Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials / Audrey LINDEN in Autism, 27-1 (January 2023)  

Public ISBD [article]  inAutism > 27-1 (January 2023) . - p.7-30 Titre : Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials Type de document : Texte imprimé et/ou numérique Auteurs : Audrey LINDEN, Auteur ; Lawrence BEST, Auteur ; Freya ELISE, Auteur ; Danielle ROBERTS, Auteur ; Aoife BRANAGAN, Auteur ; Yong Boon Ernest TAY, Auteur ; Laura CRANE, Auteur ; James CUSACK, Auteur ; Brian DAVIDSON, Auteur ; Ian DAVIDSON, Auteur ; Caroline HEARST, Auteur ; William MANDY, Auteur ; Dheeraj RAI, Auteur ; Edward SMITH, Auteur ; Kurinchi GURUSAMY, Auteur Article en page(s) : p.7-30 Langues : Anglais (eng) Mots-clés : adolescents  adults  anxiety  autism spectrum disorders  depression  interventions - pharmacologic  interventions - psychosocial/behavioural  school-age children Index. décimale : PER Périodiques Résumé : Mental health difficulties are prevalent in autistic people with ~14%-50% having experienced depression and ~40%-80% having experienced anxiety disorders. Identifying interventions that improve autistic people’s mental health is a top priority. However, at present, there is no high-quality network meta-analysis of benefits and harms of different interventions. We conducted a systematic review and network meta-analysis of randomised controlled trials, searching MEDLINE, EMBASE, other databases, and trial registers until 17 October 2020. We included randomised controlled trials reporting anxiety or depression in a suitable format. We calculated effect estimates and 95% credible intervals using Bayesian network meta-analysis. Our search identified 13,794 reports, of which 71 randomised controlled trials (3630 participants) were eligible for inclusion. All trials had high risk of bias. The follow-up period ranged from 1 to 24 months. Evidence indicates uncertainty about the effects of different interventions, with more high-quality evidence needed. Available evidence suggests that some forms of cognitive behavioural therapy may decrease anxiety and depression scores in autistic children and adults; mindfulness therapy may decrease anxiety and depression scores in autistic adults with previous mental health conditions; and behavioural interventions may provide some benefit for depression in autistic children. We recommend that autistic people are given access to mental health interventions available to non-autistic people, following principles of person-centred care. PROSPERO registration ID: CRD42019136093 Lay Abstract Nearly three out of four autistic people experience mental health problems such as stress, anxiety or depression. The research already done does not guide us on how best to prevent or treat mental health problems for autistic people. Our aim was to look at the benefits and harms of different interventions on mental health outcomes in autistic people. We searched all the published randomised controlled trials (RCTs) about interventions for mental health conditions in autistic people until 17 October 2020. We also searched for RCTs that were not published in peer-reviewed journals. These were obtained from registers of clinical trials online. We then combined the information from all these trials using advanced statistical methods to analyse how good the interventions are. Seventy-one studies (3630 participants) provided information for this research. The studies reported how participants were responding to the intervention for only a short period of time. The trials did not report which interventions worked for people with intellectual disability. In people without intellectual disability, some forms of cognitive behavioural therapy and mindfulness therapy may be helpful. However, further research is necessary. Many trials used medications to target core features of autism rather than targeting mental health conditions, but these medications did not help autistic people. Until we have more evidence, treatment of mental health conditions in autistic people should follow the evidence available for non-autistic people. We plan to widely disseminate the findings to healthcare professionals through medical journals and conferences and contact other groups representing autistic people. En ligne : http://dx.doi.org/10.1177/13623613221117931 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=491 [article] Benefits and harms of interventions to improve anxiety, depression, and other mental health outcomes for autistic people: A systematic review and network meta-analysis of randomised controlled trials [Texte imprimé et/ou numérique] / Audrey LINDEN, Auteur ; Lawrence BEST, Auteur ; Freya ELISE, Auteur ; Danielle ROBERTS, Auteur ; Aoife BRANAGAN, Auteur ; Yong Boon Ernest TAY, Auteur ; Laura CRANE, Auteur ; James CUSACK, Auteur ; Brian DAVIDSON, Auteur ; Ian DAVIDSON, Auteur ; Caroline HEARST, Auteur ; William MANDY, Auteur ; Dheeraj RAI, Auteur ; Edward SMITH, Auteur ; Kurinchi GURUSAMY, Auteur . - p.7-30. Langues : Anglais (eng) in Autism > 27-1 (January 2023) . - p.7-30 Mots-clés : adolescents  adults  anxiety  autism spectrum disorders  depression  interventions - pharmacologic  interventions - psychosocial/behavioural  school-age children Index. décimale : PER Périodiques Résumé : Mental health difficulties are prevalent in autistic people with ~14%-50% having experienced depression and ~40%-80% having experienced anxiety disorders. Identifying interventions that improve autistic people’s mental health is a top priority. However, at present, there is no high-quality network meta-analysis of benefits and harms of different interventions. We conducted a systematic review and network meta-analysis of randomised controlled trials, searching MEDLINE, EMBASE, other databases, and trial registers until 17 October 2020. We included randomised controlled trials reporting anxiety or depression in a suitable format. We calculated effect estimates and 95% credible intervals using Bayesian network meta-analysis. Our search identified 13,794 reports, of which 71 randomised controlled trials (3630 participants) were eligible for inclusion. All trials had high risk of bias. The follow-up period ranged from 1 to 24 months. Evidence indicates uncertainty about the effects of different interventions, with more high-quality evidence needed. Available evidence suggests that some forms of cognitive behavioural therapy may decrease anxiety and depression scores in autistic children and adults; mindfulness therapy may decrease anxiety and depression scores in autistic adults with previous mental health conditions; and behavioural interventions may provide some benefit for depression in autistic children. We recommend that autistic people are given access to mental health interventions available to non-autistic people, following principles of person-centred care. PROSPERO registration ID: CRD42019136093 Lay Abstract Nearly three out of four autistic people experience mental health problems such as stress, anxiety or depression. The research already done does not guide us on how best to prevent or treat mental health problems for autistic people. Our aim was to look at the benefits and harms of different interventions on mental health outcomes in autistic people. We searched all the published randomised controlled trials (RCTs) about interventions for mental health conditions in autistic people until 17 October 2020. We also searched for RCTs that were not published in peer-reviewed journals. These were obtained from registers of clinical trials online. We then combined the information from all these trials using advanced statistical methods to analyse how good the interventions are. Seventy-one studies (3630 participants) provided information for this research. The studies reported how participants were responding to the intervention for only a short period of time. The trials did not report which interventions worked for people with intellectual disability. In people without intellectual disability, some forms of cognitive behavioural therapy and mindfulness therapy may be helpful. However, further research is necessary. Many trials used medications to target core features of autism rather than targeting mental health conditions, but these medications did not help autistic people. Until we have more evidence, treatment of mental health conditions in autistic people should follow the evidence available for non-autistic people. We plan to widely disseminate the findings to healthcare professionals through medical journals and conferences and contact other groups representing autistic people. En ligne : http://dx.doi.org/10.1177/13623613221117931 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=491

