Group Depression Treatment for Autistic Youth
Condition: Autism Spectrum Disorder; Depression; Suicidal Ideation; Self Esteem
MeSH terms: Depression; Depressive Disorder; Autism Spectrum Disorder; Suicidal Ideation
Study type: Interventional

Summary: 
      Higher rates of depression are reported by autistic adolescents as compared to their
      non-autistic peers, which is problematic given adverse outcomes (e.g., negative self-esteem,
      lower academic performance) that are associated with depression. Despite the alarming rates
      of depression in autistic youth and associated safety concerns, few treatments have been
      developed. In this study, we investigate the feasibility, acceptability, and preliminary
      efficacy of an autism-adapted group cognitive-behavioral treatment for autistic adolescents
      (11-17 years old; middle and high school) in a pilot, nonrandomized trial. Specifically, we
      aim to increase adolescents' perception and understanding of self, including autistic
      identity, in order to treat depression. Intervention design and implementation were guided by
      autistic self-advocates and parents.
    

Detailed description: 
      Higher rates of depression and suicidal thoughts are reported by autistic adolescents as
      compared to their non-autistic peers, which is problematic given adverse outcomes (e.g.,
      negative self-esteem, lower academic performance) that are associated with depression.
      Despite the alarming rates of depression in autistic youth, few interventions have been
      developed or tested to reduce depression in this at-risk population. An evidence-based
      intervention for depression in non-autistic adolescents is Cognitive Behavioral Therapy
      (CBT), which CBT has strong research support for treating depression in non-autistic
      adolescents according to the American Psychological Association (APA). Autism-adapted CBT
      programs for anxiety and OCD have outperformed standard CBT approaches for autistic youth;
      however, autism-adapted CBT programs for depression in autistic adolescents have not been
      developed with stakeholders nor tested in a clinical setting. To address this gap, an adapted
      CBT group intervention for autistic adolescents (11-17 years old; middle and high school)
      with depression was designed in collaboration with autistic stakeholders.

      In the present study, the feasibility, acceptability, and preliminary efficacy of this
      12-week group intervention in improving perception and understanding of self and depressive
      symptoms will be examined in a pilot, nonrandomized trial with pretest-posttest design.
      Groups will occur in the Outpatient Clinic of the Department of Psychiatry and Behavioral
      Sciences at the Vanderbilt University Medical Center (VUMC), and study measures will be
      administered to adolescents and their parents at four timepoints: baseline (week 0), midpoint
      (week 6), post (week 12), and follow-up (week 24). Study measures include parent- and
      self-report measures of adolescent well-being (e.g., perception of self, quality of life,
      etc.) and clinical interviews of psychiatric symptoms (e.g., depressive symptoms, suicidal
      thoughts). The significance and size of intervention effects on emotional and behavioral
      outcomes will be measured using one-way ANOVAs and linear mixed models. If predicted results
      occur, it will provide information on the feasibility and acceptability of this group
      intervention, with preliminary empirical support for its efficacy in improving perception and
      understanding of self and reducing the severity of depressive symptoms in autistic
      adolescents.
    

Intervention name(s): Autism-adapted Group Cognitive Behavioral Therapy
Intervention type(s): Behavioral
Intervention description(s): The autism-adapted Group Cognitive Behavioral Therapy (CBT) was designed by the PI and research team in collaboration with autistic stakeholders (i.e., adults, parents, researchers). It is a 12-week group intervention (90 min) delivered on a weekly basis in an outpatient psychiatry clinic by licensed clinical psychologists and psychology trainees. Each group is comprised of 8-9 autistic adolescents (11-17 years old; middle and high school) with depression. The intervention targets adolescents' perception and understanding of self, including autistic identity, through a series of cognitive-behavioral approaches including psychoeducation, emotion regulation, cognitive distortions, cognitive restructuring, behavioral rehearsals, and weekly homework assignments.
Intervention model: Single Group Assignment
Intervention model description: Pilot, nonrandomized trial of a behavioral intervention for autistic adolescents.
Masking: None (Open Label)
Primary purpose: Treatment