Does Treatment Stigma among Adolescents with Autistic Spectrum Disorder and Their Guardians Affect the Effectiveness of Cognitive Behavioral Therapy? A Secondary Analysis of a Randomized Controlled Trial

Abstract

This study explored the effect of treatment stigma on the intervention effects of cognitive behavioral therapy (CBT) on adolescents with autism spectrum disorder (ASD) and their guardians. Secondary analyses were conducted using data from a randomized controlled trial, and only the intervention group (adolescents with ASD [n=23; 16 boys and 7 girls; mean age=12.8±2.2 years] and their guardians [n=23; 22 women and 1 man; mean age=44.8±6.1 years]) was used. We used the Japanese version of the Barriers to Access to Care Evaluation scale version 3 (BACEv3) to assess treatment stigma. Correlations between the BACEv3 scores at pre-intervention and the difference scores for pre-to-post-intervention in each measure were analyzed using Spearman’s rank correlation coefficient. Adolescents’ BACEv3 scores at pre-intervention were not correlated with difference scores in any measure. However, guardians’ BACEv3 scores at pre-intervention demonstrated a significant positive correlation with adolescents’ knowledge of ASD and a significant negative correlation with the communication of adaptive behaviors. Interventions through CBT are expected to be somewhat effective, regardless of adolescents’ or their guardians’ pre-treatment stigma. Further research is required to clarify whether treatment stigma in adolescents with ASD and their guardians affects CBT intervention effectiveness.