Let misophonia be heard Advancing recognition, diagnostics and treatment of misophonia in youth

Misophonia is a recently identified disorder of decreased tolerance to specific sounds or associated stimuli (so-called “triggers”). Triggers primarily include human-made sounds such as eating or breathing. Confrontation with triggers elicits intense emotional, behavioral and physiological responses that are difficult to control. Misophonia typically develops during childhood and has considerable consequences for the daily lives of children and families. Often, children can no longer eat, sleep or travel by car together with their family, and they experience problems at school and with friends. There is a great need for adequate diagnostics and evidence-based treatment. The main aim of this thesis is to improve care for children, adolescents and families suffering from misophonia. We present the first controlled study worldwide investigating misophonia in 95 children and adolescents (aged 8-18). We: 1) assessed clinical characteristics, psychiatric comorbidity and quality of life; 2) designed and validated two child-specific questionnaires for screening and severity assessment of misophonia in children and adolescents; 3) performed a randomized controlled trial (RCT) investigating combined cognitive behavioral and psychomotor group therapy (CBT+PMT); 4) performed a cost-of-illness study investigating the financial burden of misophonia on families and society. This thesis underlines the importance of classifying misophonia as a discrete disorder. By providing two validated questionnaires and the first evidence-based treatment, this thesis paves the way for improved recognition, diagnostics and treatment of misophonia in youth.