1 / 18

Professor Jeremy R Parr Professor Jacqui Rodgers Dr Barry Ingham Professor Ann Le Couteur

What do autistic people who experience anxiety tell us about existing interventions and services for the treatment of anxiety?. Professor Jeremy R Parr Professor Jacqui Rodgers Dr Barry Ingham Professor Ann Le Couteur Professor Mark Freeston Mr Colin Wilson. Dr Samuel Brice

mancilla
Download Presentation

Professor Jeremy R Parr Professor Jacqui Rodgers Dr Barry Ingham Professor Ann Le Couteur

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. What do autistic people who experience anxiety tell us about existing interventions and services for the treatment of anxiety? Professor Jeremy R Parr Professor Jacqui Rodgers Dr Barry Ingham Professor Ann Le Couteur Professor Mark Freeston Mr Colin Wilson Dr Samuel Brice Newcastle University, UK

  2. Autism Europe 2019: Autism & Anxiety Autism & Anxiety • 700,000 autistic people living in the UK (≥ 1.1%) (Brugha et al., 2012) • Anxiety is common for autistic people - variable rates reported • Anxiety causes severe distress and significant impact on daily life: • Quality of Life (Mason et al., 2018) • Employment (Chen et al., 2015) • Social life (Mazurek, 2014) • Anxiety may have a differential presentation in autistic people vs neurotypical (e.g. Wigham et al., 2016; Kearns et al., 2014) • Relationship between autism characteristics & anxiety • Increased co-morbidity with other mental health/anxiety disorders • Differential causes of anxiety (compared with diagnostic criteria) Anxiety in autism Anxiety in the generalpopulation samuel.brice@ncl.ac.uk

  3. Autism Europe 2019: Autism & Anxiety Treating Anxiety in Autistic People • Guidelines recommend talking therapy (predominantly CBT) as a first-line treatment option (NICE, 2012) • Talking therapies should be adapted to meet the needs of the individual – communication/sensory preferences, therapist’s understanding of autism etc • Such approaches have modest empirical support (Spain et al., 2015) • But… autistic people frequently report dissatisfaction with existing treatments (Crane et al., 2019) and such interventions appear to be less effective than in the general population • Developing more effective treatments for anxiety is a key research priority for autistic people samuel.brice@ncl.ac.uk

  4. Autism Europe 2019: Autism & Anxiety Autism Top 10 (James Lind Alliance & Autistica, 2016) Which interventions improve mental health or reduce mental health problems in autistic people? How should mental health interventions be adapted for the needs of autistic people? Which interventions reduce anxiety in autistic people? samuel.brice@ncl.ac.uk

  5. Autism Europe 2019: Autism & Anxiety Context to the research National survey asking autistic people about their experiences of anxiety and treatments and services that they have accessed Validation of a bespoke anxiety screening tool for autistic adults – The Anxiety Scale Autism (ASA; Rodgers et al, in prep) Development of a personalised, modular psychological treatment for anxiety in autistic adults and the development of treatment manuals – The Personalised Anxiety Treatment – Autism (PAT-Aⓒ) Pilot randomized controlled trial to test the feasibility and acceptability of the PAT-Aⓒ intervention samuel.brice@ncl.ac.uk

  6. Autism Europe 2019: Autism & Anxiety Method • Recruitment via the Adult Autism Spectrum Cohort – UK, a large research cohort (N = 2100) hosted by our team at Newcastle University – https://research.ncl.ac.uk/adultautismspectrum/ • People who were able to provide informed consent and had previously reported either a diagnosed (52%) OR suspected (24%) anxiety disorder were invited to participate • N = 568 • Age Range = 16 – 77 (Mean = 41.7, SD = 13.7) • 53.7% female; 42.8% male; 3.6% other or undisclosed • Mean SRS-2 score (autism characteristics) = 111.5 (between moderate & severe) • Participants were asked to complete: • A bespoke survey about experiences of anxiety & treatments received • questionnaires relating to: • Anxiety: Anxiety Scale Autism – Adult (ASA; Rodgers et al., in prep) • Depression: Hospital Anxiety & Depression Scale – Depression Subscale (HADS; Zigmond & Snaith, 1983) • Intolerance of Uncertainty: Intolerance of Uncertainty Scale – 12-item (IUS-12; Carleton, Norton & Asmundson, 2007 samuel.brice@ncl.ac.uk

