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Id 5e4ed88b-d96a-4689-826d-adb6c32b7935
Year 2023
Abstract
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- (Spencer et al., 2023)
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Dv Authors Samuel D. Spencer, Andrew G. Guzick, Matti Cervin, Eric A. Storch,
Dv Initial Source Misophonia MOC
Dv Status #status/Bare-bones-review
Dv Limitations • Cross-sectional design precludes causal inference. • Large number of statistical tests without family-wise error correction; elevated Type I error risk. • All measures self- or other-report; shared method variance possible. • Sample predominantly White and female; limited generalizability. • No consensus diagnostic criteria for misophonia; sample heterogeneity possible. • Variance explained in misophonia symptomology ranged 20–40%; substantial unexplained variance remains.
Dv Future Directions • Mechanistic investigation of mindfulness in misophonia using neurophysiological attention frameworks. • Research to explain why mindfulness moderation was specific to peer (not family or life satisfaction) domains. • Better characterization of cognitive vs. behavioral/affective CER processes in pediatric misophonia. • Development and testing of targeted mindfulness and emotion regulation intervention components for youth.
Dv Relevance • Study that looked at trait mindfulness and cognitive emotional regulation as moderators of functional impairment in pediatric misophonia. • Found that increased misophonia severity was related to decreased trait mindfulness, adaptive functioning across domains, and the "self-blame" aspect of cognitive emotional regulation. • Found mixed support for a role of trait mindfulness (and to a lesser extent trait cognitive emotional regulation) in misophonia, particularly by finding that mindfulness moderated difficulties functioning in peer groups. • used a Misophonia scale I am unfamiliar with ; Misophonia assessment questionnaire (MAQ)
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Mindfulness and cognitive emotion regulation in pediatric misophonia
Status:: #status/Bare-bones-review
Metadata
- Item Type: #journalArticle
- Authors:: Samuel D. Spencer, Andrew G. Guzick, Matti Cervin, Eric A. Storch,
- Date:
- Date Added: 1689996885000
- URL: https://linkinghub.elsevier.com/retrieve/pii/S2212144723000911
- DOI: 10.1016/j.jcbs.2023.07.005
- Cite Key: spencerMindfulnessCognitiveEmotion2023
- Topics: [object Object]
- Tags:: #Misophonia, #Bare-bones-review-🦴, #youth, #mindfulness, #cognitive-emotion-regulation, #Misophonia-assessment-questionnaire-(MAQ),
- PDF Attachments
Abstract
| Background/Purpose | Background- • Misophonia involves decreased tolerance of human-generated sounds and intense affective reactions; typically onset in childhood/adolescence. • Associated with elevated internalizing/externalizing disorders, reduced life satisfaction, and diminished quality of life. • Conceptual models implicate hypervigilance, attentional fixation, and behavioral avoidance; neurophysiological research indicates trait-like attentional alterations in misophonia. • Individuals with misophonia show more rigid and inflexible attentional/cognitive processes than controls. • CER deficits associated with misophonia severity and trigger reaction intensity in adults; emotion regulation often targeted in published case treatments for youth. • Reactions to misophonia triggers has shown to be mediated by higher-order contextual interpretations rather than acoustic properties (Neacsiu et al. 2022). • No prior study had examined trait mindfulness and CER jointly in a pediatric misophonia sample. Purpose- • Examine associations among trait mindfulness, CER facets, misophonia features, and adaptive functioning in youth. • Explore whether trait mindfulness and adaptive CER facets moderate the association between misophonia severity and adaptive functioning across domains. |
| Participants/samples | • N = 102 youth with clinically significant misophonia. • Age M = 13.7, SD = 2.5, range 8–17. • 67.6% female; 87.3% White. • Recruited via multimedia campaign at a private university hospital in the southern U.S. • Inclusion: ages 8–17; A-MISO-S score ≥10; confirmed by semi-structured diagnostic interview and licensed psychologist consultation. • Exclusion: psychotic disorder, organic brain syndrome, cognitive impairment, immediate suicidality, inability to speak English. • 79% met criteria for a comorbid psychiatric disorder; most common were MDD, GAD, and ADHD. |
| Measures | • A-MISO-S: misophonia severity/impairment (item 4 excluded due to prior psychometric concerns). • MAQ: broader misophonia impact including distress, pessimism, interference, and non-recognition. • CAMM: unidimensional trait mindfulness (youth self-report). • CERQ-k: 9 CER facets — adaptive (positive refocusing, planning, positive reappraisal, putting into perspective) and maladaptive (acceptance, self-blame, rumination, catastrophizing, other-blame). • PROMIS Pediatric Parent Proxy: caregiver-reported adaptive functioning across peer relationships, family relationships, and life satisfaction. • MINI-KID: structured diagnostic interview for psychiatric comorbidities. |
| Procedures | • Virtual assessment session via secure telehealth platform. • Youth and caregiver each completed self- and other-report measures via secure online platform. • Cross-sectional design; data drawn from a larger pediatric misophonia phenotyping project. |
