Ongoing Research

Current Studies:

Phenotyping Study of Misophonia

Very little is known about the nature of Misophonia, or its causes and correlates, compared to other known clinical phenomena. This means that we truly don't know the boundaries around what Misophonia is, and what it is not. Until we better understand what it is, it will be difficult to obtain funding from the NIH or other funding agencies to develop and test treatments for Misophonia.

In this study, we will collect a range of measures related to the causes and correlates of Misophonia. For example, we will use gold standard psychiatric interviews to examine whether Misophonia is differentially related to any specific psychiatric disorders. We will use laboratory psychophysiological methods to differentiate Misophonia and other clinical conditions on measures related to emotional reactivity. And, importantly, we will use ecological momentary assessment methods to characterize the temporal dynamics of Misophonia symptoms and difficulties regulating emotions over time compared to other clinical conditions.

You may be eligible for this research study if you are 18 to 65 years old and belong to one of these 3 groups:

• Extraordinarily bothered by sounds such as chewing, slurping, throat clearing, finger tapping, foot shuffling, keyboard tapping, rustling, nasal sounds, pen clicking, etc.
• Tend to feel very anxious a lot of the time
• Generally upbeat with no mental health problems (a healthy control)

Developing an interview to assess experiences with Misophonia

This study aims to develop and validate a semi-structured clinical interview to assess Misophonia in adults by means of two phases. Currently the study is in the first phase which involves piloting an initial version of the interview within a small sample to evaluate feasibility and acceptability of the instrument by participants with Misophonia. Participants who have completed the assessment portion of the phenotyping study and meet eligibility criteria are able to participate in the first phase.

Phase 1 is complete and after integrating participant and expert feedback, Phase 2 involves administration of the Misophonia interview to a large sample of adults with Misophonia. The outcome of this study is a validated interview that clinicians can use with their patients to better understand their symptoms and the impact of Misophonia in their everyday lives, and that researchers can use in future research on this sound-intolerance condition. The paper on the Duke Misophonia Interview (DMI) has been published based on 10 participants from phase 1 and 30 participants from phase 2. Phase 2 is on pause for enrollment.

Past Enrolling Studies:

Development and Validation of a New Self-report Measure of Misophonia

There are very few measures of Misophonia that have been developed rigorously with strong psychometric properties. This means that studies of Misophonia to date are limited by the quality of the measures that are used. To understand what Misophonia is and how to treat it, high quality measures are needed. That is the goal of this study. Specifically, in this study we are developing and scientifically validating a new measure of Misophonia symptoms and related problems. This involves interviews with sufferers and their family members, as well as several rounds of self-report measurement using multiple methods, including those that are prospective. Our goal is to develop a cutting-edge, reliable, and valid scale that can be used to assess Misophonia symptoms and the underlying problems that can be targeted for change in treatments.

As of August 2020, we have completed the first 2 phases of this project and received feedback from our expert collaborators in regards to the first version of our new measure. Once we incorporated the feedback, we finished the final phase of collecting a large amount of data from this early version of our measure along with other existing Misophonia measures to begin the validation process. With the help of our collaborator, Dr. Zach Williams at Vanderbilt University, we are underway with analyses and building the first version of the measure we hope to use in our ongoing & future studies in CMER.

We truly appreciate those participants (both those with misophonia and those who are family members/loved ones of those with misophonia) who gave us valuable information and feedback during our first phases of this measure development project.

We will continue to update our site as we begin the validation portion of this measure development project.

Exploring the Acceptability and Efficacy of a Transdiagnostic Treatment for Misophonia

While we continue to learn how to best understand and assess misophonia, it is also important to develop treatments that can help those who are suffering. The purpose of this study is to adapt an existing treatment, the Unified Protocol, to meet the needs of adults with misophonia. The Unified Protocol has been shown to help adults with conditions such as anxiety and depression, and we believe it can help with misophonia as well. This study (PI: Robbins) funded by the REAM foundation, will be conducted in two phases. In Phase 1 we delivered the Unified Protocol to adults with misophonia and got feedback about how helpful and acceptable the treatment was to them. We revised the treatment based on this feedback and delivered the revised treatment to patients in Phase 2 to ensure the changes were helpful. Participants who have completed the assessment portion of the phenotyping study and meet eligibility criteria are able to participate. **Please note that only individuals in North Carolina are eligible for this study** We recently completed Phase 2 as of August 2022. Results and publication pending.

Email psychcmer@dm.duke.edu for more information.

Identifying the Optimal Neural Target for Misophonia Interventions

In order to develop treatments for Misophonia, it is important to gain a better understanding about what is happening in the brain when people with Misophonia (and those without) are triggered by misophonic and non-misophonic cues. In this study (PI: Neacsiu) funded by the REAM Foundation and supported by CMER, the primary aim is to disentangle the brain circuitry dysfunction in Misophonia when compared to highly emotional dysregulated adults without Misophonia. A secondary aim is to examine changes in misophonic distress and regulation when applying inhibitory, excitatory, or sham repetitive transcranial magnetic stimulation (rTMS) over key neural networks. Study enrollment and all participant activity completed at the end of May 2022. Results, publications and exploratory analyses will be available in the coming months.

**To see some of our Center's planned Misophonia research studies, check out Upcoming Studies. Additionally, if you would like to be added to our growing list of people who are interested in hearing more about our program as well as future research opportunities please email us.