  7. Autism Europe 2019: Autism & Anxiety Results: Lifetime anxiety samuel.brice@ncl.ac.uk

  8. Autism Europe 2019: Autism & Anxiety Correlates of Anxiety *all correlations significant at p < .01 • Females reported significantly higher anxiety than males (median = 54 vs 48) • Anxiety correlated with: • Age (r = -.134) • Autism characteristics (r = .575) • Intolerance of uncertainty (r = .514) • Depression (r = .458) • Quality of life (r = -.350) samuel.brice@ncl.ac.uk

  9. Autism Europe 2019: Autism & Anxiety Impact of Anxiety samuel.brice@ncl.ac.uk

  10. Autism Europe 2019: Autism & Anxiety Treatments and Services samuel.brice@ncl.ac.uk

  11. Autism Europe 2019: Autism & Anxiety Are adaptations currently being made by services? samuel.brice@ncl.ac.uk

  12. Autism Europe 2019: Autism & Anxiety Importance & Availability of Key Adjustments (therapist) 1 = Not at all important/ Never available 5 = Very important/ Always available samuel.brice@ncl.ac.uk

  13. Autism Europe 2019: Autism & Anxiety Importance & Availability of Key Adjustments (Physical environment) 1 = Not at all important/ Never available 5 = Very important/ Always available samuel.brice@ncl.ac.uk

  14. Autism Europe 2019: Autism & Anxiety Importance & Availability of Key Adjustments (Process) 1 = Not at all important/ Never available 5 = Very important/ Always available samuel.brice@ncl.ac.uk

  15. Autism Europe 2019: Autism & Anxiety Importance & Availability of Key Adjustments • The more important an adjustment, the less likely it was to be available to the participant (r = -.25, p < .01) • Availability of key adjustments is associated with better self-reported therapeutic outcomes (r = .33, p < .01) samuel.brice@ncl.ac.uk

  16. Autism Europe 2019: Autism & Anxiety Conclusions • Anxiety is common, and related to: • autism traits • intolerance of uncertainty • depression • poorer quality of life • Anxiety significantly impacts on daily life • The effectiveness of psychological therapy is variable • But efficacy can be maximized by making key adaptations to the therapist’s approach, the physical environment and the therapeutic process • Despite this and their importance to autistic people, adaptations may not be frequently available in the UK • There is still much to learn from this data! samuel.brice@ncl.ac.uk

  17. Autism Europe 2019: Autism & Anxiety Personalised Anxiety Treatment – Adults (PAT-Aⓒ) • Pilot randomised trial to test the feasibility and acceptability of a personalised, modular psychological treatment for anxiety • Detailed assessment and formulation of anxiety & underlying causes and treatment planning using a bespoke algorithm • Any combination of modules to address: • Understanding and describing emotions • Anxiety in social situations • Coping with Uncertainty in Everyday Situations (Rodgers et al) • Virtual reality environment in the treatment of specific phobias (Maskey et al) • Mindfulness for distress tolerance • Every effort made to offer adjustments that are important to the individual • Estimated completion Summer 2020 samuel.brice@ncl.ac.uk

  18. Autism Europe 2019: Autism & Anxiety If you would like to use the Anxiety Scale - Autism (ASA) in your work - Please contact Jacqui Rodgers Samuel.Brice@ncl.ac.uk Jeremy.Parr@ncl.ac.uk Jacqui.Rodgers@ncl.ac.uk

More Related