Cognitive Behavioral Therapy for Anxiety Disorders in Adolescents With Autism

Autism Clinical Trial

Official title:

Cognitive Behavioral Therapy for Anxiety Disorders in Adolescents With Autism

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT01563003
• Other study ID #: AASD-2012
• Status: Completed
• Phase: N/A
• First received: March 22, 2012
• Last updated: April 15, 2015
• Start date: June 2011
• Est. completion date: April 2015

Study information

• Verified date: April 2015
• Source: University of South Florida
• Contact: n/a
• Is FDA regulated: No
• Health authority: United States: Institutional Review Board
• Study type: Interventional

Clinical Trial Summary

Due to the considerable prevalence of anxiety in youth with autism spectrum disorders, this study seeks to establish the efficacy of a modified cognitive behavioral therapy protocol in 50 adolescents versus other available treatment options.

Description:

This study will further examine a treatment plan for adolescents with autism spectrum disorderS (ASD) and anxiety. Many children who have an autism spectrum disorder experience substantial anxiety that can cause impairment above that of an ASD alone. Few studies have examined effective treatment options for anxiety in this population. In typically developing youth, Cognitive Behavioral Therapy (CBT) is considered the gold standard for treating anxiety. But, in order to address the unique needs of children with ASD, this study utilizes a modified CBT treatment plan which includes social skills and parent training. In our past studies, this cognitive-behavioral treatment plan has been effective in kids with ASD and anxiety compared to kids who did not receive any treatment.The current study compares this modified treatment plan to other treatment options in the community. The experimental component of this study is being assigned to 1 of 2 groups. The first group will receive CBT immediately for a period of 16 weeks. The second group will have to wait 16 weeks before receiving CBT. During this time period, children may receive any other services in the community. Overall, all adolescents receive the same type of therapy; it's matter of whether he/she receives it immediately or after a wait period. Sixteen weekly sessions comprise CBT. All therapy and assessments associated with this study will be free of charge.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 31
• Est. completion date: April 2015
• Est. primary completion date: April 2015
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: Both
• Age group: 11 Years to 16 Years

Eligibility

Inclusion Criteria:

1. Outpatient children with an autism spectrum disorder (see #2 below) between the ages 11-16 years.

2. Meets criteria for a diagnosis of autism, Asperger syndrome (AS), or PDD-NOS using scores from the Autism Diagnostic Interview-Revised and the Childhood Autism Rating Scale.

3. Meets DSM-IV criteria for a diagnosis of one of the following anxiety disorders:

separation anxiety disorder (SAD), generalized anxiety disorder (GAD), social phobia, or obsessive compulsive disorder (OCD) as determined by the ADIS-IV-C/P (with CSR 4) and all available information.

4. Minimum score of 13 on the PARS Severity Scale; this score indicates clinically significant anxiety symptom severity (RUPP, 2002) and has been used in recent major clinical trials (e.g., Walkup et al., 2008).

5. Child has a Full Scale and Verbal Comprehension IQ > 80 as assessed on a commonly used IQ test.

6. Subjects with co-morbid depression, ADHD, tic disorder or disruptive behavior disorders will be acceptable as long as the anxiety disorder is primary (i.e., most impairing/distressing).

Exclusion Criteria:

1. Receiving concurrent psychotherapy, social skills training, or behavioral interventions (e.g., applied behavior analysis). Families will have the option of discontinuing such services to enroll in the study.

2. New Treatments: Initiation of an antidepressant within 12 weeks before study enrollment or an antipsychotic 6 weeks before study enrollment. No new alternative medications, nutritionals or therapeutic diets within 6 weeks of study enrollment.

3. Established Treatment changes: Any change in established psychotropic medication (e.g., antidepressants, anxiolytics) within 8 weeks before study enrollment (6 weeks for antipsychotic). Alternative medications that might have behavioral effects must be stable for 6 weeks prior to the study baseline assessment. Any medications that the adolescent is on must remain stable during treatment. If a potential participant is taking psychotropic medication at the time of the phone evaluation or the first in-person study assessment and wishes to discontinue this medication to enter the study, the patient will be asked to discuss this option with their prescribing physician to determine whether medication discontinuation would be safe and in the adolescent's best interest. In addition, we will obtain the patient's written consent to contact their treating clinician to determine the appropriateness of study participation. We will not influence the decision patients make with their prescribing physician. All pharmacotherapy recommendations will be made in consultation with Dr. Murphy.

4. (a) Current clinically significant suicidality or (b) individuals who have engaged in suicidal behaviors within 6 months will be excluded and referred for appropriate clinical intervention.

5. Lifetime DSM-IV bipolar, schizophrenia or schizoaffective disorders; or Substance abuse in past 6 months.

6. Unwillingness of parents to make the commitment to accompany their child for multiple study visits.

7. Presence of a significant and/or unstable medical illness which might lead to hospitalization during the study.

Study Design

Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment

Related Conditions & MeSH terms

• Anxiety Disorders
• Anxiety, Separation
• Asperger Syndrome
• Asperger's Syndrome
• Autism
• Autistic Disorder
• Child Development Disorders, Pervasive
• Compulsive Behavior
• Developmental Disabilities
• Disease
• Generalized Anxiety Disorder
• Mental Disorders
• Obsessive-Compulsive Disorder
• Pervasive Developmental Disorder Not Otherwise Specified
• Separation Anxiety Disorder
• Social Phobia

Intervention

Other:
• Cognitive Behavioral Therapy
This condition involves 16 weekly CBT sessions.
• Treatment as usual
This condition allows participants to seek out various services. Considering the number of possible treatment options, there is no way to identify or list them.

Locations

Country	Name	City	State
United States	Rothman Center for Neuropsychiatry	St. Petersburg	Florida

Sponsors (1)

Lead Sponsor	Collaborator
University of South Florida

Country where clinical trial is conducted

United States, 

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Pediatric Anxiety Rating Scale	Scale range - 0 (minimum) to 25 (maximum). Higher scores represent worse anxiety symptom severity.	After an average of 16 weeks (Post-treatment)	No
Secondary	Anxiety Disorders Interview Schedule Clinical Severity Rating	Scale range - 0 (minimum) to 8 (maximum). Higher scores represent worse anxiety symptom severity.	After an average of 16 weeks (Post-treatment)	No
Secondary	Clinical Global Impression - Severity Scale	Scale range - 0 (minimum) to 6 (maximum). Higher scores represent worse anxiety symptom severity.	After an average of 16 weeks (Post-treatment)	No

External Links

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