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Effect of Co-occurring Psychiatric Disorders on Treatment of Children with Autism Spectrum Disorder and Anxiety

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Abstract

Co-occurring psychiatric diagnoses are very common in individuals with ASD. Little is known about the effect that co-occurring psychiatric conditions may have on treatment response to CBT for children with ASD and anxiety. The present study examined the relationship between co-occurring psychiatric diagnoses and response to CBT for anxiety in ninety youth with ASD. Psychiatric complexity did not appear to differentially impact treatment response. A notable portion of youth with anxiety and externalizing disorders such as ADHD, no longer met criteria for those externalizing diagnoses following intervention. Results indicate that youth with ASD and anxiety present with complex psychiatric profiles and CBT for anxiety may positively affect co-occurring diagnoses. In addition, thorough and nuanced assessment of psychiatric symptoms in youth with ASD is needed to ensure the differentiation between diagnoses of anxiety and other co-occurring psychiatric symptoms.

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Acknowledgments

Judy Reaven and Audrey Blakeley-Smith receive royalties from the publication of Facing Your Fears: Group Therapy for Managing Anxiety in Children with High-Functioning Autism Spectrum Disorders (FYF; Reaven et al., 2011). This manuscript was completed with support from National Institutes of Health (NIH) Grant R33MH089291-03 (Reaven: PI). It was also supported in part, by the Health Resources and Services Administration (HRSA) under the Leadership Education in Neurodevelopmental Disabilities (LEND) Grant T73MC11044 and by the Administration on Intellectual and Developmental Disabilities (AIDD) under the University Center of Excellence in Developmental Disabilities (UCEDD) Grant 90DD0632 of the U.S. Department of Health and Human Services (HHS).The authors would like to thank all participants and research support staff across all sites who contributed to this study.

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Authors and Affiliations

  1. JFK Partners, Department of Pediatrics, University of Colorado School of Medicine, Education 2 South, 13121 E. 17th Ave, Aurora, CO, 80045, USA

    Allison T. Meyer

  2. Wyoming Institude for Disabilities, College of Health Sciences, University of Wyoming, Laramie, WY, USA

    Eric J. Moody

  3. Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Kennedy Krieger Institute, Baltimore, MD, USA

    Amy Keefer

  4. Center for Autism and Related Disorders, Kennedy Krieger Institute, Baltimore, MD, USA

    Amy Keefer

  5. Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA

    Sarah O’Kelley

  6. Division of Developmental and Behavioral Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Amie Duncan

  7. JFK Partners, Department of Psychiatry, University of Colorado Anschutz Medical Center, Aurora, CO, USA

    Audrey Blakeley-Smith & Judy Reaven

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  1. Allison T. Meyer
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  2. Eric J. Moody
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  4. Sarah O’Kelley
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  5. Amie Duncan
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  6. Audrey Blakeley-Smith
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  7. Judy Reaven
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Contributions

JR is the PI of the original study. ATM and JR conceived of the study using secondary data analysis. ATM conducted analyses and drafted the manuscript. EJM supported data analytic planning, completion of analyses, and provided feedback during manuscript preparation. ATM and JR outlined the manuscript. ABS, AK, AD, SOK, and JR edited the manuscript. ATM, AK, AD, and SOK participated in data collection, data entry during original study (Reaven et al., 2018).

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Correspondence to Allison T. Meyer.

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Meyer, A.T., Moody, E.J., Keefer, A. et al. Effect of Co-occurring Psychiatric Disorders on Treatment of Children with Autism Spectrum Disorder and Anxiety. J Autism Dev Disord 53, 569–579 (2023). https://doi.org/10.1007/s10803-020-04540-1

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