Psychological Intervention for Misophonia

Overseen By Michael Twohig, PhD

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Utah State University

Must be taking: Psychotropic

Disqualifiers: Psychological, Neurological, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 12 weeks

60 Participants Needed

Trial Summary

Do I need to stop my current medications to join the trial?

The trial does not specify if you need to stop your current medications, but you must be stable on any psychotropic medication for at least 30 days before joining.

What data supports the effectiveness of the treatment Acceptance and Commitment Therapy (ACT) and Progressive Relaxation Training for misophonia?

While there is limited direct research on ACT and Progressive Relaxation Training specifically for misophonia, a case study showed that a psychological intervention based on emotion regulation principles, which are part of ACT, was effective in reducing misophonia symptoms and improving emotional well-being. Additionally, cognitive-behavioral therapy, which shares some techniques with ACT, has been found effective in reducing misophonia symptoms in other studies. ^{1 2 3 4 5}

Is Acceptance and Commitment Therapy (ACT) safe for humans?

Acceptance and Commitment Therapy (ACT) has been studied in various clinical trials for different conditions, and there is no evidence suggesting it is unsafe for humans. It is generally considered a safe psychological intervention. ^{6 7 8 9 10}

How is Acceptance and Commitment Therapy (ACT) unique for treating misophonia?

Acceptance and Commitment Therapy (ACT) is unique because it focuses on helping individuals accept their thoughts and feelings rather than trying to change them, using mindfulness (being present in the moment) and aligning actions with personal values. This approach is different from other treatments that might focus on directly altering the symptoms or behaviors associated with misophonia. ^{9 11 12 13 14}

What is the purpose of this trial?

The investigators are proposing to test Acceptance and Commitment Therapy (ACT)+ traditional audiological behavioral intervention as an integrated, multi-disciplinary approach for the assessment and treatment of misophonia. Participants will be 60 adults with misophonia and will be randomly assigned to receive 12 sessions of ACT+behavioral intervention or receive 12 weeks of progressive relaxation training+psychoeducation (PRT; a commonly used active control condition) after undergoing a comprehensive psychological and audiological evaluation.

Research Team

Michael P Twohig, PhD

Principal Investigator

Utah State University

Eligibility Criteria

This trial is for adults who score at least five on the Misophonia Questionnaire, are stable on psychotropic medication for a month, speak English, and seek treatment for misophonia. It excludes those with psychological/neurological issues that overshadow their misophonia or require urgent care like psychosis or active self-harm.

Inclusion Criteria

English speaking

Meet clinical cut-off for misophonia (minimum score of five on the Misophonia Questionnaire)

I have been on the same mental health medication for over a month.

Exclusion Criteria

Presence of psychological and/or neurological impairments that would preclude someone from participating in the study or exceed misophonia as the primary presenting problem (e.g. active self-harm or need for treatment for psychosis)

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive 12 sessions of either ACT+behavioral intervention or PRT+psychoeducation

12 weeks

Follow-up

Participants are monitored for safety and effectiveness after treatment

9-12 months

Treatment Details

Interventions

• Acceptance and commitment therapy
• Progressive relaxation training

Trial Overview The study tests Acceptance and Commitment Therapy (ACT) combined with traditional behavioral intervention against progressive relaxation training plus psychoeducation in treating misophonia. Participants will be randomly assigned to one of these two approaches over 12 sessions.

Participant Groups

Group I: Acceptance and commitment therapy Experimental Treatment 1 Intervention

ACT teaches skills to develop acceptance, mindfulness, and defusion from difficult internal experiences while increasing connections with personal values and encouraging meaningful behavioral changes. ACT for misophonia combines core ACT processes with a traditional audiological behavioral intervention for a integrated, multi-disciplinary approach for the assessment and treatment of misophonia. Treatment begins with a brief focus on the behavioral intervention, followed by the teaching of ACT skills to support the use of the behavioral methods. The intervention consists of 12 total individual sessions of ACT+behavioral management.

Group II: Progressive relaxation training Active Control 1 Intervention

PRT for misophonia consists of basic psychoeducation for misophonia followed by PRT. PRT involves learning to tense and relax muscles. Early sessions focus on tensing and relaxing smaller muscle groups, while later sessions focus on larger muscle groups. Final sessions focus on relaxation as produced by recalling previous relaxation and a review of skills learned. PRT consists of 12 individual total sessions.

