We all have a pet peeve that involves disturbing or annoying noises: whether it’s loud, obnoxious chewing, constant foot tapping, or one’s quiet, yet ever-present mumbling. Some of us suck it up and just deal with the noise or drown it out by putting earphones in and others…well, scream. Flashback many years to my high school Spanish class. It was the end of the year and we were all busy painting our own renditions of famous Spanish artwork; everyone’s chatting and laughing, trading paint brushes and colors, asking the teacher for advice. And then suddenly it’s all interrupted by a sharp shriek—and then silence ensues as everyone turns to stare at my friend Laura. Her face turns red as she tries to explain that someone scratched their nails on the chalkboard and she just couldn’t take the piercing noise that failed to illicit the same response from the rest of the class. While everybody at the time thought Laura was crazy, her reaction may actually be explained by an auditory disorder called misophonia, which is explored in a new paper “The brain basis of ‘hatred of sound:’ Misophonia” by Emilia Reas. Those who suffer from this controversial disorder find typically mundane noises painfully disturbing and can’t help but express their resulting rage or irritation. But wait why is it controversial? Experts can’t agree on whether this should be recognized as its own psychiatric disorder, as the symptoms often overlap with other disorders like obsessive compulsive disorder (OCD) and post-traumatic stress disorders. This rejection of misophonia as its own disorder has driven many to hide the subsequent discomfort upon hearing these everyday sounds. Fortunately, loads of new research over the past few years has been conducted to better understand and explain the disorder as well as its effects, and certain medical professionals are beginning to acknowledge its existence. The next step is to get it into the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), which lists and explores psychiatric diagnoses. A graduate student at the University of California San Diego explains why that shouldn’t be a question or an issue: “While some misophonics definitely do suffer from some of these other existing conditions, many do not and report no other ailments whatsoever. Because of this variation, I don’t believe another existing disorder can completely account for the specific constellation of symptoms present in misophonia.” There is still much research to be done about the manifestations—both psychological and behavioral—of misophonia, but experts suspect that the disorder evolves from emotional processing. This would make sense, as the extreme reactions are a direct result of the discomfort and other negative emotions one feels after hearing the seemingly mundane noise. Furthermore, effective treatments for the disorder are still being tested; so far, there is some support for the use of cognitive behavioral therapy, which works to change patterns of thinking and behavior, as well as conditioning training. There are some repetitive noises that just drive me up the wall, such as constant pen-clicking and the jiggling of one’s knee at their desk. I wonder how the perpetrators don’t realize they’re irritating everybody around…oh, nobody else seems to notice. I guess it’s just me. But I don’t jump out of my seat or yell out in distress—I actually forget about it after a few minutes. That’s the difference between having a pet peeve and having misophonia: both two very real misfortunes. Source: PLOS “The Brain Basis Of “Hatred of Sound”: Misophonia.” NeuroscienceNews. NeuroscienceNews, 24 September 2017. <http://neurosciencenews.com/misophonia-auditory-neuroscience-7560/>.
