Anxiety Disorders in Autism Spectrum Disorders (ASD) without Intellectual Disabilities

Background:  

People with ASD have specific impairments in socio-communicative skills, including facial emotional expression recognition (WHO, 1993). Previous studies reported a high prevalence of anxiety in Autism Spectrum Disorders (ASD) without intellectual disability (White, Oswald, Ollendick, et al. 2009). We hypothesized that the deficits in facial emotion recognition would be associated with anxiety disorders in this population.

Objectives:  

The purpose of this study was 1) to explore the relationship between anxiety disorders and facial emotional expression recognition in adolescents with ASD without intellectual disability and in a control group of adolescents without ASD, and 2) to characterize anxiety disorders in ASD without intellectual disability.

Methods:  Our study is cross-sectional, descriptive and comparative. Fourty-six adolescents with ASD without intellectual disability aged between 11 and 18 years participated in the study. Among them, 20 had an anxiety disorder and were compared with 20 controls of the same age, with anxiety disorder without ASD. Anxiety disorder was assessed with a parent and adolescent interviews: the Schedule for Affective Disorders and Schizophrenia for School-Age Children, Present and Lifetime Version (K-SADS-PL, Kaufman et al., 1997) according to DSM-IV criteria. Facial emotional expression recognition was studied using the DANVA 2F test (Nowicki & Carton, 1993), that consist of 24 photographs of male and female facial expressions of Happy, Sad, Angry and Fearful emotions.

Results:  

In adolescents with ASD, anxiety disorders were related to impairments in recognition of the emotions Anger and Sadness. Moreover, we found a significant correlation between the level of social anxiety and improvement in Fear recognition that was specific to ASD.

Conclusions:  

This study support the hypothesis that anxiety disorders are related to facial emotion recognition in adolescents with ASD without intellectual disability. Clinical implications concerning the assessment of anxiety comorbidities in this population and the lack of adapted treatments are discussed.