背景:杂音,声音耐受性下降的障碍,可能会导致严重的痛苦和损害。认知行为疗法(CBT)可能有助于改善耳声错音的症状,但是这种疾病的关键机制尚不清楚。
目的:本病例系列旨在评估个体,在英国的一家心理学服务机构中,为患有isophonia的患者提供配方驱动的CBT。
方法:在专门的心理学服务中,对1对1治疗的鼻音患者(n=19)进行了服务评估。患者平均完成13个小时的治疗,重点关注其对声音和相关行为的反应的含义。主要结果指标是Misophonia问卷(MQ)和阿姆斯特丹Misophonia量表(A-MISO-S)。重复测量t检验用于比较从治疗前到随访的分数,并计算了MQ的可靠和临床意义的变化。
结果:两种音声测量的得分均显着提高,MQ平均变化38%,A-MISO-S平均变化40%。从治疗前到随访,78%的患者在MQ上表现出可靠的改善,61%的患者发生了临床显着变化。
结论:限制包括缺乏对照组,小样本量,以及使用尚未对寻求治疗的样本进行彻底验证的结果测量。这些结果表明,一对一,使用实验设计进一步探索配方驱动的CBT治疗鼻音声。进一步探索的潜在机制包括担心反应升级的后果,寻求安全行为的作用以及与声音反应相关的早期记忆的影响。
BACKGROUND: Misophonia, a disorder of decreased sound tolerance, can cause significant distress and impairment. Cognitive behavioural therapy (CBT) may be helpful for improving symptoms of misophonia, but the key mechanisms of the disorder are not yet known.
OBJECTIVE: This
case series aimed to evaluate individual, formulation-driven CBT for patients with misophonia in a UK psychology service.
METHODS: A service evaluation of one-to-one therapy for patients with misophonia (n=19) was conducted in a specialist psychology service. Patients completed an average of 13 hours of therapy with a focus on the meaning applied to their reactions to sounds and associated behaviours. Primary outcome measures were the Misophonia Questionnaire (MQ) and the Amsterdam Misophonia Scale (A-MISO-S). Repeated measures t-tests were used to compare scores from pre-treatment to follow-up, and reliable and clinically significant change on the MQ was calculated.
RESULTS: Scores significantly improved on both misophonia measures, with an average of 38% change on the MQ and 40% change on the A-MISO-S. From pre-treatment to follow-up, 78% of patients showed reliable improvement on the MQ and 61% made clinically significant change.
CONCLUSIONS: Limitations included a lack of control group, small sample size, and the use of an outcome measure that had not been thoroughly validated for a treatment-seeking sample. These results suggest that one-to-one, formulation-driven CBT for misophonia is worth exploring further using experimental design. Potential mechanisms to explore further include feared consequences of escalating reactions, the role of safety-seeking behaviours and the impact of early memories associated with reactions to sounds.