A Review of Behavioral Interventions for Anxiety‐Related Behaviors in Lower‐Functioning Individuals with Autism

Anxiety is highly prevalent in persons with autism and affects individuals with higher‐functioning autism (HFA) and lower‐functioning autism (LFA). Although there is emerging support for the efficacy of cognitive‐behavioral therapy (CBT) in treating anxiety in autism, these findings are largely based on HFA samples. Moreover, CBT may be inappropriate for individuals with LFA who may struggle to grasp the cognitive components of the therapy because of their more limited verbal abilities. Behavior analytic interventions may be better suited to treat anxiety in this population; however, the quantity and quality of the extant literature have yet to be reviewed. Toward this end, the extant behavioral intervention literature was reviewed. Seven studies met the inclusion criteria and were evaluated against quality indicators for within‐subject design research. Next, the efficacy of each treatment component was assessed using established criteria for defining empirically supported therapies. Results revealed behavioral interventions to be efficacious, with desensitization and reinforcement emerging as efficacious treatment components, while prompting, modeling, and antianxiety stimuli were established as possibly efficacious. However, given that some of the quality indicators were not met, these results should be interpreted with some caution. Additional research is needed to form a more conclusive evidence base for the treatment of anxiety in individuals with LFA. Copyright © 2016 John Wiley & Sons, Ltd.     

The Relation of Exposure to Traumatic Events and Longitudinal Mental Health Outcomes for Children Enrolled in Systems of Care: Results from a National System of Care Evaluation

This study examined the relation between children's history of exposure to potentially traumatic events (PTEs) and clinical and functional mental health trajectories over a 18‐month period among a national sample of youth referred for services in children's behavioral health systems of care (SOCs). Using data from the national evaluation of the Comprehensive Community Mental Health Services program for communities funded from 1997 to 2000, the study sample included 9556 children and their families. Latent growth modeling was used to assess the effect of history of exposure to PTEs on trajectories in a number of behavioral health outcomes during the 3‐year period following referral to services, controlling for child demographic characteristics (gender, race, and age). Results revealed that, on average, children in SOCs exhibited significant improvements over time on all four outcome measures. Children with a history of exposure to PTEs had higher rates of internalizing and externalizing problem behaviors and functional impairments and fewer behavioral and emotional strengths at baseline, but experienced improvements in these outcomes at the same rates as children without exposure to a traumatic event. Finally, child race, gender, and age also were associated with differences in behavioral health trajectories among service recipients. Implications for SOCs, including approaches to make them more trauma‐informed, are discussed.     

Representing object colour in language comprehension

Embodied theories of cognition hold that mentally representing something red engages the neural subsystems that respond to environmental perception of that colour. This paper examines whether implicit perceptual information on object colour is represented during sentence comprehension even though doing so does not necessarily facilitate task performance. After reading a sentence that implied a particular colour for a given object, participants were presented with a picture of the object that either matched or mismatched the implied colour. When asked if the pictured object was mentioned in the preceding sentence, people's responses were faster when the colours mismatched than when they matched, suggesting that object colour is represented differently to other object properties such as shape and orientation. A distinction between stable and unstable embodied representations is proposed to allow embodied theories to account for these findings.     

Associations of teacher credibility and teacher affinity with learning outcomes in health classrooms

In the present study (N = 633), we examine the role of teacher credibility and teacher affinity in classrooms. We explore the relations among these two characteristics and student gains in knowledge and valuing of learning about HIV and pregnancy prevention across high school classrooms. Results marshaled support for the notion that teacher characteristics are associated with classroom-level gains in learning outcomes. Above and beyond student-level predictors, teacher credibility (aggregated to the classroom level) was positively related to increases in knowledge across classrooms, whereas aggregated teacher affinity was positively related to an increased valuing of learning about HIV and pregnancy prevention across classrooms. Future directions and implications for practice are discussed.     

The Citizenship Project Part II: Impact of a Citizenship Intervention on Clinical and Community Outcomes for Persons with Mental Illness and Criminal Justice Involvement

This study assessed the effectiveness of an intervention based on a theoretical framework of citizenship on reducing psychiatric symptoms, alcohol use, and drug use, and increasing quality of life for persons with serious mental illness (SMI) and criminal justice involvement. One-hundred fourteen adults with SMI and a history of criminal justice involvement participated in a 2 × 3 longitudinal randomized controlled trial of a four-month citizenship intervention versus usual services. Linear mixed model analyses were used to assess the intervention’s impact on quality of life, symptoms, and substance use. After controlling for baseline covariates, participants in the experimental condition reported significantly increased quality of life, greater satisfaction with and amount of activity, higher satisfaction with work, and reduced alcohol and drug use over time. However, individuals in the experimental condition also reported increased anxiety/depression and agitation at 6 months (but not 12 months) and significantly increased negative symptoms at 12 months. Findings suggest that community-oriented, citizenship interventions for persons with SMI and criminal justice histories may facilitate improved clinical and community outcomes in some domains, but some negative clinical findings suggest the need for post-intervention support for intervention participants. Implications for practice and future research are discussed.     

Adolescent suicidal behavior and popular self-report instruments of depression, social desirability, and anxiety

Popular self-report inventories of depression, hopelessness, social desirability, and anxiety, along with the Suicidal Behaviors Questionnaire, were completed by 150 college students. Tanaka-Matsumi and Kameoka (1986) had questioned the use of popular depression instruments in the assessment of this population, due to the high correlation between depression, anxiety, and social desirability scales. The present experiment also found significant correlations between the self-report instruments and suicidal behaviors. These findings may be due to the fact that anxiety and depression are often found together in clinical settings, and that the content of depression and anxiety scales is not specific to those constructs.     

Consistency and inconsistency in infant emotional and social interactive behavior across contexts and caregivers

This study examined consistency in infant emotional and social interactive behavior in stressful and nonstressful situations with mothers and fathers. Infants were seen at 12 and 13 months, once with each parent. Emotion was assessed during free play and the Strange Situation. Strange Situation social interactive behaviors were also examined. Results demonstrated that (a) proximity seeking and contact maintaining are consistent cross-parent, (b) emotion is more consistent from free play to the Strange Situation with the father than with the mother, and (c) emotion is primarily consistent cross-parent within the Strange Situation, not in free play. These results suggest both infant- and relationship-based determinants of behavior within the Strange Situation. The greater cross-context consistency in infant emotion with the father is interpreted as supportive of the view that infant—father interactions reflect primarily affiliative, rather than attachment, relationships.