Abstract
Intervention research on adults with autism spectrum disorder (ASD) is sparse. Many adults with ASD experience impaired emotion regulation (ER), which is thought to contribute to higher rates of psychiatric comorbidities among adults with ASD and indirect effects upon adaptive functioning, interpersonal relationships, and vocational status. The purpose of this study was to investigate feasibility and initial efficacy of an adapted mindfulness-based individual therapy targeting ER difficulties for adults with ASD. There is evidence for feasibility based on acceptable treatment fidelity and participant satisfaction ratings. Of nine participants, seven demonstrated improvement in at least one of the following domains; impulse control, access to ER strategies, and emotional acceptance. Further research is recommended, including additional timepoints and a clinical cutoff-derived sample.
References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. doi:10.1016/j.cpr.2009.11.004.
Baer, R. A., & Krietemeyer, J. (2006). Overview of mindfulness- and acceptance-based treatment approaches. In R. A. Baer (Ed.), Mindfulness-based treatment approaches (1st ed., pp. 3–27). London: Elsevier.
Blakeley-Smith, A., Reaven, J., Ridge, K., & Hepburn, S. (2012). Parent–child agreement of anxiety symptoms in youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(2), 707–716. doi:10.1016/j.rasd.2011.07.020.
Cachia, R. L., Anderson, A., & Moore, D. W. (2016). Mindfulness in individuals with Autism Spectrum Disorder: A systematic review and narrative analysis. Review Journal of Autism and Developmental Disorders, 3(2), 165–178. doi:10.1007/s40489-016-0074-0.
Carmody, J., & Baer, R. A. (2009). How long does a Mindfulness-Based Stress Reduction program need to be? A review of class contact hours and effect sizes for psychological distress. Journal of Clinical Psychology, 65(6), 627–638. doi:10.1002/jclp.
Chiesa, A., Serretti, A., & Christian, J. (2013). Mindfulness: Top–down or bottom–up emotion regulation strategy? Clinical Psychology Review, 33, 82–96. doi:10.1016/j.cpr.2012.10.006.
Compas, B. E., Connor-Smith, J. K., Saltzman, H., Thomsen, A. H., & Wadsworth, M. E. (2001). Coping with stress during childhood and adolescence: Problems, progress, and potential in theory and research. Psychological Bulletin, 127(1), 87–127. doi:10.1037/0033-2909.127.1.87.
Connor-Smith, J., Compass, B. E., Wadsworth, M. E., Harding Thomsen, A., & Saltzman, H. (2000). Responses to stress in adolescence: Measurement of coping and involuntary stress responses. Journal of Consulting and Clinical Psychology, 68(6), 976–992. doi:10.1037//0022-006X.68.6.976.
Eack, S. M., Greenwald, D. P., Hogarty, S. S., Bahorik, A. L., Litschge, M. Y., Mazefsky, C. A., & Minshew, N. J. (2013). Cognitive enhancement therapy for adults with autism spectrum disorder: Results of an 18-month feasibility study. Journal of Autism and Developmental Disorders, 43(12), 2866–2877. doi:10.1007/s10803-013-1834-7.
Fjorback, L. O., Arendt, M., Ornbøl, E., Fink, P., & Walach, H. (2011). Mindfulness-based stress reduction and mindfulness-based cognitive therapy: A systematic review of randomized controlled trials. Acta Psychiatrica Scandinavica, 124(2), 102–119. doi:10.1111/j.1600-0447.2011.01704.x.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. doi:10.1023/B:JOBA.0000007455.08539.94.
Gross, J. J. (2005). Emotion regulation. In M. Lewis, J. M. Haviland-Jones, L. F. Barrett (Eds.), The handbook of emotions (3rd ed.). New York: Guilford Press.
Hofvander, B., Delorme, R., Chaste, P., Nydén, A., Wentz, E., Ståhlberg, O., … Leboyer, M. (2009). Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry, 9(35), 1–9. doi:10.1186/1471-244X-9-35.
Hus, V., & Lord, C. (2014). the autism diagnostic observation schedule, module 4: Revised algorithm and standardized severity scores. Journal of Autism and Developmental Disorders, 44(8), 1996–2012. doi:10.1007/s10803-014-2080-3.
Jacobson, N. S., & Truax, P. (1991). Clinical significance: A statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19. doi:10.1037/0022-006X.59.1.12.
