Symposia
Obsessive Compulsive and Related Disorders
Adam B. Lewin, ABPP, Ph.D.
Professor
University of South Florida
St. Petersburg, Florida
Kelly Kudryk, PhD
Clinical Research Coordinator
University of South Florida
Tampa, Florida
Morgan Bolen, PsyD
Fellow
University of South Florida
St. Petersburg, Florida
Jill Ehrenreich-May, Ph.D.
Professor
University of Miami
Miami, Florida
Background: To date, there are no evidence-based treatments for misophonia, and the field lacks clarity in treatment recommendation for youth. A transdiagnostic treatment approach for misophonia seemed logical given frequent reports of emotional reactivity and autonomic arousal, intense emotional states, behavioral and emotional outbursts and high rates of comorbidity. The purpose of the current study was to compare the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-A/C) to a standard relaxation and education focused CBT protocol (RT).
Methods: Following a 4-participant pilot study (Lewin et al., 2021), forty-eight youth with misophonia (aged 8 - 17) across two sites were randomized to either 10-weeks of the transdiagnostic Unified Protocols or Relaxation/Education in a 2:1 ratio. Primary outcomes were the Clinical Global Impression Severity and Improvement (CGI) for misophonia and overall functioning.
Results: Current results are preliminary (n = 36). For the CGI-S, there was a statistically significant effect of time (Est. = -.59, SE = .16, p = .001), but not group (Est. = -0.18, SE = .41, p = .658) or group X time interaction (Est. = 0.11, SE = .35, p = .759). Similarly, CGI-S Misophonia revealed a statistically significant effect of time (Est. = -.76, SE = .15, p < .001), but not group (Est. = -.42, SE = .35, p = .241) or group X time interaction (Est. = 0.49, SE = .32, p = .139). For the CGI-I (overall), there was a statistically significant effect of time (Est. = -.75, SE = .19, p = .001), but not group (Est. = 0.50, SE = .47, p = .299) or group X time interaction (Est. = -.532, SE = .47, p = .275). For the CGI-I Misophonia, there was a statistically significant effect of time (Est. = -.872, SE = .18, p < .001), but not group (Est. = .611, SE = .39, p = .137) or the group X time interaction (Est. = 0.206, SE = .44, p = .644). Overall, there were significant declines in outcome scores, but they did not vary as a function of group. The remaining participants are expected to complete the trial before summer 2022 for inclusion in the final results.
Conclusions: To date, youth appear to respond to both treatment conditions without statistically significant separation across the two active conditions. Findings are preliminary – because we powered to detect moderate to large effects (pilot trial), it is possible that findings differ after the remaining subjects post. We will also report on changes to transdiagnostic factors – distress tolerance, anxiety sensitivity, and potential impact of Autism Spectrum Comorbidity.