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Anxiety in Children with High-Functioning Autism Spectrum Disorders: Significant Differences and the Moderating Effects of Social Impairments

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Abstract

Anxiety disorders are one of the most common comorbid disorders in individuals with autism spectrum disorders (ASDs). Although anxiety disorders are common amongst this population, little research has investigated how anxiety disorders manifest themselves differently across varying levels of functioning in ASDs. The current study investigated the differences in anxiety symptoms between those with high-functioning autism (HFA) and Asperger’s syndrome in comparison to typically developing controls and also examined the possible moderating effect of social deficits within these groups. Individuals with HFA and Asperger’s syndrome were not found to differ in levels of anxiety and both groups had significantly greater levels of anxiety when compared to controls. Social deficits were not found to significantly moderate the relationship of diagnosis with levels of anxiety, although this approached significance. Further investigation found that social deficits were a significant moderator in those with Asperger’s syndrome but only approached significance in those with Autistic Disorder.

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References

  • Anderson, J. C., Williams, S., McGee, R., & Silva, P. A. (1987). DSM-III disorders in preadolescent children: Prevalence in a large sample from the general population. Archives of General Psychiatry, 44, 69–76.

    Article  PubMed  Google Scholar 

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Article  PubMed  Google Scholar 

  • Beitchman, J. H., Wilson, B., Johnson, C. J., Leslie, A., Adlaf, E., Escobar, M., & Douglas, L. (2001). Fourteen-year follow-up of speech/language-impaired and control children: Psychiatric outcome. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 75–82.

    Article  PubMed  Google Scholar 

  • Bellini, S. (2004). Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus on Autism and Other Developmental Disabilities, 19, 78–86.

    Article  Google Scholar 

  • Bittner, A., Egger, H. L., Erkanli, A., Costello, E. J., Foley, D. L., & Angold, A. (2007). What do childhood anxiety disorders predict? Journal of Child Psychology and Psychiatry, 48, 1174–1183.

    Article  PubMed  Google Scholar 

  • Blood, G. W., Blood, I. M., Maloney, K., Meyer, C., & Qualls, C. D. (2007). Anxiety levels in adolescents who stutter. Journal of Communication Disorders, 40, 452–469.

    Article  PubMed  Google Scholar 

  • Cantwell, D. P., & Baker, L. (1987). The prevalence of anxiety in children with communication disorders. Journal of Anxiety Disorders, 1, 239–248.

    Article  Google Scholar 

  • Chowdhury, M., Benson, B. A., & Hillier, A. (2010). Changes in restricted repetitive behaviors with age: A study of high-functioning adults with autism spectrum disorders. Research in Autism Spectrum Disorders, 4, 210–216.

    Article  Google Scholar 

  • Chiang, H. M. (2008). Expressive communication of children with autism: The use of challenging behaviour. Journal of Intellectual Disability Research, 52, 966–972.

    Article  PubMed  Google Scholar 

  • Costello, E. J., Angold, A., Burns, B. J., Erkanli, A., Stangl, D. K., & Tweed, D. L. (1996). The Great Smoky Mountains study of youth: Functional impairment and serious emotional disturbance. Archives of General Psychiatry, 53, 1137–1143.

    Article  PubMed  Google Scholar 

  • Croen, L. A., Grether, J. K., Hoogstrate, J., & Selvin, S. (2002). The changing prevalence of autism in California. Journal of Autism and Developmental Disorders, 32, 207–215.

    Article  PubMed  Google Scholar 

  • Davis, T. E., III, Fodstad, J. C., Jenkins, W., Hess, J. A., Moree, B. N., Dempsey, T., & Matson, J. L. (2010). Anxiety and avoidance in infants and toddlers with autism spectrum disorders: evidence for differing symptom severity and presentation. Research in Autism Spectrum Disorders, 4, 305–313.

