Treating Adolescent Misophonia With Cognitive Behavioral Therapy: Considerations for Including Exposure

Although misophonia is not yet included in the primary diagnostic manuals used by psychologists or psychiatrists, proposed criteria suggest that this condition is characterized by a strong negative reaction to and avoidance of certain trigger sounds. Misophonic trigger sounds are largely human-made (e.g., chewing and slurping) and evoke responses such as disgust, irritation, and/or anger that are out of proportion to the situation and cause distress and/or impairment. Currently, there is no gold standard evidence-based treatment for misophonia. As the misophonia treatment literature grows, several important questions are arising: (1) should exposure to aversive sound triggers be included in treatment for misophonia and (2) how can clinicians best assess misophonia symptoms. This case offers one example of misophonia being successfully treated with a cognitive-behavioral approach to treatment (including exposures) in an adolescent girl. This case also offers an example of how clinicians may conduct a comprehensive assessment of misophonia symptoms. Theoretically and empirically derived recommendations for including exposure in misophonia treatment are presented. Information from this case may be helpful in informing future research, as there is a paucity of evidence-based assessment and treatment protocols for misophonia.

Automated summary

Even though misophonia is not officially recognized in primary diagnostic manuals, it is characterized by strong negative reactions to certain trigger sounds. With a lack of evidence-based treatment standards, questions arise about including exposure to trigger sounds in treatment and how clinicians can best assess misophonia symptoms. Successful treatment cases, like the one presented, using cognitive-behavioral therapy may provide insights for future research into assessment and treatment protocols for misophonia.