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A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Anxiety in Youth with High-Functioning Autism Spectrum Disorders

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Abstract

Cognitive-behavioral therapy (CBT) has been developed and modified to treat anxiety symptoms in youth with high-functioning autism spectrum disorders (ASD) but has yielded varying findings. The present report is a systematic review and meta-analysis examining the efficacy of CBT for anxiety among youth with ASD. A systematic search identified 14 studies involving 511 youth with high-functioning ASD. A random effects meta-analysis yielded a statistically significant pooled treatment effect size (g) estimate for CBT (g = −0.71, p < .001) with significant heterogeneity [Q (13) = 102.27, p < .001]. Removal of a study outlier yielded a statistically significant pooled treatment effect size, (g = −0.47, p < .001). Anxiety informant and treatment modality were not statistically significant moderators of treatment response. Findings suggest that CBT demonstrates robust efficacy in reducing anxiety symptoms in youth with high-functioning ASD.

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Notes

  1. Autism Spectrum Disorder diagnoses and anxiety diagnoses were based upon the Diagnostic and Statistical Manual of Mental Disorders, 4th, edition, Text Revision (DSM-IV-TR).

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Acknowledgments

The authors of this paper would like to acknowledge the support of Drs. Vicky Phares, Ph.D., and Jack Darkes. Dr. Eric Storch has received grant funding in the last 3 years from the National Institutes of Health, All Children’s Hospital Research Foundation, Centers for Disease Control, Agency for Healthcare Research and Quality, National Alliance for Research on Schizophrenia and Affective Disorders, International OCD Foundation, Tourette Syndrome Association, Janssen Pharmaceuticals, and Foundation for Research on Prader-Willi Syndrome. He receives textbook honorarium from Springer publishers, American Psychological Association, and Lawrence Erlbaum. Dr. Storch has been an educational consultant for Rogers Memorial Hospital. He is a consultant for Prophase, Inc. and CroNos, Inc., and is on the Speaker’s Bureau and Scientific Advisory Board for the International OCD Foundation. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Conflict of interest

The authors have no conflicting interests to report.

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Authors and Affiliations

  1. Department of Psychology, University of South Florida, 4202 E. Fowler Ave., PCD 4118G, Tampa, FL, 33620-7200, USA

    Danielle Ung, Robert Selles & Eric A. Storch

  2. School of Aging Studies, University of South Florida, Tampa, FL, USA

    Brent J. Small

  3. Department of Pediatrics, University of South Florida, Tampa, FL, USA

    Eric A. Storch

  4. Department of Psychiatry and Behavioral Neuroscience, University of South Florida, Tampa, FL, USA

    Eric A. Storch

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  1. Danielle Ung
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  4. Eric A. Storch
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Correspondence to Danielle Ung.

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Ung, D., Selles, R., Small, B.J. et al. A Systematic Review and Meta-Analysis of Cognitive-Behavioral Therapy for Anxiety in Youth with High-Functioning Autism Spectrum Disorders. Child Psychiatry Hum Dev 46, 533–547 (2015). https://doi.org/10.1007/s10578-014-0494-y

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