Document Type
Article
Journal/Book Title/Conference
Journal of Affective Disorders
Volume
393
Publisher
Elsevier Ltd
Publication Date
10-9-2025
Journal Article Version
Accepted Manuscript
First Page
1
Last Page
48
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Abstract
Objective: To date, no in-person-delivered psychotherapies for adults with misophonia have been tested against active control conditions. The purpose of this study was to test the preliminary efficacy of acceptance and commitment therapy (ACT), supplemented with audiologically informed behavioral strategies (e.g., functional adaptations to manage exposure to misophonic sounds), versus education and progressive relaxation training (PRT) for adults with misophonia.
Method: In a well-controlled randomized trial, 60 adults were randomized to ACT or PRT and each received 12, one-hour sessions of individualized psychotherapy for misophonia. Audiological and psychological assessments were conducted at baseline to assess for eligibility and severity of misophonia. Posttreatment, and three- and sixmonth follow-ups were collected. Assessments of assessor- and client-rated misophonia, clinical severity, wellbeing, psychological flexibility, and treatment credibility and acceptability were collected.
Results: Both treatments were rated as credible and acceptable. Response rates for participant-rated misophonia (MQ scores) were small to modest in this sample (ACT 6.67–26.67 %, PRT 3.33–20 %), depending on the subscale. On an assessor-rated measure of misophonia, there were generally large within-condition effect sizes but no between-condition differences. Response rates for assessor-rated misophonia ranged from 20 % to 70 % for ACT and 6 % to 50 % for PRT, depending on the subscale. No between-condition differences were observed on clinician and participant-rated global severity, well-being, or psychological flexibility.
Conclusions: This study showed medium to strong within condition effect sizes for ACT and PRT for misophonia. Additional research is needed, but it suggests psychosocial interventions can be beneficial for adults with misophonia.
Recommended Citation
Michael P. Twohig, Muñoz, K., Petersen, J. M., Woolley, M. G., Bowers, E. M., Donahue, M. L., Velasquez, D., Ortiz, D. Capel, L. K., & San Miguel, G. G., “Acceptance and commitment therapy versus progressive relaxation training for misophonia: A randomized controlled trial,” Journal of Affective Disorders, 2025, 393, https://doi.org/10.1016/j.jad.2025.120366.