Baylor College of Medicine.
Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA; Baylor College of Medicine.
Behav Ther. 2024 May;55(3):595-604. doi: 10.1016/j.beth.2023.09.001. Epub 2023 Sep 26.
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.
家庭适应（例如，安慰、调整日常习惯、协助回避）在患有恐音症的年轻人中尚未得到探索，但可能具有重要的临床和干预意义。我们通过访谈确认患有恐音症的 102 名儿童和青少年，以及患有焦虑症的 95 名儿童和青少年，比较了家庭适应的频率和内容。研究结果表明，家庭适应在儿科恐音症中普遍存在，甚至比患有焦虑症的青少年更为常见。帮助孩子、参与与恐音症相关的行为以及调整家庭日常习惯，这些做法得到了超过 70%的患有恐音症儿童的家长的支持。此外，与患有焦虑症的儿童的家长相比，当他们不适应时，患有恐音症的儿童的家长更频繁地报告孩子感到痛苦和愤怒。即使考虑到共病的内外向症状和社会人口因素，家庭适应也与恐音症的严重程度呈中度到高度相关。这是首次对儿科恐音症的家庭适应进行研究，表明适应可能是一个重要的临床特征。一个值得注意的研究局限性是，恐音症的测量方法没有区分适应性适应和不良性适应。在更广泛的治疗计划中，过度和不良适应可能是干预的一个潜在目标。重要的是，如果适应性适应可以改善功能和生活质量，那么在日常管理中也应该考虑它们。
