Effectiveness of a Mindfulness-Based Cognitive Behavioral Mobile Intervention for Misophonia

This study is a randomized controlled trial designed to evaluate the effectiveness of a mobile application based on mindfulness-based cognitive behavioral interventions for individuals with misophonia symptoms.

The mobile intervention was developed to address cognitive, emotional, behavioral, and physiological processes associated with misophonia. The intervention integrates psychoeducation, cognitive behavioral therapy, mindfulness-based strategies, gradual exposure and desensitization, breathing and relaxation exercises, and self-monitoring. The intervention specifically targets threat appraisal, automatic thoughts, avoidance behaviors, physiological arousal, and difficulties in emotion regulation.

A total of 60 eligible participants will be randomly assigned to an intervention group or a control group using stratified block randomization. The intervention group will receive access to the mobile application for three weeks. The application includes educational content about misophonia, identification of individual trigger sounds, cognitive restructuring exercises, a thought diary, graded exposure to trigger sounds, Subjective Units of Distress Scale (SUDS) monitoring, breathing exercises, mindfulness practices, relaxation tools, and supportive audio content. The exposure component includes graded exposure, distress monitoring, breathing support, and a safe-stop option.

Participants will be evaluated at three time points: baseline before the intervention, immediately after completion of the three-week intervention, and four weeks after the intervention. The primary outcome will be change in misophonia symptoms. Secondary outcomes will include depression, anxiety, stress, and difficulties in emotion regulation. These outcomes will be assessed using the Misophonia Scale, the Depression Anxiety Stress Scale-21 (DASS-21), and the 16-item Difficulties in Emotion Regulation Scale.

The study will examine whether the mobile intervention produces improvements in misophonia symptoms and related psychological outcomes compared with the control condition.

Inclusion criteria

• Age 18 years or older.
• Meeting the misophonia criteria proposed by Jager et al. (2020).
• Reporting at least one trigger sound.
• Having a Misophonia Scale total score greater than 60.5.
• Owning a smartphone or tablet.
• Having sufficient technological literacy to use the mobile application.

Exclusion criteria

• Misophonia symptoms being better explained by another condition or disorder based on the eligibility screening.
• A Misophonia Scale total score of 60.5 or lower.
• Development of marked distress or functional impairment during the study that requires discontinuation and referral for professional mental health support.