Reaven Judy, Cosgrove Kelly T, Losh Ainsley, Nickles Sarah, Kerns Connor M, Pickard Katherine, Blakeley-Smith Audrey, Hayutin Lisa, Meyer Allison T, Middleton Caitlin, Reyes Nuri M, Boles Richard E
JFK Partners, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States.
Front Psychiatry. 2025 Jul 23;16:1569435. doi: 10.3389/fpsyt.2025.1569435. eCollection 2025.
Autistic youth are at higher risk of developing anxiety compared to their peers, with as many as 40% experiencing clinical anxiety. Emerging research suggests that these rates are an underestimate as distinct presentations of anxiety (e.g., fear of change, idiosyncratic fears) are often not recognized. CBT is a well-established approach for managing anxiety in autistic youth, but many have difficulty accessing these interventions. School-based CBT programs, like Facing Your Fears in Schools (FYF-S), have shown effectiveness in reducing anxiety in autistic students and may increase access to care. The Anxiety and Related Disorders Interview Schedule for DSM-5 with Autism Spectrum Addendum is a semi-structured interview that captures both DSM-5 and distinct presentations of anxiety. This study aimed to: 1) characterize a subsample of students with autism or suspected autism and anxiety and 2) examine effectiveness of FYF-S using the ADIS/ASA.
This study utilized a subsample of students (=37; ages 7-14) from a larger Type 1 hybrid-effectiveness trial who had either autism or suspected autism. Students were randomized to either FYF-S or Usual Care (UC). Caregivers completed the ADIS/ASA at baseline and post-intervention. The ADIS/ASA was administered by clinicians rigorously trained to reliability and masked to condition.
Students had both DSM-5 and distinct anxiety diagnoses at Time 1. Further, students in FYF-S demonstrated significant reductions in anxiety compared to UC, as evidenced by fewer anxiety diagnoses overall and significant improvement in total anxiety.
This is the first school-based study using the ADIS/ASA to characterize anxiety and measure outcomes in autistic students. Overall, results indicate that FYF-S may be a promising school-based intervention for autistic youth.
https://clinicaltrials.gov/study/NCT03685474, identifier NCT03685474.
与同龄人相比，患有自闭症的青少年患焦虑症的风险更高，多达40%的人患有临床焦虑症。新出现的研究表明，这些比率被低估了，因为焦虑的独特表现（如对变化的恐惧、特殊恐惧）往往未被识别。认知行为疗法（CBT）是管理自闭症青少年焦虑症的一种成熟方法，但许多人难以获得这些干预措施。像学校中的直面恐惧（FYF-S）这样的基于学校的CBT项目已显示出在降低自闭症学生焦虑方面的有效性，并且可能增加获得护理的机会。《精神疾病诊断与统计手册》第5版焦虑及相关障碍访谈量表（含自闭症谱系附录）是一种半结构化访谈，可捕捉《精神疾病诊断与统计手册》第5版中的焦虑症以及焦虑的独特表现。本研究旨在：1）对患有自闭症或疑似自闭症且有焦虑症的学生子样本进行特征描述；2）使用ADIS/ASA检查FYF-S的有效性。
本研究使用了来自一项规模更大的1型混合有效性试验中的学生子样本（n = 37；年龄7 - 14岁），这些学生患有自闭症或疑似自闭症。学生被随机分为FYF-S组或常规护理（UC）组。照顾者在基线和干预后完成ADIS/ASA。ADIS/ASA由经过严格可靠性培训且对分组情况不知情的临床医生进行施测。
学生在时间1时既有《精神疾病诊断与统计手册》第5版中的焦虑症诊断，也有独特的焦虑症诊断。此外，与常规护理组相比，FYF-S组的学生焦虑症有显著减轻，总体焦虑症诊断减少以及总焦虑显著改善证明了这一点。
这是第一项使用ADIS/ASA对自闭症学生的焦虑症进行特征描述并测量结果的基于学校的研究。总体而言，结果表明FYF-S可能是一种有前景的针对自闭症青少年的基于学校的干预措施。
