Participants will complete the 8-module fully automated digital intervention based in acceptance and commitment therapy (ACT).

Waitlist condition; assessment only.

Participants will complete the 8-module fully automated digital intervention based in acceptance and commitment therapy (ACT). The digital program is based off of an ACT protocol developed in a prior randomized controlled trial and adapted for digital self-help use (Bowers et al., 2024). Modules focus on focus on acceptance, cognitive defusion, present moment awareness, values clarification, and functional adaptations.

The S-Five is a 25-item self-report measure of misophonia severity. Items (e.g., "I feel trapped if I cannot get away from certain noises") are rated on a 0 (not at all true) to 10 (completely true) ordinal scale with total scores ranging from 0 to 250. The S-Five consists of five latent factors: (1) externalizing appraisals (e.g., blaming others for making sounds), (2) internalizing appraisals (e.g., negative self-judgments triggered by misophonia), (3) impact on functioning (e.g., social and occupational impact), (4) outburst (e.g., experiences of aggression or fear of losing control), and (5) threat (e.g., feeling trapped or helpless). The S-Five demonstrates good internal consistency and convergent validity with other misophonia measures (Vitoratou et al., 2023).

The Miso-AAQ is a 7-item self-report measure of misophonia-specific psychological inflexibility, adapted from the AAQ-III (Ong et al., 2019). Items (e.g., "I'm so afraid of my reactions to sounds that I don't do things I care about" are rated from 1 (never true) to 7 (always true) Likert scale. Total scores range from 7 to 49 with higher scores indicating greater misophonia-specific psychological inflexibility. Preliminary validation from a treatment seeking sample of adults with misophonia suggest good internal consistency and convergent validity (Capel et al., 2025).

The I-HEARTS is a 25-item self-report measure assessing internalized health-related stigma, adapted here to reference misophonia specifically. Items (e.g., "I am embarrassed or ashamed that I have misophonia") are rated on a 1 (strongly disagree) to 7 (strongly agree) Likert scale, with higher scores indicating greater internalized stigma. The scale yields a total score and three subscales: (1) perceived and anticipated stigma, (2) stereotype application and self-devaluation, and (3) stigma resistance (reverse-scored). Validation in a large sample of adults with chronic health conditions demonstrated strong internal consistency, test-retest reliability, and convergent validity with related constructs such as shame, loneliness, and depression (Pearl et al., 2024).