Journal of Autism and Developmental Disorders

, Volume 43, Issue 3, pp 521–529 | Cite as

Social Anxiety in Parents of High-Functioning Children with Autism and Asperger Syndrome

  • Sanna Kuusikko-GauffinEmail author
  • Rachel Pollock-Wurman
  • Marja-Leena Mattila
  • Katja Jussila
  • Hanna Ebeling
  • David Pauls
  • Irma Moilanen
Original Paper


We evaluated social anxiety (SA) symptoms in parents of children with autism spectrum disorders (ASDs; N = 131) and community parents (N = 597) using the Social Phobia and Anxiety Inventory (SPAI). SA was significantly more common in ASD than control mothers (15.6 vs. 6.7 %) and more equal between the ASD and control fathers (3.3 vs. 4.8 %). The ASD mothers scored significantly higher than control mothers on all SPAI scales. ASD fathers scored significantly higher than control fathers on the somatic, cognitive, avoidance and agoraphobic symptoms of SA. It is of clinical import to support ASD parents’ well-being as their psychiatric features may contribute greatly to their children’s emotional development and the well-being of the whole family.


Adult Age Autism spectrum disorders Gender Social anxiety SPAI 



The research was supported by The Alma and K. A. Snellman Foundation, Oulu, Finland (PI: S. Kuusikko-Gauffin, M-L. Mattila); Rinnekoti Säätiö, Finland (PI: M-L. Mattila), Child Psychiatric Research Foundation, Finland (PI: S. Kuusikko-Gauffin, M-L. Mattila), Emil Aaltonen Foundation, Finland (PI: H. Ebeling, S. Kuusikko-Gauffin); National Alliance for Autism Research (NAAR; PI: D. Pauls). We want to thank the participants of the study.