| Results | • MAQ showed stronger and more consistent associations with all study variables than A-MISO-S; MAQ used as primary criterion in multivariable analyses. • Greater misophonia severity (MAQ) associated with all five maladaptive CER facets (self-blame, acceptance, rumination, catastrophizing, other-blame); misophonia generally not associated with adaptive CER facets. • Greater misophonia severity inversely associated with trait mindfulness and all three adaptive functioning domains. • In regression, only trait mindfulness and CER-self-blame were unique significant predictors of MAQ; no other CER facets retained significance; model explained approximately 43% of variance. • Moderation: trait mindfulness moderated the association between misophonia severity and peer relationship functioning only — high mindfulness attenuated the inverse relationship. • No significant moderation by mindfulness for family relationships or life satisfaction; CER-self-blame did not moderate any adaptive functioning outcome. |
| Discussion/Limits | Conclusion- • Rigid attentional fixation and deficits in nonjudgmental present-moment awareness (low mindfulness), along with self-blame, may function to maintain misophonia symptomology in youth. • Mindfulness may serve as a protective/buffering factor for peer relationship functioning, consistent with the decoupling mechanism of mindfulness as a process of change. • Family accommodation processes may obscure impairment in familial relationships, potentially explaining why mindfulness moderation was not found in that domain. • The preponderance of self-blame (rather than other-blame) reflects a more internalizing than externalizing misophonia profile, despite apparent outward aggression toward trigger sources. • Cognitive emotion regulation processes may be less relevant in pediatric misophonia than behavioral/affective components, given stronger associations found in adult studies using the DERS. • The CERQ-k's general stress framing may have introduced measurement error specific to misophonia contexts. • Mindfulness and emotion regulation represent potentially manipulable treatment targets consistent with ACT-based approaches that target reactions to internal events rather than the events themselves. |
| Limitations:: | • Cross-sectional design precludes causal inference. • Large number of statistical tests without family-wise error correction; elevated Type I error risk. • All measures self- or other-report; shared method variance possible. • Sample predominantly White and female; limited generalizability. • No consensus diagnostic criteria for misophonia; sample heterogeneity possible. • Variance explained in misophonia symptomology ranged 20–40%; substantial unexplained variance remains. |
| Future Directions:: | • Mechanistic investigation of mindfulness in misophonia using neurophysiological attention frameworks. • Research to explain why mindfulness moderation was specific to peer (not family or life satisfaction) domains. • Better characterization of cognitive vs. behavioral/affective CER processes in pediatric misophonia. • Development and testing of targeted mindfulness and emotion regulation intervention components for youth. |
| Relevance:: | • Study that looked at trait mindfulness and cognitive emotional regulation as moderators of functional impairment in pediatric misophonia. • Found that increased misophonia severity was related to decreased trait mindfulness, adaptive functioning across domains, and the "self-blame" aspect of cognitive emotional regulation. • Found mixed support for a role of trait mindfulness (and to a lesser extent trait cognitive emotional regulation) in misophonia, particularly by finding that mindfulness moderated difficulties functioning in peer groups. • used a Misophonia scale I am unfamiliar with ; Misophonia assessment questionnaire (MAQ) |
Notes
key terms and concepts
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Trait mindfulness – dispositional tendency toward nonjudgmental, nonavoidant present-moment awareness; measured as a unidimensional construct in youth.
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Cognitive emotion regulation (CER) – cognitive processing of, or responding to, emotionally arousing situations; assessed across adaptive and maladaptive facets.
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Self-blame – maladaptive CER facet capturing negative or overly critical attributions directed toward oneself.
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Adaptive functioning – functioning across peer relationships, family relationships, and life satisfaction domains; caregiver-reported.
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MAQ (Misophonia Assessment Questionnaire) – 21-item self-report capturing distress, recognition difficulties, interference, and pessimism related to misophonia.
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A-MISO-S (Amsterdam Misophonia Scale) – 6-item severity and impairment measure adapted from an OCD framework.
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CAMM (Child and Adolescent Mindfulness Measure) – 10-item youth self-report of unidimensional trait mindfulness.
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CERQ-k (Cognitive Emotion Regulation Questionnaire, child version) – 36-item youth self-report assessing 9 adaptive and maladaptive CER facets.
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Decoupling effect – proposed mechanism by which mindfulness attenuates the link between mental health vulnerability and maladaptive outcomes.
my engagement notes
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Bookmarks
- The Misophonia Assessment Questionnaire (MAQ;) (page 3)
reading notes
contextual statement
In a 2023 cross-sectional study, Spencer and colleagues examined the associations among trait mindfulness, cognitive emotion regulation facets, misophonia features, and adaptive functioning in 102 clinically characterized youth with misophonia (ages 8–17), using the CAMM, CERQ-k, MAQ, A-MISO-S, and PROMIS parent proxy scales.