    Article  Google Scholar 

  • Davis, T. E., III, Hess, J. A., Moree, B. N., Fodstad, J. C., Dempsey, T., Jenkins, W., & Matson, J. L. (2010). Anxiety symptoms across the lifespan in people with autistic disorder. Research in Autism Spectrum Disorders, 5, 112–118.

    Article  Google Scholar 

  • Davis, T. E., III, Hess, J. A., Matthews, R. A., Fodstad, J. C., Dempsey, T., Jenkins, W. S., & Matson, J. L. (2011). The moderating effect of anxiety on development in atypically developing toddlers. Journal of Psychopathology and Behavior Assessment, 33, 171–177.

    Article  Google Scholar 

  • Davis, T. E., III, Moree, B. N., Dempsey, T., Reuther, E. T., Fodstad, J. C., Hess, J. A., & Matson, J. L. (2011). The relationship between autism spectrum disorders and anxiety: The moderating effect of communication. Research in Autism Spectrum Disorders, 5, 324–329.

    Article  Google Scholar 

  • Davis, T. E., III, Ollendick, T. H., & Nebel-Schwalm, M. (2008). Intellectual ability and achievement in anxiety-disordered children: a clarification and extension of the literature. Journal of Psychopathology and Behavioral Assessment, 30, 43–51.

    Article  Google Scholar 

  • De Bruin, E. L., Ferdiand, R. F., Meester, S., de Nijs, F. A., & Verheij, F. (2007). Higher rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37, 877–886.

    Article  PubMed  Google Scholar 

  • Duffy, C., & Healy, O. (2011). Spontaneous communication in autism spectrum disorder: A review of topographies and intervention. Research in Autism Spectrum Disorders, 5, 977–983.

    Article  Google Scholar 

  • Field, A. P. (2009). Discovering statistics using SPSS (3rd ed.). Los Angeles: SAGE Publications.

    Google Scholar 

  • Fodstad, J. C., Matson, J. L., Hess, J. A., & Neal, D. (2009). Social and communication behaviours in infants and toddlers with autism and pervasive developmental disorder-not otherwise specified. Developmental Neurorehabilitation, 12, 152–157.

    Article  PubMed  Google Scholar 

  • Fombonne, E. (1999). The epidemiology of autism: A review. Psychological Medicine, 29, 769–786.

    Article  PubMed  Google Scholar 

  • Evans, D., Canavera, K., Kleinpeter, F., Maccubbin, E., & Taga, K. (2005). The fears, phobias, and anxieties of children with autism spectrum disorders and down syndrome: Comparisons with developmentally and chronologically age matched children. Child Psychiatry and Human Development, 36, 3–26.

    Article  PubMed  Google Scholar 

  • Ghaziuddin, M. (2010). Brief Report: Should the DSM V drop Asperger syndrome? Journal of Autism and Developmental Disorders, 40, 1146–1148.

    Article  PubMed  Google Scholar 

  • Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high functioning children with autism. Autism, 5, 277–286.

    Article  PubMed  Google Scholar 

  • Howlin, P. (2003). Outcome in high-functioning adults with autism with and without early language delays: implications for the differentiation between autism and asperger syndrome. Journal of Autism and Developmental Disorders, 33, 3–3.

    Article  PubMed  Google Scholar 

  • Kanner, L. (1943). Autistic disturbances of affective contact. The Nervous Child, 2, 217–250.

    Google Scholar 

  • Klein, R. G., & Pine, D. S. (2002). Anxiety disorders. In M. Rutter & E. Taylor (Eds.), Child and adolescent psychiatry: modern approaches (4th ed., pp. 486–509). Cambridge, MA: Blackwell Science.

    Google Scholar 

  • Kuusikko, S., Pollock-Wurman, R., Jussila, K., Carter, A. S., Mattila, M., Ebeling, H., & Moilanen, I. (2008). Social anxiety in high-functioning children and adolescents with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 38, 1697–1709.

    Article  PubMed  Google Scholar 

  • Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36, 849–861.

    Article  PubMed  Google Scholar 

  • Lord, C., & Risi, S. (1998). Frameworks and methods in diagnosing autism spectrum disorders. Mental Retardation and Developmental Disabilities Research Reviews, 4, 90–96.

