Symptoms of autism spectrum disorder (ASD) were assessed (Social Responsiveness Scale-Parent (SRS-P); coded in-session behavior) in typically-developing, anxiety-disordered children (N = 50) treated with cognitive-behavioral therapy (CBT). Study 1: children with moderate autistic symptomology (per SRS-P) were significantly more likely to improve from family CBT (FCBT) than individual CBT (ICBT; OR = 8.67). Coded behavior did not predict outcome. Study 2: CBT components were compared by treatment and ASD symptom status. At-home exposure completion was greater in FCBT and there was an interaction in child involvement for treatment and ASD status. Though both treatments reduced anxiety, FCBT outperformed ICBT for children with moderate ASD symptoms, a benefit potentially linked to more at-home exposures and greater child involvement in FCBT.

Synopsis CBT represents a combination of behavioral and cognitive theories of human behavior and psychopathology, and a melding of emotional, familial, and peer influences. The numerous intervention strategies that comprise CBT reflect its complex and integrative nature and include such topics as extinction, habituation, modeling, cognitive restructuring, problem-solving, and the development of coping strategies, mastery, and a sense of self-control. CBT targets multiple areas of potential vulnerability (e.g., cognitive, behavioral, affective) with developmentally-guided strategies and traverses multiple intervention pathways. Although CBT is often considered the “first line treatment” for many psychological disorders in youth, additional work is necessary to address treatment non-responders and to facilitate the dissemination of efficacious CBT approaches.

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Evidence is mixed regarding an independent association between anxiety and suicidality in youth. Study 1 examined suicidal ideation in treatment-referred, anxiety-disordered youth (N = 312, aged 7-17). Forty-one percent of anxiety-disordered youth endorsed suicidal ideation. Anxiety disorder severity, global impairment, and current depressive symptoms predicted suicidal ideation in a multivariate model. Study 2 compared youth (N = 216, aged 7-14) with and without anxiety disorders. Higher rates of suicidal ideation were associated with anxiety diagnosis, and levels of anxiety predicted suicidal ideation after controlling for comorbid depressive disorders, current depressive symptoms, and global impairment. Results support an association between anxiety disorders and suicidal ideation in treatment-referred youth and recommend routine screening for suicidal ideation in this population.