Johnson, S., Gur, R. M., David, Z., & Currier, E. (2015). One-session mindfulness meditation: A randomized controlled study of effects on cognition and mood. Mindfulness, 6(1), 88–98. doi:10.1007/s12671-013-0234-6.
Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8(2), 163–190.
Khor, A. S., Melvin, G. A., Reid, S. C., & Gray, K. M. (2014). Coping, daily hassles and behavior and emotional problems in adolescents with high-functioning autism/Asperger’s disorder. Journal of Autism and Developmental Disorders, 44, 593–608. doi:10.1007/s10803-013-1912-x.
Kiep, M., Spek, A., & Hoeben, L. (2015). Mindfulness-based therapy in adults with an autism spectrum disorder: Do treatment effects last? Mindfulness, 6(3), 637–644. doi:10.1007/s12671-014-0299-x.
Lambert, M. J., Burlingame, G. M., Umphress, V., Hansen, N. B., Vermeersch, D. A., Clouse, G. C., & Yanchar, S. C. (1996). The reliability and validity of the Outcome Questionnaire. Clinical Psychology and Psychotherapy, 3(4), 249–258. doi:10.1002/(SICI)1099-0879(199612)3:4<249::AID-CPP106>3.0.CO;2-S.
Leon, A. C., Davis, L. L., & Kraemer, H. C. (2011). The role and interpretation of pilot studies in clinical research. Journal of Psychiatric Research, 45(5), 626–629. doi:10.1016/j.jpsychires.2010.10.008.
Lerner, M. D., Calhoun, C. D., Mikami, A. Y., & De Los Reyes, A. (2012). Understanding parent-child social informant discrepancy in youth with high functioning autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(12), 2680–2692. doi:10.1007/s10803-012-1525-9.
Lord, C., Rutter, M., DiLavore, P. C., Risi, S., Gotham, K., & Bishop, S. (2012). Autism diagnostic observation schedule-2. Los Angeles: Western Psychological Services.
Ma, S. H., & Teasdale, J. D. (2004). Mindfulness-based cognitive therapy for depression: Replication and exploration of differential relapse prevention effects. Journal of Consulting and Clinical Psychology, 72(1), 31–40. doi:10.1037/0022-006X.72.1.31.
Maddox, B. B., & White, S. W. (2015). Comorbid social anxiety disorder in adults with autism spectrum disorder. Journal of Autism and Developmental Disorders, 45(12), 3949–3960. doi:10.1007/s10803-015-2531-5.
Mazefsky, C. A., Borue, X., Day, T. N., & Minshew, N. J. (2014). Emotion regulation patterns in adolescents with high functioning autism spectrum disorder: Comparison to typically developing adolescents and association with psychiatric symptoms. Autism Research, 7(3), 344–354. doi:10.1002/aur.1366.
Mazefsky, C. A., Herrington, J., Siegel, M., Scarpa, A., Maddox, B. B., Scahill, L., & White, S. W. (2013). The role of emotion regulation in autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 52(7), 679–688. doi:10.1016/j.jaac.2013.05.006.
Mazefsky, C. A., Kao, J., & Oswald, D. P. (2011). Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Research in Autism Spectrum Disorders, 5(1), 164–174. doi:10.1016/j.rasd.2010.03.006.
Pugliese, C. E., & White, S. W. (2014). Brief report: Problem solving therapy in college students with autism spectrum disorders: Feasibility and preliminary efficacy. Journal of Autism and Developmental Disorders, 44(3), 719–729. doi:10.1007/s10803-013-1914-8.
Rieffe, C., Oosterveld, P., Terwogt, M. M., Mootz, S., van Leeuwen, E., & Stockmann, L. (2011). Emotion regulation and internalizing symptoms in children with autism spectrum disorders. Autism: The International Journal of Research and Practice, 15(6), 655–670. doi:10.1177/1362361310366571.
Robins, C. J., & Chapman, A. L. (2004). Dialectical behavior therapy: Current status, recent developments, and future directions. Journal of Personality Disorders, 18(1), 73–89. doi:10.1521/pedi.18.1.73.32771.
