International Meeting for Autism Research: Characteristics of Anxiety in Children with Co-Occurring Autism Spectrum and Anxiety Disorders

Characteristics of Anxiety in Children with Co-Occurring Autism Spectrum and Anxiety Disorders

Friday, May 21, 2010
Franklin Hall B Level 4 (Philadelphia Marriott Downtown)
1:00 PM
F. Cruz , Clinical Psychology, Alliant International University, San Diego, CA
A. Pulido , Clinical Psychology, Alliant International University, San Diego, CA
L. Ampolos , Clinical Psychology, Alliant International University, San Diego, CA
K. La Marca , Clinical Psychology, Alliant International University, San Diego, CA
R. McNally Keehn , Clinical Psychology, Alliant International University, San Diego, CA
A. J. Lincoln , Alliant International University, San Diego, CA
Background: Anxiety symptoms have long been considered an associated feature of autism spectrum disorder (ASD). Several studies have demonstrated that children with ASD evidence higher levels of clinically significant anxiety compared to their typically developing peers (e.g., Russell & Sofronoff, 2005) and children with other intellectual and language disabilities (e.g., Gillot, Furniss, & Walter, 2001). Although high rates of anxiety in this population are well documented, little is known about the differential pattern of anxiety disorders. Furthermore, evidence regarding agreement between parent and child perceptions of anxiety symptoms in children with ASD is lacking.  Finally, no studies to date have examined the relationship between anxiety symptoms and ASD symptom severity.
Objectives: The aims of this study were threefold: 1) to examine the differential pattern of anxiety and other psychiatric symptoms among children with ASD and untreated co-occurring anxiety, 2) to determine the relationship between parent and child reported symptoms of anxiety in children with ASD, and 3) to explore the relationship between anxiety symptoms and ASD symptom severity.
Methods: Participants are twenty-two 7 – 14 year-old children with a diagnosis of ASD, at least one anxiety disorder diagnosis, and intellectual and language abilities ≥ 70.  ASD diagnoses were confirmed using the ADOS and ADI-R. Anxiety disorder diagnoses were confirmed using the Anxiety Disorders Interview Schedule - Parent Version (ADIS-P).  Ratings of anxiety symptoms were measured using both parent and child versions of the Multidimensional Anxiety Scale for Children (MASC; MASC-P) and Spence Children’s Anxiety Scale (SCAS; SCAS-P). 
Results: Within a sample of children with co-occurring ASD and anxiety diagnoses, 82% of children met criteria for Generalized Anxiety Disorder (GAD), 73% met criteria for Specific Phobia, 68% met criteria for Social Phobia, 64% met criteria for Separation Anxiety Disorder (SAD), and 9% met criteria for Obsessive Compulsive Disorder (OCD).  Two or more anxiety diagnoses were present in 96% of the sample. Additionally, 77% met criteria for at least one additional non-anxiety psychiatric diagnosis (Attention Deficit Hyperactivity Disorder, Major Depressive Disorder, or Oppositional Defiant Disorder).  The relationship between parent and child reported anxiety symptoms was not significant (r=.20 - .31, p > .05). There was a significant positive relationship between autism symptom severity and total anxiety symptoms, as measured by ADOS Social and Communication Total and SCAS-P Total scores respectively (r=.47, p= .03).
Conclusions: Results suggest that among children with ASD and clinically significant anxiety, generalized anxiety, specific phobia, social phobia, and separation anxiety disorders were most prevalent. Further, a majority of children had more than one anxiety disorder as well as additional non-anxiety psychiatric disorders. Agreement among child and parent ratings of anxiety symptoms was low, suggesting a difference in perceptions of the child’s untreated anxiety symptoms. Finally, higher levels of anxiety appear to be related to autism symptom severity in children. Further research investigating the relationship between anxiety symptoms and the severity of ASD symptoms in children with and without anxiety diagnoses is warranted. This research could elucidate whether anxiety may be an inherent feature of ASD.
See more of: Comorbidities
See more of: Clinical & Genetic Studies