Conceptualizing and Treating Social Anxiety in Autism Spectrum Disorder: A Focus Group Study with Multidisciplinary Professionals

Spain, Debbie; Rumball, Freya; O’Neill, Lucy; Sin, Jacqueline; Prunty, Jonathan E.; Happé, Francesca

doi:10.1111/jar.12320

Cited by 14 publications

(14 citation statements)

References 41 publications

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“…Significant relationships between ASD severity and the parental-rated Revised Child Anxiety and Depression Scale (24), the parental-rated K-SADS-PL (25) or clinician-rated anxiety symptoms with the MINI-plus (26) was described. Five studies in adults with ASD (26)(27)(28)(29)(30) unlighted associations between self-reported social anxiety on the Liebowitz Social Anxiety Scale LSAS and socio communicative impairments.…”

Section: Introductionmentioning

confidence: 99%

Social Anxiety in Children and Adolescents With Autism Spectrum Disorders Contribute to Impairments in Social Communication and Social Motivation

Briot

Jean²,

Jouni

et al. 2020

Front. Psychiatry

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Background: Recognition of symptoms of Social anxiety (SA) may be difficult among individuals with Autism Spectrum Disorders (ASD) because of overlap between social anxiety and autistic symptomatology. The main aim of our study was thus to explore the association between symptoms of social anxiety and clinical characteristics of ASD in order to identify individuals experiencing concomitant ASD and social anxiety disorder. We also described the prevalence of SA in a sample of children and adolescents with ASD. Method: 79 children and adolescents with ASD (with and without intellectual disability) and 28-matched control participants were recruited in two French Expert Centers for ASD, coordinated by the Fundation FondaMental. Psychiatric comorbidities, anxiety disorders and depression were screened with standard tools (Liebowitz social anxiety scale, Hamilton Depression and Anxiety Rating Scale) and correlated to autistic features and social skills assessed with the social responsiveness scale 2 (SRS-2) and the repetitive behavior scale (RBS-R). We performed bivariate analysis between the social anxiety level and the scores measured with different clinical scales. We then adjusted the observed relationships with the alterations of SRS-2 and RBS-R scores. Results: After adjustment, the level of social anxiety appeared as significantly associated with alterations in social reciprocity and particularly with the SRS-2 "social communication" and "social motivation" sub-scores, but not with RBS-R score. Conclusions: We confirm previous reports showing that individuals with ASD are at high risk for specific anxiety disorders. In particular, high levels of impairments in social motivation and

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Section: Introductionmentioning

confidence: 99%

Social Anxiety in Children and Adolescents With Autism Spectrum Disorders Contribute to Impairments in Social Communication and Social Motivation

Briot

Jean²,

Jouni

et al. 2020

Front. Psychiatry

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“…Another potential barrier to obtaining high quality and appropriate mental health support is the lack of tailored care, as autistic people and their families recurrently report that services and treatment approaches are rarely adapted to their needs (15). Impediments to delivering appropriate support include lack of staff training and knowledge on how services could be adapted, and lack of evidence on best approaches (11,(17)(18)(19)(20). This scarcity of tailored approaches and lack of information about effective tailored care further highlights the need to identify strategies used to improve access, experiences of care and mental health outcomes for autistic people.…”

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confidence: 99%

Approaches to improving mental health care for autistic people: a systematic review

