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在循证干预措施开发中融入善举伦理原则的临床考量:以儿童恐音症为例

Clinical Considerations for Integrating Ethical Principles of Beneficence in the Development of Evidence-Based Interventions: The case of Pediatric Misophonia.

作者信息

Spencer Samuel D, Petersen Julie M, Schneider Rebecca L, Guzick Andrew G, McGuire Joseph F

机构信息

Department of Psychology, University of North Texas, Denton, TX, USA.

Utah State University, Logan, UT, USA.

出版信息

Res Child Adolesc Psychopathol. 2025 May;53(5):625-637. doi: 10.1007/s10802-024-01247-0. Epub 2024 Sep 13.

DOI:10.1007/s10802-024-01247-0
PMID:39269531
Abstract

Misophonia is a condition involving decreased tolerance and intense responses to specific sounds, often those that are human-generated and repetitive in nature. Misophonia frequently onsets during childhood and is associated with significant distress, impairment, and diminished quality of life. While misophonia research remains nascent and no definitive practice guidelines exist at present, extant studies offer several promising potential avenues in intervention development for adults with misophonia. However, such research is comparatively limited for youth. Before widespread adoption of promising treatments, it is important to consider the potential for harm or non-beneficence that may arise from the mis-informed application of such treatments. In this article, we identify several potential pitfalls within intervention development for pediatric misophonia and provide recommendations to circumvent them. To that end, we focus on the following three topic areas: (a) challenges arising when psychological mechanisms are not considered in intervention development, (b) importation of a cognitive-behavior therapy (CBT) framework for obsessive-compulsive spectrum disorders without nuanced tailoring to misophonia, and (c) neglecting to include individuals with lived experience in the process of intervention development research. Considering these key areas within misophonia intervention development will be critical for upholding beneficence and minimizing harm in treatment of misophonia across the lifespan.

摘要

恐音症是一种对特定声音的耐受性降低并产生强烈反应的病症,这些声音通常是人为产生且具有重复性。恐音症常于儿童期发病,与显著的痛苦、功能损害及生活质量下降相关。虽然恐音症的研究仍处于初期阶段,目前尚无明确的实践指南,但现有研究为成年恐音症患者的干预发展提供了几个有前景的潜在途径。然而,此类研究在青少年中相对有限。在广泛采用有前景的治疗方法之前,重要的是要考虑因错误应用此类治疗而可能产生的伤害或无益的可能性。在本文中,我们确定了儿童恐音症干预发展中的几个潜在陷阱,并提供了规避这些陷阱的建议。为此,我们专注于以下三个主题领域:(a) 在干预发展中未考虑心理机制时出现的挑战;(b) 在未根据恐音症进行细微调整的情况下,将强迫症谱系障碍的认知行为疗法(CBT)框架引入;(c) 在干预发展研究过程中忽视纳入有实际经历的个体。在恐音症干预发展中考虑这些关键领域对于在整个生命周期中坚持有益原则并将治疗恐音症的伤害降至最低至关重要。

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本文引用的文献

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Prevalence, phenomenology, and impact of misophonia in a nationally representative sample of U.S. adults.美国成年人全国代表性样本中的恐声症的流行率、表现和影响。
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The effect of misophonia on cognitive and social judgments.听觉过敏对认知和社会判断的影响。
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A symptom network model of misophonia: From heightened sensory sensitivity to clinical comorbidity.恐声症的症状网络模型:从感觉敏感性增加到临床共病。
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The central role of symptom severity and associated characteristics for functional impairment in misophonia.症状严重程度及相关特征在恐音症功能损害中的核心作用。
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Effectiveness of an innovative treatment protocol for misophonia in children and adolescents: Design of a randomized controlled trial.一种针对儿童和青少年恐音症的创新治疗方案的有效性:一项随机对照试验的设计
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Misophonia in the UK: Prevalence and norms from the S-Five in a UK representative sample.英国的恐音症:来自英国代表性样本的 S-Five 中的患病率和规范。
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