Digital Intervention for Adults With Misophonia: A Randomized Controlled Trial

Efficacy and Feasibility of an Online Acceptance Based Intervention for Misophonia: A Randomized Controlled Trial

The goal of this clinical trial is to test an online intervention for adults with misophonia. The main questions it aims to answer are:

1. Is the online intervention effective, compared to a waitlist control condition?
2. Is the online intervention acceptable to use?

Participants will be randomized into either the online intervention or waitlist control condition:

1. Participants in the intervention condition will be asked to complete an 8 module acceptance and commitment therapy (ACT) program for misophonia and 5 surveys over 4 months.
2. Participants in the waitlist condition will be asked to complete 5 surveys over 4 months, and will receive access to the intervention once the study is complete.

Misophonia, characterized by intense emotional reactions to specific sounds, significantly impacts daily functioning and quality of life. Acceptance and Commitment Therapy (ACT) has shown promise in addressing misophonia symptoms by fostering psychological flexibility. While recent intervention studies demonstrate the efficacy of ACT for misophonia, accessible and scalable treatment options remain scarce. This study aims to address this gap by developing and evaluating a fully automated, online ACT-based digital mental health intervention for misophonia. We will compare the intervention to a delayed treatment group in a sample of 100 adults meeting clinical criteria for misophonia. Outcomes will include misophonia symptoms, quality of life, general distress, and psychological flexibility, assessed at baseline, mid-intervention, post-intervention, and one- and two-month follow-up. Multilevel modeling will test time by condition interactions to examine the efficacy and feasibility of an online ACT-based intervention. This fully automated online intervention aims to provide accessible, evidence-based treatment for individuals with misophonia, laying groundwork for future, larger-scale studies and public dissemination.

Inclusion Criteria:

• Currently meet clinical impairment for misophonia.
• At least 18 years old.
• Fluent English speakers.
• Currently live or reside in the United States

Exclusion Criteria:

• Currently receiving alternative psychotherapy for misophonia.
• Currently modifying or starting psychotropic medication (within 30 days of starting the study).
• Any psychological and/or neurological impairments that would preclude someone from participating in the study (e.g.,active self-harm or psychosis)