  1. Alonso, J., Angermeyer, M. C., Bernert, S., Bruffaerts, R., Brugha, T. S., Bryson, H., et al. (2004). Prevalence of mental disorders in Europe: Results from the European study of the epidemiology of mental disorders (ESEMeD) project. Acta Psychiatrica Scandinavica, 109, 21–27.CrossRefGoogle Scholar
  2. American Psychiatric Association (APA). (2000). Diagnostic statistical manual of mental disorders, (4th ed), Text revision. Washington, DC, American Psychiatric Association.Google Scholar
  3. Baker, J. K., Seltzer, M. M., & Greenberg, J. S. (2011). Longitudinal effects of adaptability on behavior problems and maternal depression in families of adolescents with autism. Journal of Family Psychology, 25(4), 601–609.PubMedCrossRefGoogle Scholar
  4. Baños, R. M., Botella, C., Quero, S., & Medina, P. (2007). The social phobia and anxiety inventory: Psychometric properties in a Spanish sample. Psychological Reports, 100(2), 441–450.PubMedCrossRefGoogle Scholar
  5. Barker, E. T., Hartley, S. L., Seltzer, M., Floyd, F. J., Greenberg, J. S., & Orsmond, G. I. (2011). Trajectories of emotional well-being in mothers of adolescents and adults with autism. Developmental Psychology, 47(2), 551–561.PubMedCrossRefGoogle Scholar
  6. Beidel, D. C., Borden, J. W., Turner, S. M., & Jacob, R. G. (1989). The social phobia and anxiety inventory: Concurrent validity with a clinic sample. Behaviour Research and Therapy, 27(5), 573–576.PubMedCrossRefGoogle Scholar
  7. Beidel, D. C., Turner, S. M., & Cooley, M. R. (1993). Assessing reliable and clinically significant change in social phobia: Validity of the social phobia and anxiety inventory. Behaviour Research and Therapy, 31(3), 331–337.PubMedCrossRefGoogle Scholar
  8. Bernstein, G. A., Layne, A. E., Egan, E. A., & Nelson, L. P. (2005). Maternal phobic anxiety and child anxiety. Journal of Anxiety Disorders, 19(6), 658–672.PubMedCrossRefGoogle Scholar
  9. Bögels, S. M., & Reith, W. (1999). Validity of two questionnaires to assess social fears: The Dutch social phobia and anxiety inventory and the blushing, trembling and sweating questionnaire. Journal of Psychopathology and Behavior Assessment, 21(1), 51–66.CrossRefGoogle Scholar
  10. Bruce, S. E., Yonkers, K. A., Otto, M. W., Eisen, J. L., Weisberg, R. B., Pagano, M., et al. (2005). Influence of psychiatric comorbidity on recovery and recurrence in generalized anxiety disorder, social phobia, and panic disorder: A 12-year prospective study. American Journal of Psychiatry, 162(6), 1179–1187.PubMedCrossRefGoogle Scholar
  11. Cohen, J. (1988). Statistical power analysis for the behavior sciences (2nd ed). Lawrence Erlbaum Associates Inc., NJ.Google Scholar
  12. Cox, B. J., Ross, L., Swinson, R. P., & Direnfeld, D. M. (1998). A comparison of social phobia outcome measures in cognitive-behavioral group therapy. Behavior Modification, 22(3), 285–297.PubMedCrossRefGoogle Scholar
  13. Craske, M. G. (2003). Origins of phobias and anxiety disorders: Why more women than men. Amsterdam: Elsevier.Google Scholar
  14. De la Marche, W., Noens, I., Luts, J., Scholte, E., Van Huffel, S., & Steyaert, J. (2011). Quantitative autism traits in first degree relatives: Evidence for the broader autism phenotype in fathers, but not in mothers and siblings. Autism (Epub ahead of print).Google Scholar
  15. de Menezes, G. B., Fontenelle, L. F., & Versiani, M. (2006). Trans-cultural aspects of social anxiety disorder and related conditions: A Brazilian case series and a review of international clinical studies. Jornal brasileiro de psiquiatria, 55, 196–200.CrossRefGoogle Scholar
  16. Edel, M. A., Rudel, A., Hubert, C., Scheele, D., Brüne, M., Juckel, G., et al. (2010). Alexithymia, emotion processing and social anxiety in adults with ADHD. European journal of medical research, 15(9), 403–409.PubMedGoogle Scholar
  17. El-Fishawy, P., & State, M. W. (2010). The genetics of autism: Key issues, recent findings, and clinical implications. The Psychiatric clinics of North America, 33(1), 83–105.PubMedCrossRefGoogle Scholar
  18. Fox, J. K., Warner, C. M., Lerner, A. B., Ludwig, K., Ryan, J. L., Colognori, D., et al. (2012). Preventive intervention for anxious preschoolers and their parents: Strengthening early emotional development. Child psychiatry and human development (Epub ahead of print).Google Scholar
