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Psychosocial Treatments Targeting Anxiety and Depression in Adolescents and Adults on the Autism Spectrum: Review of the Latest Research and Recommended Future Directions
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Purpose of review This synthesis of treatment research related to anxiety and depression in adolescents and adults with autism spectrum disorder (ASD) focuses on the scientific support for various forms of psychosocial interventions, useful adaptations to standard interventions, and engagement of candidate therapeutic mechanisms.Recent findings There is considerable evidence for the efficacy of cognitive-behavioral therapy (CBT) to treat co-occurring problems with anxiety, but there has been relatively little research on treatment of co-occurring depression. Multiple mechanisms of treatment effect have been proposed, but there has been little demonstration of target engagement via experimental therapeutics. Comorbidity between ASD and anxiety and/or mood problems is common. Although there is evidence for the use of CBT for anxiety, little work has addressed how to effectively treat depression. There is emerging support for alternative treatment approaches, such as mindfulness-based interventions. We encourage rigorous, collaborative approaches to identify and manipulate putative mechanisms of change.
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“The factors affecting mental health problems are complex and multifaceted, with many unrelated to parenting behavior or parent mental health, and require more direct management to result in improvement (White et al., 2018).”
From Parent, child, and family outcomes following Acceptance And Commitment Therapy for parents of autistic children: A randomized controlled trial (2024) · cites this paper as White et al., 2018
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“Cognitive-behavioural therapy (CBT) and mindfulness-based therapy (MBT) have been the most widely studied mental health interventions in autism (Benevides, Shore, Andresen, et al., 2020;Spain et al., 2015;White et al., 2018).”
From A mixed methods study of autistic adults' mental health therapy experiences (2023) · cites this paper as White et al., 2018
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“Emerging evidence suggests that mindfulness-based interventions may enhance stress regulation and coping with stress in autistic adults (Hourston & Atchley, 2017; White et al., 2018).”
From Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. (2024) · cites this paper as White et al., 2018
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“A small number of studies have investigated mindfulness-based interventions for autistic adults with preliminary results indicating improved well-being and quality of life (Cachia et al., 2016; Hourston & Atchley, 2017; White et al., 2018).”
From Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. (2024) · cites this paper as White et al., 2018
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“Needs and preferences among autistic adults include the utilization of written communication, elimination of metaphors from treatment materials, reduction of sensory overload as well as a stronger focus on behavioral rather than cognitive mechanisms within the intervention (Hourston & Atchley, 2017; Nicolaidis et al., 2015; White et al., 2018).”
From Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. (2024) · cites this paper as White et al., 2018
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“The experiential learning incorporated in MBSR, focusing on adaptive coping skills rather than the more cognitive focus of classical CBT (White et al., 2018), together with described adjustments in delivery may have contributed to the perceived treatment credibility.”
From Mindfulness-based stress reduction for autistic adults: A feasibility study in an outpatient context. (2024) · cites this paper as White et al., 2018
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“The anti-diabetes drug metformin has been shown to limit weight gain from these medications, possibly broadening their safe use 203 .”
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“Few randomized controlled trials (RCTs) have investigated the effectiveness of interventions for anxiety in autistic adults, although some trials report reduction in anxiety after Cognitive Behavioral Therapy (CBT) and mindfulness-based therapies [11,12].”
From Interoceptive training to target anxiety in autistic adults (ADIE): A single-center, superiority randomized controlled trial (2021) · cites this paper as [11]
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Maddox, B. B., Crabbe, S., Beidas, R. S., Brookman-Frazee, L., Cannuscio, C. C., Miller, J. S., Nicolaidis, C., & Mandell, D. S. (2020) · Autism · doi:10.1177/1362361319882227 · Cited by 203
Fuentes, J., Amaia Hervas, G., Howlin, P., & Party), (. A. W. (2020) · European Child & Adolescent Psychiatry · doi:10.1007/s00787-020-01587-4 · Cited by 246
Metadata
- Authors
- White, S. W., Simmons, G. L., Gotham, K. O., Conner, C. M., Smith, I. C., Beck, K. B., & Mazefsky, C. A.
- Affiliations
- University of Alabama (US)
- Vanderbilt University Medical Center (US)
- University of Pittsburgh (US)
- Corresponding author
- White, Susan W.
- ORCID
- Venue
- Current Psychiatry Reports
- Published
- 2018-08-28
- Volume
- 20
- Issue
- 10
- Pages
- 82-82
- ISSN
- 1523-3812 (ISSN-L)
- 1535-1645
- PMC
- PMC6421847
- OpenAlex
- W2889399987
- Cited by
- 157
- References
- 92
- Citations by year
- 2026: 15 · 2025: 16 · 2024: 19 · 2023: 27 · 2022: 30 · 2021: 24 · 2020: 16 · 2019: 9
- FWCI
- 1.61
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Current Psychiatry Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R01MH113576, K01MH103500)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development (R01HD079512)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Autism Spectrum Disorder Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Keywords
- autism spectrum disorder, anxiety, depression, psychosocial interventions, cognitive behavioral therapy, comorbidities, adolescents, adults, mindfulness-based interventions, mechanisms of change, treatment adaptation
- MeSH terms
- Autism Spectrum Disorder, Adolescent, Adult, Anxiety, Anxiety Disorders, Depression, Depressive Disorder, Humans, Cognitive Behavioral Therapy, Mindfulness
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