Anxiety in young people with autism spectrum disorder: Common and autism-related anxiety experiences and their associations with individual characteristics.

Anxiety is common in autism spectrum disorder. Many anxiety symptoms in autism spectrum disorder are consistent with Diagnostic and Statistical Manual of Mental Disorders (5th ed.) anxiety disorders (termed "common" anxieties), but others may be qualitatively different, likely relating to autism spectrum disorder traits (herein termed "autism-related" anxieties). To date, few studies have examined both "common" and "autism-related" anxiety experiences in autism spectrum disorder. We explored caregiver-reported Spence Children's Anxiety Scale-Parent version data from a multi-site (United Kingdom, Singapore, and United States) pooled database of 870 6- to 18-year-old participants with autism spectrum disorder, of whom 287 provided at least one written response to the optional open-ended Spence Children's Anxiety Scale-Parent item 39 (" Is there anything else your child is afraid of ?"). Responses were thematically coded to explore (a) common and autism-related anxiety presentations and (b) their relationship with young people's characteristics. Nearly half of the responses were autism-related anxieties (mostly sensory, uncommon, or idiosyncratic specific phobias and worries about change and unpredictability). The other half described additional common anxieties not covered in the original measure (mostly social, weather and environmental disasters, and animals). Caregivers of participants who were more severely affected by autism spectrum disorder symptoms reported more autism-related, as compared to common, additional anxieties. Implications for the assessment and understanding of anxiety in autism are discussed. Many autistic young people and adults experience anxiety. Some of the things that make autistic people anxious are also experienced by many non-autistic people (we call these common/shared anxieties), while some experiences may be more common in autistic and less common in non-autistic people (we call these autism spectrum disorder–related anxieties). Most research so far has used existing measures of anxiety developed for non-autistic people to measure autistic people's anxiety, but much less is known about the more autism spectrum disorder–related anxiety experiences of young people on the spectrum. In this study, we wanted to find out what were the different types of common but also autism spectrum disorder–related anxieties that caregivers reported their autistic children experienced. We used a question in the Spence Children's Anxiety Scale-Parent version which asks "Is there anything else your child is afraid of?" We pooled together all the responses from caregivers of 870 6- to 18-year-old young autistic people from three countries (United Kingdom, United States, and Singapore), of whom 287 provided at least one written response to this question. We then organized their responses into common and more autism spectrum disorder–related anxiety presentations: we found that about half were autism spectrum disorder related (these were sensory, some less common specific fears, and worries about change and unpredictability), and the other half were common anxieties (mostly social worries, anxiety about the weather, environmental disasters, and animals). We discuss how these findings could help better identify anxiety in autistic young people and provide more autism-informed supports. [ABSTRACT FROM AUTHOR]