Loizou

Pemovska

Stefanidou

et al. 2023

Preprint

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Background: Autistic people have a high likelihood of developing mental health difficulties but a low chance of receiving effective mental health care. Therefore, there is a need to identify and examine strategies to improve mental health care for autistic people. Aims: To identify strategies that have been implemented to improve access, experiences of care and mental health outcomes for autistic adults and examine evidence on their acceptability, feasibility and effectiveness. Method: A co-produced systematic review was conducted. MEDLINE, PsycINFO, CINHAL, medRxiv and PsyArXiv were searched. We included all study designs reporting acceptability or feasibility outcomes and empirical quantitative study designs reporting effectiveness outcomes. Data were synthesised using a narrative approach. Results: A total of 29 articles were identified. These included 16 studies of adapted mental health interventions, seven studies of service improvements and six studies of bespoke mental health interventions developed for autistic people. There was no conclusive evidence on effectiveness. However, most bespoke and adapted approaches appeared to be feasible and acceptable. Identified adaptations appeared to be acceptable and feasible, including increasing knowledge and detection of autism, providing environmental adjustments and communication accommodations, accommodating individual differences, and modifying the structure and content of interventions. Conclusion: Many identified strategies are feasible and acceptable and can be readily implemented in services with the potential to make mental health care more suitable for autistic people, but important research gaps remain. Future research should address these and investigate a co-produced package of service improvement measures.

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“…Reaven et al, 2015; J. Reaven, Blakeley-Smith, Leuthe, Moody, & Hepburn, 2012; Sofronoff, Silva, & Beaumont, 2017; Solish et al, 2020; Swain, Murphy, Hassenfeldt, Lorenzi, & Scarpa, 2019; Wise et al, 2019), two papers compared different samples before and after implementation of a new care pathway (Cervantes et al, 2019; Kuriakose et al, 2018), seven were surveys (Cooper, Loades, & Russell, 2018; Fisher, van Diest, Leoni, & Spain, 2023; Ford et al, 2019; Hollocks et al, 2019; Jones, Gangadharan, Brigham, Smith, & Shankar Background, 2021; Pickard et al, 2020; Stadnick, Brookman-Frazee, Nguyen Williams, Cerda, & Akshoomoff, 2015), and two were qualitative (Petty, Bergenheim, Mahoney, & Chamberlain, 2021; Spain et al, 2017). There were multiple papers that were from the same trials (Cervantes et al, 2019; Keefer et al, 2017; Kuriakose et al, 2018; Pickard et al, 2020; J.…”

Section: Resultsmentioning

confidence: 99%

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

Pemovska,

Loizou,

Appleton

et al. 2023

Preprint

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Autistic children and young people (CYP) experience mental health difficulties but face many barriers to accessing and benefiting from mental health care. There is a need to explore strategies in mental health care for autistic CYP to guide clinical practice and future research and support their mental health needs. Our aim was to identify strategies used to improve mental health care for autistic CYP and examine evidence on their acceptability, feasibility, and effectiveness. A systematic review and meta-analysis were carried out. All study designs reporting acceptability/feasibility outcomes and empirical quantitative studies reporting effectiveness outcomes for strategies tested within mental health care were eligible. We conducted a narrative synthesis and separate meta-analyses by informant (self, parent, clinician). Fifty-seven papers were included, with most investigating cognitive behavioural therapy (CBT)-based interventions for anxiety and several exploring service-level strategies, such as autism screening tools, clinician training, adaptations regarding organisation of services. Most papers described caregiver involvement in therapy and reported adaptations to communication and intervention content; a few reported environmental adjustments. In the meta-analyses, parent- and clinician-reported outcomes, but not self-reported outcomes, showed with moderate certainty that CBT for anxiety was an effective treatment compared to any comparison condition in reducing anxiety symptoms in autistic individuals. The certainty of evidence for effectiveness, synthesised narratively, ranged from low to moderate. Evidence for feasibility and acceptability tended to be positive. Many identified strategies are simple, reasonable adjustments that can be implemented in services to enhance mental health care for autistic individuals. Notable research gaps persist, however.

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Conceptualizing and Treating Social Anxiety in Autism Spectrum Disorder: A Focus Group Study with Multidisciplinary Professionals

Abstract: Future studies should establish how aspects of the care pathway can be improved for individuals with ASD and SA.

Cited by 14 publications

References 41 publications

Social Anxiety in Children and Adolescents With Autism Spectrum Disorders Contribute to Impairments in Social Communication and Social Motivation

Social Anxiety in Children and Adolescents With Autism Spectrum Disorders Contribute to Impairments in Social Communication and Social Motivation

Approaches to improving mental health care for autistic people: a systematic review

Approaches to improve mental health care for autistic children and young people: a systematic review and meta-analysis

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