CBT/Comorbid Anxiety Disorders/Children/Asperger Syndro*

描述(申请人提供)：焦虑症通常被诊断为患有阿斯伯格综合症(AS)和未作特殊说明的广泛性发育障碍(PDD-NOS)。焦虑症除了由AS和PDD-NOS引起的功能缺陷外，还会导致儿童的功能障碍。因此，研究人员呼吁开发针对这一人群的焦虑治疗方法(Attwood，2003)。认知行为疗法(CBT)已被发现对典型发育儿童的焦虑症有效。这项先导性研究将通过提供CBT对患有AS或PDD-NOS的儿童焦虑症的治疗效果的估计来推进这一领域。样本将包括20名7-13岁患有AS或PDD-NOS并伴有焦虑症的儿童。儿童将被随机分配到立即治疗或3个月的等待名单中。人工CBT计划包括传统的焦虑治疗部分，包括应对技能培训(例如，认知结构调整)、活体暴露、手术程序和父母培训。增加了额外的治疗成分，以加强患有强直性脊柱炎或PDD-NOS的儿童的干预反应，包括情感教育、社交技能/友谊技能培训和同伴辅导/辅导模块。训练有素的具有CBT和发育障碍专业知识的研究生将担任治疗师。治疗忠诚度将使用逐期依从性检查表进行检查。治疗可接受性和消费者满意度将在治疗后进行评估，就手册需要修订的程度提供指导。儿童焦虑的多种衡量标准，包括由独立评估员管理的结构化诊断性访谈，将构成主要结果。还将评估儿童的社会功能和服务使用情况，以确定CBT是否会影响相关的远期结局。通过比较立即治疗组和等待名单组儿童的结果，我们将估计CBT对这一人群的效果大小。随后，将进行功率分析，以规划更大规模的临床试验。这项研究可能有助于公共卫生努力，以满足越来越多被诊断为自闭症谱系障碍的儿童的心理健康需求。如果CBT被发现是有效的，这将是第一个成功适应AS和PDD-NOS儿童的循证心理治疗。

DESCRIPTION (provided by applicant): Anxiety disorders are commonly diagnosed in children with Asperger syndrome (AS) and pervasive developmental disorder not otherwise specified (PDD-NOS). Anxiety disorders contribute to children's functional impairment over and above the functional deficits attributable to AS and PDD-NOS. Thus, investigators have called for the development of anxiety treatments for this population (Attwood, 2003). Cognitive behavioral therapy (CBT) has been found to be efficacious for anxiety disorders in typically developing children. This pilot study will advance the field by providing an estimate of the treatment effects of CBT for anxiety disorders among children with AS or PDD-NOS. The sample will include 20 children aged 7- 13 years with AS or PDD-NOS and a comorbid anxiety disorder. Children will be randomly assigned to immediate treatment or a 3-month waitlist. The manualized CBT program includes traditional anxiety treatment components including coping skills training (e.g., cognitive restructuring), in vivo exposure, operant procedures, and parent training. Additional treatment components have been added to enhance intervention response in children with AS or PDD-NOS, including emotion education, social skills/friendship skills training, and peer tutoring/mentoring modules. Trained graduate students with expertise in CBT and developmental disabilities will serve as therapists. Treatment fidelity will be checked using a session-by-session adherence checklist. Treatment acceptability and consumer satisfaction will be assessed at posttreatment, providing guidance on the extent to which the manual will need to be revised. Multiple measures of children's anxiety, including a structured diagnostic interview administered by an independent evaluator, will comprise the primary outcomes. Children's social functioning and service use will also be assessed to determine if CBT can affect relevant distal outcomes. By comparing outcomes for children in the immediate treatment group versus those in the waitlist group, we will estimate effect sizes of CBT for this population. Subsequently, power analyses will be conducted in planning for a larger clinical trial. This study could contribute to public health efforts to address the mental health needs of the rising number of children diagnosed with autism spectrum disorders. If CBT is found to be efficacious, it will be the first evidence-based psychological treatment to be successfully adapted for children with AS and PDD-NOS.