(PS4-42) Examining the Predictive Utility of Facets of Executive Functioning on Anxiety Symptom Profiles in Autistic and Non-autistic Youth

Executive functioning (EF) is conceptualized as a cognitive process that grants individuals the ability to plan, organize, and regulate behavior (Corbett et al., 2009). EF difficulties are a risk factor for anxiety in autistic and non-autistic youth (Kertz et al., 2016), but few have examined predictive relationships of specific types of EF on different aspects of anxiety. In addition, limited studies have used measurement specialized for autistic youth, despite research suggesting phenotypic differences in anxiety symptoms (Kerns et al., 2017). This project sought to further specify these relationships by examining how EF facets differentially predict anxiety symptoms across autistic and non-autistic youth. As parents and children may diverge in their perceptions of both EF challenges and anxiety, particularly in neurodivergent youth (Kenworthy et al., 2021; Blakeley-Smith et al., 2012), we incorporated perspectives of both parents and children. These findings can be utilized to inform treatment approaches to address anxiety symptoms, such as cognitive behavioral therapy (CBT), of which many approaches involve EF for cognitive and behavioral changes.

            Sixty-four neurodiverse youth (M_age =11.79, SD=3.31; 58.6% male; 57% White, 12% Asian/South Asian/MENA; 6% Black, 19% Multiracial; 42 autistic) completed parent- and self-report measures of EF (Behavior Rating Inventory of Executive Function-2, which examines cognitive regulation [CR], emotion regulation [ER], behavioral regulation [BR]; Gioia et al., 2015; 31 self-report) and anxiety (Anxiety Scale for Children – ASD, which includes Performance Anxiety [PA], Anxious Arousal [AA], Social Anxiety [SA], Intolerance of Uncertainty [IU] subscales; Rodgers et al., 2016).

All EF domains significantly correlated with all anxiety domains (all rs > .03, ps < .05). Path analyses examining impacts of parent-reported EF on parent-reported anxiety indicated that more difficulties with CR (b=.57) but less challenges with BR (b=-.43) were associated with increased PA (both ps< .01). More difficulty with ER was associated with increased AA (b=.43, p< .01). More difficulty with CR (b=.31, p< .05) and ER marginally was associated with IU (b=.32, p=.06). No EF was associated with SA. Path analyses examining self-reported EF and anxiety indicated that neither ER, CR, or BR were associated with any report of anxiety.

            Findings suggest that difficulties in ER, BR, and CR may have differential impacts on anxiety symptoms. More specifically, CR and BR may be implicated in PA, while CR and ER may be implicated in IU, and ER may have distinct relationships with AA. However, these relationships are only found with parent-report, and not self-report measures. These findings suggest that incorporating EF training may be useful when approaching anxiety treatment, particularly CBT, which includes both cognitive and behavioral regulation strategies and may be particularly impacted by these impairments. Implementing such practices may be especially beneficial for autistic youth, in whom anxiety symptoms tend to be elevated.