Anxiety is frequently observed in autistic individuals. Signs ofanxiety in autismcan include increased repetitive behaviors, avoidance of social situations, sleep disturbances, and heightened sensory sensitivities.
Anxiety disorders such associal anxiety,generalized anxiety disorder, and specific phobias are also common co-occurring conditions in autism.
The high prevalence of anxiety in autistic individuals may be due to a combination of factors including difficulties withsocial interaction, sensory processing differences, and cognitive inflexibility.
Understanding and addressing anxiety is crucial for improving quality of life for autistic individuals.
Key Points
Rationale
This systematic review aimed to synthesize and evaluate existing research on trait anxiety in individuals with autism spectrum disorder (ASD). The rationale for conducting this review stems from several key factors:
By addressing these rationales, this review aimed to provide a comprehensive overview of the current state of knowledge regarding trait anxiety in ASD and inform future research directions in this important area.
Method
Thissystematic reviewwas conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The review protocol was registered with PROSPERO (registration number: CRD42020207483).
Search strategy and terms:
Eight electronic databases were searched in September 2020 with an update in March 2021: CINAHL, Embase, ERIC, MEDLINE, ProQuest Central, PsycINFO, Scopus, and Web of Science.
The search string used was: (autis* OR asd OR asc OR asperger* OR “pervasive development* disorder*” OR pdd OR hfa) AND (trait NEAR/10 anxi*). Database-specific syntax was used as needed.
Inclusion criteria:
Exclusion criteria:
The initial search yielded 1099 records. After removing duplicates, 451 titles/abstracts were screened, with 296 full-text articles assessed for eligibility.
A total of 23 studies met all inclusion criteria and were included in the review.
Statistical measures
Due to the heterogeneity of included studies, a narrative synthesis approach was used rather than meta-analysis. Descriptive statistics were used to characterize study and participant features.
Cohen’s kappa was calculated to assess inter-rater reliability for study selection. Percentages were used to evaluate reporting quality based on STROBE and CONSORT checklists.
Results
Prevalence and Severity of Trait Anxiety in ASD:
Factors Associated with Trait Anxiety in ASD:
Physiological Correlates of Trait Anxiety in ASD:
Trait Anxiety Across Different ASD Subgroups:
Trait Anxiety and Functional Outcomes in ASD:
Interventions Targeting Trait Anxiety in ASD:
Measurement of Trait Anxiety in ASD:
Insight
This systematic review provides several key insights into the current state of research on trait anxiety in autism spectrum disorder (ASD):
Future research should prioritize:
Strengths
The study had several methodological strengths including:
Limitations
The review has several limitations that should be considered:
These limitations highlight the need for more diverse and methodologically rigorous research on trait anxiety in ASD.
Implications
The findings of this systematic review have several important implications:
These implications underscore the significance of trait anxiety as an important construct in ASD research and clinical practice, with potential impacts on diagnosis, treatment, and support across various life domains.
References
Primary reference
Jolliffe, R., Adams, D., & Simpson, K. (2023). Trait anxiety in individuals on the autism spectrum: a systematic review.Review Journal of Autism and Developmental Disorders,10(3), 523-545.https://doi.org/10.1007/s40489-022-00308-8
Other references
Hollocks, M. J., Lerh, J. W., Magiati, I., Meiser-Stedman, R., & Brugha, T. S. (2019). Anxiety and depression in adults with autism spectrum disorder: a systematic review and meta-analysis.Psychological medicine,49(4), 559-572.
Kerns, C. M., & Kendall, P. C. (2012). The presentation and classification of anxiety in autism spectrum disorder.Clinical Psychology: Science and Practice,19(4), 323.
Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., Miller, J., & Herrington, J. (2014). Traditional and atypical presentations of anxiety in youth with autism spectrum disorder.Journal of autism and developmental disorders,44, 2851-2861.https://doi.org/10.1007/s10803-014-2141-7
McEwen, B. S., & Gianaros, P. J. (2011). Stress-and allostasis-induced brain plasticity.Annual review of medicine,62(1), 431-445.https://doi.org/10.1146/annurev-med-052209-100430
Spielberger, C. (1966).Theory and research on anxiety. In C. Spielberger (Ed.), Anxiety and behavior. Academic Press.
Keep Learning
Saul McLeod, PhD
BSc (Hons) Psychology, MRes, PhD, University of Manchester
Saul McLeod, PhD., is a qualified psychology teacher with over 18 years of experience in further and higher education. He has been published in peer-reviewed journals, including the Journal of Clinical Psychology.
Olivia Guy-Evans, MSc
BSc (Hons) Psychology, MSc Psychology of Education
Olivia Guy-Evans is a writer and associate editor for Simply Psychology. She has previously worked in healthcare and educational sectors.
