Skip to main content
SpringerLink
Log in

Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders

  • Original Paper
  • Published:
Journal of Autism and Developmental Disorders Aims and scope Submit manuscript

Abstract

Young people with autism spectrum disorder (ASD) have a high prevalence (~40 %) of anxiety disorders compared to their non-ASD peers. It is unclear whether cognitive and biological processes associated with anxiety in ASD are analogous to anxiety in typically developing (TD) populations. In this study 55 boys with ASD (34 with a co-occurring anxiety disorder, 21 without) and 28 male controls, aged 10–16 years and with a full-scale IQ ≥ 70, completed a series of clinical, cognitive (attention bias/interpretation bias) and biological measures (salivary cortisol/HR response to social stress) associated with anxiety in TD populations. Structural equation modelling was used to reveal that that both attentional biases and physiological responsiveness were significant, but unrelated, predictors of anxiety in ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Angold, A., & Costello, E. J. (2000). The Child and Adolescent Psychiatric Assessment (CAPA). Journal of the American Academy of Child and Adolescent Psychiatry, 39, 39–48.

    Article  PubMed  Google Scholar 

  • Bal, E., Harden, E., Lamb, D., Van Hecke, A. V., Denver, J. W., & Porges, S. W. (2010). Emotion recognition in children with autism spectrum disorders: Relations to eye gaze and autonomic state. Journal of Autism and Developmental Disorders, 40, 358–370. doi:10.1007/s10803-009-0884-3.

    Article  PubMed  Google Scholar 

  • Bar-Haim, Y. (2010). Research review: Attention bias modification (ABM): A novel treatment for anxiety disorders. Journal of Child Psychology and Psychiatry and Allied Disciplines, 51, 859–870. doi:10.1111/j.1469-7610.2010.02251.x.

    Article  Google Scholar 

  • Bar-Haim, Y., Holoshitz, Y., Eldar, S., Frenkel, T. I., Muller, D., Charney, D. S., et al. (2010). Life-threatening danger and suppression of attention bias to threat. American Journal of Psychiatry, 167(6), 694–698. doi:10.1176/appi.ajp.2009.09070956.

    Article  PubMed  Google Scholar 

  • Bar-Haim, Y., Morag, I., & Glickman, S. (2011). Training anxious children to disengage attention from threat: A randomized controlled trial. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52(8), 861–869. doi:10.1111/j.1469-7610.2011.02368.x.

    Article  Google Scholar 

  • Barrett, P. M., Rapee, R. M., Dadds, M. M., & Ryan, S. M. (1996). Family enhancement of cognitive style in anxious and aggressive children. Journal of Abnormal Child Psychology, 24, 187–203. doi:10.1007/BF01441484.

    Article  PubMed  Google Scholar 

  • Beck, A. T., & Clark, D. A. (1997). An information processing model of anxiety: Automatic and strategic processes. Behaviour Research and Therapy, 35, 49–58. doi:10.1016/S0005-7967(96)00069-1.

    Article  PubMed  Google Scholar 

  • Bitsika, V., Sharpley, C. F., Andronicos, N. M., & Agnew, L. L. (2015). Hypothalamus–pituitary–adrenal axis daily fluctuation, anxiety and age interact to predict cortisol concentrations in boys with an autism spectrum disorder. Physiology & Behavior, 138, 200–207. doi:10.1016/j.physbeh.2014.11.010.

    Article  Google Scholar 

  • Bitsika, V., Sharpley, C. F., Sweeney, J. A., & McFarlane, J. R. (2014). HPA and SAM axis responses as correlates of self- vs parental ratings of anxiety in boys with an Autistic Disorder. Physiology & Behavior, 127, 1–7. doi:10.1016/j.physbeh.2013.12.011.

    Article  Google Scholar 

  • Blakeley-Smith, A., Reaven, J., Ridge, K., & Hepburn, S. (2012). Parent–child agreement of anxiety symptoms in youth with autism spectrum disorders. Research in Autism Spectrum Disorders, 6(2), 707–716. doi:10.1016/j.rasd.2011.07.020.

    Article  Google Scholar 

  • Bögels, S. M., Snieder, N., & Kindt, M. (2003). Specificity of dysfunctional thinking in children with symptoms of social anxiety separation anxiety, and generalised anxiety. Behaviour Change. doi:10.1375/bech.20.3.160.24836.

    Google Scholar 

  • Bouma, E. M. C., Riese, H., Ormel, J., Verhulst, F. C., & Oldehinkel, A. J. (2009). Adolescents’ cortisol responses to awakening and social stress; Effects of gender, menstrual phase and oral contraceptives. The TRAILS study. Psychoneuroendocrinology, 34(6), 884–893. doi:10.1016/j.psyneuen.2009.01.003.