  19. Giallo, R., Wood, C. E., Jellett, R., & Porter, R. (2011). Fatigue, wellbeing and parental self-efficacy in mothers of children with an autism spectrum disorder. Autism (Epub ahead of print).Google Scholar
  20. Hallmayer, J., Cleveland, S., Torres, A., Phillips, J., Cohen, B., Torigoe, T., et al. (2011). Genetic heritability and shared environmental factors among twin pairs with autism. Archives of General Psychiatry, 68(11), 1095–1102.PubMedCrossRefGoogle Scholar
  21. Hofmann, S. G., Asnaani, A., & Hinton, D. E. (2010). Cultural aspects in social anxiety and social anxiety disorder. Depression and Anxiety, 27, 1117–1127.PubMedCrossRefGoogle Scholar
  22. Ingersoll, B., Meyer, K., & Becker, M. W. (2011). Increased rates of depressed mood in mothers of children with ASD associated with the presence of the broader autism phenotype. Autism Research, 4(2), 143–148.PubMedCrossRefGoogle Scholar
  23. Inglés, C. J., Piqueras, J. A., García-Fernández, J. M., García-López, L. J., Delgado, B., & Ruiz-Esteban, C. (2010). Gender and age differences in the cognitive, psychophysiological, and behavioral responses of social anxiety in adolescence. Psicothema, 22(3), 376–381.PubMedGoogle Scholar
  24. Kuusikko, S., Pollock-Wurman, R., Ebeling, H., Hurtig, T., Joskitt, L., Mattila, M. L., et al. (2009). Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R). European Child and Adolescent Psychiatry, 18(2), 116–124.PubMedCrossRefGoogle Scholar
  25. Kuusikko-Gauffin, S. (2011). Social anxiety and emotion recognition in autism spectrum disorders. Academic dissertation. Tampere: Juvenes Print.Google Scholar
  26. Larson, E. (2010). Ever vigilant: Maternal support of participation in daily life for boys with autism. Physical & occupational therapy in pediatrics, 30(1), 16–27.CrossRefGoogle Scholar
  27. Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2000). Autism diagnostic observation schedule. Los Angeles, CA: Western Psychological Services.Google Scholar
  28. Lord, C., Rutter, M., & Le Couteur, A. (1995). Autism diagnostic interview-revised (3rd ed.). Los Angeles, CA: Western Psychological Services.Google Scholar
  29. Mattila, M. L., Kielinen, M., Jussila, K., Linna, S. L., Bloigu, R., Ebeling, H., et al. (2007). An epidemiological and diagnostic study of asperger syndrome according to four sets of diagnostic criteria. Journal of the American Academy of Child and Adolescent Psychiatry, 46(5), 636–646.PubMedCrossRefGoogle Scholar
  30. Mattila, M. L., Kielinen, M., Linna, S. L., Jussila, K., Ebeling, H., Bloigu, R., et al. (2011). Autism spectrum disorders according to DSM-IV-TR and comparison with DSM-5 draft criteria: An epidemiological study. Journal of the American Academy Child and Adolescent Psychiatry, 50(6), 583–592.CrossRefGoogle Scholar
  31. Murphy, M., Bolton, P. F., Pickles, A., Fombonne, E., Piven, J., & Rutter, M. (2000). Personality traits of the relatives of autistic probands. Psychological Medicine, 30(6), 1411–1424.PubMedCrossRefGoogle Scholar
  32. Peters, L. (2000). Discriminant validity of the social phobia and anxiety inventory (SPAI), the social phobia scale (SPS) and the social interaction anxiety scale (SIAS). Behavioral Research Therapy, 38(9), 943–950.CrossRefGoogle Scholar
  33. Picon, P., Gauer, G. J., Hirakata, V. N., Haggsträm, L. M., Beidel, D. C., Turner, S. M., et al. (2005). Reliability of the social phobia and anxiety inventory (SPAI) Portuguese version in a heterogeneous sample of Brazilian university students. Revista brasileira de psiquiatria, 27(2), 124–130.PubMedCrossRefGoogle Scholar
  34. Pine, D. S., Cohen, P., Gurley, D., Brook, J., & Ma, Y. (1998). The risk for early-adulthood anxiety and depressive disorders in adolescents with anxiety and depressive disorders. Archives of General Psychiatry, 55(1), 56–64.PubMedCrossRefGoogle Scholar
  35. Pirkola, S., Isometsa, E., Suvisaari, J., Aro, H., Joukamaa, M., Poikolainen, K., et al. (2005). DSM- IV Mood-, anxiety- and alcohol use disorders and their comorbidity in the Finnish general population: Results from the health 2000 study. Social Psychiatry and Psychiatric Epidemiology, 40, 1–10.PubMedCrossRefGoogle Scholar
