Characterizing How Families Cope with Pediatric Misophonia: Youth Coping, Parent Responses, and Associations with...

Background/Objectives: Given that the evidence-based treatment for pediatric misophonia remains in its early stages, families have developed their own strategies to cope with misophonia-related distress. The control-based model of coping distinguishes between voluntary coping and involuntary responses to stressful events and provides a useful framework for understanding responses to misophonia-related distress. This report sought to characterize the range of coping strategies and involuntary stress responses among youth and families and their associations with misophonia symptom severity to inform novel targets for future family-focused interventions. Methods: Participants were recruited online across the United States and included 85 parents (M = 42.58 years, SD = 6.25) who reported on their children (M = 12.92 years, SD = 2.34) with misophonia symptoms. Parents completed questionnaires about their child's misophonia symptoms, coping and involuntary stress responses, parent responses to symptoms, perceived effectiveness of approaches, parenting stress, and family functioning. Results: Across misophonia measures, greater primary and secondary control coping were associated with lower misophonia symptom severity (rs = -0.31 to -0.59, ps ≤ 0.004), whereas involuntary engagement and involuntary disengagement were associated with greater symptom severity (rs = 0.29 to 0.60, ps ≤ 0.007). Associations between disengagement coping and symptom severity were less consistent across measures. More frequent parent responses to misophonia were associated with greater misophonia symptom severity across measures (rs = 0.45 to 0.65, ps < 0.001). Conclusions: A range of strategies are utilized by youth and families to manage misophonia-related distress, which have unique connections to misophonia symptom severity. Family-focused interventions may benefit from promoting flexible, collaborative strategy use aimed at reducing impairment, rather than categorizing strategies as uniformly "adaptive" or "maladaptive."