    Article  PubMed  Google Scholar 

  • Corbett, B. A., Schupp, C. W., & Lanni, K. E. (2012). Comparing biobehavioral profiles across two social stress paradigms in children with and without autism spectrum disorders. Molecular Autism, 3, 13. doi:10.1186/2040-2392-3-13.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dalgleish, T., Moradi, A. R., Taghavi, M. R., Neshat-Doost, H. T., & Yule, W. (2001). An experimental investigation of hypervigilance for threat in children and adolescents with post-traumatic stress disorder. Psychological Medicine, 31, 541–547. doi:10.1017/S0033291701003567.

    Article  PubMed  Google Scholar 

  • Dalgleish, T., Taghavi, R., Neshat-Doost, J., Moradi, A., Canterbury, R., & Yule, W. (2003). Information across clinical disorders: A comparison of attention, memory, and prospective cognition in children and adolescents with depression, generalized anxiety. Journal of Clinical Child and Adolescent Psychology, 32, 10–21. doi:10.1207/S15374424JCCP3201_02.

    Article  PubMed  Google Scholar 

  • Danese, A., & McEwen, B. S. (2012). Adverse childhood experiences, allostasis, allostatic load, and age-related disease. Physiology & Behavior. doi:10.1016/j.physbeh.2011.08.019.

    Google Scholar 

  • Dodd, H. F., Hudson, J. L., Morris, T. M., & Wise, C. K. (2012). Interpretation bias in preschool children at risk for anxiety: A prospective study. Journal of Abnormal Psychology. doi:10.1037/a0024589.

    PubMed  Google Scholar 

  • Hollocks, M. J., Howlin, P., Papadopoulos, A. S., Khondoker, M., & Simonoff, E. (2014). Differences in HPA-axis and heart rate responsiveness to psychosocial stress in children with autism spectrum disorders with and without co-morbid anxiety. Psychoneuroendocrinology, 46, 32–45. doi:10.1016/j.psyneuen.2014.04.004.

    Article  PubMed  Google Scholar 

  • Hollocks, M. J., Ozsivadjian, A., Matthews, C. E., Howlin, P., & Simonoff, E. (2013). The relationship between attentional bias and anxiety in children and adolescents with autism spectrum disorders. Autism Research: Official Journal of the International Society for Autism Research, 6(4), 237–247. doi:10.1002/aur.1285.

    Article  Google Scholar 

  • In-Albon, T., Dubi, K., Rapee, R. M., & Schneider, S. (2009). Forced choice reaction time paradigm in children with separation anxiety disorder, social phobia, and nonanxious controls. Behaviour Research and Therapy, 47, 1058–1065. doi:10.1016/j.brat.2009.08.003.

    Article  PubMed  Google Scholar 

  • Insel, T. R. (2014). The NIMH research domain criteria (RDoC) project: Precision medicine for psychiatry. American Journal of Psychiatry, 171(April), 395–397. doi:10.1176/appi.ajp.2014.14020138.

    Article  PubMed  Google Scholar 

  • Jansen, L. M. C., Gispen-de Wied, C. C., van der Gaag, R.-J., & van Engeland, H. (2003). Differentiation between autism and multiple complex developmental disorder in response to psychosocial stress. Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology, 28, 582–590. doi:10.1038/sj.npp.1300046.

    Article  Google Scholar 

  • Jansen, L. M. C., Gispen-de Wied, C. C., Wiegant, V. M., Westenberg, H. G. M., Lahuis, B. E., & van Engeland, H. (2006). Autonomic and neuroendocrine responses to a psychosocial stressor in adults with autistic spectrum disorder. Journal of Autism and Developmental Disorders, 36, 891–899. doi:10.1007/s10803-006-0124-z.

    Article  PubMed  Google Scholar 

  • Kerns, C. M., Kendall, P. C., Berry, L., Souders, M. C., Franklin, M. E., Schultz, R. T., et al. (2014). Traditional and atypical presentations of anxiety in youth with autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-014-2141-7.

    PubMed  Google Scholar 

  • Kirschbaum, C., Kudielka, B. M., Gaab, J., Schommer, N. C., & Hellhammer, D. H. (1999). Impact of gender, menstrual cycle phase, and oral contraceptives on the activity of the hypothalamus–pituitary–adrenal axis. Psychosomatic Medicine, 61(2), 154–162.

    Article  PubMed  Google Scholar 

  • Kirschbaum, C., Pirke, K. M., & Hellhammer, D. H. (1993). The “Trier Social Stress Test”—A tool for investigating psychobiological stress responses in a laboratory setting. Neuropsychobiology, 28, 76–81. doi:10.1159/000119004.

    Article  PubMed  Google Scholar 

  • Kodish, I., Rockhill, C., Ryan, S., & Varley, C. (2011). Pharmacotherapy for anxiety disorders in children and adolescents. Pediatric Clinics of North America. doi:10.1016/j.pcl.2010.10.002.

