Child Development and Education, University of Amsterdam.
J Consult Clin Psychol. 2015 Jun;83(3):512-523. doi: 10.1037/a0039108. Epub 2015 Apr 20.
The effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders in children with autism spectrum disorders (ASD) was examined, and compared with children without ASD.
Children with ASD and comorbid anxiety disorders (n = 79, 58 boys; Mage = 11.76) and children with anxiety disorders (n = 95, 46 boys; Mage = 12.85), and their parents, participated. All families were referred to 1 of 7 mental health care centers and received the same CBT. Anxiety, quality of life, ASD-like behaviors, and emotional-behavioral problems were measured at waitlist (ASD-group only, n = 17), pretest, posttest, and 3 months, 1 year, and 2 years after CBT.
CBT was more effective than waitlist for treating anxiety disorders (d = -1.45) and anxiety symptoms (d = -0.48) in children with ASD. At 2 years follow-up, 61% of the children with and 64% without ASD were free of their primary anxiety disorder (percentages not significantly different). The decrease in severity of anxiety disorders after CBT (d values ranging between -1.05 and -1.46) was not different for children with and without ASD. Improvements were less in children with ASD for (only) 2 out of 7 continuous outcomes measures: anxiety symptoms (d values ranging between -0.68 and -0.94 vs. d values ranging between -0.98 and -1.25) and quality of life (d values ranging between 0.39 and 0.56 vs. d values ranging between 0.77 and 0.98).
CBT for anxiety disorders is effective for children with ASD, also in the long-term. Treatment gains may be somewhat less compared with children without ASD.
研究认知行为疗法（CBT）治疗自闭症谱系障碍（ASD）儿童焦虑症的效果，并与无 ASD 的儿童进行比较。
研究纳入了 79 名 ASD 合并焦虑症的儿童（58 名男孩，平均年龄=11.76 岁）和 95 名单纯焦虑症的儿童（46 名男孩，平均年龄=12.85 岁）及其父母。所有家庭都被转诊到 7 家心理健康中心之一，并接受相同的 CBT。在等待治疗（仅 ASD 组，n=17）、治疗前、治疗后以及 CBT 后 3 个月、1 年和 2 年，测量焦虑、生活质量、ASD 样行为和情绪行为问题。
与等待治疗相比，CBT 治疗 ASD 儿童的焦虑症（d=-1.45）和焦虑症状（d=-0.48）更有效。在 2 年随访时，61%的 ASD 儿童和 64%的非 ASD 儿童无原发性焦虑症（无显著差异）。CBT 后焦虑症严重程度的下降（d 值在-1.05 到-1.46 之间）在 ASD 儿童和非 ASD 儿童之间没有差异。在只有 2 个连续结果测量中，ASD 儿童的改善程度较低：焦虑症状（d 值在-0.68 到-0.94 之间，而 d 值在-0.98 到-1.25 之间）和生活质量（d 值在 0.39 到 0.56 之间，而 d 值在 0.77 到 0.98 之间）。
CBT 治疗 ASD 儿童的焦虑症有效，长期效果也较好。与非 ASD 儿童相比，治疗获益可能略低。
