Journal of Autism and Developmental Disorders

, Volume 43, Issue 6, pp 1336–1346 | Cite as

Patterns and Predictors of Anxiety Among Siblings of Children with Autism Spectrum Disorders

  • Carolyn M. Shivers
  • Lauren K. Deisenroth
  • Julie Lounds TaylorEmail author
Original Paper


The purpose of this study was to examine patterns of anxiety among siblings of children with autism spectrum disorders (ASD), and determine the characteristics of the child with ASD and their parents that predicted anxiety. Data was collected from 1,755 siblings of children with ASD whose families participated in the Simons Simplex Collection; siblings ranged in age from 3 to 18 years (M = 9 years). Male siblings were at increased risk for sub-clinical anxiety problems during middle childhood. Parental history of anxiety disorders, higher maternal pragmatic language, and more proband behavior problems predicted higher anxiety. While siblings overall did not show elevated anxiety symptoms, higher rates of sub-clinical anxiety problems among males and siblings in middle childhood are cause for concern.


Anxiety Autism spectrum disorder Siblings Broader autism phenotype 



We would like to thank the Simons Foundation Autism Research Initiative for the use of their data, with special thanks to Alison Vehorn and Melissa Potter for their help obtaining data. Core support was received from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (P30 HD15052, E. M. Dykens, PI). Thanks to Dr. Warren Lambert for statistical consultation. The authors report no financial interests or potential conflicts of interest.


