A cognitive help or hindrance? A systematic review of cognitive behavioural therapy to treat anxiety in young people with autism spectrum disorder.

K Roberts, P M Rankin
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Abstract

Objective: Anxiety rates amongst autistic youth range from 11% to 84%. While Cognitive Behavioural Therapy (CBT) is an effective treatment of anxiety in neurotypical youth, there are concerns autistic youth lack the cognitive resources necessary to effectively engage with CBT. It is also unclear whether standard or adapted CBT is more effective. This review aims to compare the effects of standard and adapted CBT in the treatment of anxiety in autistic youth.

Methods: Articles were searched across three online databases. 24 articles were selected for final review. All articles were published between 2008 and 2024. Total sample size was 1,140 and participant age ranged from 4-18 years. Various designs, settings, and CBT formats were incorporated.

Results: When treating anxiety in autistic youth, standard CBT is effective although CBT adapted to accommodate the autism-related needs of the youth appears more effective, with gains maintained up to 26 months post-treatment. Statistical analysis was not significant.

Conclusions: Standard and adapted CBT are effective treatments of anxiety in autistic youth. To optimise outcomes, it may be important to consider the common cognitive styles associated with autism and adapt the therapeutic intervention accordingly. However, there is not yet statistical evidence for this hypothesis.

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认知帮助还是阻碍?认知行为疗法治疗自闭症谱系障碍青少年焦虑症的系统综述。
目的:自闭症青少年的焦虑率从11%到84%不等。虽然认知行为疗法(CBT)是一种有效的治疗焦虑症的神经正常的年轻人,有担心自闭症青少年缺乏必要的认知资源,有效地参与CBT。目前也不清楚标准CBT和改编CBT哪个更有效。本综述旨在比较标准和适应CBT治疗自闭症青少年焦虑的效果。方法:在三个在线数据库中检索文章。24篇文章入选最终审稿。所有文章都发表于2008年至2024年之间。总样本量为1140人,参与者年龄在4-18岁之间。各种设计、设置和CBT格式被纳入。结果:当治疗自闭症青少年的焦虑时,标准的CBT是有效的,尽管适应青少年自闭症相关需求的CBT似乎更有效,其收益维持到治疗后26个月。统计学分析无统计学意义。结论:标准和适应CBT是治疗自闭症青少年焦虑的有效方法。为了优化结果,考虑与自闭症相关的常见认知方式并相应地调整治疗干预可能很重要。然而,目前还没有统计证据支持这一假设。
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