Treatment of Misophonia: Comparison of Exposure and Sound Therapy

Study Overview
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Brief Summary
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The goal of this clinical trial is to compare the effects of possible treatments in misophonics. The main question it aims to answer is: - Is exposure more effective on misophonic symptoms than sound therapy? Participants are randomly assinged to three groups of treatment; Psychoeducation Psychoeducation + Exposure Psychoeducation + Sound Therapy

Official Title
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Treatment of Misophonia: Comparison of Exposure and Sound Therapy

Conditions
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Misophonia

Intervention / Treatment
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* Behavioral: Exposure Therapy
* Other: Sound Therapy
* Other: Psychoeducation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: People have Misophonia Exclusion Criteria: Current psychosis Mental retardation or dementia those who had previously received exposure or sound therapy for misophonia symptoms.

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Participants were randomly assigned to one of three groups: psychoeducation only (the active control group), exposure therapy with psychoeducation, and sound therapy with psychoeducation. All participants were assessed at baseline, and then at 3rd and 6th weeks. All of them received psychoeducation at study intake. A random one third received no further active treatment, one third received exposure, and one third received sound therapy.
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Other: Psychoeducation<br>This was an active control group and included information on the proposed mechanism of the development of misophonia, how symptoms are reinforced, and basic coping skills. | Other: Psychoeducation<br>* A psychoeducation session, prepared by the research team was delivered by the investigator to each patient at the study intake.<br>|
| Experimental: Exposure Therapy and Psychoeducation<br>Exposure has been successfully used in the treatment of anxiety disorders, phobias, and obsessions. There are also case reports showing its effectiveness in the treatment of misophonia. The proposed procedure is to expose the misophonic person to the triggering sound in a controlled and gradual manner until habituation/desensitization to the trigger occurs. In the current research setting, each participant was asked to choose the two misophonic sounds that are most disturbing. | Behavioral: Exposure Therapy<br>* At Week 0, the homework was to expose oneself to these sounds for 20 minutes a day, three days a week for three weeks. At the Week 3 interview, the frequency and severity of the homework were adjusted based on the degree of improvement in the symptoms and the person's adherence to the instructions.<br>Other: Psychoeducation<br>* A psychoeducation session, prepared by the research team was delivered by the investigator to each patient at the study intake.<br>|
| Active Comparator: Sound Therapy and Psychoeducation<br>The music used in the current study was adapted from the protocol used by Jastreboff and Jastreboff (2013) for the treatment of misophonia. It includes noises such as white (noise with equal volume in all octaves) or pink noise (noise that decreases by 3 dB per octave towards high frequencies) or relaxing instrumental music | Other: Sound Therapy<br>* Participants were asked to listen to specifically modulated music for twenty minutes a day, three days a week, for the first three weeks. At the Week 3 assessment, if the patient reported no or little benefit in their misophonia symptoms, the instruction was modified (intensified) to listening to the same music for forty minutes a day, three days a week.<br>Other: Psychoeducation<br>* A psychoeducation session, prepared by the research team was delivered by the investigator to each patient at the study intake.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| The mean change in Misophonia Total Score (MTS) | The difference between MTS Week 0 and MTS Week 6 was calculated, divided by MTS Week 0, and multiplied by 100, to elicit the percent change in MTS between Week 0 and Week 6. | Week 0 and Week 6 | 
| The improvement | It was rated by the investigator (KBA) based on her clinical judgement (0=some worsening, 1=no improvement, 2=some improvement, 3=moderate improvement, 4=much improvement). If there was a moderate to much improvement at any point, the case was rated as improved; and not improved if the score was little worsening, no improvement, or some improvement. | Week 3 and Week 6 | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Misophonia, sound therapy, exposure, psychoeducation, treatment