Self-Reported Anxiety Following An Evaluated Verbal Performance Task: Similarities and Differences Between Children with and without Autism

Background: Autism is a neurodevelopmental disorder characterized by prominent social and communication deficits, as well as increased stress in response to novel situations. The Trier Social Stress Task (TSST) is a standardized social stress protocol that represents a novel social interaction and is known for its ability to reliably induce stress and anxiety, activating the LHPA axis, in a laboratory setting.

Objectives: The current study was designed to investigate the relationship between self-reported trait (persistent) anxiety and self-reported state (present) anxiety following performance of the TSST in children with autism and typically developing children.

Methods: The preliminary study included 25 children ages 8-to-12 years old with autism (AUT, n=11) and with typical development (TYP, n=14). Participants completed a version of the TSST that has been modified for use with children as well as the State-Trait Anxiety Inventory for Children (STAIC) as part of a larger research protocol. Using analysis of variance, we assessed associations between trait anxiety (persistent), state anxiety (present) and diagnosis across participants.

Results: Self-report of trait (persistent) anxiety varied significantly between the groups [F(1,24)=10.894, p<.01), such that children with autism report more trait anxiety than typically developing children. However, no significant differences were found between groups for self-report of state (present) anxiety, following completion of the TSST [F(1,24)=0.234, n.s.]. As a group, the children with autism reported less state (present) anxiety (x=32.36), following TSST performance, than trait (persistent) anxiety (x=39.36).

Conclusions: These results provide preliminary evidence for a different pattern of self-reported anxiety in children with and without autism. As expected, children with autism report experiencing higher levels of general anxiety throughout their day than typically developing children. However, following performance of a stress-evoking task, children with autism and typically developing children report comparable levels of acute anxiety. The finding that children with autism report less anxiety following the stressor relative to their general level of anxiety (rather than an increased or stable level) requires further investigation. The limitations of reliance on a self-report measure in children with autism could be one explanation for the above findings (i.e. lack of insight into emotional understanding). Alternatively, it may be the case that children with autism did not perceive the experimental setting or task to be anxiety-provoking; however, this possibility seems unlikely given previous research reporting that children with autism demonstrate increased cortisol following completion of the TSST (Jansen, et al., 2003). To further analyze the present findings, these data will be compared to biological indices of stress, neuropsychological test performance and behavioral ratings of stress as part of a larger study.