First Evidence of the Efficacy of a Novel Positive Emotion Regulation Training for Individuals with Autism Spectrum Disorder

Background: Emotional disturbances including irritability and associated comorbidities are of high prevalence in individuals with Autism Spectrum Disorder (ASD) and posit one of the main reasons why parents of children with ASD reach out for help. Over the past decade, there is mounting evidence that maladaptive emotion regulation plays a crucial role in the emergence of emotional disturbances. Moreover, despite the adaptive functions of positive emotions, none of the interventions targeting emotional disturbances in individuals with ASD had a particular focus on positive emotions.

Objectives: The goal of the present study was to develop and test the efficacy of a novel psycho-educative multi-media training that aims at increasing emotion regulation skills and positive emotions in individuals with ASD.

Methods: Twenty-nine high-functioning individuals with ASD (mean age: 17.76, SD=5.50 years, 5 females) completed three sessions of the psycho-educative positive emotion regulation training with 18 participants in the training group and 11 participants in the waitlist control group. The two groups did not differ regarding age, gender, or ASD symptom severity as assessed with the Social Responsiveness Questionnaire and the Autism Quotient. The training consisted of three individual sessions that aimed at increasing emotional awareness and the use of three adaptive emotion regulation strategies (focus on positive elements in daily lives, positive cognitive reappraisal, and positive emotional expressions) by providing theoretical background information, examples supported by multi-media elements such as animated cartoons, and interactive exercises and homework for the participants. Participants and their parents completed questionnaires on emotion reactivity, well-being, emotion regulation, alexithymia, and problematic behaviors pre- and post training. The training was delivered in person or online (with optional assistance via skype). 55.2% completed the training with in person, 17.2 via skype with assistance, and 27.65% alone.

Results: Compared to the waitlist control group which did not show changes, individuals that completed the training showed an increase in the use of the emotion regulation strategies “focus on positive” (t(17)=-2.51, p<.05) and cognitive reappraisal (t(17)=-2.35, p<.05) and as well as a decrease in negative emotions (t(17)=3.55, p<.01). Interestingly, alexithymia did not have a moderating effect on any of these findings.

Conclusions: This brief psycho-educative training shows promising effects to target emotional disturbances in individuals with ASD. This training may be useful to add to more comprehensive intervention programs targeting emotional disturbances in ASD.