No Offense Intended: Fear of Negative Evaluation in Adolescents and Adults with Autism Spectrum Disorder.

Marsack et al. (2017) asked 40 autistic and 40 typical teens and adults to fill out the Fear of Negative Evaluation scale.

They also rated their own social motivation and social disability.

The team then looked at how these scores linked together in each group.

Autistic and typical people both worried about being judged.

The way social problems tied to this worry differed a little between groups, but the overall fear scores were almost the same.

In other words, fear of negative evaluation matters in ASD, yet the pattern is not identical to peers.

Lievore et al. (2026) extends this work by adding real-life stress. They had autistic kids give a speech while wearing a heart-rate monitor. Heart rate stayed flat even when parents saw high social anxiety, showing the body and the mind do not always match in ASD.

Bitsika et al. (2017) used parent reports and found that social tension predicted general anxiety in younger autistic boys. Together, these studies say: ask the teen, ask the parent, and watch the body before you decide what kind of anxiety you are seeing.

Stokes et al. (2007) gives a real-world reason to care. Their older sample showed more stalking-type courting behaviors, likely tied to poor social learning. If we miss fear of judgment in day-to-day settings, we may also miss chances to teach safer social approaches.

You can’t treat social anxiety in ASD like you would in typical teens. Check all three channels: self-report, parent report, and live performance. If a teen says “I don’t care what they think,” but parents see avoidance and tasks flop, dig deeper. Use role-play, heart-rate feedback, or peer video review to build skills instead of relying on talk-only CBT.