Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting / Johan PAHNKE in Autism, 27-5 (July 2023)  

Public ISBD [article]  inAutism > 27-5 (July 2023) . - p.1461-1476 Titre : Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting Type de document : texte imprimé Auteurs : Johan PAHNKE, Auteur ; Markus JANSSON-FRÖJMARK, Auteur ; Gerhard ANDERSSON, Auteur ; Johan BJUREBERG, Auteur ; Jussi JOKINEN, Auteur ; Benjamin BOHMAN, Auteur ; Tobias LUNDGREN, Auteur Article en page(s) : p.1461-1476 Langues : Anglais (eng) Mots-clés : acceptance and commitment therapy;anxiety;autism;cognitive defusion;depression;interventions-psychosocial/behavioral;mindfulness;psychological flexibility;quality of life;stress Index. décimale : PER Périodiques Résumé : Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21-72 years) with autism spectrum disorder and normal intellectual ability (IQ M 108.5; SD 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual (d 0.70-0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further. Lay abstract Autistic adults are often stressed and feel depressed or anxious. However, mental health programs that are suited for autistic adults are few. Acceptance and commitment therapy is a psychotherapy method that seems to help people feel better, although not thoroughly evaluated in autistic individuals. In this study, 20 autistic adults had 14 weeks of acceptance and commitment therapy group treatment suited for autism (NeuroACT), while 19 autistic adults had ordinary care. The acceptance and commitment therapy group treatment program seemed logical and reasonable to the participants. Also, when comparing the participants in the NeuroACT group with those in the ordinary care group, the NeuroACT participants reported less stress and higher quality of life. Compared to the ordinary care group, they could also manage distressing thoughts better, perceived themselves as more flexible, and did not avoid stressful situations as much as before. However, there was no significant difference between the groups in depression, anxiety, sleep problems, social aspects of autism, everyday functioning, or executive challenges. Slightly more NeuroACT participants did not finish the treatment than ordinary care participants. In conclusion, the NeuroACT program may be a treatment for autistic adults who feel stressed and have reduced quality of life. More studies are needed to see how helpful the NeuroACT program is for autistic adults. En ligne : http://dx.doi.org/10.1177/13623613221140749 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507 [article] Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting [texte imprimé] / Johan PAHNKE, Auteur ; Markus JANSSON-FRÖJMARK, Auteur ; Gerhard ANDERSSON, Auteur ; Johan BJUREBERG, Auteur ; Jussi JOKINEN, Auteur ; Benjamin BOHMAN, Auteur ; Tobias LUNDGREN, Auteur . - p.1461-1476. Langues : Anglais (eng) in Autism > 27-5 (July 2023) . - p.1461-1476 Mots-clés : acceptance and commitment therapy;anxiety;autism;cognitive defusion;depression;interventions-psychosocial/behavioral;mindfulness;psychological flexibility;quality of life;stress Index. décimale : PER Périodiques Résumé : Autistic adults are at risk of stress-related psychiatric disorders and reduced life quality due to social, cognitive, and perceptual challenges. Mental health interventions adapted to autistic adults are scarce. Acceptance and commitment therapy has preliminarily indicated health benefits in autistic adults, although it has not been robustly evaluated. Overall, 39 adults (21 males; 21-72 years) with autism spectrum disorder and normal intellectual ability (IQ M 108.5; SD 13.5) were randomized to 14 weeks of adapted acceptance and commitment therapy group treatment (NeuroACT) or treatment as usual. The intervention was feasible. Perceived stress and quality of life (primary outcomes), alongside psychological inflexibility, cognitive fusion, cognitive and behavioral avoidance, and autistic mannerism were statistically significantly improved in NeuroACT compared with treatment as usual (d 0.70-0.90). Clinically significant changes in perceived stress and quality of life were in favor of NeuroACT. Between-group altered depression, anxiety, sleep problems, one quality of life measure, functional impairment, social aspects of autism, and executive difficulties were statistically non-significant. Dropout was slightly higher in NeuroACT. NeuroACT may be a promising treatment for autistic adults with co-existing stress and reduced quality of life. More extensive studies are warranted to evaluate NeuroACT further. Lay abstract Autistic adults are often stressed and feel depressed or anxious. However, mental health programs that are suited for autistic adults are few. Acceptance and commitment therapy is a psychotherapy method that seems to help people feel better, although not thoroughly evaluated in autistic individuals. In this study, 20 autistic adults had 14 weeks of acceptance and commitment therapy group treatment suited for autism (NeuroACT), while 19 autistic adults had ordinary care. The acceptance and commitment therapy group treatment program seemed logical and reasonable to the participants. Also, when comparing the participants in the NeuroACT group with those in the ordinary care group, the NeuroACT participants reported less stress and higher quality of life. Compared to the ordinary care group, they could also manage distressing thoughts better, perceived themselves as more flexible, and did not avoid stressful situations as much as before. However, there was no significant difference between the groups in depression, anxiety, sleep problems, social aspects of autism, everyday functioning, or executive challenges. Slightly more NeuroACT participants did not finish the treatment than ordinary care participants. In conclusion, the NeuroACT program may be a treatment for autistic adults who feel stressed and have reduced quality of life. More studies are needed to see how helpful the NeuroACT program is for autistic adults. En ligne : http://dx.doi.org/10.1177/13623613221140749 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=507

Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study / Johan PAHNKE in Autism, 18-8 (November 2014)  

Public ISBD [article]  inAutism > 18-8 (November 2014) . - p.953-964 Titre : Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study Type de document : texte imprimé Auteurs : Johan PAHNKE, Auteur ; Tobias LUNDGREN, Auteur ; Timo HURSTI, Auteur ; Tatja HIRVIKOSKI, Auteur Article en page(s) : p.953-964 Langues : Anglais (eng) Mots-clés : acceptance and commitment therapy  adolescents  autism spectrum disorder  cognitive behavioural therapy  high-functioning  mindfulness  skills training  treatment Index. décimale : PER Périodiques Résumé : Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13–21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361313501091 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=242 [article] Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: A quasi-experimental pilot study [texte imprimé] / Johan PAHNKE, Auteur ; Tobias LUNDGREN, Auteur ; Timo HURSTI, Auteur ; Tatja HIRVIKOSKI, Auteur . - p.953-964. Langues : Anglais (eng) in Autism > 18-8 (November 2014) . - p.953-964 Mots-clés : acceptance and commitment therapy  adolescents  autism spectrum disorder  cognitive behavioural therapy  high-functioning  mindfulness  skills training  treatment Index. décimale : PER Périodiques Résumé : Autism spectrum disorder is characterized by social impairments and behavioural inflexibility. In this pilot study, the feasibility and outcomes of a 6-week acceptance and commitment therapy-based skills training group were evaluated in a special school setting using a quasi-experimental design (acceptance and commitment therapy/school classes as usual). A total of 28 high-functioning students with autism spectrum disorder (aged 13–21 years) were assessed using self- and teacher-ratings at pre- and post-assessment and 2-month follow-up. All participants completed the skills training, and treatment satisfaction was high. Levels of stress, hyperactivity and emotional distress were reduced in the treatment group. The acceptance and commitment therapy group also reported increased prosocial behaviour. These changes were stable or further improved at the 2-month follow-up. Larger studies are needed to further evaluate the benefits of acceptance and commitment therapy for autism spectrum disorder. En ligne : http://dx.doi.org/10.1177/1362361313501091 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=242

Technology-delivered cognitive-behavioral therapy for pediatric anxiety disorders: a meta-analysis of remission, posttreatment anxiety, and functioning / Matti CERVIN in Journal of Child Psychology and Psychiatry, 63-1 (January 2022)  

