Cognitive behavioral therapy for Misophonia, RCT

Individuals with misophonia experience extreme negative emotions such as anger
and disgust when they are exposed to specific human sounds, such as chewing or
sniffing. These negative emotions cause individuals to avoid situations where
they might be exposed to the trigger sound, compromising the ability to
function in daily life. Even though it has only recently been discovered and it
concerns specific and striking symptoms, there are indications that the
prevalence is quite high. All these patients could easily be missing out on
proper treatment when no explicit diagnostic criteria would have been
established. In 2013, researchers at the Academic Medical Center (AMC) in
Amsterdam proposed the first diagnostic criteria for misophonia based on the
extensive research on 42 patients. Since the first referrals of patients
suffering from misophonia to the AMC department of Psychiatry, many followed.
Several of these patients have, after being on a waiting list for several
months, experimentally been treated in a group therapy. This group therapy was
developed at the same department. To our knowledge, this is the very first
therapy worldwide, for specifically treating misophonia. This group therapy
consists of 8 sessions during 16 weeks, and is based on psychoeducation,
cognitive behavioural interventions, attention training and relaxation
exercises. In the last three years, this group therapy has led to a reduction
of misophonia symptoms in a considerable number of participating patients. In
fact, based on pre- and post-treatment A-MISO-S scores, a reduction of at least
35% of the total score was found in 53% of the patients. However, the
components of the therapy and their order have occasionally undergone several
minor changes, due to systematic and frequent evaluations by both patients and
therapists.

To evaluate the effect of the CBT groep treatment for misophonia.

The present study entails a randomized, wait-list controlled clinical trial
directed at patients suffering from misophonia met follow-up. The patients will
be randomly assigned to the intervention condition (group therapy for
misophonia) or to the control condition (waiting list for group therapy after
allocation at intake).

Cognitive Therapy (CT), attention training and applied relaxation. Subjects
will take part in our treatment program, which was especially developed for
treating patients with misophonia. The program follows a strict standardized
protocol for treatment in a group. Every two weeks, participants engage in a 90
minutes session of cognitive therapy, directly followed by a 75 minutes session
of both attention training and applied relaxation techniques. The program
consists of eight of these combined sessions. Two months and twelve month after
the last sessions, a 90 minutes follow-up session takes place. The group size
will be 8 patients maximum. Eligibility for the group therapy will be
determined by a team of psychiatrists, psychologists and psychiatric nurses,
who are specialized in treatment for misophonia and anxiety disorders.
Wait-list condition: Since there is no TAU for treating misophonia, a
randomized wait-list controlled trial was chosen as design. No interventions
targeted at treating the misophonia complaints will be carried out during the
wait-list condition.

Patients will undergo a 1/2hour during testbattery to report about their
complaints. These assessments will be repeated halfway treatment, posttreatment
and at 2 and 12 month followup. No risks are attached to this study.