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10 min read Alcohol use disorder: Causes, symptoms, and treatments Sarah Barness 6 min read Fetishistic disorder: Exploring fetishes, paraphilic disorders, and stigma-free treatment options Jason Crosby 4 min read Your guide to adjustment disorder: Symptoms, causes, treatment, and more Taylor Bennett 3 min read Language Disorder DSM-5: Causes, Symptoms and Treatment 315.39 (F80-9) Taylor Bennett 5 min read CPTSD vs BPD: What are the differences, and how do I know if I have one or the other? Hannah DeWitt 6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit Find a provider ... Award-winning therapy, covered by insurance Call to book We'll help you find the right provider and get you scheduled. Call (833) 966-4233 Book online Find the right provider for you and book your first session in minutes. Find a provider
6 min read Fetishistic disorder: Exploring fetishes, paraphilic disorders, and stigma-free treatment options Jason Crosby 4 min read Your guide to adjustment disorder: Symptoms, causes, treatment, and more Taylor Bennett 3 min read Language Disorder DSM-5: Causes, Symptoms and Treatment 315.39 (F80-9) Taylor Bennett 5 min read CPTSD vs BPD: What are the differences, and how do I know if I have one or the other? Hannah DeWitt 6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit Find a provider ... Award-winning therapy, covered by insurance Call to book We'll help you find the right provider and get you scheduled. Call (833) 966-4233 Book online Find the right provider for you and book your first session in minutes. Find a provider
4 min read Your guide to adjustment disorder: Symptoms, causes, treatment, and more Taylor Bennett 3 min read Language Disorder DSM-5: Causes, Symptoms and Treatment 315.39 (F80-9) Taylor Bennett 5 min read CPTSD vs BPD: What are the differences, and how do I know if I have one or the other? Hannah DeWitt 6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit Find a provider ... Award-winning therapy, covered by insurance Call to book We'll help you find the right provider and get you scheduled. Call (833) 966-4233 Book online Find the right provider for you and book your first session in minutes. Find a provider
3 min read Language Disorder DSM-5: Causes, Symptoms and Treatment 315.39 (F80-9) Taylor Bennett 5 min read CPTSD vs BPD: What are the differences, and how do I know if I have one or the other? Hannah DeWitt 6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit Find a provider ... Award-winning therapy, covered by insurance Call to book We'll help you find the right provider and get you scheduled. Call (833) 966-4233 Book online Find the right provider for you and book your first session in minutes. Find a provider
5 min read CPTSD vs BPD: What are the differences, and how do I know if I have one or the other? Hannah DeWitt 6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit Find a provider ... Award-winning therapy, covered by insurance Call to book We'll help you find the right provider and get you scheduled. Call (833) 966-4233 Book online Find the right provider for you and book your first session in minutes. Find a provider
6 min read What is hyperfixation? Symptoms, causes, and how to manage it Hannah DeWitt 7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit
7 min read Panic disorder: How to identify symptoms and find treatment Hannah DeWitt 3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby No comments yet Disclaimer The information on this page is not intended to replace assistance, diagnosis, or treatment from a clinical or medical professional. Readers are urged to seek professional help if they are struggling with a mental health condition or another health concern. If you’re in a crisis, do not use this site. Please call the Suicide & Crisis Lifeline at 988 or use these resources to get immediate help. Thank you for sharing, . We'll reach out soon Look for a confirmation email in your inbox shortly. We'll help find you a provider and guide you through everything you should know about starting care at Thriveworks. At Thriveworks, you'll get a provider that matches your needs, and more No membership fees or subscriptions Evening and weekend sessions Award-winning therapy & psychiatry Questions? Call (855) 204-2767 Call us We'll reach out when we have a match Fill out this quick form and we'll be in touch when the right provider becomes available. First name Last name Email Phone number What support are you seeking? Individual therapy Psychiatry/medication Couples/marriage therapy Family therapy Who is attending the session? Select an option... Myself A child or teen Where you live State Select your state AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVirginiaWashingtonWashington DCWest VirginiaWisconsinWyoming I only want in-person sessions Your insurance (optional) Select your insurance I'm only interested in self-pay You acknowledge that by submitting this form, you are providing what may be considered “sensitive data” and consent to Thriveworks Privacy Policy & Terms. By submitting this information, you consent to receive communication from Thriveworks about our services via automatic calls, artificial or pre-recorded messages, or texts at the phone number provided, or by email at the address provided. You have the option to opt out of communications. We will contact you with availability updates based on the preferences you provided for up to six months. Submit
3 min read Unspecified Personality Disorder: Causes, Symptoms, and Treatment DSM-5 301.9 (F60.9) Taylor Bennett 6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby
6 min read Delusional disorder: Causes, symptoms, treatment, and more Jason Crosby 9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby
9 min read What is schizophrenia? Early warning signs, behavioral traits, at-risk groups, and treatment Jason Crosby 5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby
5 min read Personality disorder clusters: Discover their defining symptoms, differences between groups, and available treatments Jason Crosby