Who benefits most? Exploring demographic and psychological predictors of misophonia psychotherapy outcomes.

Misophonia is characterized by intense emotional and physiological responses to specific auditory triggers, typically repetitive, human-generated sounds. Treatment research in misophonia is nascent, with several studies showing promising outcomes across a range of treatments. While these findings suggest that misophonia symptoms are responsive to psychological interventions, more research is needed to identify which treatments are most effective, and for whom. This study examined baseline prognostic factors of treatment outcome from a randomized controlled trial for adults with misophonia, comparing acceptance and commitment therapy to progressive relaxation training for misophonia. Using multilevel modeling, the following baseline variables were tested as prognostic factors of clinician- and self-reported misophonia symptoms over time: age, age of misophonia onset, number of comorbid psychological diagnoses, psychological flexibility, and baseline misophonia severity. While exploratory, the findings suggest that older age, earlier age of onset and greater comorbidity, psychological inflexibility, and baseline symptom severity have small-to-moderate clinical and statistical effects on the longitudinal maintenance of treatment gains. Together, these findings highlight the complexity of treating misophonia and identifying potential treatment responders early on.