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Updated: May 12, 2026
TMS: Using the Theta-Burst Protocol to Explore Mechanism of Plasticity in Individuals with Fragile X Syndrome and Autism
Published on: December 28, 2010
Optimizing single-session CBT delivery in an 8-session longitudinal therapeutic assessment (FRAX-TA) for women with
Federica Alice Maria Montanaro1,2, Giuseppina Spano3, Randi J Hagerman4,5
1Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy.
Background:
Therapeutic Assessment (TA) is a client-centered approach that uses psychological evaluation to promote therapeutic change. While TA has shown benefits across populations, its application to genetically at-risk groups remains limited. Women with the FMR1 premutation (PM) are vulnerable to mood, anxiety, and cognitive symptoms, collectively referred to as Fragile X-associated Neuropsychiatric Disorders (FXAND). However, tailored psychological assessments for this population are still lacking. This study introduces FRAX-TA, a TA-based protocol for women with the PM, integrating a Single-Session Cognitive Behavioral Therapy (SS-CBT) component: the Psychoeducational Assessment (PA). The aim was to offer psychological support, while collecting quantitative data. We also explored whether varying the timing of the PA influences outcomes.
Methods:
Eighty-one Italian women with genetically confirmed PM (M age = 50.5 ± 9.41) completed an 8-week TA protocol based on the Cognitive Behavioral Assessment for Outcome Evaluation (CBA-VE). Participants were randomized into four groups receiving the PA during the 4th, 6th, 8th, or 10th week from baseline. Mixed-design Bayesian ANOVAs assessed changes across timepoints (baseline, post-PA, follow-up) and the effect of the PA timing on the five CBA-OE psychological domains (anxiety, wellbeing, perception of positive change, depression, and psychological distress). An anonymous feedback questionnaire evaluated participant experiences.
Results:
Participants showed significant reductions in the CBA-VE anxiety, depression, and distress scores. The PA had both immediate and delayed effects, particularly for depression and anxiety. Mid-phase delivery led to more stable improvements in CBA-VE perceived positive change. Qualitative feedback indicated high satisfaction and emotional support.
Conclusion:
FRAX-TA appears effective for women with the PM, providing therapeutic benefit even without ongoing treatment. Findings underscore the added value of SS-CBT within assessment and suggest that repeated sessions may enhance symptom recognition and prompt further care. Future studies should include control groups, larger samples, and examine personalized timing to optimize outcomes.
