4 - (SYM 35) Impact of a Transdiagnostic Group Behavioral Activation Treatment (GBAT) on Emotion Regulation Among Autistic Adults

Emotion regulation (ER) difficulties and rates of co-occurring anxiety and depression are higher among autistic adults than the general population (Conner et al., 2020; Lai et al., 2019). Thus, transdiagnostic treatments targeting internalizing problems and aspects of ER are urgently needed for autistic adults (e.g., Weiss et al., 2014). Group Behavioral Activation Treatment (GBAT; Chu et al., 2009), originally designed for non-autistic youth with depression, anxiety, or anger, is a strengths-based, transdiagnostic intervention that may be particularly well-suited for autistic adults (Bal et al., 2023).

This study aims to evaluate the feasibility of three GBAT+ versions adapted for autistic adults and preliminary ER changes after GBAT+ compared to Watchful Waiting (WW; 10-week biweekly support check-ins without GBAT).

Phase 1: GBAT+I (adding four additional individual sessions) and GBAT+E (adding new materials to increase engagement) were piloted to inform adaptations (n=10; Mage=29.2 years, 40% male, 70% White, 30% Hispanic). Phase 2: Autistic adults were randomly assigned (n=6 WW, n=5 newly recruited) to GBAT+I or GBAT+E (M_age=26.5 years, 64% male, 82% White, 9% Hispanic). Phase 3: GBAT+IE is underway (n=5; M_age=25.8 years, 20% male, 60% White, 40% Hispanic). Participants completed questionnaires and assessments at baseline, midpoint, outcome, and 6-week follow-up to assess goals and clinical symptoms. ER was measured with the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004), which has six subscales (Nonacceptance of Emotional Response, Difficulty in Goal-Directed Behavior, Impulse Control Difficulties, Lack of Emotional Awareness, Limited ER Strategies, Lack of Emotional Clarity).

Seventeen (81%) Phase 1 and 2 participants completed GBAT+; attendance was high (M=9.2 groups). Compared to WW, GBAT+ produced the most improvement in Lack of Emotional Clarity (M_diff=-1.24 (2.05), p=.02, d=.60), whereas change in Nonacceptance of Emotional Response, Difficulty in Goal-Directed Behavior and Limited ER Strategies were associated with small effects (d=.21-.30). The WW group showed a worsening of Impulse Control Difficulties (d=.71) and Lack of Emotional Awareness (d=.24); GBAT+ showed no change in these domains (d=.00-.04). Target problem severity decreased across groups.
Results suggest GBAT+ may promote improvements in ER and goal-directed behaviors in autistic adults. Associations between ER, self-reported BA, and clinical symptoms will be examined and compared across group formats (+I, +E, +IE).