Anxiety Levels in Children with Autism Spectrum Disorder: A Meta-Analysis

Abstract

The aim of the current study was to meta-analytically examine whether anxiety levels in children with autism spectrum disorders (ASD) are elevated. A total of 83 articles were selected from a systematic literature search and were included in the meta-analyses. Results demonstrated that children with ASD had higher anxiety levels compared to typically developing children, and this difference increased with IQ. Youth with ASD also tended to have higher anxiety levels compared to clinically referred children, and this difference increased with age. Children with ASD had higher anxiety levels compared to youth with externalizing or developmental problems, but not when compared to youth with internalizing problems. The study findings highlight the importance of more research in order to fully understand the nature and development of anxiety in children with ASD. More specifically, the results suggest that especially high-functioning adolescents with ASD may be at risk for developing anxiety disorders. Therefore, it seems important to carefully follow and monitor children with ASD transcending to adolescence.

Autism‐related behaviors in the cyclooxygenase‐2‐deficient mouse model

“…Results from the open field test revealed that (COX)‐2 − mice have elevated ambulatory activity and adult (COX)‐2 − males spend less time in the center, which are analogous to greater hyperactivity and anxiety behaviors, respectively . These behaviors seem to be comparable with symptoms commonly reported in ASD cases . For example, a number of cross‐sectional studies have reported that 40% to 55% of children with ASD also had ADHD or anxiety disorders .…”

“…The marble burying test showed that (COX)‐2 − animals buried a higher number of marbles compared with WT controls representing increased repetitive and anxiety‐related behaviors, which are characteristic symptoms of autism . Sex differences were also seen in control and (COX)‐2 − animals: males buried more marbles than females suggesting that males show higher levels of anxiety‐related and repetitive behaviors.…”

“…59 These behaviors seem to be comparable with symptoms commonly reported in ASD cases. 78,79 For example, a number of cross-sectional studies have reported that 40% to 55% of children with ASD also had ADHD [80][81][82] or anxiety disorders. [83][84][85] Our analysis on sex differences in the open field test revealed that (COX)-2 − males showed increased movement or hyperactivity compared with (COX)-2 − females, which is reminiscent of a bias in the prevalence for ADHD in males with ASD.…”

Gray space and green space proximity associated with higher anxiety in youth with autism

“…Anxiety is typically viewed as a negative condition associated with higher levels of stress and mental health disorders (Mash and Barkley, 2003). However, some research indicates that increased anxiety is associated with better functioning in social/communication domains in children with ASD (Van Steensel and Heeman, 2017). Future research could therefore dissect the complex relationship between anxiety and nature in youth with ASD in more detail, perhaps using in-depth clinical anxiety measures with sub-scales for social and non-social anxiety facets as well as language/communication outcome variables (Grills and Ollendick, 2003).…”

Brain changes in adolescence—it is about time to get serious in autism spectrum disorder research

“…It is known that adolescents with ASDs are at greatly increased risk of depression and anxiety disorders (Hofvander et al, ; Lugnegard, Hallerback, & Gillberg, ). The discrepancy between prevalence rates of depression and anxiety in ASD compared to TD populations increases with age during adolescence (van Steensel & Heeman, ), indicating specific vulnerability in adolescents with ASDs. Rates of suicidality are higher in the ASD than in the TD population—a difference that also emerges during late adolescence and the transition to young adulthood (Veenstra‐Vander Weele, ).…”