1/3 Treatment of Anxiety in Autism Spectrum Disorder

项目摘要/摘要 自闭症谱系障碍(ASD)是常见的神经发育综合征，影响1%的美国儿童。 共患焦虑症的自闭症儿童中有40%到50%患有焦虑症，会造成严重的痛苦和损害。 此外，ASD本身也造成了这种情况。高度焦虑与ASD的严重程度增加有关 受影响青年的症状和社会适应不良。此外，患有自闭症儿童的父母考虑焦虑- 相关问题是他们的孩子面临的两个最大挑战之一。[虽然这是标准做法 认知行为疗法(Cbt)已被证实是治疗焦虑症的一种有效且安全的疗法。 在典型的发育中的年轻人中，它在ASD共病病例中的作用尚不清楚。到目前为止， 还没有研究将标准的CBT与认知行为干预进行实验比较 为患有焦虑和自闭症的儿童量身定做。]文学上的这一空白是 尤其令人担忧的是，对于患有自闭症和自闭症的青少年，没有经验支持的治疗方案 并存的焦虑和现有的药物干预可能有一些缺点(例如，有限 在该人群中的有效性、副作用和潜在的药物x药物相互作用)。[因此，我们正在 建议在三个治疗地点进行随机对照试验，以评估 自闭症儿童焦虑的个性化CBT(自闭症儿童焦虑的行为干预：BIACA) 相对于焦虑症的标准实践CBT(应对猫计划)。在过去五年，建议的 BIACA干预已针对高功能儿童的特点和需求进行了调整和量身定做 与ASD合作；应对猫计划反映了在 NIH资助的多项试验。]为了响应NIH路线图倡议，BIACA采用了模块化治疗 这种方法使干预能够针对每个青少年的独特需求进行个性化。[因此，拟议的 研究将：(1)检验BIACA相对于应对猫的有效性，这代表了标准做法 治疗，(2)评估治疗收益的维持，(3)检查个性化的影响 对社会反应性、孤独感和友谊质量等功能结果的干预，(4)测验 自闭症严重程度作为治疗结果的调节因子，以及(5)探索其他调节因子和调节因子 治疗结果。]总共180名患有自闭症和共生焦虑的青年(年龄在8-13岁)将随机 分配到两种治疗条件中的一种。这项研究的三个招聘网站是加州大学洛杉矶分校、 南佛罗里达大学(USF)和坦普尔大学。美国联邦将提供数据管理服务。 考虑到越来越多的儿童被诊断为ASD，以及ASD的频率和严重程度 并发焦虑，建议的工作是为ASD青少年的独特需求量身定做的，并将提供及时的 对公共卫生工作的贡献。

Project Summary/Abstract Autism spectrum disorders (ASD) are common neurodevelopmental syndromes affecting 1% of U.S. children. Comorbid anxiety disorders affect 40 to 50% of children with ASD, causing substantial distress and impairment over and above that caused by ASD alone. High anxiety is associated with increased severity of ASD symptoms and social maladjustment in affected youth. Further, parents of children with ASD consider anxiety- related problems to be among the top two challenges facing their children. [Although standard practice cognitive-behavioral therapy (CBT) has been established as an efficacious and safe treatment for anxiety disorders among typically developing youth, its utility in comorbid cases with ASD remains unknown. To date, no studies have experimentally compared standard practice CBT to a cognitive-behavioral intervention that has been personalized for children with a comorbid presentation of anxiety and ASD.] This gap in the literature is of particular concern because there are no empirically-supported treatment options for youth with ASD and comorbid anxiety, and existing pharmacological interventions may have some disadvantages (e.g., limited efficacy in this population, side effects, and potential for drug x drug interactions). [Accordingly, we are proposing a randomized controlled trial to be conducted at three treatment sites to evaluate the efficacy of personalized CBT for anxiety in ASD (Behavioral Intervention for Anxiety in Children with Autism: BIACA) relative to standard practice CBT for anxiety (Coping Cat program). Over the last five years, the proposed BIACA intervention has been adapted and tailored to the characteristics and needs of high-functioning children with ASD; the Coping Cat program reflects the community standard that has been empirically supported in multiple NIH-funded trials.] In response to the NIH Roadmap Initiative, BIACA employs a modular treatment approach, allowing the intervention to be personalized to each youngster's unique needs. [Thus, the proposed research will: (1) examine the efficacy of BIACA relative to Coping Cat, which represents standard practice treatment, (2) evaluate the maintenance of treatment gains, (3) examine the impact of personalized intervention on functional outcomes such as social responsiveness, loneliness, and friendship quality, (4) test autism severity as a moderator of treatment outcome, and (5) explore other moderators and mediators of treatment outcome.] A total of 180 youth (ages 8-13 years) with ASD and co-occurring anxiety will be randomly assigned to one of the two treatment conditions. The three recruitment sites for this study are UCLA, the University of South Florida (USF), and Temple University. USF will provide data management services. Considering the rising number of children diagnosed with ASD together with the frequency and severity of comorbid anxiety, the proposed work is tailored to the unique needs of youth with ASD and will provide a timely contribution to public health efforts.