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Title: Social anxiety in adults with autism spectrum disorders
Author: Spain, Deborah Carolyn
ISNI:       0000 0004 7660 031X
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2018
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Individuals who have autism spectrum disorders (ASD) commonly experience social anxiety. Whether this manifests as part of, or is comorbid to, ASD, continues to prompt clinical and academic discussion. To date, empirical studies have predominantly investigated social anxiety in children and adolescents. We know relatively little about prevalence rates, demographic and clinical correlates, causal and maintaining mechanisms, and best ways to provide psychological interventions for adults who have both ASD and social anxiety. This thesis focuses on two principal areas: understanding social anxiety and treating this (and associated characteristics) in adults with ASD. A systematic review of literature on social anxiety in individuals with ASD sets the scene for the empirical studies reported in the thesis. Rates and levels of social anxiety and a range of demographic and clinical correlates are examined cross-sectionally, in community and clinical samples. Using a qualitative study design, the opinions of multidisciplinary clinicians and researchers about assessment, formulation and interventions for individuals with ASD and social anxiety, are explored. The empirical evidence for psychological interventions for adults, in particular group social skills interventions (GSSI), cognitive behaviour therapy (CBT) and mindfulness, are synthesised in three systematic reviews. Finally, the design, delivery and evaluation of two novel pilot group CBT interventions - one addressing social interaction anxiety, and the second addressing low self-esteem - are described. Overall, study findings indicate that at least 45% of males and females with ASD have clinically significant cognitive and affective symptoms and behavioural responses indicative of social anxiety. In line with previous research, social anxiety, in these samples, was significantly associated with age, self-reported ASD traits, depression and general anxiety, but not with clinician-rated ASD measures, IQ or theory of mind. Causal and maintaining mechanisms likely comprise bio-psycho-social factors, underpinned by the presence and impact of core ASD symptomatology. A conceptual framework is put forward to outline putative relationships between these mechanisms. CBT interventions, adapted to suit the needs of adults with ASD, appear to be feasible and effective for reducing social anxiety.
Supervisor: Happe, Francesca Gabrielle Elizabeth ; Murphy, Declan G. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available