Exploring the Association Between Cognitive Functioning and Anxiety in Children With Autism Spectrum Disorders: The Role of Social Understanding and Aggression

Abstract

This study examined relations between anxiety, aggression, social understanding, IQ, and diagnosis in a sample of 231 children (ages 2-9) diagnosed with Autism Spectrum Disorders (ASDs; Autistic Disorder, Asperger's Disorder, Pervasive Developmental Disorder Not Otherwise Specified) in a hospital setting. Children were administered tests of IQ, and parents completed measures of remaining variables. ASD diagnosis was associated with level of anxiety, and level of IQ explained this relation. IQ was significantly and positively associated with anxiety. Tests of a developmental model to explain the relation between IQ and anxiety showed that social understanding and aggression mediated the relation for toddlers. For preschool- and early elementary school-aged children, respectively, three-way interactions between IQ, social understanding, and aggression predicted anxiety, and graphs of the interactions suggest that the association between IQ and anxiety is increasingly driven by either aggression or social understanding over the course of childhood.

An Examination of the Relationship of Anxiety and Intelligence to Adaptive Functioning in Children with Chromosome 22q11.2 Deletion Syndrome

“…Few studies have looked at the relationship between anxiety and adaptive function, with high anxiety related to lower IQ in typical populations [27], but this is not the case in some developmental disorders such as autism, where higher anxiety is found in those with high IQ [28]. Our findings indicate that in 22q11.2DS, anxiety may affect individuals across all levels of cognition, thereby suggesting other modulatory factors such as environmental demands.…”

Decreased aggression and increased repetitive behavior in Pten haploinsufficient mice

“…This suggests that the direction of effect for dysregulation of aggression may be species specific. Alternatively, the difference may relate to a qualitative difference in aggression toward a stranger as opposed to a familiar individual: the resident–intruder assay measures the aggressive (and other) behavioral response to an intruder entering the home cage of the resident, whereas the majority of reports of increased aggression in ASD are toward teachers and/or caregivers (e.g., Hartley et al ; Lecavalier ; Lecavalier et al ; Maskey et al ) or unspecified targets (e.g., Holden & Gitlesen ; McDougle et al ; Niditch et al ; Robb ). Some studies have found that the presence of a stranger leads to minimal social interaction (Hobson & Lee ; Lord ) and increased stereotypic, repetitive behavior (Hutt & Hutt ), which is consistent with our current findings that Pten +/− mice showed decreased social interaction and aggressive behavior and increased repetitive behavior.…”

“…Notably, male Pten +/− mice were less anxious than their Pten +/+ littermates (Clipperton‐Allen & Page ). Aggression has been associated with anxiety in humans with (e.g., Niditch et al ; Pugliese et al ) and without ASD (e.g., Frick et al ; Hatfield & Dula ; Marsee et al ; Sareen et al ; Tsiouris et al ), and it has previously been suggested that more aggressive male mice may also be more anxious (Ferrari et al ; Guillot & Chapouthier ).…”

The Association Between Social Cognition and Executive Functioning and Symptoms of Anxiety and Depression in Adolescents With Autism Spectrum Disorders

“…Specifically, participants with both high and low levels of empathy had lower levels of self‐reported anxiety symptoms [Bellini, ]. In contrast, Niditch, Varela, Kamps, and Hill [ ] examined the relationship between social understanding and anxiety in a large group of children with an ASD (n = 231), both measured via the parent rating scale from the Behavior Assessment System for Children‐2 [Reynolds & Kamphaus, ]. Results indicated that greater social understanding was significantly correlated with higher anxiety [Niditch et al., ].…”