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CBT May well Be an Successful Cure for Misophonia

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In a research published in the July 2021 problem of Depression and Panic, Jager and colleagues current findings from the to start with randomized, controlled demo of cognitive behavioral treatment for the remedy of misophonia. Just before summarizing the investigation’s conclusions, permit me describe what misophonia is and what leads to it.

What is misophonia?

Misophonia usually means hatred of selected sounds. Normal misophonia triggers are breathing appears and ingesting appears — heavy respiratory, sniffing, chewing, lip-smacking, swallowing, throat clearing, sucking, slurping, sighing, and yawning. On the other hand, misophonia triggers are not the very same for anyone (or at distinctive situations). In fact, any patterned and repetitive audio (e.g., clicking, tapping), specifically sounds that are tough to steer clear of, could be triggering.

Psychological reactions to misophonia triggers can include stress, panic, pain, discomfort, disgust, and especially anger and rage. Misophonia is affiliated not only with powerful psychological reactions but also bodily reactions (e.g., muscle mass rigidity, improved heart amount), and behavioral responses (e.g., aggressive outbursts). A wide range of psychological illnesses could co-happen with misophonia, the most widespread just one staying obsessive-compulsive disorder (OCD).

What triggers misophonia?

Small is identified about the leads to of misophonia. Misophonia is not acknowledged as a psychiatric health issues or a neurological condition, that means there are no conventional diagnostic criteria. However, misophonia seems to be a lot more of a psychiatric problem than a neurological just one. For instance, hearing sensitivity would seem to be normal in people with misophonia, nevertheless the processing of sound may perhaps be irregular, maybe due to autonomic anxious system and limbic excitation.

Some study implies that what underlies misophonia is a blend of “abnormal salience attributed to usually innocuous sounds” and altered interoception, that means irregular perception of inner states.

Misophonia normally develops in childhood or the early teenage a long time. In one particular investigation, a single-third of people today with misophonia had family customers with misophonia, suggesting the existence of genetic threat things or genetic causes. And just about half the sample experienced co-transpiring mental health and fitness ailments (e.g., tinnitus, PTSD, ADHD, taking in disorders).

Approximately 4% also had hyperacusis—a problem frequently puzzled with misophonia. Hyperacusis is characterized by high sensitivity to sounds knowledgeable as unbearably and painfully loud (e.g., auto engines, vacuum cleaners, barking canines, refrigerator lovers). Misophonia differs from hyperacusis in that it is characterised extra by psychological reactions to specific sounds than by intolerance of sounds professional as too loud.

In the earlier mentioned review, 50 percent of the sample also professional autonomous sensory meridian response (ASMR)—tingling sensations on the scalp, neck, and back, and accompanied by emotions of leisure and euphoria. The importance of this connection involving ASMR and misophonia is not very clear.

Cognitive behavioral treatment for misophonia

Let me now transform to treatment plans for misophonia precisely, the examine of cognitive behavioral remedy (CBT) for misophonia by Jager et al.


Folks with misophonia were recruited from an outpatient clinic. The diagnostic conditions utilized ended up proposed by Schroder et al. Exclusion requirements provided using specific medicine, a latest diagnosis of psychiatric issues (e.g., nervousness, depression, schizophrenia, autism, bipolar ailment), and stroke or structural nervous technique ailments.

Participants (54 38 gals typical age of 33 yrs) were being randomly assigned to a misophonia therapy and a ready list problem.

The intervention was a variation of group CBT. It consisted of the next parts: process concentration workouts, stimulus manipulation (manipulating the trigger appears on a laptop), arousal and stress reduction, good have an impact on labeling, reevaluation of ingesting norms, psychoeducation for household and buddies, and training the learned procedures with the family members.

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The intervention comprised 7 weekly meetings of psychotherapy and psychomotor treatment, moreover a follow-up session a few months afterwards.

The major outcomes were being misophonia indicators, which ended up assessed using the Amsterdam Misophonia Scale‐Revised (AMISOS‐R).

Secondary results, mostly linked to mental and physical health and fitness and working, consisted of the CGI Severity scale (CGI‐S), Symptom Checklist‐90‐Revised, the five‐dimensional EuroQol (EQ5‐D), the WHO High-quality of Life‐BREF (WHOQoL‐BREF), and the Sheehan Disability Scale (SDS).


Analysis of knowledge showed that “CBT resulted in statistically noticeably much less misophonia signs or symptoms in the short‐term (−9.7 AMISOS‐R 95% CI, −12. to −7.4 p < .001, d = 1.97).”

Clinical improvement in symptoms, operationalized as CGI‐I < 3, was noted in 37% of individuals with misophonia in the CBT treatment, compared to 0% in those in the waiting list control condition (p < .001).

Aside from the improvement in misophonia symptoms, there was a reduction in mental dysfunction and physical dysfunction—particularly in terms of impairment and disability in social and family functioning. The beneficial effects of cognitive behavioral therapy were maintained a year later.


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How to deal with misophonia

As noted, misophonia is commonly defined as hatred of sound, especially certain eating sounds (e.g., slurping) and breathing sounds (e.g., yawning). A variety of self-help and therapeutic methods are used to manage misophonia: earplugs, headphones, white noise, distraction, anti-anxiety medications (e.g., benzodiazepines), antidepressants (e.g., the SSRIs), certain therapies (e.g., tinnitus retraining therapy), etc. However, these approaches have had limited success.

The findings reviewed today—of the first randomized, controlled trial of CBT for treating misophonia—indicate CBT may be an effective intervention for misophonia worthy of serious consideration.

If you already have a diagnosis of misophonia and are seeing a therapist, ask if CBT might be helpful for managing your symptoms.

In terms of self-help strategies, it is important to follow a healthy lifestyle—regular physical activity, sufficient sleep, eating healthily, and using effective stress management techniques (e.g., relaxation exercises, meditation practices).

Finally, regardless of the nature of the triggers and causes of misophonia, sometimes the quickest and simplest solution is to leave a triggering situation. While away from the situation, you can work on reducing your stress and tension (e.g., by engaging in breathing techniques, mindfulness meditation, or progressive muscle relaxation). Return only when feeling more centered, calm, and relaxed.