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The People with Asperger syndrome and anxiety disorders (PAsSA) trial: a pilot multicentre, single-blind randomised trial of group cognitive–behavioural therapy

Published online by Cambridge University Press:  02 January 2018

Peter E. Langdon ,
Glynis H. Murphy ,
Lee Shepstone ,
Edward C.F. Wilson ,
David Fowler ,
David Heavens ,
Alexandra Russell ,
Alice Rose ,
Aida Malovic  and
Louise Mullineaux
Peter E. Langdon*
Affiliation:
Tizard Centre, University of Kent, Canterbury, UK; Broadland Clinic, Hertfordshire Partnership University NHS Foundation Trust in Norfolk, Norwich, UK
Glynis H. Murphy
Affiliation:
Tizard Centre, University of Kent, Canterbury, UK, and Oxleas NHS Foundation Trust, Dartford, UK
Lee Shepstone
Affiliation:
Department of Population Health and Primary Care, Norwich Medical School, University of East Anglia, Norwich, UK
Edward C.F. Wilson
Affiliation:
School of Clinical Medicine, University of Cambridge, Cambridge, UK
David Fowler
Affiliation:
School of Psychology, University of Sussex, Brighton, UK
David Heavens
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, and Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
Alexandra Russell
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK, and Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
Alice Rose
Affiliation:
Tizard Centre, University of Kent, Canterbury, UK
Aida Malovic
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK, and Hertfordshire Partnership University NHS Foundation Trust in Norfolk, Norwich, UK
Louise Mullineaux
Affiliation:
Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, UK, and Hertfordshire Partnership University NHS Foundation Trust in Norfolk, Norwich, UK
*
Peter Langdon, Tizard Centre, University of Kent, Canterbury CT2 7LR, UK. Email: [email protected]
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Abstract

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Background

There is a growing interest in using cognitive–behavioural therapy (CBT) with people who have Asperger syndrome and comorbid mental health problems.

Aims

To examine whether modified group CBT for clinically significant anxiety in an Asperger syndrome population is feasible and likely to be efficacious.

Method

Using a randomised assessor-blind trial, 52 individuals with Asperger syndrome were randomised into a treatment arm or a waiting-list control arm. After 24 weeks, those in the waiting-list control arm received treatment, while those initially randomised to treatment were followed up for 24 weeks.

Results

The conversion rate for this trial was high (1.6:1), while attrition was 13%. After 24 weeks, there was no significant difference between those randomised to the treatment arm compared with those randomised to the waiting-list control arm on the primary outcome measure, the Hamilton Rating Scale for Anxiety.

Conclusions

Trials of psychological therapies with this population are feasible. Larger definitive trials are now needed.

Type
Research Article
Information
BJPsych Open , Volume 2 , Issue 2 , March 2016 , pp. 179 - 186
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY) licence (http://creativecommons.org/licenses/by/4.0/).
Copyright
Copyright © The Royal College of Psychiatrists 2016

Footnotes

Declaration of interest

None.

