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Cited by 109Autism Spectrum Disorder ResearchAnxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychological Treatments and Assessments

The DOI matches its Crossref record; 77 of the 77 references it cites were found in a registry or an index.

Cognitive behavioural therapy for anxiety in children and young people on the autism spectrum: a systematic review and meta-analysis

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Sharma, Shivani, Hucker, Abigail, Matthews, Terry, Grohmann, Dominique, Laws, Keith R.·2021·BMC Psychology
DOI 10.1186/s40359-021-00658-8PMC PMC8487131
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Abstract

Background: Anxiety is common in youth on the autism spectrum and cognitive behavioural therapy (CBT) has been adapted to address associated symptoms. The aim of the current systematic review and meta-analysis was to examine the efficacy of CBT for reducing anxiety in autistic youth. Method: Searches of PubMed and Scopus databases were undertaken from January 1990 until December 2020. Studies were included if they consisted of randomised controlled trials (RCTs) using CBT to reduce anxiety in autistic youth. Separate random effects meta-analyses assessed anxiety ratings according to informant (clinician; parent; child), both at end-of-trial and at follow-up. Results: A total of 19 RCTs met our inclusion criteria (833 participants: CBT N = 487; controls N = 346). Random effects meta-analyses revealed a large effect size for clinician rated symptoms (g = 0.88, 95% CI 0.55, 1.12, k = 11), while those for both parent (g = 0.40, 95% CI 0.24, 0.56; k = 18) and child-reported anxiety (g = 0.25, 95% CI 0.06, 0.43; k = 13) were smaller, but significant. These benefits were not however maintained at follow-up. Moderator analyses showed that CBT was more efficacious for younger children (for clinician and parent ratings) and when delivered as individual therapy (for clinician ratings). Using the Cochrane Risk of Bias 2 tool, we found concerns about reporting bias across most trials. Conclusions: The efficacy of CBT for anxiety in autistic youth was supported in the immediate intervention period. However, substantial inconsistency emerged in the magnitude of benefit depending upon who was rating symptoms (clinician, parent or child). Follow-up analyses failed to reveal sustained benefits, though few studies have included this data. It will be important for future trials to address robustness of treatment gains overtime and to further explore inconsistency in efficacy by informant. We also recommend pre-registration of methods by trialists to address concerns with reporting bias.

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Crossref · 10.1186/s40359-021-00658-8

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Fig. 1 PRISMA flow diagram
Fig. 1 PRISMA flow diagramCC BY · PubMed Central
Fig. 2 Forest plot of parent-rated measures of anxiety (minus Chalfant et al. [46])
Fig. 2 Forest plot of parent-rated measures of anxiety (minus Chalfant et al. [46])CC BY · PubMed Central
Fig. 3 Forest plot of clinician-rated measures of anxiety
Fig. 3 Forest plot of clinician-rated measures of anxietyCC BY · PubMed Central
Fig. 4 Forest plot of child-rated measures of anxiety (minus Chalfant et al. [46])
Fig. 4 Forest plot of child-rated measures of anxiety (minus Chalfant et al. [46])CC BY · PubMed Central

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Research works printed but not linked: 2

  1. Higgins JP, Thomas J, Chandler J, Cumpston M, Li T, Page MJ, Welch VA, editors. Cochrane handbook for systematic reviews of interventions. Hoboken: Wiley; 2019.
  2. Spence SH. Spence children’s anxiety scale-parent version. Brisbane: University of Queensland; 1999.

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Metadata

Authors
Sharma, S., Hucker, A., Matthews, T., Grohmann, D., & Laws, K. R.
Affiliations
University of Hertfordshire (GB)
Corresponding author
Sharma, Shivani
ORCID
Venue
BMC Psychology
Publisher
Springer Science and Business Media LLC
Published
2021-10-01
Volume
9
Issue
1
Pages
151-151
ISSN
2050-7283 (ISSN-L)
DOI
10.1186/s40359-021-00658-8
PMC
PMC8487131
OpenAlex
W3202426903
Cited by
109
References
77
Citations by year
2026: 18 · 2025: 18 · 2024: 54 · 2023: 12 · 2022: 5 · 2021: 2
FWCI
2.70
Type
journal article
Language
en
Open access
Licence
Locations
  • BMC Psychology (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (acceptedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • University of Hertfordshire Research Archive (University of Hertfordshire) (submittedVersion, cc-by)
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
cognitive behavioral therapy, autism spectrum disorder, anxiety, autistic youth, treatment efficacy, clinician ratings, parent ratings, child self-report, individual psychotherapy, age differences, follow-up maintenance, reporting bias
MeSH terms
Adolescent, Anxiety, Anxiety Disorders, Autistic Disorder, Humans, Parents, Cognitive Behavioral Therapy

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