Social Anxiety in Young People with Autism: Cognitive and Behavioural Models
Social anxiety is more prevalent in adolescents with autism spectrum disorder (ASD) than typically-developing adolescents (Bellini, 2004), and is one of the most common anxiety disorders in adolescents with ASD (White et al., 2009). Whilst the cognitive model of social anxiety has a well-established evidence-base for typically-developing individuals (Clark & Wells, 1995), its applicability for individuals with ASD is unclear. The cognitive model outlines how appraisals about one’s own social performance and self-focused attention are central factors in the development and maintenance of social anxiety and are important focii for any intervention. Historically interventions for social anxiety in ASD have adopted a deficit model with improvements in social skills considered essential. Adolescents and young adults with ASD (n=52) took part in a paradigm designed to elicit social anxiety (adapted from Cartwright-Hatton et al., (2003)).
Objectives: to explore the role of cognitive factors in social anxiety in Autism.
Methods: An adapted paradigm provoking social anxiety was employed, and individual ratings of social performance were compared with objective observer ratings. Self focused attention was measured using an adapted autonomic perceptions questionnaire.
Results: Approximately 50% of the group scored above clinical threshold on a measure of social anxiety. Group differences in the discrepancy between self-and observer ratings of social performance skills were recorded, with the socially anxious group rating social performance as significantly poorer than observer ratings. An adapted version of the Autonomic Perceptions Questionnaire also revealed between-group differences in the extent of self-focused attention.
Conclusions: These findings suggest that cognitive factors may be as relevant in our understanding of social anxiety in young people with ASD as typically developing youth and have implications for psychological treatments.