Anxiety in people diagnosed with autism and intellectual disability: Recognition and phenomenology

Helverschou, Sissel Berge; Martinsen, Harald

doi:10.1016/j.rasd.2010.05.003

Cited by 65 publications

(53 citation statements)

References 34 publications

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“…This result is encouraging as differences in the perceived level of stress have been suggested to affect findings of previous studies of physiological function in children with ASD. Caution must be taken in interpreting this finding given the known deficits in introspection, emotion awareness, and communication of emotions in ASD [10].…”

Section: Discussionmentioning

confidence: 97%

“…This is important as recognition of anxiety symptoms in ASD, especially in lower-functioning individuals, is a challenging task. The challenge relates to the symptom overlap between ASD and anxiety disorders (e.g., panic attacks and obsessions), idiosyncratic or atypical anxiety symptoms, and limited understanding of subjective experiences of anxiety due to deficits with communication and introspection [10]. The difficulties in recognition of anxiety symptoms can lead to diagnostic overshadowing [10] and complicate treatment of anxiety in ASD.…”

Section: Discussionmentioning

confidence: 99%

“…Self-reports are often not reliable in ASD because of deficits in communication as well as difficulties with emotional awareness and introspection [10]. Behavioural symptoms of anxiety are also difficult to recognize in ASD due to the symptom overlap between the two conditions as well as the idiosyncratic or atypical nature of anxiety symptoms in this population [10]. These difficulties necessitate the development of a physiological marker that can reliably document anxiety in ASD.…”

Section: Introductionmentioning

confidence: 99%

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Investigating the Autonomic Nervous System Response to Anxiety in Children with Autism Spectrum Disorders

et al. 2013

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Assessment of anxiety symptoms in autism spectrum disorders (ASD) is a challenging task due to the symptom overlap between the two conditions as well as the difficulties in communication and awareness of emotions in ASD. This motivates the development of a physiological marker of anxiety in ASD that is independent of language and does not require observation of overt behaviour. In this study, we investigated the feasibility of using indicators of autonomic nervous system (ANS) activity for this purpose. Specially, the objectives of the study were to 1) examine whether or not anxiety causes significant measurable changes in indicators of ANS in an ASD population, and 2) characterize the pattern of these changes in ASD. We measured three physiological indicators of the autonomic nervous system response (heart rate, electrodermal activity, and skin temperature) during a baseline (movie watching) and anxiety condition (Stroop task) in a sample of typically developing children (n = 17) and children with ASD (n = 12). The anxiety condition caused significant changes in heart rate and electrodermal activity in both groups, however, a differential pattern of response was found between the two groups. In particular, the ASD group showed elevated heart rate during both baseline and anxiety conditions. Elevated and blunted phasic electrodermal activity were found in the ASD group during baseline and anxiety conditions, respectively. Finally, the ASD group did not show the typical decrease in skin temperature in response to anxiety. These results suggest that 1) signals of the autonomic nervous system may be used as indicators of anxiety in children with ASD, and 2) ASD may be associated with an atypical autonomic response to anxiety that is most consistent with sympathetic over-arousal and parasympathetic under-arousal.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Investigating the Autonomic Nervous System Response to Anxiety in Children with Autism Spectrum Disorders

et al. 2013

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“…Additional research is needed to form a more conclusive evidence base for the treatment of anxiety in individuals with LFA. Copyright © 2016 John Wiley & Sons, Ltd. Individuals with autism spectrum disorder (ASD) are thought to be predisposed to the development of anxiety (Bellini, 2006), a phenomenon that is evident for individuals across the spectrum with varying degrees of impairment (Hallett et al, 2013;Helverschou & Martinsen, 2011;Simonoff et al, 2008). A recent meta-analysis reported that the prevalence of anxiety disorders in those with autism is approximately 40% (van Steensel, Bögels, & Perrin, 2011).…”

mentioning

confidence: 99%

A Review of Behavioral Interventions for Anxiety‐Related Behaviors in Lower‐Functioning Individuals with Autism

Rosen

Connell

Kerns

2016

Behavioral Interventions

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Anxiety is highly prevalent in persons with autism and affects individuals with higher‐functioning autism (HFA) and lower‐functioning autism (LFA). Although there is emerging support for the efficacy of cognitive‐behavioral therapy (CBT) in treating anxiety in autism, these findings are largely based on HFA samples. Moreover, CBT may be inappropriate for individuals with LFA who may struggle to grasp the cognitive components of the therapy because of their more limited verbal abilities. Behavior analytic interventions may be better suited to treat anxiety in this population; however, the quantity and quality of the extant literature have yet to be reviewed. Toward this end, the extant behavioral intervention literature was reviewed. Seven studies met the inclusion criteria and were evaluated against quality indicators for within‐subject design research. Next, the efficacy of each treatment component was assessed using established criteria for defining empirically supported therapies. Results revealed behavioral interventions to be efficacious, with desensitization and reinforcement emerging as efficacious treatment components, while prompting, modeling, and antianxiety stimuli were established as possibly efficacious. However, given that some of the quality indicators were not met, these results should be interpreted with some caution. Additional research is needed to form a more conclusive evidence base for the treatment of anxiety in individuals with LFA. Copyright © 2016 John Wiley & Sons, Ltd.

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“…Given that heightened sensitivity to environmental stimulation and difficulties in sensory modulation are related to anxiety in individuals with ASD (Green & Ben-Sasson, 2010; Pfeiffer Kinnealey, Reed, & Herzberg, 2005), it is not surprising that specific phobias involving adverse sensory stimulation more commonly arise among these youth. Differences in the somatic expression and severity of anxiety in ASD youth have also been noted, with some studies suggesting that ASD youth display more difficulty controlling their worries and more severe overall anxiety, despite fewer physiological symptoms of anxiety (Helverschou & Martinsen, 2011; Russell & Sofronoff, 2005; Weisbrot et al, 2005). …”

Section: Introductionmentioning

confidence: 97%

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

Settipani

Puleo

Conner

et al. 2012

Journal of Anxiety Disorders

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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.

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Anxiety in people diagnosed with autism and intellectual disability: Recognition and phenomenology

Cited by 65 publications

References 34 publications

Investigating the Autonomic Nervous System Response to Anxiety in Children with Autism Spectrum Disorders

Investigating the Autonomic Nervous System Response to Anxiety in Children with Autism Spectrum Disorders

A Review of Behavioral Interventions for Anxiety‐Related Behaviors in Lower‐Functioning Individuals with Autism

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

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