Asperger Syndrome, Autistic Disorder, Atypical Autism
Conditions
Keywords
Asperger syndrome, Autistic disorder, Adult, Psychotherapy
Brief summary
The purpose of this study is to determine if adults with autism spectrum disorder and with normal intelligence improve from 36 sessions (1 calendar year) of group treatment with Cognitive Behavioural Therapy or recreational activity in groups with 6-8 participants.
Detailed description
The purpose of this study was to compare two group interventions for psychiatric patients with Autism spectrum disorder and normal intelligence: Cognitive Behavioural Therapy developed to suit adults with Autism spectrum disorder, and recreational activity, enabling social interaction. The recreational activity intervention served as a low-impact option, easily organised within the community. It is not a placebo; rather it controls for the positive effects that come out of a structured social environment and group setting. The investigators hypothesized that both interventions would lead to improvement in quality of life, well-being and relief in psychiatric symptoms, with a greater effect in the Cognitive Behavioural Therapy intervention compared to recreational activity. A cumulative follow-up was made, within 5 1/2 years after the start of the treatments. Additional questions adapted to the patient group were added at this 5 1/2 year time point.
Interventions
BEHAVIORALCognitive behaviour therapy
The CBT intervention consisted of five elements: (a) structure, (b) group setting, (c) psycho-education, (d) social training and (e) CBT. The participants were presented with the session plan for the whole year and given a binder in which they kept all materials. In addition, each session followed a strict agenda: (1) introduction and presentation of the agenda of the day, (2) resume of homework assignments from the previous session, (3) psycho-educative lecture and discussions on the session topic, (4) coffee break with buns or sandwiches, and social interaction, (5) relaxation or mindfulness exercise, (6) discussions and exercises on the session topic, (7) distribution of homework and (8) evaluation and end of session.
BEHAVIORALRecreational activity intervention
The therapists did not provide any deliberate interventions, such as psychoeducation, social training or CBT. Instead, the intervention relied on structure and group setting only. During the first session the participants were asked to write down group activities they would like to engage in. The therapists created a list of the suggested activities, such as visiting museums, board game playing, cooking, restaurant visits, boating, cinema and taking walks. The participants voted for the activity of the next session.
Sponsors
Ministry of Health and Social Affairs, Sweden
Karolinska Institutet
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Clinical diagnosis of autism spectrum disorders * Normal intelligence as assumed by mainstream schooling * Acceptance of a group setting * Being able to transport themselves to the clinic (with or without support)
Exclusion criteria
* Current substance abuse * Current psychosis
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Clinical Global Impression scale - Improvement (patient CGI-I) | Before treatment (at baseline) and at a cumulative follow-up within 5 years after treatment termination | Patient rating on a seven-step Likert scale |
| The Quality of Life Inventory (QOLI, Frisch et al. 1992) | Baseline, after 36 sessions (1 calendar year) and at a cumulative follow-up within 5 years after treatment termination | Changes in the Quality of Life Inventory from baseline. |
| Sense of Coherence (SoC, Antonovsky 1993) | At baseline and after 36 sessions (1 calendar year) | Self-rating scale, change from baseline |
| The ten-item Rosenberg Self Esteem Scale (RSES, Rosenberg 1962) | Before treatment (baseline) and after 36 sessions (1 calendar year) | This was used to measure self esteem, change from baseline. |
| The patient versions of the Clinical Global Impression scale - Severity (patient CGI-S) | Before treatment and after 36 sessions (1 calendar year) | Severity of impairment at baseline rated by the patient. Change from baseline. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Autism Quotient (AQ, Baron-Cohen et al. 2001) | At baseline and after 36 sessions (1 calendar year) | A 50-item screening instrument for measuring autistic traits. Change from baseline. |
| Adult ADHD Self-Report Scale (ASRS, Kessler et al. 2005) | At baseline and after 36 sessions (1 calendar year) | This is for self rating scale for measuring inattention, hyperactivity and impulsivity. |
| Beck Depression Inventory (BDI, Beck et al. 1996) | At baseline and after 36 sessions (1 calendar year) | This is a 20-item questionnaire to assess depression. |
| Symptom Checklist 90 (SCL-90, Derogatis & Cleary 1977) | At baseline and after 36 sessions (1 calendar year) | This is a 90-item self rating questionnaire assessing the presence and severity of various psychiatric symptoms |
Other
| Measure | Time frame | Description |
|---|---|---|
| Drop-out | After 36 sessions (1 calendar year) | How many sessions that each patient attended of the 36 sessions. |
Countries
Sweden
Outcome results
None listed