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- Cervin, Matti, et al.
(author)
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Effects of cognitive-behavioral therapy on core aspects of anxiety in anxious youth with autism
- 2023
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In: Research in Autism Spectrum Disorders. - 1750-9467. ; 107, s. 1-10
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Journal article (peer-reviewed)abstract
- BackgroundAnxiety disorders (ADs) are common in youth with autism and cognitive-behavioral therapy (CBT) may be less efficacious than among anxious youth without autism. Yet, little is known about which aspects of anxiety are targeted less effectively by CBT in youth with autism.MethodWe pooled youth with autism and ADs randomized to CBT or a control condition from five randomized controlled trials (RCTs; CBT, n = 197, Mage = 10.30 [2.05], age range: 7–16; control conditions, n = 83; Mage = 10.57 [2.30], age range: 7–16) and examined whether CBT outperformed control conditions across core aspects of anxiety and whether more pronounced autism traits predicted outcomes. CBT response in youth with autism was also compared to CBT response among anxious youth without autism (n = 129; Mage = 11.16 [2.80], age range: 7–17).ResultsCBT for youth with autism yielded significantly better effects than control conditions for frequency of symptoms, intensity of anxiety, avoidance, family interference, and social interference but not for physical symptoms of anxiety. Youth with more pronounced autism traits had poorer outcomes for frequency of symptoms, family interference, and social interference. Compared to anxious youth without autism, youth with autism had poorer outcomes for physical symptoms and family interference.ConclusionsCBT is efficacious across core aspects of anxiety for youth with autism, but outcomes for anxiety-related interference, particularly for those with more pronounced autism traits, may be poorer than among youth without autism. More work is needed to better understand how anxiety impacts the everyday lives of anxious youth with autism and which interventions and support are needed.
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- Hunsche, Michelle, et al.
(author)
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Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis
- 2022
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In: Journal of Abnormal Psychology. - : American Psychological Association (APA). - 0021-843X. ; 131:2, s. 198-208
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Journal article (peer-reviewed)abstract
- Co-occurring anxiety in children on the autism spectrum is associated with greater social challenges, including poorer social skills and relationships, which may influence the severity and presentation of anxiety symptoms, particularly social anxiety. The current study used Bayesian network analytics (Williams & Mulder, 2020) and a multimethod approach to examine (a) how different facets of social functioning relate to one another and to anxiety severity and comorbidity, (b) which facet(s) are most influential and thus may represent optimal targets for intervention, and (c) how social functioning relates to the presentation of social fears in a large treatment-seeking sample of autistic children with anxiety disorders (n = 191, 7–13 years). Results indicated strong associations among measures of social ability (i.e., theory of mind [ToM], social motivation, friendship attainment) and among measures of social integration (i.e., bullying, interpersonal and peer difficulties), with only bullying demonstrating a significant association with anxiety. ToM was the most interconnected variable in the network, and social motivation demonstrated the strongest individual connections with other variables, particularly with other facets of social ability. Socially anxious children with impaired ToM were less likely to express fears of negative evaluation, resulting in a distinct diagnostic presentation of social fears. Findings suggest that social motivation and ToM may represent important targets for intervention for autistic children with co-occurring anxiety. Further, social–cognitive difficulties associated with autism, like ToM, may play a role in distinct manifestations of anxiety in these youth.
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