There is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress. Ten groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention). Participants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program. The absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study. These findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

中文翻译：

---

改良 CBT 治疗患有自闭症谱系障碍的年轻人的社交焦虑和社交功能


迫切需要研究针对患有自闭症谱系障碍 (ASD) 的青少年和成人的有效治疗方案。社交焦虑加剧、社交功能困难和心理健康状况不佳都被确定为该群体的核心治疗目标。虽然理论模型假设社交焦虑和自闭症谱系障碍社交功能缺陷之间存在很强的双向性，但很少有干预措施同时针对这两个领域。在之前对患有自闭症谱系障碍的青少年和成人进行的两组干预中，仅在社交焦虑或社交功能方面观察到显着结果，并没有推广到整体情绪的变化。本研究的目的是评估团体认知行为疗法 (CBT) 干预对自闭症谱系障碍 (ASD) 年轻人的潜在益处、耐受性和可接受性。主要治疗结果是社交焦虑症状和社交功能困难；次要结果是自我报告的情绪和总体痛苦。十组参与者完成了为期八周、针对社交焦虑和社交功能的改良团体 CBT 干预，其中包括社交技能训练、暴露任务和行为实验部分。从社区、Headspace 中心和大脑与思维中心的自闭症诊所招募了 78 名患有自闭症谱系障碍 (ASD) 的青少年和年轻人，年龄在 16 至 38 岁之间（M = 22.77；SD = 5.31），无智力障碍。 ，悉尼大学。 通过自我报告问卷（在线或通过返回硬拷贝小册子进行）来测量干预前后的结果（社交焦虑、社交功能和情绪），并邀请参与者提供有关干预的匿名反馈（在干预的中点和结束时）。参与者在干预后的所有结果指标上都表现出了统计上的显着改善。具体而言，社交焦虑症状减少 (p < .001)，并且社交功能的特定子领域在干预后得到改善，特别是在社交动机 (p = .032) 以及限制兴趣和重复行为 (p = .025) 方面。自我报告的症状改善也适用于情绪（抑郁、焦虑和压力；p < .05）。所有改进均显示出较小的效果。参与者的反馈是积极的，表明对该计划非常满意。缺乏对照组和后续措施、依赖自我报告工具作为结果测量以及排除智力障碍者是本研究的重大局限性。这些发现表明，团体 CBT 干预似乎是对患有自闭症谱系障碍 (ASD) 的青少年和年轻人自我报告的社交焦虑、社会功能和整体心理健康的有益干预。干预措施的独立性质与积极的参与者反馈相结合表明其耐受性良好，具有潜在的临床实用性，并值得在随机对照、随访设计中进行进一步研究。