Family Accommodation in Children and Adolescents With Misophonia

Authors

Eric A Storch
Andrew G Guzick
Johann D'Souza
Jane Clinger
Daphne Ayton
Minjee Kook
Conor Rork
Eleanor E Smith
Isabel A Draper
Nasim Khalfe
Catherine E Rast
Nicholas Murphy
Marijn Lijfijjt
Wayne K Goodman
Matti Cervin

Publication Date

5-1-2024

Journal

Behavior Therapy

DOI

10.1016/j.beth.2023.09.001

PMID

38670671

PMCID

PMC11055978

PubMedCentral® Posted Date

5-1-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

Humans, Male, Female, Adolescent, Child, Family, Anxiety Disorders, Parents, Family Relations, Adaptation, Psychological, Misophonia, Children, Family accommodation, Anxiety, Treatment

Abstract

Family accommodation (e.g., reassurance, modifying routines, assisting avoidance) has not been explored among youth with misophonia but may have important clinical and intervention implications. We examined family accommodation in 102 children and adolescents with interview-confirmed misophonia and compared its frequency and content to family accommodation in 95 children and adolescents with anxiety disorders. Findings showed that family accommodation was ubiquitous in pediatric misophonia and may be even more frequent than in youth with anxiety disorders. Assisting the child, participating in misophonia-related behaviors, and modifying family routines were endorsed by more than 70% of parents of children with misophonia. Further, compared to parents of children with anxiety disorders, parents of children with misophonia more frequently reported child distress and anger when they did not accommodate. Family accommodation was moderately to strongly associated with misophonia severity even when accounting for co-occurring internalizing and externalizing symptoms and sociodemographic factors. This first study of family accommodation in pediatric misophonia suggests accommodation may be an important clinical feature. A notable study limitation is that the measure of misophonia did not delineate between adaptive versus maladaptive accommodations. Excessive and maladaptive accommodation may be one potential candidate to target in interventions when considered within a broader treatment plan. Importantly, adaptive accommodations should also be considered in day-to-day management if they improve functioning and quality of life.