Variability in Autism Symptom Severity: The Role of Diurnal Cortisol and Daily Stress in Youth with Autism Spectrum Disorder

Thursday, May 14, 2015: 11:30 AM-1:30 PM
Imperial Ballroom (Grand America Hotel)
P. Renno1, L. Sterling2, J. T. McCracken3, K. S. Mallya4 and J. J. Wood5, (1)Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, (2)Claremont McKenna College, Los Angeles, CA, (3)Psychiatry and Biobehavioral Sciences, UCLA Semel Institute for Neuroscience & Human Behavior, Los Angeles, CA, (4)Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, CA, (5)Departments of Education and Psychiatry, University of California Los Angeles, Los Angeles, CA
Background: The literature indicates increased rates of anxiety disorders in children with autism spectrum disorder (ASD); however, little research has investigated the determinants and consequences, physiologic and functional, of anxiety in ASD. Wood and Gadow (2010) have proposed a model in which daily stressors contribute to increased mood dysregulation and anxiety, which then exacerbates clinically impairing ASD symptoms.

Objectives: The current study aimed to investigate the relation between diurnal cortisol levels and parent-report of ASD-related stressors in youth with ASD. Secondly, it aimed to examine the relations among daily stressors, anxiety, and ASD symptom severity by testing Wood and Gadow’s (2010) hypothetical mediational model.

Methods: Participants were 43 youth, aged 7-14, with ASD. Cortisol levels were collected at four time points throughout the day for three days. Parent, child and diagnostician reports of daily stressors (e.g., Stress Schedule Survey), anxiety symptoms (e.g., Pediatric Anxiety Rating Scale), and ASD symptom severity (e.g., Social Responsiveness Scale) were collected.

Results: Results from multilevel modeling suggest diurnal cortisol samples in youth with ASD follow a similar daily pattern established in the typically developing population, and that increased daily cortisol is related to greater ASD-related daily stressors (t = 2.34, p < .05). Additionally, results from path analysis suggest anxiety partially mediates the relation between ASD-related stressors and ASD-symptom severity.  

Conclusions: Findings from this study establish a relation between physiological response and subjective reports of stressors and anxiety in youth with ASD and suggest that increased stressors contribute to greater anxiety and ASD symptom severity. These results suggest that treatments aimed at reducing anxiety and stressors in youth with ASD may also affect core ASD symptom severity and impairment. Future research should continue to investigate these potential relations, other related factors, and response to treatments for increased anxiety and ASD symptom severity in youth with ASD.