目的:混音是一种精神病,其特征是对听觉刺激有强烈的情绪和/或行为反应,导致痛苦和功能障碍。尽管以前尝试过定义和分类这种情况,目前,《精神疾病诊断和统计手册》或《国际疾病分类》中没有混音。缺乏正式的诊断共识对旨在评估和治疗这种临床表现的研究提出了挑战。
方法:本研究在迄今为止最大的寻求治疗的样本中,呈现了青年(N=47)患有鼻音的临床特征。我们检查了样本的人口统计学特征,合并症的频率,特定错音症状的频率(即,触发器,情绪和行为反应,和损伤),和照顾者-儿童症状协议。使用包括临床医生在内的多模式评估来评估混音症状,青春,和护理人员关于凭经验确定的不发音措施的报告,并评估了措施之间的一致性。
结果:寻求治疗的青少年出现明显的错音症状和一系列合并症。青年和护理人员确定了各种问音症状的触发因素(例如,咀嚼的声音,呼吸声),以及广泛的情感(例如,愤怒,烦恼,厌恶)和行为(例如,侵略,避免)对触发器的响应。青年和护理人员对错音触发因素的共识很高,但对症状严重程度和相关损害的共识较低。与年龄较小的儿童(8-13岁)相比,年龄较大的儿童(14岁以上)似乎更可靠地报告症状严重程度和相关损伤.
结论:混音是一种异质性和损害性的临床疾病,值得未来的研究和循证治疗发展。
OBJECTIVE: Misophonia is a psychiatric condition characterized by strong emotional and/or behavioral responses to auditory stimuli, leading to distress and functional impairment. Despite previous attempts to define and categorize this condition, misophonia is not currently included in the Diagnostic and Statistical Manual of Mental Disorders or International Classification of Diseases. The lack of formal diagnostic consensus presents challenges for research aimed at assessing and treating this clinical presentation.
METHODS: The current study presents clinical characteristics of youth (N = 47) with misophonia in the largest treatment-seeking sample to date. We examined demographic characteristics of the sample, frequency of comorbid disorders, frequency of specific misophonia symptoms (i.e., triggers, emotional and behavioral responses, and impairments), and caregiver-child symptom agreement. Misophonia symptoms were evaluated using a multimodal assessment including clinician, youth, and caregiver reports on empirically established misophonia measures, and concordance among measures was assessed.
RESULTS: Youth seeking treatment for misophonia presented with marked misophonia symptoms and an array of comorbid conditions. Youth and caregivers identified various triggers of misophonia symptoms (e.g., chewing sounds, breathing sounds), as well as a wide range of emotional (e.g., anger, annoyance, disgust) and behavioral (e.g., aggression, avoidance) responses to triggers. Youth and caregivers exhibited high agreement on misophonia triggers but lower agreement on symptom severity and associated impairment. Compared to younger children (aged 8-13), older children (aged 14+) appeared to report symptom severity and associated impairment more reliably.
CONCLUSIONS: Misophonia is a heterogenous and impairing clinical condition that warrants future investigation and evidence-based treatment development.