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A systematic review of treatments for anxiety in youth with autism spectrum disorders.

TitleA systematic review of treatments for anxiety in youth with autism spectrum disorders.
Publication TypeJournal Article
Year of Publication2014
AuthorsVasa, RA, Carroll, LM, Nozzolillo, AA, Mahajan, R, Mazurek, MO, Bennett, AE, Wink, LK, Bernal, MPilar
JournalJournal of Autism and Developmental Disorders
Date Published2014 Dec
KeywordsAdolescent, airp, Anxiety, Child, Child Development Disorders, Pervasive, Citalopram, Clinical Trials as Topic, Cognitive Therapy, Humans, Treatment Outcome

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.


Lead Author
Roma A. Vasa

Study Aims and Objectives
To determine the efficacy of medication and alternative therapy use to treat anxiety in children with Autism Spectrum Disorder through a systematic literature review.

Methods- Sample, Procedure, Study Measures, Analysis
Investigators searched several scientific databases for articles that met inclusion criteria. Four medication trials, nine cognitive behavioral therapy, and two alternative treatment studies were selected for final review. All the medication trials were small studies and did not include a placebo control group. Nine studies were randomized control trials of cognitive behavioral therapy and one study was a non-randomized trial of cognitive behavioral therapy. Two studies were random control trials of alternative therapies.

Results- Main Findings
The medication treatment studies showed that while there were some benefits to taking medication to reduce anxiety in this population, adverse side effects limited their efficacy and use. Several of the drug trials showed that some children had an increase in negative behaviors while on the medication, which prompted many participants to discontinue medication use. 7 of the 9 non-medication randomized control trials showed that modified cognitive behavioral therapy can be effective in reducing anxiety in children with ASD. Small sample sizes and limited research into alternative therapies means that more work should be done to study the effectiveness of alternative anxiety management techniques.

Conclusion- Summary Statement
More research is needed to develop treatments for anxiety in individuals with ASD. Until this information becomes available, it is important to prescribe medications carefully. Cognitive behavioral therapy can be considered for some individuals with ASD.

Alternate JournalJ Autism Dev Disord
PubMed ID25070468
Grant ListUA3 MC 11054 / / PHS HHS / United States