Year: 2019
Type: dissertation
Abstract: There has been much debate over the years as to whether anxiety is simply a part of the disorder of autism or if it should be considered a separate, co-occurring disorder. Previous research indicates that 11-84 percent of individuals with an autism spectrum disorder (ASD) also experience significant symptoms of anxiety, with 30-50 percent of those individuals being diagnosed with at least one anxiety disorder. These co-occurring disorders often lead to increased social impairment, social avoidance and awkward interactions with peers, and can be a trigger for behavioral concerns such as tantrums, self-injury, and aggressive behaviors. The purpose of Study 1 was to estimate the overall effect size of the association between ASD and anxiety, to determine how the moderators of “year of publication” and “number of children and youth included in the study” impact prevalence rates of anxiety in children and youth with ASD, and to determine if the meta-analysis was homogeneous. Individuals with ASD diagnosed with generalized anxiety disorder and social anxiety disorder were included in the study, and twenty-five articles met the inclusion/exclusion criteria. The meta-analysis results were homogenous indicating that the field is stable and that anxiety is problematic for children and youth with ASD. The regression analysis confirmed that the moderator variables of year of study publication and number of individuals in the studies were not significant, meaning they had no impact on the fact that individuals with ASD are prone to developing an anxiety disorder. The purpose of Study 2 was to investigate which of seven parent-answered questions related to anxious behavior could significantly predict a parent-reported comorbid anxiety disorder in both a sample of boys diagnosed with ASD and sample of girls diagnosed with ASD. Participants were drawn from the 2011 CDC Survey of Pathways to Diagnosis and Services database which includes a nationally representative sample of 4,032 children with special health care needs (CSHCN) ages 6-17. After data were weighted to permit nationally representative estimates with adjustment of complex samples, 668 participants remained (539 boys and 129 girls) age 11-17. The 7 variables were selected based on their relevance to underlying symptoms of an anxiety disorder based on the DSM-5. A logistic regression was conducted to determine which items were able to classify autism with co-morbid anxiety based on parent-reported information, as well as to determine if there was a significant difference between which items classify boys and girls with co-morbid autism and anxiety. Results of the study indicated that for boys with ASD, the two items that were found to most likely predict comorbid anxiety were “Is rather solitary, prefers to be alone or would rather be alone” when the caregiver response was “often,” and “Has many worries or often seems worried” when the caregiver response was either “often” or “sometimes.” For girls with ASD, the three items that were found to most likely predict comorbid anxiety were “Has many worries or often seems worried” when the caregiver response was “often,” “Has many fears, is easily scared” when the caregiver response was “often” or “sometimes,” and “Often complains of headaches, stomach-aches or sickness” when the caregiver response was “often.” Both studies in this dissertation support the hypothesis that anxiety is significantly problematic for individuals with ASD. In addition, Study 2 provides specific questions that should be asked for individuals with ASD who are at risk for an anxiety disorder. Implications for the practice of school psychology were also explored, as the findings of these studies indicate that additional assessment for individuals with ASD and symptoms of an anxiety disorder may be warranted.
Author: Christy K. Chapman
Language: English
Subfield: Cognitive Neuroscience
Field: Neuroscience
Domain: Life Sciences
Open Access status: green
OpenAlex ID: W3030214559