Symptom overlap on the srs-2 adult self-report between adults with asd and adults with high anxiety.
The SRS-2 Adult Self-Report mixes up ASD and high anxiety too often to stand alone.
01Research in Context
What this study did
South et al. (2017) asked if the SRS-2 Adult Self-Report can tell ASD from high anxiety in adults.
They gave the same form to three groups: adults with ASD, adults with high anxiety, and typical adults.
Then they checked how often the tool put each person in the right group.
What they found
The form got it wrong a lot. It only spotted ASD 65 % of the time overall.
When the two clinical groups went head-to-head, accuracy dropped to 48 %.
In plain words, the SRS-2-ASR acts like a coin flip when ASD and anxiety look alike.
How this fits with other research
Meier et al. (2012) already warned that ASD and social phobia share social slips but differ in emotion skills. Their review set the stage for this harder numbers check.
Capio et al. (2013) showed one parent rating an adolescent is enough on the SRS. That earlier work boosts the form’s simple use, yet Mikle’s adult data now show the scores themselves can mislead.
Burrows et al. (2018) found intolerance of uncertainty in ASD stays high even after anxiety is removed. This helps explain why SRS items tapping rigidity may lift scores for both groups.
Why it matters
If you screen adults for ASD, do not stop at the SRS-2-ASR. Add an anxiety scale, check emotion recognition, or watch real social bids. A second tool guards against calling anxiety autism, or missing ASD behind anxiety.
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02At a glance
03Original abstract
Many people diagnosed with autism spectrum disorder (ASD) also experience significant symptoms of anxiety, while many people with anxiety disorders likewise experience social difficulties. These concerns can be difficult to tease apart in general clinical settings. The Social Responsiveness Scale (SRS) is one of the most frequently used measures of dimensional ASD symptoms. In order to investigate the overlap of autism and anxiety on the SRS, we compared three groups of adults (an ASD group, n = 40; a high anxious group, n = 56; and a typical comparison group, n = 29) using the new Adult Self Report version of the SRS-2nd Edition (SRS-2-ASR) alongside a battery of anxiety questionnaires. Based on previous research with children from the parent-report SRS (first edition), we hypothesized that the SRS-2-ASR would have difficulty discriminating between the ASD and high anxious groups. Results showed that both these clinical groups scored significantly higher on the SRS than a typical control group. Discriminant validity was poor, including sensitivity of 0.65 when including all participants and 0.48 when only the two clinical groups were included. In particular, the Social Motivation subscale of the SRS-ASR failed to distinguish between ASD and anxiety groups. As recommended in the SRS-2 manual, we highlight the need for caution when using the SRS-2-ASR to support diagnostic decision making, especially in clinical settings involving anxiety, ADHD, or other concerns that can affect reciprocal social communication and/or behavioral flexibility. Autism Res 2017. © 2017 International Society for Autism Research, Wiley Periodicals, Inc. Autism Res 2017, 10: 1215-1220. © 2017 International Society for Autism Research, Wiley Periodicals, Inc.
Autism research : official journal of the International Society for Autism Research, 2017 · doi:10.1002/aur.1764