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Adams D, Ambrose K, Simpson K, Malone S, Dargue N. The relationshipbetween anxiety and social outcomes in autistic children and adolescents: A meta-analysis. Clin Child Fam Psychol Rev 2023; 26:706-720. [PMID: 37606793 PMCID: PMC10465686 DOI: 10.1007/s10567-023-00450-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2023] [Indexed: 08/23/2023]
Abstract
Anxiety is one of the most frequently reported co-occurring conditions for autistic children and adolescents. The relationship between anxiety and social outcomes in autistic youth has been the focus of a range of studies, with mixed results. This meta-analysis aimed to identify the strength of the association between anxiety and a frequently researched social outcome (social competence) in autistic young people and whether that association is influenced by individual or research design factors. A previous preregistered systematic review was updated with a search of the same three databases (CINAHL, ERIC, and PsycINFO) as the original review. Through this, 20 studies with sufficient data on a neurotypically-defined measure of social competence and anxiety were identified. Results were synthesised using a mixed effects model. The meta-analysis on 2,321 participants (from 22 samples) highlighted wide heterogeneity in results. The findings show that anxiety has a significant, small negative impact on social competence (d = - 0.48; 95% CI = - 0.71, - 0.26), meaning that as scores on measures of anxiety increase, scores on measures of social competence decrease. This relationship between anxiety and social competence was moderated by age, becoming weaker as age increased. Whilst this is an important finding for supporting mental health and well-being of autistic young people, the large amount of variance left unexplained suggests that multiple factors, including the use of measures designed for neurotypical people and the potential impact of camouflaging on such measures, need to be considered in future designs.
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Affiliation(s)
- Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia.
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia.
- Autism CRC, Brisbane, Australia.
| | - Kathryn Ambrose
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Autism CRC, Brisbane, Australia
| | - Kate Simpson
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Autism CRC, Brisbane, Australia
| | - Stephanie Malone
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
| | - Nicole Dargue
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
- Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, QLD 4122, Brisbane, Australia
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Ambrose K, Simpson K, Adams D. The relationship between social and academic outcomes and anxiety for children and adolescents on the autism spectrum: A systematic review. Clin Psychol Rev 2021; 90:102086. [PMID: 34598053 DOI: 10.1016/j.cpr.2021.102086] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 12/28/2022]
Abstract
Anxiety is the most common co-occurring condition in children on the autism spectrum but the potential impacts of anxiety on social and academic outcomes of children on the autism spectrum have not been systematically examined. In this review, 50 studies were identified that explore the relationship between anxiety and scores on social or academic measures in children on the autism spectrum. Social competence was frequently measured, and the findings of these studies were mixed. While other social constructs have received little attention, associations were found between anxiety and victimisation, and anxiety and social relationships. Only three studies focused on the impact of anxiety on scores on academic measures, highlighting the need for further research in this area. Anxiety was most frequently measured using subscales from broader behavioural instruments, which may not capture the range of anxiety symptoms of children on the autism spectrum. Future studies that include multi-informant methodologies and proportional representation of females and children with intellectual disability will further knowledge of the impact of anxiety in children on the spectrum.
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Affiliation(s)
- Kathryn Ambrose
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia.
| | - Kate Simpson
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
| | - Dawn Adams
- Autism Centre of Excellence, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; Griffith Institute for Educational Research, Griffith University, Messines Ridge Road, Mt Gravatt, Brisbane, QLD 4122, Australia; The Co-operative Research Centre for Living with Autism (Autism CRC), PO Box 6068, St Lucia, QLD 4067, Australia
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Kovacs Balint Z, Raper J, Michopoulos V, Howell LH, Gunter C, Bachevalier J, Sanchez MM. Validation of the Social Responsiveness Scale (SRS) to screen for atypical social behaviors in juvenile macaques. PLoS One 2021; 16:e0235946. [PMID: 34014933 PMCID: PMC8136728 DOI: 10.1371/journal.pone.0235946] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 04/12/2021] [Indexed: 12/28/2022] Open
Abstract
Primates form strong social bonds and depend on social relationships and networks that provide shared resources and protection critical for survival. Social deficits such as those present in autism spectrum disorder (ASD) and other psychiatric disorders hinder the individual’s functioning in communities. Given that early diagnosis and intervention can improve outcomes and trajectories of ASD, there is a great need for tools to identify early markers for screening/diagnosis, and for translational animal models to uncover biological mechanisms and develop treatments. One of the most widely used screening tools for ASD in children is the Social Responsiveness Scale (SRS), a quantitative measure used to identify individuals with atypical social behaviors. The SRS has been adapted for use in adult rhesus monkeys (Macaca mulatta)–a species very close to humans in terms of social behavior, brain anatomy/connectivity and development–but has not yet been validated or adapted for a necessary downward extension to younger ages matching those for ASD diagnosis in children. The goal of the present study was to adapt and validate the adult macaque SRS (mSRS) in juvenile macaques with age equivalent to mid-childhood in humans. Expert primate coders modified the mSRS to adapt it to rate atypical social behaviors in juvenile macaques living in complex social groups at the Yerkes National Primate Research Center. Construct and face validity of this juvenile mSRS (jmSRS) was determined based on well-established and operationalized measures of social and non-social behaviors in this species using traditional behavioral observations. We found that the jmSRS identifies variability in social responsiveness of juvenile rhesus monkeys and shows strong construct/predictive validity, as well as sensitivity to detect atypical social behaviors in young male and female macaques across social status. Thus, the jmSRS provides a promising tool for translational research on macaque models of children social disorders.
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Affiliation(s)
- Z. Kovacs Balint
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
| | - J. Raper
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
- Department of Pediatrics, Emory University, Atlanta, Georgia, United States of America
| | - V. Michopoulos
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
| | - L. H. Howell
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
| | - C. Gunter
- Department of Pediatrics, Emory University, Atlanta, Georgia, United States of America
- Marcus Autism Center, Children’s Healthcare of Atlanta, Atlanta, Georgia, United States of America
- Department of Human Genetics, Emory University, Atlanta, Georgia, United States of America
| | - J. Bachevalier
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
- Department of Psychology, Emory University, Atlanta, Georgia, United States of America
| | - M. M. Sanchez
- Yerkes National Primate Research Center, Emory University, Atlanta, Georgia, United States of America
- Department of Psychiatry & Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, United States of America
- * E-mail:
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Hillman K, Dix K, Ahmed K, Lietz P, Trevitt J, O'Grady E, Uljarević M, Vivanti G, Hedley D. Interventions for anxiety in mainstream school-aged children with autism spectrum disorder: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2020; 16:e1086. [PMID: 37131419 PMCID: PMC8356281 DOI: 10.1002/cl2.1086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Kylie Hillman
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Katherine Dix
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Kashfee Ahmed
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Petra Lietz
- Australian Council for Educational ResearchAdelaideSouth AustraliaAustralia
| | - Jenny Trevitt
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Elizabeth O'Grady
- Australian Council for Educational ResearchCamberwellVictoriaAustralia
| | - Mirko Uljarević
- Division of Child and Adolescent Psychiatry, Stanford Autism Center, Department of Psychiatry and Behavioral Sciences, School of MedicineStanford UniversityPalo AltoCalifornia
| | - Giacomo Vivanti
- A. J. Drexel Autism InstituteDornsife School of Public Health, Drexel UniversityPhiladelphiaPennsylvania
| | - Darren Hedley
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, College of Science, Health and EngineeringLaTrobe UniversityBundooraVictoriaAustralia
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