Language

English

Publication Date

1-1-2023

Journal

Journal of Clinical Child & Adolescent Psychology

DOI

10.1080/15374416.2022.2025596

PMID

35072578

PMCID

PMC9308830

PubMedCentral® Posted Date

11-1-2024

PubMedCentral® Full Text Version

Author MSS

Abstract

Objective: Cognitive-behavioral therapy (CBT) is an effective treatment for anxiety in youth with autism spectrum disorder (ASD). However, research has yet to examine what cognitive characteristics may influence treatment response. The current study investigated decision-making ability and social cognition as potential (a) predictors of differential treatment response to two versions of CBT and (b) moderators of the effect of treatment condition.

Method: The study included 148 children (mean age = 9.8 years) with interfering anxiety and a diagnosis of ASD who were enrolled in a randomized clinical trial comparing two versions of CBT for anxiety (standard and adapted for ASD). Participants completed pretreatment measures of decision-making ability (adapted Iowa Gambling Task) and social cognition (Strange Stories) and analyses tested whether task performance predicted treatment response across and between (moderation) treatment conditions.

Results: Our findings indicate that decision-making ability moderated treatment outcomes in youth with ASD and anxiety, with a better decision-making performance being associated with higher post-treatment anxiety scores for those who received standard, not adapted, CBT.

Conclusions: Children with ASD and anxiety who are more sensitive to reward contingencies and reinforcement may benefit more from adapted CBT approaches that work more explicitly with reward.

Keywords

Adolescent, Humans, Child, Autistic Disorder, Autism Spectrum Disorder, Anxiety, Cognitive Behavioral Therapy, Treatment Outcome, Reward

Published Open-Access

yes

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