Public ISBD [article]  inJournal of Child Psychology and Psychiatry > 63-1 (January 2022) . - p.7-18 Titre : Technology-delivered cognitive-behavioral therapy for pediatric anxiety disorders: a meta-analysis of remission, posttreatment anxiety, and functioning Type de document : texte imprimé Auteurs : Matti CERVIN, Auteur ; Tobias LUNDGREN, Auteur Article en page(s) : p.7-18 Langues : Anglais (eng) Mots-clés : Adolescent  Anxiety  Anxiety Disorders/therapy  Child  Cognitive Behavioral Therapy  Female  Humans  Technology  Anxiety disorders  adolescents  children  iCBT  internet  meta-analysis  tCBT  technology Index. décimale : PER Périodiques Résumé : BACKGROUND: The efficacy of technology-delivered cognitive-behavioral therapy (tCBT) for pediatric anxiety disorders (ADs) is uncertain as no meta-analysis has examined outcomes in trials that used structured diagnostic assessments at pre- and posttreatment. METHODS: We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) of tCBT for pediatric ADs that included participants <18 years of age with a confirmed primary AD according to a structured diagnostic interview. Nine studies with 711 participants were included. RESULTS: tCBT outperformed control conditions for remission for primary AD (37.9% vs. 10.2%; k = 9; OR = 4.73; p < .0001; I(2)  = 0%; moderate certainty), remission for all ADs (19.5% vs. 5.3%; k = 8; OR = 3.32; p < .0001; I(2)  = 0%; moderate certainty), clinician-rated functioning (k = 7; MD = -4.38; p < .001; I(2)  = 56.9%; low certainty), and caregiver-reported anxiety (k = 7; SMD = 0.27; p = .02; I(2)  = 41.4%; low certainty), but not for youth-reported anxiety (k = 9; SMD = 0.13; p = .12; I(2)  = 0%; low certainty). More severe pretreatment anxiety, a lower proportion of completed sessions, no face-to-face sessions, media recruitment, and a larger proportion of females were associated with lower remission rates for primary AD. CONCLUSIONS: tCBT has a moderate effect on remission for pediatric ADs and clinician-rated functioning, a small effect on caregiver-reported anxiety, and no statistically significant effect on youth-reported anxiety. The certainty of these estimates is low to moderate. Remission rates vary substantially across trials and several factors that may influence remission were identified. Future research should examine for whom tCBT is most appropriate and what care to offer the large proportion that does not remit. Future RCTs should consider contrasting tCBT with partial tCBT (e.g., including therapist-led exposure) and/or face-to-face CBT. En ligne : http://dx.doi.org/10.1111/jcpp.13485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=456 [article] Technology-delivered cognitive-behavioral therapy for pediatric anxiety disorders: a meta-analysis of remission, posttreatment anxiety, and functioning [texte imprimé] / Matti CERVIN, Auteur ; Tobias LUNDGREN, Auteur . - p.7-18. Langues : Anglais (eng) in Journal of Child Psychology and Psychiatry > 63-1 (January 2022) . - p.7-18 Mots-clés : Adolescent  Anxiety  Anxiety Disorders/therapy  Child  Cognitive Behavioral Therapy  Female  Humans  Technology  Anxiety disorders  adolescents  children  iCBT  internet  meta-analysis  tCBT  technology Index. décimale : PER Périodiques Résumé : BACKGROUND: The efficacy of technology-delivered cognitive-behavioral therapy (tCBT) for pediatric anxiety disorders (ADs) is uncertain as no meta-analysis has examined outcomes in trials that used structured diagnostic assessments at pre- and posttreatment. METHODS: We carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) of tCBT for pediatric ADs that included participants <18 years of age with a confirmed primary AD according to a structured diagnostic interview. Nine studies with 711 participants were included. RESULTS: tCBT outperformed control conditions for remission for primary AD (37.9% vs. 10.2%; k = 9; OR = 4.73; p < .0001; I(2)  = 0%; moderate certainty), remission for all ADs (19.5% vs. 5.3%; k = 8; OR = 3.32; p < .0001; I(2)  = 0%; moderate certainty), clinician-rated functioning (k = 7; MD = -4.38; p < .001; I(2)  = 56.9%; low certainty), and caregiver-reported anxiety (k = 7; SMD = 0.27; p = .02; I(2)  = 41.4%; low certainty), but not for youth-reported anxiety (k = 9; SMD = 0.13; p = .12; I(2)  = 0%; low certainty). More severe pretreatment anxiety, a lower proportion of completed sessions, no face-to-face sessions, media recruitment, and a larger proportion of females were associated with lower remission rates for primary AD. CONCLUSIONS: tCBT has a moderate effect on remission for pediatric ADs and clinician-rated functioning, a small effect on caregiver-reported anxiety, and no statistically significant effect on youth-reported anxiety. The certainty of these estimates is low to moderate. Remission rates vary substantially across trials and several factors that may influence remission were identified. Future research should examine for whom tCBT is most appropriate and what care to offer the large proportion that does not remit. Future RCTs should consider contrasting tCBT with partial tCBT (e.g., including therapist-led exposure) and/or face-to-face CBT. En ligne : http://dx.doi.org/10.1111/jcpp.13485 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=456

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