Samson, A. C., Hardan, A. Y., Lee, I. A., Phillips, J. M., & Gross, J. J. (2015). Maladaptive behavior in autism spectrum disorder: The role of emotion experience and emotion regulation. Journal of Autism and Developmental Disorders, 45, 3424–3432. doi:10.1007/s10803-015-2388-7.
Samson, A. C., Huber, O., & Gross, J. J. (2012). Emotion regulation in Asperger’s syndrome and high-functioning autism. Emotion, 12(4), 659–665. doi:10.1037/a0027975.
Samson, A. C., Phillips, J. M., Parker, K. J., Shah, S., Gross, J. J., & Hardan, A. Y. (2014). Emotion dysregulation and the core features of autism spectrum disorder. Journal of Autism and Developmental Disorders, 44, 1766–1772. doi:10.1007/s10803-013-2022-5.
Segal, Z. V., Teasdale, J. D., & Williams, M. G. (2004). Mindfulness-based cognitive therapy: Theoretical rationale and empirical status. In S. C. Hayes, V. M. Follette & M. M. Linehan (Eds.), Mindfulness and acceptance: Expanding the cognitive-behavioral traditions (pp. 45–65). New York: Guilford Press.
Segal, Z. V., Williams, J. M., & Teasdale, J. (2013). Mindfulness-based cognitive therapy for depression (2nd ed.). London: Guilford Press.
Sheehan, D. V., & Lecrubier, Y. (2006). The Mini-International Neuropsychiatric Interview (M.I.N.I.) (English Ve). Retrieved from http://www.nccpsychiatry.info/File/MINI500.pdf.
Sizoo, B. B., & Kuiper, E. (2017). Cognitive behavioural therapy and mindfulness based stress reduction may be equally effective in reducing anxiety and depression in adults with autism spectrum disorders. Research in Developmental Disabilities, 64, 47–55. doi:10.1016/j.ridd.2017.03.004.
Spek, A. A., van Ham, N. C., & Nyklíček, I. (2013). Mindfulness-based therapy in adults with an autism spectrum disorder: A randomized controlled trial. Research in Developmental Disabilities, 34(1), 246–253. doi:10.1016/j.ridd.2012.08.009.
Stange, J. P., Eisner, L. R., Hölzel, B. K., Peckham, A. D., Dougherty, D. D., Rauch, S. L., … Deckersbach, T. (2011). Mindfulness-based cognitive therapy for bipolar disorder: Effects on cognitive functioning. Journal of Psychiatric Practice, 17(6), 410–419. doi:10.1097/01.pra.0000407964.34604.03.
Swain, D., Scarpa, A., White, S., & Laugeson, E. (2015). Emotion dysregulation and anxiety in adults with ASD: Does social motivation play a role? Journal of Autism and Developmental Disorders, 45(12), 3971–3977. doi:10.1007/s10803-015-2567-6.
Wahbeh, H., Lane, J. B., Goodrich, E., Miller, M., & Oken, B. S. (2014). One-on-one mindfulness meditation trainings in a research setting. Mindfulness, 5(1), 88–99. doi:10.1007/s12671-012-0155-9.
Wechsler, D. (2011). Wechsler abbreviated scale of intelligence, second edition (WASI-II) (2nd ed.). San Antonio, TX: NCS Pearson.
Wong, C., Odom, S. L., Hume, K. A., Cox, A. W., Fettig, A., Kucharczyk, S., … Schultz, T. R. (2015). Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. Journal of Autism and Developmental Disorders, 45(7), 1951–1966. doi:10.1007/s10803-014-2351-z.
Funding
This study was funded by Organization for Autism Research Graduate Research Grant 2014. Findings were part of C. M. Conner’s doctoral dissertation.
Author Contributions
CMC primarily developed the study aims, design, coordination, and performed data analysis with SWW’s assistance as her doctoral dissertation mentor. CMC acted as the study clinician with SWW providing licensed supervision. CMC drafted the dissertation and initial draft of manuscript with SWW providing feedback. Both authors read and approved the final manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.
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Informed consent was obtained from all individual participants included in the study.
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Conner, C.M., White, S.W. Brief Report: Feasibility and Preliminary Efficacy of Individual Mindfulness Therapy for Adults with Autism Spectrum Disorder. J Autism Dev Disord 48, 290–300 (2018). https://doi.org/10.1007/s10803-017-3312-0
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DOI: https://doi.org/10.1007/s10803-017-3312-0