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Published on: July 31, 2017
Exposure, Extinction, and Cognitive Appraisals in Autistic Adults With Social Anxiety: Evidence From a Structured
Bruna B Roisenberg1,2, Kelsie A Boulton1,2, Emma E Thomas1,2
1Clinic for Autism and Neurodevelopment (CAN) Research, Brain and Mind Centre, Children's Hospital Westmead Clinical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia.
Summary
Autistic adults with social anxiety (SA) show fear responses during speech exposure therapy consistent with cognitive-behavioral therapy (CBT) models. Fear reduction during the task predicts successful treatment outcomes.
Area of Science:
- Psychiatry
- Clinical Psychology
- Neurodevelopmental Disorders
Background:
- Social anxiety (SA) is common in autistic adults, but their responses to therapies like exposure tasks are not well understood.
- Cognitive-behavioral therapy (CBT) is a common treatment for SA, but modifications may be needed for autistic individuals.
Purpose of the Study:
- To examine how autistic adults respond to a structured speech exposure task within a modified CBT (M-CBT) program.
- To investigate the association between fear extinction during exposure and treatment response in autistic adults with SA.
Main Methods:
- Thirty-two autistic adults with SA completed a speech exposure task and pre/post-task anxiety and cognitive appraisal assessments.
- Participants' anxiety responses, self-focused attention, perceived performance, appearance concerns, and threat appraisals were measured.
- Fear extinction during the task was assessed and linked to post-treatment changes on the Liebowitz Social Anxiety Scale (LSAS-SR).
Main Results:
- Autistic adults showed expected patterns of anticipatory anxiety followed by anxiety reduction during the speech task.
- Higher anxiety correlated with increased self-focused attention and threat appraisals but also with better self-rated performance.
- Significant fear extinction during exposure was linked to greater post-treatment improvement in SA symptoms, similar to a non-autistic comparison group.
Conclusions:
- Autistic individuals' responses to exposure tasks align with CBT models of SA.
- Fear extinction during exposure is a significant predictor of treatment response to M-CBT in autistic adults.
- Findings support the use of exposure-based interventions for social anxiety in autistic populations, warranting further research with objective measures.
Related Concept Videos
01:19Autism Spectrum Disorder
Autism spectrum disorder (ASD) is a neurodevelopmental condition marked by persistent deficits in social communication and interaction alongside restrictive and repetitive behaviors or interests. ASD is sometimes accompanied by intellectual impairment.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
These core symptoms manifest differently among individuals, ranging from mild to severe. The disorder's complexity extends beyond its clinical presentation, encompassing a diverse range of biological, cognitive, and sociocultural influences.
01:28Social Anxiety Disorder
Social anxiety disorder, also known as social phobia, is characterized by an intense fear of social situations where one might face humiliation, rejection, embarrassment, or negative evaluation. This disorder leads individuals to avoid activities like casual conversations, public speaking, or seemingly simple tasks such as eating, signing documents, or swimming, in public settings. Its impact extends beyond discomfort, often significantly interfering with daily functioning and quality of life.
01:22Behavior Therapy
Behavior therapy incorporates diverse techniques rooted in classical conditioning principles to address maladaptive behaviors and anxiety disorders. These methods aim to reduce avoidance behaviors, foster adaptive coping mechanisms, and alter associations between stimuli and responses, making them effective in a wide range of therapeutic contexts.
Exposure therapy is a cornerstone of behavioral treatment for anxiety disorders. It involves systematic exposure to feared stimuli, either in real...
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01:26Modeling in Therapy
Modeling, a key technique in therapy, uses observational learning to help clients acquire and practice new skills by watching therapists demonstrate desired behaviors. This approach, rooted in Albert Bandura's concept of vicarious learning, plays a significant role in therapeutic interventions for various psychological conditions, including social anxiety, ADHD, and depression.
Participant Modeling
Participant modeling involves therapists demonstrating calm and effective behaviors in situations...
Participant Modeling
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01:18Anxiety: Overview
Anxiety is a common mental disorder featuring excessive worry, fear, and apprehension, significantly affecting daily life. People with anxiety disorders experience persistent and intense anxiety, interrupting their everyday functioning.
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
Individuals with anxiety often experience a range of physical and emotional symptoms, including sweating, trembling, tachycardia, and disturbances in sleep patterns. These symptoms vary in intensity and frequency but are generally disruptive and distressing.
01:04Social Facilitation
Not all intergroup interactions lead to negative outcomes. Sometimes, being in a group situation can improve performance. Social facilitation occurs when an individual performs better when an audience is watching than when the individual performs the behavior alone. This typically occurs when people are performing a task for which they are skilled.