3 - (SYM 35) Improving Emotion Dysregulation in Autistic Adolescents and Young Adults with a Mindfulness-based Intervention: The Emotion Awareness and Skills Enhancement (EASE) Program

Background: Autistic people are four times more likely to experience emotion dysregulation, defined as difficulty managing emotions to reach one’s goals, than non-autistic peers. The Emotion Awareness and Skills Enhancement (EASE) program is a 16-week individual mindfulness-based intervention developed to improve emotion dysregulation in autistic adolescents and young adults; in a pilot study, EASE was found to be feasible, acceptable, and improved emotion dysregulation, depression, and anxiety in autistic adolescents. The current study, a multi-site randomized controlled trial comparing EASE to supportive therapy, was conducted to establish efficacy. It was hypothesized that participants who received EASE would demonstrate greater improvements in emotion dysregulation, depression, and anxiety symptoms compared to the control group.

Methods: 74 autistic adolescents and young adults (ages 12-22) were eligible and completed treatment and measures at baseline, midpoint (after session 8), and endpoint. Eligibility consisted of a confirmed autism diagnosis, full-scale IQ > 75, and a clinically elevated score for emotion dysregulation. A condition-naïve clinician rated participants on the Clinical Global Impressions Scale (CGI), and caregivers completed the Emotion Dysregulation Inventory (EDI), PROMIS depression, and PROMIS anxiety scales. The final sample included 57 males (17 females) that identified as non-Hispanic white (75.6%), non-Hispanic Black (10.8%), Asian (4.1%), Native American (5.4%), and other or missing (4.1%).

Results:

Significantly more participants who completed EASE were treatment responders (65%) compared to the active control group (31%; p=.017). While participants in both groups evidenced decreased in emotion dysregulation, participants who completed EASE had significantly steeper declines in EDI-Reactivity (p= .023) and EDI-Dysphoria (p= .029). However, there were no group-level differences in depression or anxiety.

Conclusions:

EASE is an empirically supported therapy for emotion dysregulation in autistic adolescents and adults. Emotion dysregulation decreased significantly more in participants who received EASE compared to general supportive therapy, although depression and anxiety decreased similarly regardless of therapy type. Future work will evaluate EASE and the ability to implement it in a large-scale comparative effectiveness trial in community mental health clinics.