The association between parents' ratings of ASD symptoms and anxiety in a sample of high-functioning boys and adolescents with Autism Spectrum Disorder.
Social tension raises GAD risk in younger autistic boys, while rigidity to change does so in teens.
01Research in Context
What this study did
Bitsika et al. (2017) asked parents to rate two things: autism symptoms and anxiety in their high-functioning sons. The sample was 5- to young learners boys with ASD.
Parents filled out the Social Responsiveness Scale and two anxiety checklists. The team then looked for which autism behaviors best predicted Generalized Anxiety Disorder (GAD).
What they found
In younger boys (5-13), social tension—like not knowing how to join a game—was the strongest GAD predictor.
In teen boys (14-18), trouble handling changes to routine—such as a sudden substitute teacher—most strongly predicted GAD.
How this fits with other research
Eussen et al. (2016) extends these findings by adding girls: early-teen girls with ASD show more depression than boys, so age-plus-sex screening is needed.
Germani et al. (2014) is a predecessor that also used parent ratings; they saw girls display more social anxiety while boys show more hyperactivity, hinting that anxiety type already differs by sex before puberty.
Day et al. (2021) extends the picture in teens by showing camouflaging—masking autism—drives anxiety in both sexes. Vicki’s team did not measure camouflaging, so combining both papers suggests you should ask teens how much they mask on top of watching social tension or rigidity.
Why it matters
If you work with autistic boys, tweak your anxiety screen by age. For elementary and middle-school clients, probe social moments: “Any trouble joining groups?” For high-school clients, ask about routine shifts: “How do you handle schedule changes?” These quick add-ons take two minutes and align your intervention plan with the strongest parent-reported predictors of GAD.
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02At a glance
03Original abstract
BACKGROUND: The relationship between symptoms of Autism Spectrum Disorder (ASD) and Generalised Anxiety Disorder (GAD) is complex and sometimes confounding. However, exploration of that relationship has significant potential to assist in treatment or avoidance of GAD by identifying ASD-related behaviours as 'targets' for intervention with anxious children as well as for preventative treatments that could be implemented into daily routines before children become anxious. To further understanding of this relationship, the association between parent-ratings of their sons' ASD symptoms and GAD symptoms was investigated in two samples of boys with high-functioning ASD. METHODS: Parents of a sample of 90 pre-adolescent (M age=8.8yr) and 60 adolescent males (M age=14.6yr) completed the Social Responsiveness Scale (SRS) and the GAD subscale of the Child and Adolescent Symptom Inventory (CASI-4 GAD) about their sons. RESULTS: Pre-adolescents had significantly higher SRS scale scores than adolescents. For pre-adolescents, high levels of tension in social situations were associated with 3.5-times greater likelihood of having GAD; for adolescents, experiencing difficulty in changes in routine was associated with a 10-fold increase in risk of GAD. CONCLUSIONS: In addition to focussing upon GAD itself, preventative and treatment options aimed at reducing GAD or its risk might profitably recognise and focus upon these two aspects of ASD that are different across the two age groups but each of which was significantly associated with GAD severity and prevalence in this study.
Research in developmental disabilities, 2017 · doi:10.1016/j.ridd.2017.02.010