Evaluating the online delivery of an autistic-led programme to support newly diagnosed or identified autistic adults / Caroline HEARST ; Maria ASHWORTH ; Jade DAVIES in Autism & Developmental Language Impairments, 8 (January-December 2023)  

Public ISBD [article]  inAutism & Developmental Language Impairments > 8 (January-December 2023) Titre : Evaluating the online delivery of an autistic-led programme to support newly diagnosed or identified autistic adults Type de document : Texte imprimé et/ou numérique Auteurs : Caroline HEARST, Auteur ; Maria ASHWORTH, Auteur ; Jade DAVIES, Auteur Langues : Anglais (eng) Mots-clés : Post-diagnostic support  peer group  psychoeducation  telehealth  autistic adults Index. décimale : PER Périodiques Résumé : Background & aimsExploring Being Autistic is an autistic-led group-based programme providing psychoeducation and peer support to newly identified/diagnosed autistic adults. In 2020, due to social distancing measures implemented following the coronavirus pandemic, Exploring Being Autistic was adapted for online delivery. Here, we aimed to replicate previous research into the in-person delivery of Exploring Being Autistic, to determine whether similar results were obtained when the programme was delivered online. Further, we aimed to identify the unique opportunities and challenges that online delivery afforded.MethodsWe used a community-based participatory research (CBPR) approach, whereby the autistic developer and facilitator of Exploring Being Autistic worked collaboratively with a team of academic researchers throughout the research process. Together, we evaluated two iterations of the online Exploring Being Autistic programme, involving 16 attendees. Attendees completed questionnaires before, during and after the programme. Attendees were also invited to participate in two post-programme (group or individual) interviews: one following the completion of the programme (time one) and another 6-8 months later (time two). Attendees were included in the research if they completed at least one questionnaire or interview. Data were analysed qualitatively, using reflexive thematic analysis.ResultsExperiences of participating in the programme tended to be positive. Participants appreciated the autistic-led nature of the programme, found unity in the diversity of the group, and developed a positive and practical outlook as a result of the programme. Further analyses of our data revealed mixed views regarding the online delivery of the programme. Opportunities of online delivery were noted, such as this mode of participation reducing cognitive load, enabling the programme to be accessible to more participants, and fostering meaningful social connections among participants. However, technology and practical issues were felt to cause barriers, and some human aspects of participation were felt to be 'lost in translation' (e.g., in breakout groups).ConclusionsThe online delivery of the Exploring Being Autistic programme yielded similar results to previous, in-person evaluations of the programme. While we identified positive aspects of online delivery, this mode did not entirely suit everyone's needs.ImplicationsFrom the current findings, we can make several recommendations to develop online support for autistic people. First, flexibility is key. To make support accessible and inclusive to a broad range of autistic people, the option for attendees to engage in-person, online or in hybrid formats should be considered. Second, if delivering support online, the use of breakout rooms should be carefully considered. While participants appreciated the opportunity to meet different people, some participants found the unpredictability and lack of scaffolding associated with breakout rooms challenging. To mitigate these challenges, groups could be pre-determined and shared with the attendees in advance (although consideration should be given to how the groups 'fit' together, and whether groupings should be changed at set intervals). Gentle warnings should also be given to those in breakout rooms, to alert them of the need to re-join the main group. Finally, support with technological aspects relating to engagement should be prioritised. En ligne : https://dx.doi.org/10.1177/23969415231189608 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=518 [article] Evaluating the online delivery of an autistic-led programme to support newly diagnosed or identified autistic adults [Texte imprimé et/ou numérique] / Caroline HEARST, Auteur ; Maria ASHWORTH, Auteur ; Jade DAVIES, Auteur. Langues : Anglais (eng) in Autism & Developmental Language Impairments > 8 (January-December 2023) Mots-clés : Post-diagnostic support  peer group  psychoeducation  telehealth  autistic adults Index. décimale : PER Périodiques Résumé : Background & aimsExploring Being Autistic is an autistic-led group-based programme providing psychoeducation and peer support to newly identified/diagnosed autistic adults. In 2020, due to social distancing measures implemented following the coronavirus pandemic, Exploring Being Autistic was adapted for online delivery. Here, we aimed to replicate previous research into the in-person delivery of Exploring Being Autistic, to determine whether similar results were obtained when the programme was delivered online. Further, we aimed to identify the unique opportunities and challenges that online delivery afforded.MethodsWe used a community-based participatory research (CBPR) approach, whereby the autistic developer and facilitator of Exploring Being Autistic worked collaboratively with a team of academic researchers throughout the research process. Together, we evaluated two iterations of the online Exploring Being Autistic programme, involving 16 attendees. Attendees completed questionnaires before, during and after the programme. Attendees were also invited to participate in two post-programme (group or individual) interviews: one following the completion of the programme (time one) and another 6-8 months later (time two). Attendees were included in the research if they completed at least one questionnaire or interview. Data were analysed qualitatively, using reflexive thematic analysis.ResultsExperiences of participating in the programme tended to be positive. Participants appreciated the autistic-led nature of the programme, found unity in the diversity of the group, and developed a positive and practical outlook as a result of the programme. Further analyses of our data revealed mixed views regarding the online delivery of the programme. Opportunities of online delivery were noted, such as this mode of participation reducing cognitive load, enabling the programme to be accessible to more participants, and fostering meaningful social connections among participants. However, technology and practical issues were felt to cause barriers, and some human aspects of participation were felt to be 'lost in translation' (e.g., in breakout groups).ConclusionsThe online delivery of the Exploring Being Autistic programme yielded similar results to previous, in-person evaluations of the programme. While we identified positive aspects of online delivery, this mode did not entirely suit everyone's needs.ImplicationsFrom the current findings, we can make several recommendations to develop online support for autistic people. First, flexibility is key. To make support accessible and inclusive to a broad range of autistic people, the option for attendees to engage in-person, online or in hybrid formats should be considered. Second, if delivering support online, the use of breakout rooms should be carefully considered. While participants appreciated the opportunity to meet different people, some participants found the unpredictability and lack of scaffolding associated with breakout rooms challenging. To mitigate these challenges, groups could be pre-determined and shared with the attendees in advance (although consideration should be given to how the groups 'fit' together, and whether groupings should be changed at set intervals). Gentle warnings should also be given to those in breakout rooms, to alert them of the need to re-join the main group. Finally, support with technological aspects relating to engagement should be prioritised. En ligne : https://dx.doi.org/10.1177/23969415231189608 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=518

