Maladaptive cognitive appraisals in children with high-functioning autism: associations with fear, anxiety and theory of mind.
Verbally fluent autistic kids harbor distinct maladaptive threat and coping thoughts—bake appraisal checks into anxiety CBT.
01Research in Context
What this study did
Sharma et al. (2014) compared verbally fluent autistic kids with typical peers. They asked both groups how they think about scary events. The team also tested how well each child can read other people's minds (theory-of-mind tasks).
The goal was to see if the way autistic children judge threat, coping, and future risk links to their anxiety levels.
What they found
Autistic children showed a unique pattern of maladaptive appraisals. They over-predicted danger and under-rated their own ability to cope. These skewed thoughts went hand-in-hand with higher fear scores and weaker theory-of-mind skills.
How this fits with other research
Wetterneck et al. (2006) built the first autism-friendly interview for spotting anxiety; Shilpi's team later used similar tools to show that anxiety inside these interviews is driven by distorted threat appraisals.
Fombonne et al. (2020) surveyed thousands of autistic adults and found two-thirds carry lifetime anxiety diagnoses. Shilpi's child data help explain why: the same maladaptive thinking patterns may start early and persist.
Greene et al. (2019) discovered that autistic adults often feel their traits are mislabeled as mental illness. Linking this with Shilpi's findings suggests teaching kids to reappraise threat could reduce later misdiagnosis.
Why it matters
When you run CBT for anxiety with verbal autistic clients, probe their future expectancy and coping appraisals. Add brief theory-of-mind checks; poor scores flag kids who may benefit from extra cognitive-restructuring practice. Targeting these specific thoughts early could lower both anxiety and the chance their autism behaviors are mistaken for psychiatric symptoms later.
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02At a glance
03Original abstract
Despite the well-documented success of cognitive restructuring techniques in the treatment of anxiety disorders, there is still little clarity on which cognitions underpin fear and anxiety in children with high-functioning autism spectrum disorder. This study examined whether certain cognitive appraisals, known to be associated with fear and anxiety in typically developing groups, may help explain these emotions in children with high-functioning autism spectrum disorder. It also investigated relations between these cognitive appraisals and theory of mind. Appraisals, fear and anxiety were assessed using a vignette approach in 22 children with high-functioning autism spectrum disorders and 22 typically developing children. The two groups differed significantly on all four appraisal types. Anxiety was negatively correlated with future expectancy and positively with problem-focused coping potential in the high-functioning autism spectrum disorder group but was not correlated with appraisals in the typically developing group. The two appraisals associated with fear were emotion-focused coping potential (in the high-functioning autism spectrum disorder group only) and self-accountability (in the typically developing group only). Linear regression analysis found that appraisals of emotion-focused coping potential, problem-focused coping potential and future expectancy were significant predictors of theory-of-mind ability in the high-functioning autism spectrum disorders group. These findings indicate that specific, problematic patterns of appraisal may characterise children with high-functioning autism spectrum disorders.
Autism : the international journal of research and practice, 2014 · doi:10.1177/1362361312472556