Beyond Behaviour: Is Social Anxiety Low in Williams Syndrome?

Abstract

Individuals with Williams syndrome (WS) exhibit striking social behaviour that may be indicative of abnormally low social anxiety. The present research aimed to determine whether social anxiety is unusually low in WS and to replicate previous findings of increased generalised anxiety in WS using both parent and self report.Fifteen individuals with WS aged 12-28 years completed the Spence Children's Anxiety Scale (SCAS) and the Children's Automatic Thoughts Scale (CATS). Their responses were compared to clinically anxious and community comparison groups matched on mental age. The findings suggest that WS is not associated with unusually low social anxiety but that generalised anxiety symptoms and physical threat thoughts are increased in WS, relative to typically developing children. Williams Syndrome (WS) is a genetic disorder caused by a microdeletion of a sequence of genes on chromosome 7. Prevalence is between 1 in 7,500 and 1 in 20,000 (Martin, Snodgrass, & Cohen, 1984;Stromme, Bjornstad, & Ramstad, 2002).The deletion typically results in dysmorphic facial features, short stature and a mild to moderate intellectual imapairment (Bellugi, Lichtenberger, Jones, Lai, & St, 2000;Mervis et al., 2000). Additionally, individuals with WS exhibit outgoing, gregarious social behaviour, as if they have little or no social anxiety (Doyle, Bellugi, Korenberg, & Graham, 2004;Jones et al., 2000). In contrast to this social behaviour, there is emerging evidence that individuals with WS may be at increased risk for Generalised Anxiety Disorder (GAD) and Specific Phobia (Dykens, 2003; Leyfer, WoodruffBorden, Klein-Tasman, Fricke, & Mervis, 2006). These findings may indicate that the WS deletion specifically increases risk for certain anxiety disorders whilst decreasing risk for Social Phobia. However, it is also possible that individuals with WS do experience social anxiety but that their outgoing social behaviour masks these thoughts and feelings of social anxiety. Due to the limitations of previous research, it is not currently possible to differentiate between these two hypotheses. The present study utilises a multi-method, multi-informant approach to examine the evidence that social anxiety is unusually low in WS.Although a number of early studies reported that WS is associated with increased anxiety (Davies, Udwin, & Howlin, 1998;Einfeld, Tonge, & Florio, 1997;Sarimski, 1997), there has been little examination of specific subtypes of anxiety (e.g. (2006) found evidence of high rates of GAD (12%) and Specific Phobia (54%) in children with WS, relative to rates reported for typically developing children, and also reported that 1.7% of their sample met criteria for Social Phobia. Similar prevalence rates for GAD and Specific Phobia were found by Dodd & Porter (in press) for a sample of children and adults with WS, however, no cases of Social Phobia were found. By comparing these prevalence rates to those reported for typically developing children (for example, Bolton et al., 2006;Costello et al., 1996), it is clear ...

There's that scary picture: Attention bias to threatening scenes in Williams syndrome

“…Similar prevalence rates have also been found in samples of adults with WS Dykens, 2003). Interestingly, however, there is little evidence that rates of Social Phobia are elevated in this population; prevalence rates and levels of anxiety symptoms tend to be consistent or lower than those reported in typically developing groups Dodd, Schniering & Porter, 2009;Leyfer et al, 2006).…”

Diurnal Cortisol Profile in Williams Syndrome in Novel and Familiar Settings

“…Often, it is assumed, for example, that individuals with WS are hypersociable, with atypically low levels of social anxiety. However, a recent report suggests that individuals with WS experience symptoms of social anxiety at the same level as mental age matched peers (Dodd et al, 2009). The HPA is especially responsive to socio-evaluative situations (Dickerson & Kemeny, 2004), rendering it a particularly promising way of sorting out reactivity to social versus non-social anxiety and stressors in WS.…”

Linking social behaviour and anxiety to attention to emotional faces in Williams syndrome

“…Thus it is possible that eye-gaze allocation to emotional facial expressions may be related to variation in levels of anxiety and social impairments in WS. In recent years, evidence has suggested that alongside increased sociability exists a strikingly opposing profile of increased non-social anxiety in WS ( Leyfer, Woodruff-Borden, Klein-Tasman, Fricke, & Mervis, 2006;Dodd, Schniering, & Porter, 2009). In particular, high levels of generalised anxiety disorder (GAD) as well as disorder specific fears and phobias have been identified in individuals with WS (Blomberg, Rosander, & Andersson, 2006;Rodgers, Riby, Janes, Conolly & McConachie , 2012).…”