Supporting Newly Identified or Diagnosed Autistic Adults: An Initial Evaluation of an Autistic-Led Programme / Laura CRANE in Journal of Autism and Developmental Disorders, 51-3 (March 2021)  

Public ISBD [article]  inJournal of Autism and Developmental Disorders > 51-3 (March 2021) . - p.892-905 Titre : Supporting Newly Identified or Diagnosed Autistic Adults: An Initial Evaluation of an Autistic-Led Programme Type de document : Texte imprimé et/ou numérique Auteurs : Laura CRANE, Auteur ; Caroline HEARST, Auteur ; Maria ASHWORTH, Auteur ; Jade DAVIES, Auteur ; Elisabeth L HILL, Auteur Article en page(s) : p.892-905 Langues : Anglais (eng) Mots-clés : Adults  Autism  Autistic-led  Diagnosis  Peer support  Post-diagnostic support Index. décimale : PER Périodiques Résumé : Sixteen adults (diagnosed or self-identified as autistic) participated in one of two iterations of a ten-week autistic-led programme, aimed at helping autistic adults learn more about autism within a peer group context. Motivations for taking part in the programme included a desire for: (1) exploration of autism; (2) empowerment; and (3) the development of practical strategies and coping mechanisms. Interviews were conducted upon completion of the programme and again 6 months later. Using thematic analysis, three themes were identified: (1) appreciation of the autistic-led nature of the programme; (2) unity in diversity; and (3) developing a positive, practical outlook on autism. These promising initial results highlight the value of autistic-led peer support for those recently diagnosed/identified as autistic. En ligne : http://dx.doi.org/10.1007/s10803-020-04486-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443 [article] Supporting Newly Identified or Diagnosed Autistic Adults: An Initial Evaluation of an Autistic-Led Programme [Texte imprimé et/ou numérique] / Laura CRANE, Auteur ; Caroline HEARST, Auteur ; Maria ASHWORTH, Auteur ; Jade DAVIES, Auteur ; Elisabeth L HILL, Auteur . - p.892-905. Langues : Anglais (eng) in Journal of Autism and Developmental Disorders > 51-3 (March 2021) . - p.892-905 Mots-clés : Adults  Autism  Autistic-led  Diagnosis  Peer support  Post-diagnostic support Index. décimale : PER Périodiques Résumé : Sixteen adults (diagnosed or self-identified as autistic) participated in one of two iterations of a ten-week autistic-led programme, aimed at helping autistic adults learn more about autism within a peer group context. Motivations for taking part in the programme included a desire for: (1) exploration of autism; (2) empowerment; and (3) the development of practical strategies and coping mechanisms. Interviews were conducted upon completion of the programme and again 6 months later. Using thematic analysis, three themes were identified: (1) appreciation of the autistic-led nature of the programme; (2) unity in diversity; and (3) developing a positive, practical outlook on autism. These promising initial results highlight the value of autistic-led peer support for those recently diagnosed/identified as autistic. En ligne : http://dx.doi.org/10.1007/s10803-020-04486-4 Permalink : https://www.cra-rhone-alpes.org/cid/opac_css/index.php?lvl=notice_display&id=443

---

1 (1 - 3 / 3)