Abstract
Individuals with autism spectrum disorder (ASD) experience high levels of anxiety symptomatology with an estimated prevalence rate of anxiety disorders as high as 40 %. It is likely that anxiety is prominent in individuals with ASD throughout the life-span and that factors such as age, IQ, and ASD symptoms may influence the rates, symptoms, or anxiety subtypes. The high comorbidity rate of anxiety in ASD is likely to be explained by ASD deficits that make the individual more prone to develop anxiety disorders; however, diagnostic overlap may also partly explain the high rates of anxiety. In addition, there is some limited evidence that the same risk factors identified in the development and maintenance of anxiety disorders in typically developing children may also play a role in youth with ASD. Self-reports as well as other informant reports, physiological measures, and direct observations are likely to be useful in assessing anxiety in ASD. To date, cognitive-behavioral therapy appears to hold the most evidence in treating anxiety in individuals with ASD. Other psychosocial interventions (including mindfulness-based and social-recreational interventions) may also be considered, although evidence has only recently began to emerge and more work is needed to understand which ASD-specific modifications or adaptations are likely to be most helpful.
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References
American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-IV-TR). Washington, DC: American Psychiatric Association; 2000.
Anderson S, Morris J. Cognitive behaviour therapy for people with Asperger syndrome. Behav Cogn Psychother. 2006;34:293–303.
Bellini S. Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus Autism Other Dev Disabil. 2004;19:78–86.
Blakeley-Smith A, Reaven J, Ridge K, Hepburn S. Parent–child agreement of anxiety symptoms in youth with autism spectrum disorders. Res Autism Spectr Disord. 2012;6:707–16.
Bögels SM, Brechman-Toussaint ML. Family issues in child anxiety: attachment, family functioning, parental rearing and beliefs. Clin Psychol Rev. 2006;26:834–56.
Bögels SM, Siqueland L. Family cognitive behavioral therapy for children and adolescents with clinical anxiety disorders. J Am Acad Child Adolsc Psychiatry. 2006;45:134–41.
Bögels SM, Hoogstad BH, van Dun L, de Schutter S, Restifo K. Mindfulness training for adolescents with externalizing disorders and their parents. Behav Cogn Psychother. 2008;36:193–209.
Buitelaar JK, van der Gaag RJ, van der Hoeven J. Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: results of an open-label study. J Clin Psychiatry. 1998;59:56–9.
Cardaciotto L, Herbert JD. Cognitive behavior therapy for social anxiety disorder in the context of Asperger’s syndrome: a single-subject report. Cogn Behav Pract. 2004;11:75–81.
Caron C, Rutter M. Comorbidity in child psychopathology; concepts, issues and research strategies. J Child Psychol Psychiatry. 1991;32:1063–80.
Chalfant AM. Managing anxiety in people with autism: a treatment guide for parents, teachers, and mental health professionals. Betheseda: Woodbine House; 2011.
Chalfant AM, Rapee R, Caroll L. Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial. J Autism Dev Disord. 2007;37:1842–57.
Chok JT, Demanche J, Kennedy A, Studer L. Utilizing physiological measures to facilitate phobia treatment with individuals with autism and intellectual disability: a case study. Behav Interv. 2010;25:325–37.
Costello EJ, Egger HL, Angold A. The developmental epidemiology of anxiety disorders: phenomenology, prevalence, and comorbidity. Child Adolesc Psychiatr Clin N Am. 2005;14:631–48.
Davis III TE, Hess JA, Moree BN, et al. Anxiety symptoms across the lifespan in people diagnosed with autistic disorder. Res Autism Spectr Disord. 2011;5:112–8.
Davis III TE, Moree BN, Demspey T, et al. The effect of communication deficits on anxiety symptoms in infants and toddlers with autism spectrum disorders. Behav Ther. 2012;43:142–52.
Drahota A, Wood JJ, Sze KM, van Dyke M. Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders. J Autism Dev Disord. 2011;41:257–65.
Evans DW, Canavera K, Kleinpeter FL, Maccubbin E, Taga K. The fears, phobias and anxieties of children with autism spectrum disorders and down syndrome: comparisons with developmental and chronologically age matched children. Child Psychiatry Hum Dev. 2005;36:3–26.
Farrugia S, Hudson J. Anxiety in adolescents with Asperger syndrome: negative thoughts, behavioral problems, and life interference. Focus Autism Other Dev Disabil. 2006;21:25–35.
