(PS8-C53) Who Is Seeking Treatment for Youth Misophonia?

Misophonia in youth often causes significant emotional distress and functional impairment. To date, few to no studies have examined the psychopathology associated with youth misophonia or its treatment.  Thus, we sought to describe a sample of treatment-seeking youth with misophonia with respect to demographic and clinical characteristics. Also, we aimed to examine whether child- and parent-reported misophonia severity were associated with anxiety, depression, functional impairment, distress tolerance, and anxiety sensitivity.

The sample included 44 youth with misophonia, aged 9-17 years (M=13.3, SD= 2.0) and their parents presenting for treatment at two university-research sites. Both parent and youth completed diagnostic interviews and online questionnaires before being randomized to receive either a 10-session course of transdiagnostic cognitive behavioral therapy or relaxation therapy. Data were collected from December 2019 to December 2021.

Youth were predominantly female (63.3%), White (93.2%), and Hispanic/Latinx (38.6%). Nearly 68% had at least moderate-severe symptoms of misophonia. Approximately 56% of youth also met criteria for at least one anxiety disorder, with generalized anxiety disorder presenting most commonly (50%). Moreover, 15.9% of youth met criteria for a depressive disorder; 8% met criteria for autism spectrum disorder (ASD). Using a bivariate correlation model, we found youth-reported misophonia severity to be moderately-to-strongly associated with anxiety symptoms (r = .313, p </em>= .039); depressive symptoms (r = .415, p = .005); distress intolerance (r = .595, p < .001); and anxiety sensitivity (r = .391, p = .009). Youth-reported misophonia severity was also strongly correlated with youth-reported functional impairment (r =.735, p < .001). Specifically, moderate to strong associations were found between misophonia severity and related impairment in school (r = .344, p = .022), social life (r = .590, p < .001) and family life domains (r = .693, p < .001). Parent-reported youth misophonia severity was found to have moderate to strong associations with parent-reported youth anxiety (r = .469, p = .001), depression (r = .685, p < .001), and functional impairment (r = .506, p < .001). Specifically, parent-reported youth misophonia severity was moderately-to-strongly correlated with parent-reported youth impairment in school (r = .329, p = .029), social life (r = .502, p = .001), and family life domains (r = .655, p < .001).

Youth within the sample showed a high severity of misophonia and high comorbidity with anxiety; other comorbid disorders included depression and ASD. Symptoms impacted youth across the school, social life, and family life domains. Misophonia was significantly associated with high distress intolerance and high anxiety sensitivity, pointing to these factors as promising targets for treatment. Notably, greater reported misophonia severity was also associated with greatest related impairments in the home. This suggests that home-based impairments related to misophonia might be strong motivators for families to seek intervention for this concern. Future research would benefit from collection of a larger, more diverse sample of treatment-seeking youth with misophonic symptoms.