  36. Piven, J., & Palmer, P. (1999). Psychiatric disorder and the broad autism phenotype: Evidence from a family study of multiple-incidence autism families. American Journal of Psychiatry, 156(4), 557–563.PubMedGoogle Scholar
  37. Ranta, K., Junttila, N., Laakkonen, E., Uhmavaara, A., La Greca, A. M., & Niemi, P. M. (2012). Social anxiety scale for adolescents (SAS-A): Measuring social anxiety among Finnish adolescents. Child Psychiatry and Human Development (Epub ahead of print).Google Scholar
  38. Ranta, K., Kaltiala-Heino, R., Rantanen, P., & Marttunen, M. (2009). Social phobia in Finnish general adolescent population: Prevalence, comorbidity, individual and family correlates, and service use. Depression and Anxiety, 26(6), 528–536.PubMedGoogle Scholar
  39. Ries, B. J., McNeil, D. W., Boone, M. L., Turk, C. L., Carter, L. E., & Heimberg, R. G. (1998). Assessment of contemporary social phobia verbal report instruments. Behavioral Research Therapy, 36(10), 983–994.CrossRefGoogle Scholar
  40. Rodebaugh, T. L., Chambless, D. L., Terrill, D. R., Floyd, M., & Uhde, T. (2000). Convergent, discriminant, and criterion-related validity of the social phobia and anxiety inventory. Depression and Anxiety, 11(1), 10–14.PubMedCrossRefGoogle Scholar
  41. Schwichtenberg, A. J., Young, G. S., Sigman, M., Hutman, T., & Ozonoff, S. (2010). Can family affectedness inform infant sibling outcomes of autism spectrum disorders? Journal of Child Psychology and Psychiatry, 51(9), 1021–1030.PubMedCrossRefGoogle Scholar
  42. Smalley, S. L., McCracken, J., & Tanguay, P. (1995). Autism, affective disorders, and social phobia. American Journal of Medical Genetics, 60(1), 19–26.PubMedCrossRefGoogle Scholar
  43. Szatmari, P., Georgiades, S., Duku, E., Zwaigenbaum, L., Goldberg, J., & Bennett, T. J. (2008). Alexithymia in parents of children with autism spectrum disorder. Autism and Developmental Disorders, 38(10), 1859–1865.CrossRefGoogle Scholar
  44. Taylor, S. (1999). Anxiety sensitivity: Theory, research and treatment of the fear of anxiety. NJ: Lawrence Erlbaum Associates Inc.Google Scholar
  45. Turner, S. M., Beidel, D. C., & Dancu, C. V. (2004). SPAI. Social phobia and anxiety inventory. Manual. NY: Multi-Health system Inc.Google Scholar
  46. Virkud, Y. V., Todd, R. D., Abbacchi, A. M., Zhang, Y., & Constantino, J. N. (2008). Familial aggregation of quantitative autistic traits in multiplex versus simplex autism. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics, 150B(3), 328–334.CrossRefGoogle Scholar
  47. Weiss, L. A., & Arking, D. E. (2009). The gene discovery project of John Hopkins, the autism consortium. A genomwide linkage and association scan reveals novel loci for autism. Nature, 461(7265), 802–808.PubMedCrossRefGoogle Scholar
  48. White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009). Anxiety in children and adolescents with autism spectrum disorders. Clinical psychology review, 29(3), 216–229.PubMedCrossRefGoogle Scholar
  49. Williams, S. R., Kertz, S. J., Schrock, M. D., & Woodruff-Borden, J. (2012). A sequential analysis of parent-child interactions in anxious and nonanxious families. Journal of Clinical Child & Adolescent Psychology, 41(1), 64–74.Google Scholar
  50. Wittchen, H. U., Stein, M. B., & Kessler, R. C. (1999). Social fears and social phobia in a community of adolescents and young adults: Prevalence, risk factors and comorbidity. Psychological Medicine, 29, 309–323.PubMedCrossRefGoogle Scholar
  51. World Health Organisation (WHO). (1993). ICD-10 Classification of mental and behavioural disorders: Diagnostic criteria for research. Geneva, Switzerland.Google Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Sanna Kuusikko-Gauffin
    • 1
    Email author
  • Rachel Pollock-Wurman
    • 2
  • Marja-Leena Mattila
    • 1
  • Katja Jussila
    • 1
  • Hanna Ebeling
    • 1
  • David Pauls
    • 2
  • Irma Moilanen
    • 1
  1. 1.Department of Child Psychiatry, Faculty of Medicine, Institute of Clinical MedicineUniversity and University Hospital of OuluOuluFinland
  2. 2.Harvard Medical SchoolMassachusetts General HospitalBostonUSA

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