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Autism Spectrum and Developmental Disorders

Predictors of Youth-Reported Anxiety Among Autistic Children and Adolescents

(PS4-59) Predictors of Youth-reported Anxiety Among Autistic Children and Adolescents

Friday, November 15, 2024
1:00 PM – 2:00 PM EST
Location: Franklin Hall, Level 4, Marriott Downtown
Abstract Text: Anxiety symptoms frequently co-occur with ASD, as approximately 40% of autistic youth exhibit clinically significant anxiety symptoms (Van Steensel et al., 2011; White & Roberson-Nay, 2009). Clinicians face several challenges when assessing for anxiety in ASD due to the lack of assessment tools (Braconnier et al., 2022), varied manifestations and limitations of self-report (Kerns et al., 2016), as well as discrepancies among parent- and youth-rated anxiety (Kalvin et al., 2020). Often, parent-reports of youth behaviors are used in isolation and youth-reported measures are seldom included in the diagnosis of mental health concerns. As such, current research lacks a coherent understanding of how youth-rated variables may predict anxiety among autistic youth. To explore this, we sought to understand how youth-rated variables of executive function (EF), social skills, and self-concept may predict youth-reported anxiety among autistic youth. Thirty-three youths aged 11-18 years (M = 14.32, SD = 1.85), who received an ASD diagnosis following a comprehensive psychological evaluation at a community-based clinic, were included in the present study. Scores from the Autism Diagnostic Observation Schedule, 2nd Edition (ADOS-2; Lord et al., 2012), Stanford-Binet Intelligence Scales, 5th Edition (SB-5; Roid & Barram, 2004), Behavior Rating Inventory of Executive Function, 2nd Edition (BRIEF2; Gioia et al., 2015), Social Skills Improvement System Rating Scales (SSIS; Gresham & Elliott, 2008), and Beck Youth Inventories, 2nd Edition (BYI-2; Beck, 2005) were extracted for analyses. Hierarchical multiple regression analyses were conducted to understand if youth-reported self-concept, social skills, and EF indices (behavior, emotion, and cognitive regulation) predicted youth-reported anxiety after controlling for VIQ, age, and ASD symptom severity. Next, relative importance analyses were used to understand the relative importance of primary variables. Hierarchical regression analyses revealed that youth-reported emotion regulation accounted for a significant proportion of variance in youth anxiety (F(1, 26) = 28.65, p < .001) and emerged as the only significant predictor (b = .014, t(26) = 5.35, p < .001) within the overall model (F(6, 26) = 5.21 p < .01). Relative importance analyses suggested that emotion regulation accounted for 89.5% of variance, social skills accounted for 8.9% of variance, and approximately 1.6% of variance was attributable to ASD symptom severity, VIQ, age, and self-concept, combined. Results suggest that EF, particularly emotion regulation, may be an important mechanism underlying anxiety among autistic youth. Screening for EF and emotion regulation challenges within ASD diagnostic evaluations and at routine visits may prove to be a vital diagnostic indicator of anxiety among autistic youth. Moreover, researchers and clinicians should consider exerting caution when generalizing findings from studies utilizing parent-reported measures, as the present study demonstrates that these relationships may not always be upheld. Future research should focus on investigating the internal experiences of autistic youth and further elucidate the role of EF as it relates to youth anxiety.