Date of Award


Degree Type

Selective Evidence-Based Medicine Review

Degree Name

Master of Science in Health Sciences - Physician Assistant


Physician Assistant Studies


OBJECTIVE: The objective of this selective review is to determine whether or not cognitive behavioral therapy (CBT) is effective in decreasing the severity of distress in abnormal auditory perception of sound.

STUDY DESIGNS: Review of two randomized controlled trials and one open trial, published in the English language in 2008, 2014, and 2017.

DATA SOURCES: The three studies used in this review were published in peer-reviewed journals, in English and found in PubMed.

OUTCOMES MEASURED: Decrease in severity of distress by the patient after receiving treatment. Recording methods included the Symptom Checklist 90 (SCL-90-R), The Quality of Life Inventory (QOLI), and Amsterdam Misophonia Scale (A-MISO-S).

RESULTS: Robinson et al., (Viirre ES, Bailey KA, et al. A randomized controlled trial of cognitive-behavior therapy for tinnitus. Int Tinnitus J. 2008;14(2):119-126) reported a significant effect which showed a group-by-time interaction (F[3,87] = 5.542; p = .01), concluding that there were overall improvements in distress symptoms. Juris et al., (Andersson G, Larsen HC, Ekselius L. Cognitive behaviour therapy for hyperacusis: A randomized controlled trial. Behav Res Ther. 2014;54:30-37. doi:10.1016/j.brat.2014.01.001) showed a significant treatment effect (F(1,55) = 4.3, p <0.05, also concluding that distress symptoms decreased after implementation of CBT. Schroder et. Al, (Vulink NC, van Loon AJ, Denys DA. Cognitive behavioral therapy is effective in misophonia: An open trial. J Affect Disord. 2017;217:289-294. doi: S0165- 0327(16)32168-1 [pii]) showed a mean reduction in A-MISO-S scores following treatment was - 4.5 (SD 3.4, range 6-15) (t = -12.198, df = 89, p < .001), corresponding with an improvement to mild misophonia.

CONCLUSIONS: The data suggests that cognitive behavioral therapy effectively decreases severity of distress in abnormal auditory perception of sound. Future study is warranted, especially RCTs, to evaluate abnormal auditory perception of sound with broader inclusion criteria, including more than one sound disorder.