Abstract
BackgroundAutism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction; restrictive, repetitive patterns of behavior, interests, or activities; and a preference for sameness and routines. The majority of adult ASD patients suffer from comorbid conditions such as depression and anxiety. Therapy options for adult ASD patients are lacking, with presently no available evidence-based interventions in Germany. Recently, two interventions to improve social responsiveness have been published. FASTER (“Freiburger Asperger-Spezifische Therapie für ERwachsene” = Freiburg Asperger-specific therapy for adults) is a manualized group psychotherapy program including three modules on psychoeducation, stress regulation management, and non-verbal and verbal social communication training with videotaped tasks. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy.MethodsThree hundred sixty adult participants with an autism spectrum disorder (ASD) will take part in a randomized controlled three-armed multi-center trial to prove the efficacy of manualized group psychotherapy and a manualized computer-based training program. Both interventions will be compared with a treatment as usual (TAU) group, aiming to establish evidence-based psychotherapy approaches for adult individuals with ASD. The primary outcome is evaluated by parents, spouses, or others who have sufficient insight into the respective participant’s social communication and interaction, and will be measured with the Social Responsiveness Scale. First, each of both interventions will be compared to TAU. If at least one of the differences is significant, both interventions will be compared against each other. The primary outcome will be measured at baseline (T0) and 4 months after baseline (T1).DiscussionThe trial is the first to validate psychiatric therapeutic and training interventions for adult ASD patients in Germany. A trial is needed because the prevalence of ASD in adulthood without intellectual disability is high, and no evidence-based intervention can be offered in Germany.Trial registrationGerman Clinical Trial Register DRKS00017817. Registered on 20 April 2020.
Highlights
Background and rationale {6a} Autism spectrum disorders (ASD) are neurodevelopmental conditions behaviorally characterized by impairments in social communication and interaction as well as the presence of repetitive and restricted patterns of behaviors, interests, and activities [1, 2]
While the topic is well established in Child and Adolescent Psychiatry and Psychotherapy, this is not yet the case in Adult Psychiatry and Psychotherapy (APP), the current prevalence rate with 1–2% of ASD in the general population [2, 3] is high, as ASD is a lifelong condition, in which symptoms do not disappear
As the DSM personality interviews such as the Structured Clinical Interview for DSM-5 (SCID-5-PD, [42]) may lead to multiple diagnoses of personality disorders related to the high overlap of ASD symptoms, we considered a more general description of the personality to be more appropriate
Summary
Background and rationale {6a} Autism spectrum disorders (ASD) are neurodevelopmental conditions behaviorally characterized by impairments in social communication and interaction as well as the presence of repetitive and restricted patterns of behaviors, interests, and activities [1, 2]. Few adult high-functioning patients received the diagnosis ASD, but instead were often been diagnosed only by their secondary psychiatric conditions [4] In these constellations, ASD without intellectual disability can be understood as a kind of basic disorder from which typical psychosocial consequences, communicatory problems, and interpersonal conflicts arise. Autism spectrum disorder (ASD) is a chronic neurodevelopmental condition with a prevalence rate above 1%, characterized by deficits in social communication and interaction; restrictive, repetitive patterns of behavior, interests, or activities; and a preference for sameness and routines. SCOTT&EVA (“Social Cognition Training Tool”, and its enhancement “Emotionen Verstehen und Ausdruecken” = understanding and expressing emotions) is a computer-based training program to enhance social cognition including video and audio material of emotional expressions and complex real-life social situations. Initial studies for both programs have shown good feasibility and efficacy
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