  1. Achenbach, T. M., & Edelbrock, C. (1983). Manual for the child behavior checklist and revised child behavior profile. Burlington, VT: University of Vermont.Google Scholar
  2. Achenbach, T. M., & Rescorla, L. A. (2001). Manual for the ASBEA school-age forms and profiles. Burlington, VT: University of Vermont.Google Scholar
  3. American Psychiatric Association. (2000). Diagnostics and statistical manual of mental disorders (DSM-IV-TR) (4th ed., text revision). Washington, DC: American Psychiatric Association.Google Scholar
  4. Barnard, K. E., & Solchany, J. E. (2002). Mothering. In M. H. Bernstein (Ed.), Handbook of parenting (Vol. 3, pp. 3–25)., Being and becoming a parent Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  5. Beesdo, K., Knappe, S., & Pine, D. S. (2009). Anxiety and anxiety disorders in children and adolescents: Developmental issues and implications for DSM-V. Psychiatric Clinics of North America, 32(3), 483–524.PubMedCrossRefGoogle Scholar
  6. Benson, P. R., & Karlof, K. L. (2008). Child, parent, and family predictors of latter adjustment in siblings of children with autism. Research in Autism Spectrum Disorders, 2(4), 583–600.CrossRefGoogle Scholar
  7. Bernstein, G. A., Borchardt, C. M., & Perwien, A. R. (1996). Anxiety disorders in children and adolescents: A review of the past 10 years. Journal of the American Academy of Child and Adolescent Psychiatry, 35(9), 1110–1119.PubMedCrossRefGoogle Scholar
  8. Bongers, I. L., Koot, H. M., van der Ende, J., & Verhulst, F. C. (2003). The normative development of child and adolescent problem behavior. Journal of Abnormal Psychology, 112(2), 179–192.PubMedCrossRefGoogle Scholar
  9. Cartwright-Hatton, S. (2006). Editorial: Anxiety of childhood and adolescence: Challenges and opportunities. Clinical Psychology Review, 26(7), 813–816.PubMedCrossRefGoogle Scholar
  10. Cartwright-Hatton, S., McNicol, K., & Doubleday, E. (2006). Anxiety in a neglected population: Prevalence of anxiety disorders in pre-adolescent children. Clinical Psychology Review, 26(7), 817–833.PubMedCrossRefGoogle Scholar
  11. Caspi, A., Moffitt, T. E., Newman, D. L., & Silva, P. A. (1998). Behavioral observations at age 3 years predict adult psychiatric disorders: Longitudinal evidence from a birth cohort. In M. E. Hertzig & E. A. Farber (Eds.), Annual progress in child psychiatry and child development: 1997 (pp. 319–331). Philadelphia, PA: Brunner/Mazel.Google Scholar
  12. Cents, R. A. M., Tiemeier, H., Luijk, M. P. C. M., Jaddoe, V. W. V., Hofman, A., Verhulst, F. C., et al. (2011). Grandparental anxiety and depression predict young children’s internalizing and externalizing problems: The generation R study. Journal of Affective Disorders, 128(1–2), 95–105.PubMedCrossRefGoogle Scholar
  13. Costello, E. J., Mustillo, S., Erkanli, A., Keeler, G., & Angold, A. (2003). Prevalence and development of psychiatric disorders in childhood and adolescence. Archives of General Psychiatry, 60(8), 837–844.PubMedCrossRefGoogle Scholar
  14. Dempsey, A. G., Llorens, A., Brewton, C., Mulchandani, S., & Goin-Kochel, R. P. (2012). Emotional and behavioral adjustment in typically developing siblings of children with autism spectrum disorders. Journal of Autism and Developmental Disorders, 42(7), 1393–1402.PubMedCrossRefGoogle Scholar
  15. Ebesutani, C., Bernstein, A., Nakamura, B. J., Chorpita, B. F., Higa-McMillan, C. K., & Weisz, J. R. (2010). Concurrent validity of the child behavior checklist DSM-oriented scales: Correspondence with DSM diagnoses and comparison to syndrome scales. Journal of Psychopathology and Behavioral Assessment, 32(3), 373–384.PubMedCrossRefGoogle Scholar
  16. Elliot, C. D. (2007). Differential ability scales (2nd ed.). Minneapolis, MN: Pearson.Google Scholar
  17. Fombonne, E. (1999). The epidemiology of autism: A review. Psychological Medicine, 29(4), 769–786.PubMedCrossRefGoogle Scholar
  18. Foundation, Simons. (2010). SFARI base/SSC researcher welcome packet. New York, NY: Simons Foundation.Google Scholar
  19. Gardner, W., Mulvey, E. P., & Shaw, E. C. (1995). Regression analyses of counts and rates: Poisson, overdispersed Poisson, and negative binomial models. Psychological Bulletin, 118(3), 392–404.PubMedCrossRefGoogle Scholar
  20. Gau, S. S., Chou, M., Lee, J., Wong, C., Chou, W., Chen, M., et al. (2010). Behavioral problems and parenting style among Taiwanese children with autism and their siblings. Psychiatry and Clinical Neurosciences, 64(1), 70–78.PubMedCrossRefGoogle Scholar
  21. Glasberg, B. A. (2000). The development of siblings’ understanding of autism spectrum disorders. Journal of Autism and Developmental Disorders, 30(2), 143–156.PubMedCrossRefGoogle Scholar
  22. Gold, N. (1993). Depression and social adjustment in siblings of boys with autism. Journal of Autism and Developmental Disorders, 23, 147–163.PubMedCrossRefGoogle Scholar
  23. Gotham, K., Pickles, A., & Lord, C. (2009). Standardizing ADOS scores for a measure of severity in autism spectrum disorders. Journal of Autism and Developmental Disorders, 39(5), 693–705.PubMedCrossRefGoogle Scholar
  24. Harrell, F. E. (2001). Regression modeling strategies. New York: Springer.CrossRefGoogle Scholar
