(PS9-82) Developing Personalized Misophonia Treatment: Values and Challenges of Cognitive Reappraisal in Research and Therapy

Misophonia is a disorder recently proposed for inclusion in the ICD-11 and currently under review by the board. It is characterized by strong emotional reactions to specific sounds, such as chewing, breathing, or clicking, which can significantly impact an individual's daily life. Cognitive reappraisal (CR), a core technique within Cognitive Behavioral Therapy (CBT), has shown promise in treating various conditions but has not yet been experimentally investigated for misophonia as a standalone technique. CR involves changing one’s interpretation of a situation to alter emotional responses. This study aimed to develop a CR protocol tailored for individuals with misophonia and evaluate its feasibility and preliminary efficacy through qualitative and quantitative analyses.
The treatment consisted of a 90-minute group session and three 30-minute individual sessions conducted online over four weeks. Twenty-three adult, Polish-speaking participants were recruited using psychometrically validated questionnaires and structured interviews. Pre- and post-treatment assessments focused on misophonia symptoms, depression, and anxiety. While the quantitative results demonstrated a significant decrease in externalizing responses to misophonia triggers (Estimate = -8.47, SE = 2.32, t(42.45) = -3.65, p < 0.001), and similar results were observed across other misophonia scales, this presentation will primarily focus on the qualitative aspects of the study, analyzed through Reflexive Thematic Analysis (Braun & Clarke, 2021).
Two main themes were developed. The first theme, Speaking in One Voice of Misunderstanding and Hope, highlights the common experience of isolation and misunderstanding among misophonia sufferers, while emphasizing the value of shared experiences within the group therapy setting. The second theme, The Need for Misophonia-Tailored but Individualized Therapy, reflects the necessity of adapting CR to the unique needs of each individual. The goal of this presentation is to explore how CR can be adjusted to better address the needs of misophonia sufferers, as well as to delve into the challenges and potential pitfalls when tailoring such interventions. These findings suggest that while CR may be beneficial, further research is necessary to refine its application and assess how it can be personalized to maximize its effectiveness for individuals with misophonia.
This study underscores the importance of understanding the lived experiences of participants when developing treatments for misophonia and the need for flexibility in therapeutic approaches. The implications of these findings will be discussed, with particular focus on the complexities of misophonia treatment and the role of CR in this process.