Who Is Running the Clinical Trial?

Utah State University

Lead Sponsor

Trials

48

Recruited

5,200+

Findings from Research

A multi-site randomized clinical trial is currently evaluating Acceptance and Commitment Therapy (ACT) as a treatment for trauma-related mental health issues in military personnel, addressing the need for effective therapies for veterans with high comorbidity.

ACT is considered a promising transdiagnostic treatment approach, which means it can be beneficial for multiple mental health diagnoses, making it potentially more efficient for veterans readjusting after service.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Evaluating transdiagnostic treatment for distress and impairment in veterans: a multi-site randomized controlled trial of Acceptance and Commitment Therapy. Lang, AJ., Schnurr, PP., Jain, S., et al.[2013]

Acceptance and Commitment Therapy (ACT) has shown effectiveness in improving outcomes for patients with chronic pain and may also benefit those with mild to moderate depression, making it a valuable tool for general practitioners.

ACT employs mindfulness and acceptance strategies to help patients align their behaviors with their values, and it has shown preliminary benefits in various conditions, including obsessive-compulsive disorder and emotional issues after gastric band surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy - pathways for general practitioners. Smout, M.[2012]

Internet-based Acceptance and Commitment Therapy (iACT) shows small effects in reducing depressive symptoms, anxiety, stress, psychological distress, and improving quality of life, based on a systematic review of 39 randomized controlled trials.

While iACT was effective compared to passive control groups, it did not show significant advantages over active control groups, indicating the need for further high-quality studies to compare its efficacy with other established therapies like cognitive behavioral therapy.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. Han, A., Kim, TH.[2022]

References

1. Switzerland pubmed.ncbi.nlm.nih.gov

Development and Initial Validation of the Duke Misophonia Questionnaire. [2022]

2. United States pubmed.ncbi.nlm.nih.gov

Online Emotion Regulation for an Adolescent With Misophonia: A Case Study. [2022]

3. Switzerland pubmed.ncbi.nlm.nih.gov

The central role of symptom severity and associated characteristics for functional impairment in misophonia. [2023]

4. United States pubmed.ncbi.nlm.nih.gov

A systematic review of treatments for misophonia. [2023]

5. Switzerland pubmed.ncbi.nlm.nih.gov

Psychometric validation of a brief self-report measure of misophonia symptoms and functional impairment: The duke-vanderbilt misophonia screening questionnaire. [2023]

6. England pubmed.ncbi.nlm.nih.gov

The efficacy of Acceptance and Commitment Therapy: an updated systematic review and meta-analysis. [2018]

7. United States pubmed.ncbi.nlm.nih.gov

Evaluating transdiagnostic treatment for distress and impairment in veterans: a multi-site randomized controlled trial of Acceptance and Commitment Therapy. [2013]

8. Iran pubmed.ncbi.nlm.nih.gov

The effectiveness of acceptance and commitment therapy in treating a case of obsessive compulsive disorder. [2020]

9. Australia pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy - pathways for general practitioners. [2012]

10. United States pubmed.ncbi.nlm.nih.gov

Acceptance and commitment therapy in the treatment of anxiety: a systematic review. [2018]

11. Canada pubmed.ncbi.nlm.nih.gov

Efficacy of Internet-Based Acceptance and Commitment Therapy for Depressive Symptoms, Anxiety, Stress, Psychological Distress, and Quality of Life: Systematic Review and Meta-analysis. [2022]

12. Bosnia and Herzegovina pubmed.ncbi.nlm.nih.gov

Determining the Effectiveness of Acceptance and Commitment Therapy (ACT) on Life Expectancy and Anxiety Among Bereaved Patients. [2022]

13. Switzerland pubmed.ncbi.nlm.nih.gov

Acceptance and Commitment Training Within the Scope of Practice of Applied Behavior Analysis. [2022]

14. Argentina pubmed.ncbi.nlm.nih.gov

[ACCEPTANCE AND COMMITMENT THERAPY (ACT): BEHAVIORISM, MINDFULNESS AND VALUES]. [2015]