[Expectations concerning psychotherapy of high-functioning adults with autism spectrum disorders]. / Erwartungen an eine Psychotherapie von hochfunktionalen erwachsenen Personen mit einer Autismus-Spektrum-Störung.

BACKGROUND: In recent years there has been a strong increase in psychiatric diagnoses belonging to the autism spectrum in adulthood. For this diagnostic group of patients, often characterised by normal or above-average intelligence, i.e, high-functioning autism or Asperger syndrome, only few adequate psychotherapeutic treatment options exist. In order to develop a disorder-specific psychotherapeutic group training in a demand-oriented manner, we surveyed adults with autism spectrum disorders (ASD) concerning their needs and expectations relating to psychotherapy. METHODS: A two-step analysis of needs was carried out: First, after a set of open questions written descriptions of 33 individuals with ASD were analysed using the qualitative content analysis according to Mayring. The resulting category system provided the basis for the closed questionnaire EPAS ("Expectations Psychotherapy Autism Spectrum"). In a second step, 64 individuals with ASD were assessed by EPAS to confirm the relevance of the qualitatively derived dimensions. RESULTS: Both the results of the qualitative and the quantitative analysis confirmed the initial hypothesis that adults with ASD expressed problems associated with disorder-specific core symptoms. Moreover, the quantitative analysis demonstrated that in addition to deficits in social competence and identity formation, the lack of stress management skills represents a crucial load factor. Also, the therapist-associated variables were reported to play an important role for the patients. DISCUSSION: The analysis of needs indicates that psychotherapy for adults with ASD should focus on the training and development of social-communicative skills. Furthermore, dealing with stress in everyday situations and identity formation after diagnosis should also be considered. Psychotherapists can refer to well-established techniques from cognitive behavioural therapy, which are known to be effective in the identified fields and should have sufficient disorder-specific knowledge, not least in order to prevent misunderstandings within the therapeutic working relationship.

Visuospatial perspective taking in a dynamic environment: perceiving moving objects from a first-person-perspective induces a disposition to act.

Spatial perspective taking is an everyday cognitive process that is involved in predicting the outcome of goal directed behavior. We used dynamic virtual stimuli and fMRI to investigate at the neural level whether motion perception interacts with spatial perspective taking in a life-like design. Subjects were asked to perform right-left-decisions about the position of either a motionless, hovering (STATic) or a flying ball (DYNamic), either from their own (1PP) or from the perspective of a virtual character (avatar, 3PP). Our results showed a significant interaction of STIMULUS TYPE and PERSPECTIVE with significantly increased activation in right posterior intraparietal sulcus (IPS) for 1PPDYN condition. As the IPS is critically involved in the computation of object-directed action preparation, we suppose that the simple perception of potentially action-relevant dynamic objects induces a 'readiness for (re)action', restricted to the 1PP. Results are discussed against the background of current theories on embodiment and enactive perception.