Impacts of Distress Intolerance and Anxiety Sensitivity on the Maintenance and Treatment of Youth Misophonia.

OBJECTIVE

Misophonia often co-occurs with emotional disorders in youth, indicating that these conditions may share underlying risk factors, such as distress intolerance and anxiety sensitivity. However, the specific relationships between misophonia severity, distress intolerance, and anxiety sensitivity have not been formally explored. Understanding how these transdiagnostic risk factors impact misophonia severity and related impairment could offer valuable insights into misophonia phenomenology and identify key therapeutic targets for affected youth.

METHODS

This study examined the impacts of distress intolerance and anxiety sensitivity on misophonia severity during treatment in youth (N = 43) randomized to either a 10-week course of the Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents (UP-C/A; N = 29) or psychoeducation/relaxation training (PRT; N = 14). Youth completed self-report measures at 0-, 5-, and 10-weeks post-enrollment.

RESULTS

Greater distress intolerance and anxiety sensitivity were both associated with greater misophonia symptom severity at pre-treatment. Distress intolerance, but not anxiety sensitivity, improved significantly across treatment course. Compared to youth receiving PRT, youth receiving UP-C/A exhibited greater improvements in distress intolerance across treatment, and indirect effect estimates indicated that improvement in distress intolerance was a mechanism through which the UP-C/A elicited change in misophonia symptom severity.

CONCLUSION

Preliminary findings support distress intolerance as a mechanism of symptom change in transdiagnostic cognitive-behavioral treatment for youth misophonia. Future large-scale trials are warranted to further investigate distress intolerance and other transdiagnostic factors as treatment targets for misophonia.