  25. Hastings, R. P. (2003). Behavioral adjustment of siblings of children with autism. Journal of Autism and Developmental Disorders, 33(2), 99–104.PubMedCrossRefGoogle Scholar
  26. Hastings, R. P. (2007). Longitudinal relationships between sibling behavioral adjustment and behavior problems of children with developmental disabilities. Journal of Autism and Developmental Disorders, 37(8), 1485–1492.PubMedCrossRefGoogle Scholar
  27. Huang, L. N. (1999). Family communication patterns and personality characteristics. Communication Quarterly, 47(2), 230–243.CrossRefGoogle Scholar
  28. Hurley, R. S. E., Losh, M., Parlier, M., Reznick, J. S., & Piven, J. (2007). The broad autism phenotype questionnaire. Journal of Autism and Developmental Disorders, 37(9), 1679–1690.PubMedCrossRefGoogle Scholar
  29. Johnson, E. O., Chilcoat, H. D., & Breslau, N. (2000). Trouble sleeping and anxiety/depression in childhood. Psychiatry Research, 94(2), 93–102.PubMedCrossRefGoogle Scholar
  30. Keiley, M. K., Bates, J. E., Dodge, K. A., & Pettit, G. S. (2000). A cross-domain growth analysis: Externalizing and internalizing behaviors during 8 years of childhood. Journal of Abnormal Child Psychology, 28, 161–179.PubMedCrossRefGoogle Scholar
  31. Kelly, L., Keaten, J. A., Finch, C., Duarte, I. B., Hoffman, P., & Michels, M. M. (2002). Family communication and the development of reticence. Communication Edition, 51(2), 202–209.CrossRefGoogle Scholar
  32. Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distribution of DSM-IV disorders in the national comorbidity survey replication. Archives of General Psychiatry, 62, 593–602.PubMedCrossRefGoogle Scholar
  33. Kessler, R. C., & McLeod, J. D. (1984). Sex differences in vulnerability to undesirable life events. American Sociological Review, 49, 620–631.CrossRefGoogle Scholar
  34. King, M. D., & Bearman, P. S. (2011). Socioeconomic status and the increased prevalence of autism in California. American Sociological Review, 76(2), 320–346.PubMedCrossRefGoogle Scholar
  35. La Greca, A. M., & Lopez, N. (1998). Social anxiety among adolescents: Linkages with peer relations and friendships. Journal of Abnormal Child Psychology, 26, 83–94.PubMedCrossRefGoogle Scholar
  36. Lainhart, J. E. (1999). Psychiatric problems in individuals with autism, their parents and siblings. International Review of Psychiatry, 11(4), 278–298.CrossRefGoogle Scholar
  37. Landman-Peeters, K. M. C., Hartman, C. A., van der Pompe, G., den Boer, J. A., Minderaa, R. B., & Ormel, J. (2005). Gender differences in the relation between social support, problems in parent-offspring communication, and depression and anxiety. Social Science and Medicine, 60(11), 2549–2559.PubMedCrossRefGoogle Scholar
  38. Last, C. G., Perrin, A., Hersen, M., & Kazdin, A. E. (1992). DSM-III-R anxiety disorders in children: Sociodemographic and clinical characteristics. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1070–1076.PubMedCrossRefGoogle Scholar
  39. Lord, C., Risi, S., DiLavore, P. S., Shulman, C., Thurm, A., & Pickles, A. (2006). Autism from 2 to 9 years of age. Archives of General Psychiatry, 63(6), 694–701.PubMedCrossRefGoogle Scholar
  40. Lord, C., Rutter, M., Goode, S., Heemsbergen, J., Jordan, H., Mawhood, L., et al. (1989). Autism diagnostic observation schedule: A standardized observation of communicative and social behavior. Journal of Autism and Developmental Disorders, 19, 185–212.PubMedCrossRefGoogle Scholar
  41. McClure, E. B., Brennan, P. A., Hammen, C., & Le Brocque, R. M. (2001). Parental anxiety disorders, child anxiety disorders, and the perceived parent–child relationship in an Australian high-risk sample. Journal of Abnormal Child Psychology, 29(1), 1–10.PubMedCrossRefGoogle Scholar
  42. Merikangas, K. R. (2002). Familial factors and substance use disorder. In R. J. McMahon & R. D. Peters (Eds.), The effects of parental dysfunction on children (pp. 17–40). New York: Kluwer Academic/Plenum.CrossRefGoogle Scholar
  43. Micali, N., Chakrabarti, S., & Fombonne, E. (2004). The broad autism phenotype. Autism, 8(1), 21–37.PubMedCrossRefGoogle Scholar
  44. Mullen, E. M. (1995). Mullen scales of early learning. Circle Pines, MN: American Guidance Services.Google Scholar
  45. Neece, C. L., Blacher, J., & Baker, B. L. (2010). Impact on siblings of children with intellectual disability: The role of child behavior problems. American Journal on Intellectual and Developmental Disabilities, 115(4), 291–306.PubMedCrossRefGoogle Scholar
  46. Orsmond, G. I., Kuo, H., & Seltzer, M. M. (2009). Siblings of individuals with an autism spectrum disorder: Sibling relationships and wellbeing in adolescence and adulthood. Autism, 13(1), 59–80.PubMedCrossRefGoogle Scholar
  47. Orsmond, G. I., & Seltzer, M. M. (2009). Adolescent siblings of individuals with an autism spectrum disorder: Testing a diathesis-stress model of sibling well-being. Journal of Autism and Developmental Disorders, 39(7), 1053–1065.PubMedCrossRefGoogle Scholar
  48. Parke, R. D. (2002). Fathers and families. In M. H. Bernstein (Ed.), Handbook of parenting: Being and becoming a parent (Vol. 3, pp. 27–74). Mahwah, NJ: Lawrence Erlbaum Associates.Google Scholar
