Social anxiety symptoms in autism spectrum disorder and social anxiety disorder: Considering the reliability of self-report instruments in adult cohorts.
Everyday social-anxiety questionnaires are reliable for verbally fluent autistic adults.
01Research in Context
What this study did
The team tested four short social-anxiety questionnaires.
They gave the forms to verbally fluent autistic adults.
They also gave the same forms to adults who only have social anxiety disorder.
Then they checked if the answers were reliable and valid.
What they found
All four scales worked well in both groups.
The autistic adults answered as consistently as the SAD-only adults.
Strong scores meant the tools can be trusted for clinic use.
How this fits with other research
Lemons et al. (2015) looked at youth with autism.
Parents and kids filled out anxiety forms, but they rarely agreed.
The new study shows that when autistic adults speak fluently, their own answers are steady—so age and reporter matter.
Nah et al. (2018) used a two-minute mood screener in autistic adults.
They found high anxiety rates, but they did not test if the tool was sound.
Shawler et al. (2021) now proves the longer social-anxiety scales are psychometrically solid, building on that early clue.
Bakhtiari et al. (2021) warned that youth self-reports can look invalid if IQ or attention is low.
The current work echoes the caution: it only included verbally fluent adults, showing the same attention-to-ability rule still applies at older ages.
Why it matters
You can grab the LSAS-SR, SIAS, SPS, or BFNE and use them straight away with fluent autistic clients.
No need to hunt for autism-only forms.
Just make sure language and attention skills are strong, then let the client self-rate.
This speeds intake, tracks progress, and helps justify anxiety treatment in your ABA plan.
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02At a glance
03Original abstract
Adults with autism spectrum disorder (ASD) are at elevated risk for social anxiety disorder (SAD). Limited information exists on the reliability of social anxiety instruments with these adults and their performance when compared to individuals with SAD without ASD. This study examines psychometric properties of self-report social anxiety instruments in autistic adults without intellectual disability, compared to adults with SAD. Additionally, we compared instrument scores between a subgroup of autistic adults with a dual diagnosis of SAD (ASD + SAD) and adults with SAD only. Adults diagnosed with SAD (N = 316) or ASD (N = 102) were recruited from the Brain and Mind Centre in New South Wales, Australia. Sixty autistic participants also received a diagnosis of SAD (ASD + SAD). Participants completed the Liebowitz Social Anxiety Scale-self-report, the Social Interaction Anxiety Scale, the Social Phobia Scale, and the Brief Fear of Negative Evaluation Scale. All instruments showed excellent internal consistency in autistic adults. The instruments showed evidence of convergent validity, and the strength of relationships between measures were equivalent between ASD and SAD groups. For all instruments, performance of these instruments in autistic adults with a SAD diagnosis was very similar to performance in adults diagnosed with SAD but without ASD. Findings support the use of these instruments for identifying social anxiety symptoms in autistic adults without intellectual disability and have utility for mental health clinical services. LAY SUMMARY: Autistic adults often experience social anxiety. We examined the use of four social anxiety questionnaires in autistic adults, compared to adults with SAD. We found similar results between autistic adults and adults with SAD, suggesting that these questionnaires can be useful for measuring social anxiety symptoms in autistic adults. These findings have implications for clinical services, as they show that these instruments are reliable when used with autistic adults.
Autism research : official journal of the International Society for Autism Research, 2021 · doi:10.1002/aur.2572