Misophonia is a complex condition in which individuals experience a strong negative emotional response to specific sounds, such as chewing, breathing, swallowing or foot tapping. These reactions are not primarily determined by the volume of the sound. Although relatively few patients present with a diagnosis of misophonia in audiology or ENT services, research suggests that symptoms may be present in up to 20% of the population. This raises important questions about whether the condition is under-recognised and at what point symptoms become sufficiently distressing or impairing to warrant clinical intervention. There is evidence to suggest that the degree of distress experienced may be influenced by the person producing the sound. Close family members often provoke the strongest reactions, followed by friends, while strangers typically elicit less distress. The same sound heard in a café may cause mild annoyance, yet at a family dinner table it may evoke intense anger, disgust, or both, despite similar acoustic characteristics. Individuals are often referred from ENT clinics to audiology services for assessment before consideration of psychological interventions. This editors’ choice article explores the complexities involved in developing effective treatment plans for individuals with misophonia. While cognitive behavioural therapy (CBT) techniques developed for other conditions can be helpful, they may require adaptation before being applied to misophonia. As misophonia is thought to involve learned responses shaped by personal experiences, treatment should take a holistic approach that considers lifestyle factors, cognitive patterns and specific trigger sounds. The editors would like to thank all of our journal reviewers for their valuable contributions.
Gaynor and Nazia
Cognitive behavioural therapy (CBT) for misophonia has long been considered a treatment option. Nowadays, the question seems to be less about how it is delivered and more about who is best placed to deliver it. How are patients identified and streamed into this treatment pathway? Is there a combination of interventions that works best? How did the thought process emerge that CBT should be the main treatment option? This scoping review examined the available studies, while also attempting to map patterns of clinical delivery, finding much of the evidence base to be small-scale. Given what is currently known about misophonia, it is likely to be a difficult condition to evaluate quantitatively or on a larger scale. This is a highly individualised cohort, with symptom perception often varying according to the person or relationship involved, which, by any estimation, may also spill over into the therapeutic relationship with the clinician delivering treatment. Have a read, and consider which questions might be applied.
Cognitive-Behavioural Therapy applied to Misophonia, a scoping review.
Detroy N, Norena AJ.
HEAR RES
2026;477:109661.
