Department of Child and Adolescent Psychiatry, Research Unit, Aarhus University Hospital, Aarhus, Denmark.
Centre for Emotional Health, School of Psychological Sciences, Macquarie University, Sydney, NSW, Australia.
Nord J Psychiatry. 2024 Jul;78(5):421-430. doi: 10.1080/08039488.2024.2338206. Epub 2024 May 1.
Autism includes core symptoms affecting general and social development. Up to 60% of autistic adolescents experience co-occurring anxiety disorders negatively influencing educational, social, and general development together with quality of life. A manualised cognitive behavioural therapy (CBT) program 'Cool Kids - Autism Spectrum Adaptation (ASA)' has previously demonstrated efficacy in reducing anxiety in children with co-occurring autism. The current study investigates the feasibility of adapting this program for adolescents.
Fifteen autistic adolescents, aged 14-17 years, with co-occurring anxiety disorders were enrolled in the study. Outcome measures collected from both adolescents and parents pre-, post-treatment and at 3-month follow-up included participant evaluation of the program, scores from a semi-structured anxiety interview, and questionnaires on anxiety symptoms, life interference, and quality of life.
92% of the families who completed the program found it useful and would recommend it to other families in a similar situation. At follow-up, 55% no longer met the criteria for their primary anxiety diagnosis and 34% of adolescents were free of all anxiety diagnoses. Of the five adolescents who did not attend school before treatment three (60%) had returned to school after treatment.
This study suggests that the adaptation of the program 'Cool Kids - ASA' into an adolescent version is feasible and has the potential to show good effects thus enhancing the possibility of education, development and independence in future life for this group. Larger RCTs studies are, however, needed to examine the efficacy of the adolescent version.
自闭症包括影响一般和社会发展的核心症状。多达 60%的自闭症青少年同时患有焦虑症，这对他们的教育、社交和整体发展以及生活质量都有负面影响。一个名为“酷小孩-自闭症谱系适应（ASA）”的基于认知行为疗法（CBT）的手册化程序已被证明在减少伴有自闭症的儿童的焦虑方面有效。本研究旨在调查该程序在青少年中应用的可行性。
15 名年龄在 14-17 岁之间、同时患有焦虑症的自闭症青少年参与了该研究。在治疗前、治疗后和 3 个月随访时，从青少年及其家长那里收集了结果测量数据，包括参与者对该项目的评价、半结构化焦虑访谈的分数、焦虑症状、生活干扰和生活质量的问卷。
完成该项目的家庭中有 92%认为该项目有用，如果他们的情况与其他家庭相似，他们会推荐该项目。在随访时，55%的青少年不再符合主要焦虑症诊断标准，34%的青少年没有任何焦虑症诊断。在治疗前没有上学的五名青少年中，有三人（60%）在治疗后回到了学校。
本研究表明，将“酷小孩-ASA”项目改编为青少年版本是可行的，并且有可能显示出良好的效果，从而提高该群体未来生活接受教育、发展和独立的可能性。然而，需要进行更大规模的 RCT 研究来检验青少年版本的疗效。