References

1 Rescorla, LA. Preschool psychiatric disorders: diagnostic classification and symptom patterns. J Am Acad Child Adolesc Psychiatry 1986; 25: 162–9.Google Scholar
2 Russell, E, Sofronoff, K. Anxiety and social worries in children with Asperger syndrome. Aust N Z J Psychiatry 2005; 39: 633–8.Google Scholar
3 Szatmari, P, Archer, L, Fisman, S, Streiner, D, Wilson, F. Asperger syndrome and autism: differences in behavior, cognition and adaptive functioning. J Am Acad Child Adolesc Psychiatry 1995; 34: 1662–70.Google Scholar
4 Tantam, D. Lifelong eccentricity and social isolation. Part 2: Asperger's syndrome or schizoid personality disorder? Br J Psychiatry 1988; 153: 783–91.Google Scholar
5 Kim, JA, Szatmari, P, Bryson, SE, Streiner, DL, Wilson, FJ. The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism 2000; 4: 117–32.Google Scholar
6 Green, J, Gilchrist, A, Burton, D, Cox, A. Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorder. J Autism Dev Disord 2000; 30: 279–93.Google Scholar
7 Lugnegård, T, Hallerbäck, MU, Gillberg, C. Psychiatric comorbidity in young adults with a clinical diagnosis of Asperger syndrome. Res Dev Disabil 2011; 32: 1910–7.Google Scholar
8 Sukhodolsky, DG, Bloch, MH, Panza, KE, Reichow, B. Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. Pediatrics 2013; 132: e1341–50.Google Scholar
9 Cardaciotto, L, Herbert, AD. Cognitive behavior therapy for social anxiety disorder in the context of Asperger's syndrome: a single-subject report. Cogn Behav Pract 2004; 11: 75–81.Google Scholar
10 Weiss, JA, Lunsky, Y. Group cognitive behavioural therapy for adults with Asperger syndrome and anxiety or mood disorders: a case series. Clin Psychol Psychother 2010; 17: 438–46.Google Scholar
11 Spek, AA, van Ham, NC, Nyklíček, I. Mindfulness-based therapy in adults with an autism spectrum disorder: a randomized controlled trial. Res Dev Disabil 2013; 34: 246–53.Google Scholar
12 Russell, AJ, Jassi, A, Fullana, MA, Mack, H, Johnston, K, Heyman, I, et al. Cognitive behavior therapy for comorbid obsessive-compulsive disorder in high-functioning autism spectrum disorders: a randomized controlled trial. Depress Anxiety 2013; 30: 697–708.Google Scholar
13 McGillivray, J, Evert, H. Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. J Autism Dev Disord 2014; 44: 2041–51.Google Scholar
14 Russell, AJ, Mataix-Cols, D, Anson, M, Murphy, D. Psychological treatment for obsessive-compulsive disorder in people with autism spectrum disorders – a pilot study. Psychother Psychosom 2009; 78: 59–61.Google Scholar
15 Wechsler, D. Wechsler Abbreviated Scale of Intelligence. The Psychological Corporation, 1999.Google Scholar
16 Langdon, PE, Murphy, GH, Wilson, E, Shepstone, L, Fowler, D, Heavens, D, et al. Asperger syndrome and anxiety disorders (PAsSA) treatment trial: a study protocol of a pilot, multicentre, single-blind, randomised crossover trial of group cognitive behavioural therapy. BMJ Open 2013; 3, e003449.Google Scholar
17 Heavens, D, Murphy, GH, Langdon, PE. People with Asperger Syndrome and Anxiety (PAsSA) Trial Treatment Manual (Version 3.0). University of East Anglia, 2012.Google Scholar
18 Hamilton, M. The assessment of anxiety states by rating. BMJ 1959; 32: 50–5.Google Scholar
19 Connor, KM, Davidson, JRT, Churchill, LE, Sherwood, A, Weisler, RH, Foa, E. Psychometric properties of the Social Phobia Inventory (SPIN). Br J Psychiatry 2000; 176: 379–86.Google Scholar
20 Heimberg, RG, Horner, KJ, Juster, HR, Safren, SA, Brown, EJ, Schneier, FR, et al. Psychometric properties of the Liebowtiz Social Anxiety Scale. Psychol Med 1999; 29: 199–212.Google Scholar
21 Rutter, M, LeCouteur, A, Lord, C, MacDonald, H, Rios, P, Folstein, S. Diagnosis and sub-classification of autism: concepts and instrument development. In Diagnosis and Assessment in Autism (eds Schopler, E, Mesibov, GB): 239–59. Springer, 1988.Google Scholar
22 Heimberg, RG, Mueller, GP, Holt, CS, Hope, DA, Liebowitz, MR. Assessment of anxiety in social interaction and being observed by others: the Social Interaction Anxiety Scale and the Social Phobia Scale. Behav Ther 1992; 23: 53–73.Google Scholar
23 Brown, EJ, Turovsky, J, Heimberg, RG, Juster, HR, Brown, TA, Barlow, DH. Validation of the Social Interaction Anxiety Scale and the Social Phobia Scale across the anxiety disorders. Psycholl Assess 1997; 9: 21–7.Google Scholar
24 Marks, IM, Matthews, AM. Brief standard self-rating scale for phobic patients. Behav Res Ther 1979; 17: 263–7.Google Scholar
25 Hamilton, M. A rating scale for depression. J Neurol Neurosurg Psychiatry 1960; 23: 56–62.Google Scholar
26 Hofmann, SG, Smits, JA. Cognitive-behavioral therapy for adult anxiety disorders: a meta-analysis of randomized placebo-controlled trials. J Clin Psychiatry 2008; 69: 621.Google Scholar
27 Hróbjartsson, A, Gøtzsche, PC. Is the placebo powerless? An analysis of clinical trials comparing placebo with no treatment. N Engl J Med 2001; 344: 1594–602.Google Scholar
28 Wampold, BE, Minami, T, Tierney, SC, Baskin, TW, Bhati, KS. The placebo is powerful: estimating placebo effects in medicine and psychotherapy from randomized clinical trials. J Clin Psychol 2005; 61: 835–54.Google Scholar
29 National Institute for Health and Care Excellence. Autism: Recognition, Referral, Diagnosis Rand Management of Adults on the Autism Spectrum NICE Clinical Guideline 142. British Psychological Society & The Royal College of Psychiatrists, 2012.Google Scholar
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