Emotion awareness and cognitive behavioural therapy in young people with autism spectrum disorder

Abstract

Young people with autism spectrum disorder experience high levels of emotional problems, including anxiety and depression. Adapted cognitive behavioural therapy is recommended for such difficulties. However, no evidence suggests whether emotion awareness is important in treatment outcome for young people on the autism spectrum. This study aimed to investigate the potential differences in emotion awareness between (1) young people on the autism spectrum and typically developing youth and (2) young people on the autism spectrum with and without experience of cognitive behavioural therapy. Three groups (aged 11-20 years) participated: (1) typically developing young people ( n = 56); (2) young people on the autism spectrum with no experience of cognitive behavioural therapy ( n = 23); and (3) young people on the autism spectrum who had attended cognitive behavioural therapy ( n = 33). All participants completed the Emotion Awareness Questionnaire-30 item version. Young people on the autism spectrum differed significantly from typically developing young people on the emotional awareness measure. Young people on the autism spectrum who had attended cognitive behavioural therapy scored significantly lower on the Differentiating Emotions subscale, and significantly higher on the Attending to Others' Emotions subscale, compared to young people on the autism spectrum who had not attended cognitive behavioural therapy. This study highlights the importance of psycho-educational components of cognitive behavioural therapy when adapting for young people on the autism spectrum.

Evaluating the effects of a yoga-based program integrated with third-wave cognitive behavioral therapy components on self-regulation in children on the autism spectrum: A pilot randomized controlled trial

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Alexithymia in autism: cross-sectional and longitudinal associations with social-communication difficulties, anxiety and depression symptoms

“…Similar to many psychological therapies, this approach requires individuals to reflect on and discuss emotions and their antecedents. Yet, paradoxically, autistic individuals with particularly low emotional awareness are the most likely to be referred for CBT (likely due to associated mental health problems; Roberts-Collins, Mahoney-Davies, Russell, Booth, and Loades, 2018). This raises several questions around the long-term effectiveness of current treatment approaches and highlights the stark need for additional research to develop and evaluate treatment modifications for managing mental health symptoms in autism (Walters, Loades, & Russell, 2016).…”

I Have a Fear of Negative Evaluation, Get Me Out of Here! Examining Latent Constructs of Social Anxiety and Autistic Traits in Neurotypical and Autistic Young People

“…How best to adapt the evidence-based CBT treatment protocols for social anxiety so that the cognitive techniques with proven efficacy are accessible to autistic individuals is a critical question for clinical research. Well documented difficulties in noticing and reporting subtle shifts in emotional and bodily states (Hill et al 2004 ; Rieffe et al 2011 ; Roberts-Collins et al 2018 ) and reduced introspection (Williams 2010 ) have led to an emphasis on psychoeducation and the use of behavioural techniques in autism adapted Cognitive Behaviour Therapy (CBT) (National Institute for Care and Excellence [NICE] 2012, 2013). These adapted CBT protocols have been shown to be effective in the general treatment of anxiety co-occurring with autism (e.g., Weston et al 2016 ).…”