Clinical trial NCT05862467: A Pilot Participatory Program Evaluation of a Virtual Trauma Support Program for Autistic Adults
Official title: Efficacy of a Posttraumatic Stress Disorder (PTSD) Intervention for Autistic Adults on Biobehavioral Health
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Autism
Trauma
Posttraumatic Stress Disorder
Posttraumatic Stress Symptom
Lead sponsor: University of Wyoming
Sponsor class: OTHER
First posted: 2023-05-17
Enrollment: 28
Sex: ALL
Minimum age (years): 18
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Intervention model description: This is a single group study, where all participants receive telehealth-based Written Exposure therapy (WET). Feasibility and initial efficacy is assessed via pre-post assessments, conducted pre-WET, at the end of WET, and 1 and 6 months post program completion.
Primary purpose: TREATMENT

Brief summary: The goal of this single-group clinical trial is to learn about the initial efficacy and feasibility of telehealth-delivered Written Exposure Therapy (WET) for autistic adults with traumatic stress symptoms. The main questions the investigators aim to answer are:

* Do symptoms of posttraumatic stress disorder (PTSD) and co-occurring mental health concerns decrease after receiving WET?
* Do biobehavioral health outcomes, including objective (Fitbit indicators of activity, sleep, and heart rate) and subjectively-reported health variables (e.g., sleep, pain, health-related quality of life), improve after receiving WET?
* How do autistic adults experience WET, and how can this program be modified and enhance in the future in collaboration with autistic adults?

Participants will complete the following as part of the study, which is completed entirely over telehealth.

* Participants will first complete an initial assessment, involving brief measures of cognition and autistic traits, as well as interviews and questionnaires about PTSD, mental health, and physical health. If eligible, participants will proceed to the following steps:
* Eligible participants will then start wearing a Fitbit, to be used for the duration of the study.
* Participants will then participate in 5 weekly virtual visits involving the WET protocol, including weekly brief assessment of PTSD and mental and physical health.
* Then, participants will complete a sixth virtual visit the following week where PTSD, mental and physical health, and treatment feedback are assessed.
* Lastly, participants will complete virtual visits 1 and 6 months later involving re-assessment of PTSD and mental and physical health.

Therefore, this is a pre-post single group design, where all participants will receive WET to establish initial efficacy and feasibility. Investigators will also consult with an autistic advisory board throughout the project, and make adaptations as recommended in consultation with autistic adults. The goal is to better understand the initial efficacy and feasibility of WET for supporting autistic adults who have experienced trauma.


Eligibility criteria: Inclusion Criteria:

* Autistic
* Age 18 years or over
* Has experienced trauma and reports clinically significant symptoms of traumatic stress (clinically elevated score on either Posttraumatic Symptom Checklist (PCL-5) or Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (SCID-5), and/or other self-report/interview evidence of significant traumatic stress symptoms for which participant wants support/program
* Comfortable speaking and writing in English
* Full Scale Intelligence Quotient (FSIQ) score \>= 65 (given written nature of Written Exposure Therapy) on the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2)
* Access to device with internet access for telehealth visits

Exclusion Criteria:

* Participant is not Autistic
* Participant is unable to understand English
* Participant is currently receiving trauma-focused therapeutic services
* Participant does not have access to internet connected device for telehealth visits
* Participant receives Full Scale Intelligence Quotient (FSIQ) score \< 65 on the Wechsler Abbreviated Scale of Intelligence-Second Edition (WASI-2)
* If there are significant safety concerns for any participant (e.g., imminent risk of harm to self or other) the Principal Investigator may determine whether it is not in the adult's best interest to be enrolled given that this study does not provide care/services relating to active risk.

Primary outcomes:
measure: Change in posttraumatic stress disorder (PTSD) symptoms on the Posttraumatic Symptom Checklist for DSM-5 (PCL-5) Scale
timeFrame: Change across baseline to follow-up (an average of 6 months)
Secondary outcomes:
measure: Change in depressive symptoms on the Patient Health Questionnaire (PHQ) Scale
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in anxiety symptoms on the Anxiety Scale for Autism-Adults (ASA-A)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in loneliness symptoms on the University of California Los Angeles (UCLA) 3-Item Loneliness Scale
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in psychological adjustment concerns on the Brief Adjustment Scale (BASE-6)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in experiential avoidance symptoms on the Brief Experiential Avoidance Questionnaire
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in emotion regulation difficulties on the Difficulties in Emotion Regulation Scale (DERS-16)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in stigma towards help-seeking on the Ultra-Brief Self-Stigma of Seeking Help (SSOSH-3) Scale
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in camouflaging on the Camouflaging Autistic Traits Questionnaire (CATQ)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in sleep difficulties on the Pittsburgh Sleep Quality Index (PSQI)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in pain intensity on the Patient-Reported Outcome Measurement Information System (PROMIS) Pain Intensity Short Form Scale.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in pain interference on the Patient-Reported Outcome Measurement Information System (PROMIS) Pain Interference Short Form Scale.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in health-related quality of life on the Centers for Disease Control Health-Related Quality of Life Scale (CDC HRQOL)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in PTSD symptoms on the clinician-administered Structured Clinical Interview for DSM-5
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in physical activity as assessed on Fitbit.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in sleep quality as assessed on Fitbit.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in sleep duration as assessed on Fitbit.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in resting heart rate as assessed on Fitbit.
timeFrame: Change across baseline to follow-up (an average of 6 months)
Other outcomes:
measure: Change in autistic quality of life on the Autism Spectrum Quality of Life Scale.
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in overall quality of life on the World Health Organization Quality of Life Scale
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: Change in positive Autistic identity on the Autism Spectrum Identity Scale (ASIS)
timeFrame: Change across baseline to follow-up (an average of 6 months)
measure: End of program working alliance reported on the Working Alliance Inventory (Short-Revised)
timeFrame: 6 weeks (after baseline, on average)
measure: End of program satisfaction reported on the Program Satisfaction Questionnaire
timeFrame: 6 weeks (after baseline, on average)
measure: History of benevolent/positive childhood experiences reported on the Benevolent Childhood Experiences Checklist.
timeFrame: Baseline
measure: History of adverse experiences on the Sexual and Gender Minority Adverse Childhood Experiences Scale
timeFrame: Baseline
measure: Racial trauma symptoms on the Racial Trauma Scale (RTS-Brief Research Version)
timeFrame: Baseline
measure: Discrimination experiences on the Everyday Discrimination Scale (EDS)
timeFrame: Baseline
measure: History of childhood stressful experiences on the Childhood Experiences Survey
timeFrame: Baseline
Locations:
city: Laramie
country: United States
facility: University of Wyoming
state: Wyoming
Study officials:
References: