Behavioural interventions to treat anxiety in adults with autism and moderate to severe intellectual disabilities: The BEAMS-ID feasibility study.

BACKGROUND: The aim of this feasibility study was to adapt and model a behavioural intervention for anxiety with autistic adults with moderate to severe intellectual disabilities. METHOD: Twenty-eight autistic adults with moderate or severe intellectual disabilities, 37 carers, and 40 therapists took part in this single-group non-randomised feasibility study designed to test intervention feasibility and acceptability, outcome measures, and research processes. RESULTS: The intervention was judged as feasible and acceptable by autistic adults with intellectual disabilities, carers, and therapists. Minor intervention revisions were suggested. Carers completed 100% of outcome measures and the missing data rate was low. Complying with legislation governing the inclusion of participants who lack capacity to decide whether they wanted to take part in this study led to an average 5-week enrolment delay. CONCLUSION: The intervention and associated study processes were judged to be feasible and acceptable and should now be tested within a larger randomised trial.

Factors affecting compliance and resistance to auditory command hallucinations: perceptions of a clinical population.

BACKGROUND: Elements of voice content and characteristics of a hallucinatory voice are considered to be associated with compliance and resistance to auditory command hallucinations. However, a need for further exploration of such features remains. AIMS: To explore the associations across different types of commands (benign, self-harm, harm-other) with a range of symptom measures and a trait measure of expressed compliance with compliance to the most recent command and command hallucinations over the previous 28 days. METHODS: Participants meeting Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria for schizophrenia or schizoaffective disorder, with auditory hallucinations in the previous 28 days were screened. Where commands were reported a full-assessment of positive symptoms, social-rank, beliefs about voices and trait compliance was completed. RESULTS: Compliance with the last self-harm command was associated with elevated voice malevolence, heightened symptom presentation and perceived consequences for non-compliance. Compliance with the last harm-other command was associated with elevated symptom severity, higher perceived consequences for non-compliance and higher levels of voice social rank. However, these associations were not maintained for compliance during the previous 28 days. CONCLUSIONS: Findings indicate the importance of identifying the content of commands, overall symptom severity and core variables associated with compliance to specific command categories. The temporal stability of established mediating variables needs further examination.

Horizontal rhythmical eye movements consistently diminish the arousal provoked by auditory stimuli.

OBJECTIVES: Theoretical models implicating the orienting reflex as an explanatory mechanism in the eye-movement desensitization and reprocessing (EMDR) treatment protocol are contrasted and tested empirically. We also test whether EMDR effects are due to a distraction effect. DESIGN: A repeated measure design is used in two experiments. The first experiment employed two independent variables, eye condition (moving vs. stationary) and tone (a pseudo-randomized series of low and high intensity tones). In Expt 2, eye condition was replaced by attentional demand conditions (low or high). In both cases, electrodermal responses served as the dependent variable. METHOD: Participants were recruited from the Psychology Department at Cardiff University. In Expt 1, participants were required to either pursue a moving stimulus following auditory challenge or engage in an eyes-stationary task. In Expt 2, the task following auditory challenge required participants to identify specific items from letter strings in low and high attentional demand conditions. RESULTS: Lower levels of electrodermal arousal were identified in tasks eliciting eye movements, compared to no eye movements. This effect was not due to the attentional requirements of the task. CONCLUSIONS: Eye movements following auditory challenge result in an effect of psychophysiological de-arousal. This supports the reassurance reflex model of EMDR proposed by MacCulloch and Feldman (1996).