  49. Petalas, M. A., Hastings, R. P., Nash, S., Hall, L. M., Joannidi, H., & Dowey, A. (2012). Psychological adjustment and sibling relationships in siblings of children with autism spectrum disorders: Environmental stressors and the broad autism phenotype. Research in Autism Spectrum Disorders, 6, 546–555.CrossRefGoogle Scholar
  50. Pilowsky, T., Yirmiya, N., Doppelt, O., Gross-Tsur, V., & Shaley, R. S. (2004). Social and emotional adjustment of siblings of children with autism. Journal of Child Psychology and Psychiatry, 45(4), 855–865.PubMedCrossRefGoogle Scholar
  51. Piven, J., Chase, G. A., Landa, R., Wzored, M., Gayle, J., Cloud, D., et al. (1991). Psychiatric disorders in the parents of autistic individuals. Journal of the American Academy of Child and Adolescent Psychiatry, 30(3), 471–478.PubMedCrossRefGoogle Scholar
  52. Rosbrook, A., & Whittingham, K. (2010). Autistic traits in the general population: What mediates the link with depressive and anxious symptomatology? Research in Autism Spectrum Disorders, 4(3), 415–424.CrossRefGoogle Scholar
  53. Roza, S. J., Hofstra, M. B., van der Ende, J., & Verhulst, F. C. (2003). Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood: A 14-year follow-up during childhood, adolescence, and young adulthood. The American Journal of Psychiatry, 160(12), 2116–2121.PubMedCrossRefGoogle Scholar
  54. Rutter, M., LeCouteur, A., & Lord, C. (2003). The autism diagnostic interview-revised (ADI-R). Los Angeles, CA: Western Psychological Services.Google Scholar
  55. Smalley, S. L., McCracken, J., & Tanguay, P. (1995). Autism, affective disorders, and social phobia. American Journal of Medical Genetics (Neuropsychiatric Genetics), 60, 19–26.CrossRefGoogle Scholar
  56. Snow, A. V., & Lecavalier, L. (2011). Comparing autism, PDD-NOS, and other developmental disabilities on parent-reported behavior problems: Little evidence for ASD subtype validity. Journal of Autism and Developmental Disorders, 41, 302–310.PubMedCrossRefGoogle Scholar
  57. Spratt, K. G., Nicholas, J. S., Brady, K. T., Crpenter, L. A., Hatcher, C. R., Meekinds, K. A., et al. (2012). Enhanced cortisol response to stress in children in autism. Journal of Autism and Developmental Disorders, 42, 75–81.PubMedCrossRefGoogle Scholar
  58. The Psychological Corporation. (1999). Wechsler abbreviated scale of intelligence. San Antonio, TX: The Psychological Corporation.Google Scholar
  59. United States Census Bureau. (2012). Household and families: 2010. 2010 census briefs no. 14. Retrieved on July 23, 2012 from
  60. United States Census Bureau. (2011). Household income for states: 2009 and 2010. American Community service briefs no. 10-0). Retrieved on July 23, 2012 from
  61. van Oort, F. V. A., Greaves-Lord, K., Verhulst, F. C., Ormel, J., & Huizink, A. C. (2009). The developmental course of anxiety symptoms during adolescence: The TRIALS study. Journal of Child Psychology and Psychiatry, 50(10), 1209–1217.PubMedCrossRefGoogle Scholar
  62. Verte, S., Roeyers, H., & Buysse, A. (2003). Behavioural problems, social competence, and self-concept in siblings of children with autism. Child: Care, Health, and Development, 29(3), 193–205.CrossRefGoogle Scholar
  63. Visu-Petra, L., Tincas, I., Cheie, L., & Benga, O. (2010). Anxiety and visual-spatial memory updating in young children: An investigation using emotional facial expressions. Cognition and Emotion, 24(2), 223–240.CrossRefGoogle Scholar
  64. Vitiello, B., & Waslick, B. (2010). Pharmacotherapy for children and adolescents with anxiety disorders. Psychiatric Annals, 40(4), 185–191.CrossRefGoogle Scholar
  65. Wadsworth, M. E., Hudziak, J. J., Heath, A. C., & Achenbach, T. M. (2001). Latent class analysis of child behavior checklist anxiety/depression in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 40(1), 106–114.PubMedCrossRefGoogle Scholar
  66. Wechsler, D. (2003). Wechsler intelligence scale for children. San Antonio, TX: The Psychological Corporation.Google Scholar
  67. Wittchen, H. U., Nelson, C. B., & Lachner, G. (1998). Prevalence of mental disorders and psychosocial impairments in adolescents and young adults. Psychological Medicine, 28, 109–126.PubMedCrossRefGoogle Scholar
  68. Yirmiya, N., Shaked, M., & Erel, O. (2001). Comparison of siblings of individuals with autism and siblings of individuals with other diagnoses: An empirical summary. In E. Schopler, N. Yirmiya, C. Schulman, & L. M. Marcus (Eds.), The research basics for autism intervention (pp. 59–73). New York: Kluwer Academic/Plenum.Google Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Carolyn M. Shivers
    • 1
    • 3
  • Lauren K. Deisenroth
    • 3
  • Julie Lounds Taylor
    • 2
    • 3
    Email author
  1. 1.Department of Psychology and Human DevelopmentVanderbilt UniversityNashvilleUSA
  2. 2.Department of PediatricsVanderbilt University School of Medicine and the Monroe Carell Jr. Children’s Hospital at VanderbiltNashvilleUSA
  3. 3.Vanderbilt Kennedy Center for Human DevelopmentVanderbilt UniversityNashvilleUSA

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