Acceptance and commitment therapy (ACT) in an adapted form (NEUROACT) has been evaluated at Karolinska Institutet as stress management for people with an autism diagnosis.
The three studies are part of the doctoral dissertation Acceptance and Commitment Therapy for Autism Spectrum Disorder: Evaluation of feasibility, effectiveness, and validity of a novel contextual behavioral treatment.
Johan Pahnke’s dissertation
Outcomes of an acceptance and commitment therapy-based skills training group for students with high-functioning autism spectrum disorder: a quasi-experimental pilot study. Authors: Pahnke, J, Lundgren, T., Hursti, T., & Hirvikoski, T. (2014). Published in Autism: the International Journal of Research and Practice. Autism.
The study was conducted on 28 autistic adolescents and young adults in a school setting. We compared students who received NEUROACT to those who had teaching as usual. All students completed the NEUROACT training. The method proved to be valuable and suitable for the students. The results showed a statistically significant reduction in self- and teacher-experienced stress. We also observed reduced self-rated mental illness (primarily anger and depression), reduced hyperactivity and inattention, and increased self-perceived prosociality. These results were within medium to large effect size ranges (d = 0.67-0.81, 95 % CI) in the NEUROACT group compared to the control group. We did not observe effects pertaining to conduct problems, peer relation problems, or anxiety symptoms.
Acceptance and commitment therapy for autistic adults: an open pilot study in a psychiatric outpatient context. Authors: Pahnke, J., Hirvikoski, T., Bjureberg, J., Bölte, S., Jokinen, J., Bohman, B., & Lundgren, T. (2019). Published in the Journal of Contextual Behavioral Science.
The study evaluated the appropriateness and effectiveness of ACT adapted for adults on the autism spectrum (NEUROACT). The trial was an open pilot conducted on 10 adults with an autism diagnosis in outpatient psychiatry. Nine participants completed the NEUROACT program. The method proved to be useful and appropriate for adults on the autism spectrum in outpatient psychiatry. The results showed statistically significant reductions in perceived stress and depression, as well as increases in quality of life, psychological flexibility, and cognitive defusion, with small to large effect sizes. The study also indicated that participants' perceived social skills had increased. However, there was no significant improvement in anxiety and work- or family-related functioning.
Acceptance and commitment therapy for autistic adults: A randomized controlled pilot study in a psychiatric outpatient setting. Författare: Pahnke, J., Jansson-Fröjmark, M., Andersson, G., Bjureberg, J., Jokinen, J., Bohman, B., & Lundgren, T. (2022). Publicerad i Autism: The International Journal of Research and Practice.
A controlled randomized study was performed on 39 autistic adults in outpatient psychiatry. In the NEUROACT group, 85% completed the training. NEUROACT proved to be valuable and suitable for autistic adults in outpatient psychiatric care. The results showed statistically and clinically significantly improved perceived stress and quality of life (primary outcome measures) in the NEUROACT group compared with autistic adults who received regular mental health care. The results also showed a statistically significant decrease in perceived avoidance behaviors and improved perceived quality of sleep, psychological flexibility, cognitive defusion (ability to manage thoughts), and a statistical trend regarding reduced depressive symptoms compared with autistic adults receiving regular mental health care. In addition, there was a statistically significant improvement in perceived cognitive inflexibility (autistic mannerism) and a statistical trend for perceived improved social motivation. The results were within medium to large effect size ranges (d = 0.57-1.24, 95 % CI) in the NEUROACT group compared to the group that received regular care. There was no statistically significant difference or trend regarding perceived sleep-related breathing problems, fatigue during the day or awakening problems, or perceived functional level (social, work, and family-related), social awareness, social cognition, or communication compared with the control group. Intention-to-treat (ITT) analyses indicated a statistical trend for improved perceived executive functions compared with the control group.
Social Allostasis and Social Allostatic Load: A New Model for Research in Social Dynamics, Stress, and Health (Darby E. Saxbe, Lane Beckes, Sarah A. Stoycos, and James A. Coan, 2020)
Theories such as social baseline theory have argued that social groups serve a regulatory function but have not explored whether this regulatory process carries costs for the group. Allostatic load, the wear and tear on regulatory systems caused by chronic or frequent stress, is marked by diminished stress system flexibility and compromised recovery. We argue that allostatic load may develop within social groups as well and provide a model for how relationship dysfunction operates. Social allostatic load may be characterized by processes such as groups becoming locked into static patterns of interaction and may ultimately lead to up-regulation or down-regulation of a group’s set point, or the optimal range of arousal or affect around which the group tends to converge. Many studies of emotional and physiological linkage within groups have reported that highly correlated states of arousal, which may reflect failure to maintain a group-level regulatory baseline, occur in the context of stress, conflict, and relationship distress. Relationship strain may also place greater demands on neurocognitive regulatory processes. Just as allostatic load may be detrimental to individual health, social allostatic load may corrode relationship quality.