Ongoing Research at Duke CMER
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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)
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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.
Once Phase 1 is complete, after integrating participant and expert feedback, Phase 2 will involve administration of the Misophonia interview to a large sample of adults with Misophonia. The outcome of this study will be 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.
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 are delivering the Unified Protocol to adults with misophonia and getting feedback about how helpful and acceptable the treatment is to them. We will then revise the treatment based on this feedback and deliver the revised treatment to patients in Phase 2 to ensure the changes are helpful. We are currently recruiting for Phase 1. 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**
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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.
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