Characteristics and anxiety symptom presentation associated with autism spectrum traits in youth with anxiety disorders

Abstract

There is limited information about the nature of anxiety among youth with symptoms of autism spectrum disorder (ASD). The present study examined (a) differences in the clinical characteristics of anxious youth with and without symptoms of ASD and (b) the symptoms of anxiety that best distinguish between these groups. Results indicated that anxious youth with elevated ASD symptoms had significantly more diagnoses (e.g., specific phobias), and were more likely to meet diagnostic criteria for social phobia (and list social concerns among their top fears) than youth without elevated ASD symptoms. At the symptom level, severity of interpersonal worry based on parent report and severity of fear of medical (doctor/dentist) visits based on youth report best differentiated ASD status. The findings inform diagnostic evaluations, case conceptualization, and treatment planning for youth with anxiety disorders and ASD symptoms.

Figure 1

Final decision tree depicting the prediction of elevated or non-elevated levels of ASD symptoms. The model had a relative error = 0.64 and a cross validation error = 0.71 (SE = 0.11). Circles represent nodes and squares represent the outcome variable. Numbers on the lines represent the cut-points on the variables of interest that define the split (i.e., individuals whose score is > 4 on severity of interpersonal worry from the GAD section of the parent ADIS are split to the right, or the elevated ASD symptoms, side of the tree). Noted below each terminal node are the number of participants without elevated ASD symptoms (W/O), the number with elevated ASD symptoms (W), and the percentage of participants the tree classified correctly (C). Estimation was based on 100 participants and 398 variables.