of these approaches. • Examine associations among youth responses, parent responses, and misophonia symptom severity. • Explore how parenting stress and family functioning relate to youth and parent processes. • Hypothesis: greater primary and secondary control coping associated with lower symptom severity; greater disengagement coping, involu |
| Participants/samples | • N = 85 parents reporting on their children with misophonia symptoms; mostly mothers. • Youth aged 8–17; mean age ~13; slightly more female than male. • Recruited online across the United States through misophonia organizations, social media, and listservs. • Inclusion: U.S. residence; parent-reported child aged 8–17 with misophonia symptoms on a parent-reported Duke-Vanderbilt Misophonia Screening Questionnaire. • Exclusion: responses with indicators of invalid responding (internally inconsistent responses across overlapping items, completion in under 15 min, highly similar response patterns); duplicate email/IP addresses at screening. |
| Measures | • Symptom severity (all parent-report adaptations): Amsterdam Misophonia Scale (A-MISO-S; five-item total excluding item four; a priori primary measure), Misophonia Assessment Questionnaire (MAQ), Duke-Vanderbilt Misophonia Screening Questionnaire (DVMSQ), Duke Misophonia Questionnaire (DMQ; affective, physiological, and cognitive subscale composite, cognitive items reworded to thoughts the child expressed). • Youth coping and involuntary stress responses: Responses to Stress Questionnaire (RSQ) adapted for misophonia; five factors calculated as proportion scores; parents also rated perceived effectiveness of broad coping categories. • Parent responses: Family Accommodation Scale for Misophonia (FAS); nine-item frequency sum score; parents rated perceived effectiveness of each response type. • Family context: Parenting Stress Scale (PSS); Family Assessment Device–General Functioning Subscale (FAD-GF). |
| Procedures | • Cross-sectional online survey battery completed via REDCap after informed consent under a waiver of documentation. • RSQ: parents rated misophonia-related stressors their child experienced in the past six months, then how the youth responded to those stressors. • Analyses: bivariate correlations; three linear regressions predicting A-MISO-S (coping model with primary control, secondary control, and disengagement as simultaneous predictors; involuntary stress response model with involuntary engagement and disengagement; parent response model with FAS frequency). • Two hierarchical regressions tested parent responses × coping domains and parent responses × involuntary stress response domains; mean-centered predictors; significant interactions probed with simple slopes at low, mean, and high parent responses. • Benjamini-Hochberg FDR correction applied separately to youth–parent response correlations and family context correlations. |
| Results | Descriptive patterns • Involuntary engagement accounted for the largest proportion of youth stress responses, followed by involuntary disengagement, secondary control, primary control, and disengagement coping. • Avoidance and problem-solving/environmental modification were perceived as most helpful youth strategies; rumination least helpful. • Most frequent parent responses: modifying own behavior, assisting in avoidance of triggers, providing reassurance, modifying family routines; modifying own behavior, assisting in avoidance, modifying routines, and providing needed items (e.g., headphones) perceived as most helpful. Associations with symptom severity • Greater primary and secondary control coping associated with lower symptom severity across measures and independently in the coping model. • Greater involuntary engagement and involuntary disengagement associated with greater symptom severity across measures and independently in regression. • Disengagement coping associated with lower severity on the A-MISO-S only (not other measures); independently associated with lower severity in the coping model. • More frequent parent responses associated with greater symptom severity across measures and in regression. • No youth–parent response correlations survived multiple-comparison correction. Moderation by parent responses • Coping interaction terms did not improve model fit overall; disengagement coping × parent responses was significant, with greater disengagement coping associated with lower severity at mean and high but not low parent responses. • Involuntary stress response interaction terms improved model fit; involuntary disengagement × parent responses was significant, with greater involuntary disengagement associated with greater severity at mean and high but not low parent responses; primary control, secondary control, and involuntary engagement interactions were not significant. Family context - Greater parenting stress associated with lower primary and secondary control coping and greater involuntary engagement and disengagement; not with disengagement coping or parent responses. - No significant associations between family functioning and youth or parent responses after correction. |