Gadow KD, Roohi J, DeVincent CJ, Hatchwell E. Association of ADHD, tics, and anxiety with dopamine transporter (DAT1) genotype in autism spectrum disorder. J Child Psychol Psychiatry. 2008;49:1331–8.
Gaus V. Cognitive behavioral therapy for adult Asperger syndrome. New York: The Guildford; 2007.
Ghaziuddin M. Mental health aspects of autism and Asperger syndrome. London: Jessica Kingsley; 2005.
Gillott A, Standen PJ. Levels of anxiety and sources of stress in adults with autism. J Intellect Disabil. 2007;11:359–70.
Green SA, Ben-Sasson A. Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: is there a causal relationship? J Autism Dev Disord. 2010;40:1495–504.
Gregory AM, Eley TC. Genetic influences on anxiety in children: what we’ve learned and where we’re heading. Clin Child Fam Psychol Rev. 2007;10:199–212.
Hagopian LP, Jennett HK. Behavioral assessment and treatment of anxiety in individuals with intellectual disabilities and autism. J Dev Phys Disabil. 2008;20:467–83.
Helverschou SB, Martinsen H. Anxiety in people diagnosed with autism and intellectual disability: recognition and phenomenology. Res Autism Spectr Disord. 2011;5:377–87.
Hermans H, van der Pas FH, Evenhuis HM. Instruments assessing anxiety in adults with intellectual disabilities: a systematic review. Res Dev Disabil. 2011;32:861–70.
Hofvander B, Delorme R, Chaste P, et al. Psychiatric and psychosocial problems in adults with normal-intelligence autism spectrum disorders. BMC Psychiatry. 2009;9:35–44.
Jennett HK, Hagopian LP. Identifying empirically supported treatments for phobic avoidance in individuals with intellectual disabilities. Behav Ther. 2008;39:151–61.
Kanner L. Autistic disturbances of affective contact. Nerv Child. 1943;2:217–50.
Kelly AB, Garnett MS, Attwood T, Peterson C. Autism spectrum symptomatology in children: the impact of family and peer relationships. J Abnorm Child Psychol. 2008;36:1069–81.
Kuusikko S, Pollock-Wurman R, Jussila K, et al. Social anxiety in high-functioning children and adolescents with autism and Asperger syndrome. J Autism Dev Disord. 2008;38:1697–709.
Lang R, Regester A, Lauderdale S, Ashbaugh K, Haring A. Treatment of anxiety in autism spectrum disorders using cognitive behavior therapy: a systematic review. Dev Neurorehabil. 2010;13:53–63.
Lecavalier L. Behavioral and emotional problems in young people with pervasive developmental disorders: relative prevalence, effects of subject characteristics and empirical classification. J Autism Dev Disord. 2006;36:1101–14.
Leyfer OT, Folstein SE, Bacalman S, et al. Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. J Autism Dev Disord. 2006;36:849–61.
MacNeil BM, Lopes VA, Minnes PM. Anxiety in children and adolescents with autism spectrum disorders. Res Autism Spectr Disord. 2009;3:1–21.
Magiati I, Patrycia F, Tan JWL, Sung M, Fung D, Poon K. Using the Spence Children’s Anxiety Scale (SCAS) and the Developmental Behavior Checklist (DBC) to measure anxiety in children and youth with ASD. (in preparation).
Matson JL, González ML. Autism spectrum disorders – comorbidity – child version. Baton Rouge: Disability Consultants; 2007.
Matson JL, Boisjoli J, Wilkins J. The baby and infant screen for children with autism traits (BISCUIT). Baton Rouge: Disability Consultants; 2007.
Mazefsky CA, Kao J, Oswald DP. Preliminary evidence suggesting caution in the use of psychiatric self-report measures with adolescents with high-functioning autism spectrum disorders. Res Autism Spectr Disord. 2011;5:164–74.
Moree BN, Davis III TE. Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: modification trends. Res Autism Spectr Disord. 2010;4:346–54.
Mule R, Trentacoste SV, Rapin I. The genetics of autism. Pediatr. 2004;113:472–86.
Murphy M, Bolton PF, Pickles A, Fombonne E, Piven J, Rutter M. Personality traits of the relatives of autistic probands. Psychol Med. 2000;30:1411–24.
