Anxiety symptoms in young people with autism spectrum disorder attending special schools: Associations with gender, adaptive functioning and autism symptomatology

Abstract

Anxiety-related problems are among the most frequently reported mental health difficulties in autism spectrum disorder. As most research has focused on clinical samples or high-functioning children with autism spectrum disorder, less is known about the factors associated with anxiety in community samples across the ability range. This cross-sectional study examined the association of gender, age, adaptive functioning and autism symptom severity with different caregiver-reported anxiety symptoms. Participants were caregivers of 241 children (6-18 years old) with autism spectrum disorder attending special schools in Singapore. Measures included the Spence Children's Anxiety Scale and assessments of overall emotional, behavioural and adaptive functioning. Caregivers reported more anxiety symptoms in total, but fewer social anxiety symptoms, than Spence Children's Anxiety Scale Australian/Dutch norms. There were no gender differences. Variance in total anxiety scores was best explained by severity of repetitive speech/stereotyped behaviour symptoms, followed by adaptive functioning. Severity of repetitive speech/behaviour symptoms was a significant predictor of separation anxiety, generalized anxiety, panic/agoraphobia and obsessive-compulsive subscale symptoms, but not of social phobia and physical injury fears. Adaptive functioning and chronological age predicted social phobia and generalized anxiety symptoms only. Severity of social/communication autism symptoms did not explain any anxiety symptoms, when the other variables were controlled for. Findings are discussed in relation to the existing literature. Limitations and possible implications for prevention, assessment and intervention are also discussed.

Examining bidirectional effects between the autism spectrum disorder (ASD) core symptom domains and anxiety in children with ASD

“…In addition, the types of anxiety symptoms that are most common may differ across different developmental periods. For example, higher levels of generalized anxiety and social anxiety symptoms have been associated with an older age and higher levels of separation anxiety symptoms with a younger age in ASD samples (Magiati et al., ; van Steensel et al., ), consistent with developmental changes in the prevalence of anxiety subtypes in the general population (Copeland, Angold, Shanahan, & Costello, ; Van Oort, Greaves‐Lord, Verhulst, Ormel, & Huizink, ). This indicates the need to replicate findings across different age groups.…”

“…In addition, restricted/repetitive behavior may be a reaction to higher levels of anxiety or arousal as a coping mechanism (Rodgers, Glod, Connolly, & McConachie, 2012). Consistently, levels of anxiety have been associated with autistic social impairment (Sukhodolsky et al, 2008), social skill deficits (Bellini, 2006), repetitive and stereotyped behavior (Magiati et al, 2016;Rodgers et al, 2012), and sensory symptoms (Ben-Sasson, Carter, & Briggs-Gowan, 2009) in mostly cross-sectional studies.…”

Anxiety Disorders and Obsessive-Compulsive Disorder in Individuals with Autism Spectrum Disorder

“…Furthermore, other studies have found that only specific anxiety symptoms (e.g., generalized, separation, and panic-related worries) were associated with higher IQ in individuals with ASD [23]. A similar mixture of findings is also evident regarding the relationship of anxiety in individuals with ASD and verbal abilities [10, 26, 27]. Some evidence suggests that assessment methods (questionnaires versus interviews) contribute to the wide range of estimates, as higher prevalence rates of generalized anxiety are reported in studies that used questionnaires compared to studies that used interviews [28, 29].…”

Don't ask me what's the matter, ask me what matters: Acute mental health facility experiences of people living with autism spectrum conditions

“…() found significantly higher levels of psychiatric comorbidity in ASC populations when compared with non‐ASC populations including major mood/depressive disorders, bipolar disorder and psychosis. Particularly high comorbidity concerned multiple anxiety disorders including phobias, separation anxiety disorder, agoraphobia, social phobias, obsessive–compulsive disorder, post‐traumatic stress disorder and generalized anxiety disorders (Magiati et al., ). Mannion et al.…”

“…A meta‐analysis undertaken by Van Steensel, Bögels, and Dirksen () suggested 40% of young people with ASC met the criteria for an anxiety disorder, and Magiati et al. () suggested that people with greater ASC symptomatology that is more effected by the core features of autism are more vulnerable to anxiety‐related difficulties. The intolerance of uncertainty (IU) is defined as a broad dispositional risk factor for the development and maintenance of clinically significant anxiety (Carleton, ).…”