| Discussion/Limits | Conclusion- • Coping responses: Families use diverse voluntary coping strategies, involuntary stress responses, and parental support to manage misophonia-related distress, representing potential targets for family-focused interventions. • Involuntary responses: Engagement and disengagement were most prevalent, consistent with the automatic physiological arousal associated with triggers. Interventions should distinguish between modifiable coping strategies and less controllable stress responses. • Control-based coping: Increasing primary and secondary control coping may reduce misophonia severity, particularly when strategies are matched to stressor controllability (primary for changeable, secondary for unchangeable stressors). • Disengagement and avoidance: Unlike anxiety and OCD, disengagement plays a complex role in misophonia. Given prevalent avoidance and low exposure acceptability, interventions should emphasize flexible, collaborative coping rather than treating avoidance as uniformly maladaptive. • Parental influence: Parent responses were directly associated with severity and moderated associations between disengagement and severity, although causality remains unclear. Parental involvement may help promote proactive coping. • Treatment implications: Interventions should target modifiable coping strategies, match approaches to stressor controllability, incorporate parental support, and align with family goals. • Conclusion: Findings provide preliminary support for applying the control-based coping model to misophonia and developing tailored, family-focused interventions. |
| Limitations:: | • Cross-sectional design precludes conclusions about causality or directionality. • Only symptom severity examined, not other indicators of functioning or quality of life over time. • Not all parent-report symptom measures were validated; internal consistency for primary control coping relatively low. • Online data collection limited control over completion conditions. • Parents were sole informants and may lack insight into child’s internal coping processes; shared method variance and conceptual overlap between symptom and coping items (e.g., avoidance) may have inflated associations. • Relatively small sample may have limited detection of smaller interaction effects. • Recruitment from misophonia-affiliated sources may overrepresent families seeking support, with more severe symptoms, or greater parental engagement; parent response–severity associations may not generalize. • Some misophonia-central strategies (e.g., headphone use) do not cleanly map onto coping or involuntary response categories; function and context may matter as much as the behavior. |
| Future Directions:: | • Multi-informant, longitudinal studies in larger samples to examine coping and involuntary stress responses across clinically meaningful outcomes over time (symptom severity, daily activity engagement, quality of life). • Differentiate specific coping behaviors from their function to test whether the framework captures misophonia-specific coping. • Measure real-time coping in context, e.g., ecological momentary assessment. • Pilot new interventions with iterative family feedback to evaluate feasibility and acceptability while minimizing unintended harm. |
| Relevance:: | • info on coping with Misophonia |
Notes
key terms and concepts
- Coping – conscious and volitional efforts to regulate emotion, cognition, behavior, physiology, and the environment in response to stressful events or circumstances.
- Involuntary stress responses – reactions to stress less directly under conscious control, including those influenced by temperament or conditioned responses.
- Control-based model of coping – framework distinguishing three coping categories (primary control, secondary control, disengagement) and two involuntary stress response categories (involuntary engagement, involuntary disengagement).
- Primary control coping – efforts to directly alter the stressor or one’s emotional response to it (problem solving, emotion regulation, emotional expression).
- Secondary control coping – efforts to adapt to aspects of the problem that cannot be directly changed (positive thinking, acceptance, cognitive reappraisal, distraction).
- Disengagement coping – efforts to orient away from the stressor (denial, avoidance, wishful thinking).
- Involuntary engagement – intrusive thoughts, rumination, and emotional or physiological arousal; RSQ factor also includes impulsivity.
- Involuntary disengagement – emotional numbing, cognitive interference, and escape behaviors (fleeing, inaction).
- Parent responses – parent behaviors in response to youth misophonia symptoms (participation in symptoms, assisting with avoidance, providing needed items such as headphones), assessed with the Family Accommodation Scale for Misophonia.
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contextual statement
In a 2026 study, Pine attempted to characterize youth coping, involuntary stress responses, and parent responses to pediatric misophonia and their associations with symptom severity by surveying 85 U.S. parents of youth aged 8–17 with misophonia symptoms using parent-report misophonia severity measures (A-MISO-S, MAQ, DVMSQ, DMQ), a misophonia-adapted Responses to Stress Questionnaire, the Family Accommodation Scale for Misophonia, and measures of parenting stress and family functioning.
Zettelkasten
Youth Coping and Parental Responses to Misophonia-Related Distress