Social Anxiety and ASD: Patterns of Experiences and Beliefs in Adolescence
Pickard, H., Hirsch, C., Simonoff, E., & Happé., F. (2019, May 1-4). Cognitive, emotional, and sensory correlates of social anxiety in autistic and neurotypical adolescents [Conference poster presentation]. International Society for Autism Research 2019 Annual Conference, Montreal, Québec, Canada.
Background
Social anxiety is the experience of anxiety in social situations related to fear of negative judgment by others. Social anxiety is a challenge reported by individuals with and without ASD that can make it difficult to form friendships and impact school performance. Some research suggests that factors, such as hypersensitivity to stimulation from the environment, are related to social anxiety in people with ASD, but there is not enough research to say for sure.
Who was involved?
Sixty-one adolescents with ASD and 62 adolescents without ASD between the ages of 11 and 17 years of age and 119 parents participated in this study. A reading level at or above age 10 and normative or better intellectual ability were required to participate. Adolescents completed several questionnaires on social anxiety symptoms, ability to cope with uncertainty, sensory processing, emotion regulation, ability to identify and describe emotions, and awareness of bodily sensations. They also completed a measure of their intellectual functioning and tasks related to sense experience accuracy and confidence (heartbeat tracking task and their confidence in their answer). Parents of the adolescents completed questionnaires on their child’s autism traits and on their tolerance of uncertainty.
What was the outcome?
Adolescents with and without ASD reported similar levels of social anxiety and other emotional experiences related to depressed mood and general anxiousness. In both groups, having more social anxiety was associated with greater intolerance of uncertainty, difficulty with emotion regulation, poor emotional awareness and coping, and sensory hypersensitivity. In other words, the experience of social anxiety in adolescents with and without ASD was more similar than different.
What are the strengths and limitations of the study?
Strengths: Adolescents with and without ASD were matched based on intellectual ability, which allows the researchers to know that different results are not due to differences in intellectual ability. This study was also designed so that adolescents with and without ASD filled out their own questionnaires, which provides a more direct measure of traits, emotions, and behaviors than asking caregivers alone.
Limitations: This study focuses on individuals without intellectual disability which may impact our understanding of individuals with ASD across all ability levels. Additional peer review of the findings may be necessary to know whether the methods are strong enough to generate firm conclusions.
What are the implications?
Social anxiety can be very challenging for the affected person; however, the experience of social anxiety may not differ all that much between adolescents with and without ASD. If the experience of social anxiety does not differ substantially between adolescents with and without ASD, then interventions that have been demonstrated to work for social anxiety in adolescents without ASD might be useful for adolescents with ASD. More research is needed to confirm this pattern of similarity and to determine if interventions work well across both clinical groups.
