Anxiety in adolescents with high functioning autism
The theoretical basis of psychological and emotional distress such as anxiety in individuals with autism is under researched. The present study draws upon a mainstream information processing model of childhood anxiety along with theoretical accounts of autism to investigate some of the possible factors associated with the development and maintenance of anxiety in this population. Adolescents with high functioning autism were compared to two comparison control groups on measures of anxiety and social worries. Comparison groups were children with expressive language disorder and typically developing children. There were 15 children in each group aged between 11-16 years and matched across groups for age and gender. Children with autism were found to be more anxious than typically developing children. There were no significant differences between groups in levels of social worries as reported by the children themselves. Parent ratings showed that children with autism were perceived to have considerably more social worries than both comparison groups. The groups were compared on measures of the recognition and expression of emotion, theory of mind and/or central coherence abilities, social and communication abilities and social competence with peers. The children with autism performed significantly worse than both comparison groups on the measure of social ability. They also perceived themselves to be less socially competence with peers. On the measure of emotional recognition and theory of mind/central coherence, the children with autism performed at a similar level to children with an expressive language disorder. Children with expressive language disorder showed poorer performance than children with autism and typically developing children on the measure of communication. The pattern of between group differences for self perceived social competence with peers was the same as the pattern of difference for anxiety. Social ability was found to correlate negatively with anxiety for the autism group. Therefore social competence with peers and impairments in social ability were highlighted as possible factors associated with anxiety in adolescents with high functioning autism. A simple schematic model of how such factors may be associated with the experience of anxiety in adolescents with high functioning autism is presented, from an information processing perspective. Impaired social ability is considered in relation to the response access or construction stage of the information processing sequence. It is suggested that adolescents with high functioning autism may lack the social skills required for adaptive coping responses to anxiety provoking situations, showing greater reliance on responses directed at escape or avoidance. The selection of escape/avoidant responses at the response selection stage of the information processing sequence is considered in relation to the possible lack of perceived competence and low estimation of coping ability for children with autism. The implications of these findings for clinical practice are discussed and recommendations for future research are made.