Treatment of Youth Misophonia: A Randomized Controlled Trial Comparing Transdiagnostic Cognitive-Behavioral Therapy to Psychoeducation and Relaxation Training

Misophonia is a distinct clinical disorder that lacks official diagnostic classification. Despite growing evidence of the prevalence and impairment associated with this condition, little research has tested possible evidence-based interventions. The current study presents outcomes from a two-site randomized controlled trial (N=43) comparing the efficacy of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; n=29) to a psychoeducation and relaxation training (PRT; n=14) intervention for youth with misophonia. Participants in each condition received 10 telehealth treatment sessions and completed symptom assessments at 5- and 10-weeks postenrollment. Across both conditions, 47% of youth were treatment responders. Approximately half (54%) of youth receiving UP-C/A were treatment responders, and approximately one quarter (25%) of youth receiving PRT were treatment responders. Compared to those receiving PRT, participants receiving UP-C/A treatment exhibited greater improvement in misophonia symptoms and global functioning on some but not all outcome measures. Participants in each condition reported comparable treatment satisfaction. Results suggest that existing evidence-based interventions may be effectively applied, in a brief format, to treat youth misophonia. Moreover, findings highlight the high acceptability of cognitive-behavioral intervention (i.e., UP-C/A) for this youth sample. Future large-scale trials with a longer treatment duration and a follow-up period are needed to inform the development of evidence-based interventions for youth misophonia.