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Randomized Controlled Trial
. 2024 Oct;55(5):1259-1268.
doi: 10.1007/s10578-022-01489-3. Epub 2022 Dec 28.

Anger Outbursts in Youth with ASD and Anxiety: Phenomenology and Relationship with Family Accommodation

Allie N Townsend  1 , Andrew G Guzick  1 , Alyssa G Hertz  1 , Connor M Kerns  2 , Wayne K Goodman  1 , Leandra N Berry  3   4 , Philip C Kendall  5 , Jeffrey J Wood  6 , Eric A Storch  7
Affiliations
Randomized Controlled Trial

Anger Outbursts in Youth with ASD and Anxiety: Phenomenology and Relationship with Family Accommodation

Allie N Townsend et al. Child Psychiatry Hum Dev. 2024 Oct.

Abstract

Anger outbursts (AO) are associated with severe symptoms, impairment and poorer treatment outcomes for anxious children, though limited research has examined AO in youth with co-occurring autism and anxiety disorders. This study examined AO in children with autism and anxiety by evaluating clinical characteristics, family accommodation, and changes in AO following anxiety-focused treatment. The sample comprised 167 youth with autism and anxiety enrolled in a multi-site randomized clinical trial comparing standard care CBT for anxiety, CBT adapted for youth with autism, and usual care. Most participants (60%) had AO, which contributed to impairment above and beyond anxiety and autism. AO impacted functional impairment indirectly through a pathway of parental accommodation. AO reduced with anxiety-focused treatment. Findings highlight that AO are common in this population and uniquely contribute to functional impairment, indicating a need for direct targeting in treatment.

Keywords: Anger outbursts; Anxiety; Autism-spectrum disorder; Rage.

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Conflict of interest statement

Competing Interests I declare that the authors have no competing interests as defined by Springer, or other interests that might be perceived to influence the results and/or discussion reported in this paper.

Figures

Fig. 1
Fig. 1
Mediation model predicting anxiety-related impairment. (ROARS Rage Outbursts and Anger Rating Scale, PAS-F Pediatric Accommodation Scale, CAIS-P Child Anxiety Impact Scale. *p < .05, **p < .001)
Fig. 2
Fig. 2
ROARS item-level analysis
See this image and copyright information in PMC

References

    1. Maenner MJ (2020) Prevalence of Autism Spectrum Disorder among Children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2016. MMWR Surveillance Summaries 69 (4) - PMC - PubMed
    1. O’Nions E, Happé F, Evers K, Boonen H, Noens I (2017) How do parents manage irritability, challenging Behaviour, Non-Compliance and anxiety in children with Autism Spectrum Disorders? A Meta-synthesis. J Autism Dev Disord 48(4):1272–1286 - PMC - PubMed
    1. Hollocks MJ, Lerh JW, Magiati I, Meiser-Stedman R, Brugha TS (2019) Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis. Psychol Med 49(4):559–572 - PubMed
    1. Van Steensel FJA, Bögels SM, Perrin S (2011) Anxiety Disorders in children and adolescents with autistic Spectrum Disorders: a Meta-analysis. Clin Child Fam Psychol Rev 14(3):302–317 - PMC - PubMed
    1. Cervantes P, Matson JL, Tureck K, Adams HL (2013) The relationship of comorbid anxiety symptom severity and challenging behaviors in infants and toddlers with autism spectrum disorder. Res Autism Spectr Disorders 7(12):1528–1534

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