    Article  Google Scholar 

  • Lord, C., Rutter, M., & LeCouteur, A. (1994). Autism Diagnostic Interview-Revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–686.

    Article  PubMed  Google Scholar 

  • Loukusa, S., & Moilanen, I. (2009). Pragmatic inference abilities in individuals with Asperger syndrome or high-functioning autism: A review. Research in Autism Spectrum Disorders, 3, 890–904.

    Article  Google Scholar 

  • Matson, J. L. (2007). Current status of differential diagnosis for children with autism spectrum disorders. Research in Developmental Disabilities, 28, 109–118.

    Article  PubMed  Google Scholar 

  • Matson, J. L., Baglio, C. S., Smiroldo, B. B., Hamilton, M., Packlowskyj, T., Williams, D., et al. (1996). Characteristics of autism as assessed by the Diagnostic Assessment for the Severely Handicapped-II (DASH-II). Research in Developmental Disabilities, 17, 135–143.

    Article  PubMed  Google Scholar 

  • Matson, J. L., & Boisjoli, J. A. (2007). Differential diagnosis of PDDNOS in children. Research in Autism Spectrum Disorders, 1, 75–84.

    Article  Google Scholar 

  • Matson, J. L., & Boisjoli, J. A. (2008). Strategies for assessing Asperger’s syndrome: A critical review of data based methods. Research in Autism Spectrum Disorders, 2, 237–248.

    Article  Google Scholar 

  • Matson, J. L., & Boisjoli, J. A. (2009). Factor structure of the Autism Spectrum Disorders-Diagnostic for Children (ASD-DC). Journal of Developmental and Physical Disabilities, 21, 195–211.

    Article  Google Scholar 

  • Matson, J. L., Boisjoli, J. A., & Dempsey, T. (2009). Factor structure of the Autism Spectrum Disorders-Diagnostic for Children (ASD-DC). Journal of Developmental and Physical Disabilities, 21, 195–211.

    Article  Google Scholar 

  • Matson, J. L., Carlisle, C. B., & Bamburg, J. W. (1998). The convergent validity of the Matson Evaluation of Social Skills for Individuals with Severe Retardation (MESSIER). Research in Developmental Disabilities, 19, 493–500.

    Article  PubMed  Google Scholar 

  • Matson, J. L., & González, M. (2007a). Autism Spectrum Disorder-Comorbid for Children. Baton Rouge, LA: Disability Consultants, LLC.

    Google Scholar 

  • Matson, J. L., & González, M. (2007b). Autism Spectrum Disorder-Diagnostic for Children. Baton Rouge, LA: Disability Consultants, LLC.

    Google Scholar 

  • Matson, J. L., González, M., & Wilkins, J. (2009). Validity study of the Autism Spectrum Disorders-Diagnostic for Children (ASD-DC). Research in Autism Spectrum Disorders, 3, 196–206.

    Article  Google Scholar 

  • Matson, J. L., González, M., Wilkins, J., & Rivet, T. T. (2008). Reliability of the Autism Spectrum Disorders-Diagnostic for Children (ASD-DC). Research in Autism Spectrum Disorders, 2, 696–706.

    Article  Google Scholar 

  • Matson, J. L., Hess, J. A., Mahan, S., & Fodstad, J. C. (2010). Convergent validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC) and Autism Diagnostic Interview-Revised (ADI-R). Research in Autism Spectrum Disorders, 4, 741–745.

    Article  Google Scholar 

  • Matson, J. L., & Love, S. R. (1990). A comparison of parent reported fear for autistic and non-handicapped age-matched children and youth. Australia and New Zealand Journal of Developmental Disabilities, 16, 257–349.

    Google Scholar 

  • Matson, J. L., & LoVullo, S. V. (2009). Trends and topics in autism spectrum disorders research. Research in Autism Spectrum Disorders, 3, 252–257.

