Treating Transdiagnostic Processes in ASD: Going Beyond Anxiety

Abstract

In reviewing the programs that have aimed to address anxiety in children with autism spectrum disorders (ASD) through cognitive behavioral therapy (CBT) approaches, it is clear that many of these have included material that is typically not used in a traditional anxiety program. We review the modifications that are recommended but, in looking at these more closely, we face the question of whether it makes sense to develop programs that are narrowly focused on just one psychological domain when working with this population. The fact that emotional dysregulation is a central feature in this population means that there will be significant overlap and diversity in presentations of anxiety, anger, behavioral problems, and depressive symptoms. Indeed, we already have evidence to demonstrate this as well as demographic characteristics of children in the studies that indicate overlapping symptoms. Some programs have been developed to manage presentations of emotion dysregulation other than anxiety and appropriate expression of affectionate behavior. What is important to note here is that these programs use essentially the same format and content as the anxiety program evaluated by this group but focus on a different target. Including the modifications to CBT that have been shown to be useful, there is also a focus on teaching emotion recognition from the outset, accounting for individual differences in learning style, and an awareness of other issues that may present in the context of program delivery—e.g., behavioral issues, restlessness, the need to incorporate a special interest, and so on. Finally, it is important to recognize that many of the programs that we are developing and evaluating are already moving in a transdiagnostic direction. Clearly, we are moving to recognize that even within a good anxiety program we must go beyond anxiety in this population. (PsycINFO Database Record (c) 2016 APA, all rights reserved)