Parent-Rated Anxiety Symptoms in Children with Pervasive Developmental Disorders: Frequency and Association with Core Autism Symptoms and Cognitive Functioning
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In addition to the core symptoms, children with Pervasive Developmental Disorders (PDD) often exhibit other problem behaviors such as aggression, hyperactivity, and anxiety, which can contribute to overall impairment and, therefore, become the focus of clinical attention. Limited data are available on the prevalence of anxiety in these children. We examined frequency and correlates of parent-rated anxiety symptoms in a large sample of children with PDD.
The goals of this study were to examine the frequency and correlates of parent-rated anxiety symptoms in a sample of 171 medication-free children with PDD who participated in two NIH-funded medication trials. Twenty items of the Child and Adolescent Symptom Inventory (CASI) were used to measure anxiety.
Forty three percent of the total sample met screening cut-off criteria for at least one anxiety disorder. Higher levels of anxiety on the 20-item CASI scale were associated with higher IQ, the presence of functional language use, and with higher levels of stereotyped behaviors. In children with higher IQ, anxiety was also associated with greater impairment in social reciprocity.
Anxiety is common in PDD and warrants consideration in clinical evaluation and treatment planning. This study suggests that parent ratings could be a useful source of information about anxiety symptoms in this population. Some anxiety symptoms such as phobic and social anxiety may be closer to core symptoms of PDD. Further efforts to validate tools to ascertain anxiety are needed, as are studies to empirically test approaches to treat anxiety in PDD.
KeywordsPervasive developmental disorders Autism Anxiety Comorbid psychiatric psychopathology
Aberrant Behavior Checklist
Autism Diagnostic Interview-Revised
Child and Adolescent Symptom Inventory
Pervasive Developmental Disorders
Research Units on Pediatric Psychopharmacology
From the Research Units on Pediatric Psychopharmacology Autism Network. Supported by contracts from the National Institute of Mental Health (N01MH70001, to Dr. McDougle; N01MH70009, to Dr. Scahill; N01MH80011, to Dr. Aman; and N01MH70010 and 1K24 MH01805 to Dr McCracken), General Clinical Research Center grants from the National Institutes of Health (M01 RR00750, to Indiana University; M01 RR06022, to Yale University; M01 RR00034, to Ohio State University; and M01 RR00052, to Johns Hopkins University), and the Korczak Foundation, Dr. Scahill.
The opinions and assertions contained in this report are the private views of the authors and are not to be construed as official or as reflecting the views of the National Institute of Mental Health, the National Institutes of Health, or the Department of Health and Human Services.
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