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A Systematic Review of Treatments for Anxiety in Youth with Autism Spectrum Disorders

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Abstract

This study systematically examined the efficacy and safety of psychopharmacological and non-psychopharmacological treatments for anxiety in youth with autism spectrum disorders (ASD). Four psychopharmacological, nine cognitive behavioral therapy (CBT), and two alternative treatment studies met inclusion criteria. Psychopharmacological studies were descriptive or open label, sometimes did not specify the anxiety phenotype, and reported behavioral activation. Citalopram and buspirone yielded some improvement, whereas fluvoxamine did not. Non-psychopharmacological studies were mainly randomized controlled trials (RCTs) with CBT demonstrating moderate efficacy for anxiety disorders in youth with high functioning ASD. Deep pressure and neurofeedback provided some benefit. All studies were short-term and included small sample sizes. Large scale and long term RCTs examining psychopharmacological and non-psychopharmacological treatments are sorely needed.

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Acknowledgments

This research activity was supported by cooperative agreement UA3 MC 11054 from the U.S. Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Research Program, to the Massachusetts General Hospital. The work was conducted through the Autism Speaks Autism Treatment Network serving as the Autism Intervention Research Network on Physical Health. The views expressed in this publication do not necessarily reflect the views of Autism Speaks, Inc.

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Authors and Affiliations

  1. Kennedy Krieger Institute, 3901 Greenspring Avenue, Baltimore, MD, 21211, USA

    Roma A. Vasa & Rajneesh Mahajan

  2. Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Roma A. Vasa & Rajneesh Mahajan

  3. Johns Hopkins University, 3400 N Charles Street, Baltimore, MD, 21218, USA

    Laura M. Carroll

  4. Center for Child and Adolescent Health Research and Policy, Massachusetts General Hospital for Children, 55 Fruit Street, Boston, MA, 02114, USA

    Alixandra A. Nozzolillo

  5. Department of Health Psychology, University of Missouri, One Hospital Drive, DC116.88, Columbia, MO, 65212, USA

    Micah O. Mazurek

  6. Thompson Center for Autism and Neurodevelopmental Disorders, 205 Portland Street, Columbia, MO, 65201, USA

    Micah O. Mazurek

  7. Division of Developmental and Behavioral Pediatrics, Children’s Hospital of Philadelphia, 34th Street and Civic Center Boulevard, Philadelphia, PA, 19104, USA

    Amanda E. Bennett

  8. Division of Child and Adolescent Psychiatry, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Logan K. Wink

  9. Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94304, USA

    Maria Pilar Bernal

  10. The Permanente Medical Group, Oakland, CA, USA

    Maria Pilar Bernal

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  1. Roma A. Vasa
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Vasa, R.A., Carroll, L.M., Nozzolillo, A.A. et al. A Systematic Review of Treatments for Anxiety in Youth with Autism Spectrum Disorders. J Autism Dev Disord 44, 3215–3229 (2014). https://doi.org/10.1007/s10803-014-2184-9

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