Comorbid Social Anxiety Disorder in Adults with Autism Spectrum Disorder

Abstract

Social anxiety symptoms are common among cognitively unimpaired youth with autism spectrum disorder (ASD). Few studies have investigated the co-occurrence of social anxiety disorder (SAD) in adults with ASD, although identification may aid access to effective treatments and inform our scientific efforts to parse heterogeneity. In this preliminary study, we examined the clinical presentation of SAD in adults with ASD (n = 28), relative to SAD uncomplicated by ASD (n = 26). A large subset (50 %) of the adults with ASD met diagnostic criteria for SAD. The adults with ASD plus SAD differed from those with ASD without SAD on several characteristics. Findings demonstrate that many adults with ASD are aware of their social difficulties and experience impairing social anxiety.

Social anxiety in adult males with autism spectrum disorders

“…: Sheehan et al, 1998), as well as the LSAS. Finally, Maddox and White (2015) investigated SAD in three adult samples; individuals with ASD (n=28), individuals with SAD but no ASD (n=26), and non-clinical controls (n=25). Using self-report questionnaires and an objective assessment of anxiety, their findings indicated that 50% of individuals with ASD presented with clinically significant SAD as measured by the Anxiety Disorders Interview Schedule (ADIS-IV: Brown et al, 1994), and the Social Interaction Anxiety Scale (SIAS: Mattick and Clarke, 1998).…”

“…Berthoz and Hill, Social anxiety in adults with ASD 5 2005;Cadman et al, 2015), commonly used social anxiety measures are yet to be validated for the ASD population. Use of multiple measures that focus on a range of behavioural, cognitive and affective characteristics associated with social anxiety may therefore enhance the screening and assessment process (Kreiser and White, 2014;Maddox and White, 2015;Tyson and Cruess, 2012).…”

“…The Brief Fear of Negative Evaluation Scale (Brief FNE: Leary, 1983), used in one previous ASD study (Maddox and White, 2015), is a self-report questionnaire rating the strength of belief in cognitions associated with social anxiety, for example "When I am talking to someone, I worry about what they may be thinking of me". Items are rated on a five point Likert-scale.…”

“…The Social Interaction Anxiety Scale (SIAS: Mattick and Clarke, 1998) is a 20 item self-report questionnaire rating behavioural, affective and cognitive responses during social interaction, for example "I feel tense if I am alone with just one person [and] when mixing socially, I feel uncomfortable". The SPS and SIAS are typically administered together, although in one recent ASD study, the SIAS was used in isolation (Maddox and White, 2015). Items for both questionnaires are rated on a five point Likert-scale.…”

Recent progress in understanding skills and impairments in social cognition

“…Anxiety, especially SAD, is very common in ASD and may exacerbate sociocognitive difficulties. Maddox and White [53] compared SAD symptoms in comorbid ASD þ SAD (N ¼ 14) vs. ASD-SAD (N ¼ 14) and SAD alone (N ¼ 26). Half the ASD sample met criteria for SAD, with significantly more ASD women (69%) than men affected (33%).…”