Nadeau J, Sulkowski ML, Ung D, et al. Treatment of comorbid anxiety and autism spectrum disorders. Neuropsychiatry. 2011;6:567–78.
Ooi YP, Lam CM, Sung M, et al. Effects of cognitive-behavioral therapy on anxiety for children with high-functioning autistic spectrum disorders. Singapore Med J. 2008;49:215–20.
Ozsivadjian A, Knott F. Anxiety problems in young people with autism spectrum disorder: a case series. Clin Child Psychol Psychiatry. 2011;16:203–14.
Posey DJ, McDougle CJ. Pharmacotherapeutic management of autism. Expert Opin Pharmacother. 2001;4:587–600.
Reaven JA, Blakeley-Smith A, Nichols S, et al. Cognitive-behavioral group treatment for anxiety symptoms in children with high-functioning autism spectrum disorders: a pilot study. Focus Autism Other Dev Disabil. 2009;24:27–37.
Reaven JA, Blakeley-Smith A, Culhane-Shelburne K, Hepburn S. Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial. J Child Psychol Psychiatry. 2012;53:410–9.
Russell E, Sofronoff K. Anxiety and social worries in children with Asperger syndrome. Aust N Z J Psychiatry. 2005;39:633–8.
Russell AJ, Mataix-Cols D, Anson MAW, Murphy DGM. Psychological treatment for obsessive-compulsive disorder in people with autism spectrum disorders – a pilot study. Psychother Psychosom. 2009;78:59–61.
Simonoff E, Pickles A, Charman T, et al. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47:921–9.
Singh NN, Lancioni GE, Manikam R, et al. A mindfulness-based strategy for self-management of aggressive behavior in adolescents with autism. Res Autism Spectr Disord. 2011;5:1153–8.
Smith P, Perrin S, Yule W, Clark D. Post traumatic stress disorder: cognitive therapy with children and young people. London: Routledge; 2009.
Sofronoff K, Attwoord T, Hinton S. A randomized controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. J Child Psychol Psychiatry. 2005;46:1152–60.
Spiker MA, Enjey Lin CE, Van Dyke M, Wood JJ. Restricted interests and anxiety in children with autism. Autism. 2011;24:1–13.
Sukhodolsky DG, Scahill L, Gadow KD, et al. Parent-rated anxiety symptoms in children with pervasive developmental disorders: frequency and association with core autism symptoms and cognitive functioning. J Abnorm Child Psychol. 2008;36:117–28.
Sung M, Ooi YP, Goh TJ et al. Effects of cognitive-behavioral therapy on anxiety in children with autism spectrum disorders: a randomized controlled trial. Child Psychiatry Hum Dev. 2012; doi:10.1007/s10578-011-0238-1.
Tsakanikos E, Costello H, Holt G, et al. Psychopathology in adults with autism and intellectual disability. J Autism Dev Disord. 2006;36:1123–9.
van Steensel FJA, Bögels SM, Perrin S. Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis. Clin Child Fam Psychol Rev. 2011;14:302–17.
White SW, Ollendick T, Scahill L, Oswald D, Albano AM. Preliminary efficacy of a cognitive-behavioral treatment program for anxious youth with autism spectrum disorders. J Autism Dev Disord. 2009a;39:1652–62.
White SW, Oswald D, Ollendick T, Scahill L. Anxiety in children and adolescents with autism spectrum disorders. Clin Psychol Rev. 2009b;29:216–29.
White SW, Albano AM, Johnson CR, et al. Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism. Clin Child Fam Psychol Rev. 2010;13:77–90.
White SW, Schry AR, Maddox BB. Brief report: the assessment of anxiety in high-functioning adolescents with autism spectrum disorder. J Autism Dev Disord. 2012;42:1138–45.
Wood JJ, Drahota A, Sze K, Har K, Chiu A, Langer DA. Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Child Psychol Psychiatry. 2009;50:224–34.
Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clin Psychol: Res Pract. 2010;17:281–92.
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van Steensel, F.J.A., Bögels, S.M., Magiati, I., Perrin, S. (2014). Anxiety in Individuals with ASD: Prevalence, Phenomenology, Etiology, Assessment, and Interventions. In: Patel, V., Preedy, V., Martin, C. (eds) Comprehensive Guide to Autism. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-4788-7_31
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