    Article  Google Scholar 

  • Matson, J. L., LoVullo, S. V., Rivet, T. T., & Boisjoli, J. A. (2009). Validity of the Autism Spectrum Disorder—Comorbid for Children (ASD-CC). Research in Autism Spectrum Disorders, 3, 345–357.

    Article  Google Scholar 

  • Matson, J. L., Mahan, S., Hess, J. A., Fodstad, J. C., & Neal, D. (2010). Convergent validity of the Autism Spectrum Disorder-Diagnostic for Children (ASD-DC) and Childhood Autism Rating Scale (CARS). Research in Autism Spectrum Disorders, 4, 633–638.

    Article  Google Scholar 

  • Matson, J. L., & Wilkins, J. (2008a). Nosology and diagnosis of Asperger’s syndrome. Research in Autism Spectrum Disorders, 2, 288–300.

    Article  Google Scholar 

  • Matson, J. L., & Wilkins, J. (2008b). Reliability of the Autism Spectrum Disorders—Comorbid for Children (ASD-CC). Journal of Developmental and Physical Disabilities, 20, 327–336.

    Article  Google Scholar 

  • Pinborough-Zimmerman, J., Satterfield, R., Miller, J., Bilder, D., Hossain, S., & McMahon, W. (2007). Communication disorders: Prevalence and comorbid intellectual disability, autism, and emotional/behavioral disorders. American Journal of Speech-Language Pathology, 16, 359–367.

    Article  PubMed  Google Scholar 

  • Reynolds, C. R., & Kamphaus, R. W. (2004). Behavioral assessment system for children manual (2nd ed.). Circle Pines, MN: AGS Publishing.

    Google Scholar 

  • Schopler, E., Reichler, R. J., & Rochen-Renner, B. R. (1988). The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services.

    Google Scholar 

  • Sevin, J. A., Matson, J. L., Coe, D., Love, S. R., Matese, M., & Benavidez, D. A. (1995). Empirically derived subtypes of pervasive developmental disorder. Journal of Autism and Developmental Disorders, 25, 561–578.

    Article  PubMed  Google Scholar 

  • Silverman, W., & Ollendick, T. H. (2008). Child and adolescent anxiety disorders. In J. Hunsley & E. J. Mash (Eds.), A Guide to Assessments that Work (pp. 181–206). New York, NY: Oxford University Press.

    Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929.

    Article  PubMed  Google Scholar 

  • Sipes, M., Matson, J. L., Worley, J. A., & Kozlowski, A. M. (2011). Gender differences in symptoms of autism spectrum disorders in toddlers. Research in Autism Spectrum Disorders, 5, 1465–1470.

    Article  Google Scholar 

  • Stella, J., Mundy, P., & Tuchman, R. (1999). Social and nonsocial factors in Childhood Autism Rating Scale. Journal of Autism and Developmental Disorders, 29, 307–317.

    Article  PubMed  Google Scholar 

  • Szatmari, P. (1992). The validity of autistic spectrum disorders: A literature review. Journal of Autism and Developmental Disorders, 22, 583–600.

    Article  PubMed  Google Scholar 

  • Thorson, R. T., & Matson, J. L. (2012). Cutoff scores for the Autism Spectrum Disorder—Comorbid for Children (ASD-CC). Research in Autism Spectrum Disorders, 6, 556–559.

    Article  Google Scholar 

  • Tsai, L. (1996). Brief report: Comorbid psychiatric disorders of autistic disorder. Journal of Autism and Developmental Disabilities, 26, 159–163.

    Article  Google Scholar 

  • Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 477–496.

    Article  PubMed  Google Scholar 

  • White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229.

    Article  PubMed  Google Scholar 

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Rieske, R.D., Matson, J.L., May, A.C. et al. Anxiety in Children with High-Functioning Autism Spectrum Disorders: Significant Differences and the Moderating Effects of Social Impairments. J Dev Phys Disabil 24, 167–180 (2012). https://doi.org/10.1007/s10882-011-9264-y

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