The purpose of this study is to determine if adults with autism spectrum disorder and with normal intelligence improve from 36 sessions (1 calendar year) of group treatment with Cognitive Behavioural Therapy or recreational activity in groups with 6-8 participants.
The purpose of this study was to compare two group interventions for psychiatric patients with Autism spectrum disorder and normal intelligence: Cognitive Behavioural Therapy developed to suit adults with Autism spectrum disorder, and recreational activity, enabling social interaction. The recreational activity intervention served as a low-impact option, easily organised within the community. It is not a placebo; rather it controls for the positive effects that come out of a structured social environment and group setting. The investigators hypothesized that both interventions would lead to improvement in quality of life, well-being and relief in psychiatric symptoms, with a greater effect in the Cognitive Behavioural Therapy intervention compared to recreational activity. A cumulative follow-up was made, within 5 1/2 years after the start of the treatments. Additional questions adapted to the patient group were added at this 5 1/2 year time point.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
68
The CBT intervention consisted of five elements: (a) structure, (b) group setting, (c) psycho-education, (d) social training and (e) CBT. The participants were presented with the session plan for the whole year and given a binder in which they kept all materials. In addition, each session followed a strict agenda: (1) introduction and presentation of the agenda of the day, (2) resume of homework assignments from the previous session, (3) psycho-educative lecture and discussions on the session topic, (4) coffee break with buns or sandwiches, and social interaction, (5) relaxation or mindfulness exercise, (6) discussions and exercises on the session topic, (7) distribution of homework and (8) evaluation and end of session.
The therapists did not provide any deliberate interventions, such as psychoeducation, social training or CBT. Instead, the intervention relied on structure and group setting only. During the first session the participants were asked to write down group activities they would like to engage in. The therapists created a list of the suggested activities, such as visiting museums, board game playing, cooking, restaurant visits, boating, cinema and taking walks. The participants voted for the activity of the next session.
Northern Stockholm psychiatry, St. Göran hospital
Stockholm, Sweden
The Quality of Life Inventory (QOLI, Frisch et al. 1992)
Changes in the Quality of Life Inventory from baseline.
Time frame: Baseline, after 36 sessions (1 calendar year) and at a cumulative follow-up within 5 years after treatment termination
Sense of Coherence (SoC, Antonovsky 1993)
Self-rating scale, change from baseline
Time frame: At baseline and after 36 sessions (1 calendar year)
The ten-item Rosenberg Self Esteem Scale (RSES, Rosenberg 1962)
This was used to measure self esteem, change from baseline.
Time frame: Before treatment (baseline) and after 36 sessions (1 calendar year)
The patient versions of the Clinical Global Impression scale - Severity (patient CGI-S)
Severity of impairment at baseline rated by the patient. Change from baseline.
Time frame: Before treatment and after 36 sessions (1 calendar year)
Clinical Global Impression scale - Improvement (patient CGI-I)
Patient rating on a seven-step Likert scale
Time frame: Before treatment (at baseline) and at a cumulative follow-up within 5 years after treatment termination
Autism Quotient (AQ, Baron-Cohen et al. 2001)
A 50-item screening instrument for measuring autistic traits. Change from baseline.
Time frame: At baseline and after 36 sessions (1 calendar year)
Adult ADHD Self-Report Scale (ASRS, Kessler et al. 2005)
This is for self rating scale for measuring inattention, hyperactivity and impulsivity.
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Time frame: At baseline and after 36 sessions (1 calendar year)
Beck Depression Inventory (BDI, Beck et al. 1996)
This is a 20-item questionnaire to assess depression.
Time frame: At baseline and after 36 sessions (1 calendar year)
Symptom Checklist 90 (SCL-90, Derogatis & Cleary 1977)
This is a 90-item self rating questionnaire assessing the presence and severity of various psychiatric symptoms
Time frame: At baseline and after 36 sessions (1 calendar year)