    PubMed  Google Scholar 

  • Krämer, M., Seefeldt, W. L., Heinrichs, N., Tuschen-Caffier, B., Schmitz, J., Wolf, O. T., et al. (2012). Subjective, autonomic, and endocrine reactivity during social stress in children with social phobia. Journal of Abnormal Child Psychology. doi:10.1007/s10802-011-9548-9.

    Google Scholar 

  • Lang, P. J. (1985). The cognitive psychophysiology of emotion: Fear and anxiety. In A. H. Tuma & J. D. Maser (Eds.), Anxiety and the anxiety disorders (pp. 131–170). Hillsdale, NJ: Lawrence Erlbaum Associates, Inc.

    Google Scholar 

  • Lanni, K. E., Schupp, C. W., Simon, D., & Corbett, B. A. (2012). Verbal ability, social stress, and anxiety in children with autistic disorder. Autism: The International Journal of Research and Practice, 16, 123–138. doi:10.1177/1362361311425916.

    Article  Google Scholar 

  • Lau, J. Y. F., Hilbert, K., Goodman, R., Gregory, A. M., Pine, D. S., Viding, E. M., et al. (2012). Investigating the genetic and environmental bases of biases in threat recognition and avoidance in children with anxiety problems. Biology of Mood and Anxiety Disorders, 2(1), 12. doi:10.1186/2045-5380-2-12.

    Article  PubMed  PubMed Central  Google Scholar 

  • Levine, T. P., Sheinkopf, S. J., Pescosolido, M., Rodino, A., Elia, G., & Lester, B. (2012). Physiologic arousal to social stress in children with autism spectrum disorders: A pilot study. Research in Autism Spectrum Disorders, 6, 177–183. doi:10.1016/j.rasd.2011.04.003.

    Article  PubMed  PubMed Central  Google Scholar 

  • Lord, C., Risi, S., Lambrecht, L., Cook, E. H., Leventhal, B. L., DiLavore, P. C., et al. (2000). The autism diagnostic observation schedule-generic: A standard measure of social and communication deficits associated with the spectrum of autism. Journal of Autism and Developmental Disorders, 30, 205–223. doi:10.1023/A:1005592401947.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., & Le Couteur, A. (1994). Autism diagnostic interview-revised: A revised version of a diagnostic interview for caregivers of individuals with possible pervasive developmental disorders. Journal of Autism and Developmental Disorders, 24, 659–685. doi:10.1007/BF02172145.

    Article  PubMed  Google Scholar 

  • Losh, M., & Capps, L. (2006). Understanding of emotional experience in autism: Insights from the personal accounts of high-functioning children with autism. Developmental Psychology, 42, 809–818. doi:10.1037/0012-1649.42.5.809.

    Article  PubMed  Google Scholar 

  • Lothmann, C., Holmes, E. A., Chan, S. W. Y., & Lau, J. Y. F. (2011). Cognitive bias modification training in adolescents: Effects on interpretation biases and mood. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52, 24–32. doi:10.1111/j.1469-7610.2010.02286.x.

    Article  Google Scholar 

  • Lyneham, H. J., & Rapee, R. M. (2005). Evaluation and treatment of anxiety disorders in the general pediatric population: A clinician’s guide. Child and Adolescent Psychiatric Clinics of North America, 14(4), 845–861. doi:10.1016/j.chc.2005.05.002.

    Article  PubMed  Google Scholar 

  • Martel, F. L., Hayward, C., Lyons, D. M., Sanborn, K., Varady, S., & Schatzberg, A. F. (1999). Salivary cortisol levels in socially phobic adolescent girls. Depression and Anxiety, 10, 25–27. doi:10.1002/(SICI)1520-6394(1999)10:1<25:AID-DA4>3.0.CO;2-O.

    Article  PubMed  Google Scholar 

  • May, T., Cornish, K., & Rinehart, N. J. (2015). Mechanisms of anxiety related attentional biases in children with autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-015-2500-z.

    PubMed  Google Scholar 

  • Merikangas, K. R., He, J.-P., Burstein, M., Swanson, S. A., Avenevoli, S., Cui, L., et al. (2010). Lifetime prevalence of mental disorders in U.S. adolescents: Results from the National Comorbidity Survey Replication-Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry, 49, 980–989. doi:10.1016/j.jaac.2010.05.017.

    Article  PubMed  PubMed Central  Google Scholar 

  • Mikita, N., Hollocks, M. J., Papadopoulos, A. S., Aslani, A., Harrison, S., Leibenluft, E., et al. (2015). Irritability in boys with autism spectrum disorders: An investigation of physiological reactivity. Journal of Child Psychology and Psychiatry. doi:10.1111/jcpp.12382.

    PubMed  PubMed Central  Google Scholar 

  • Ming, X., Julu, P. O. O., Brimacombe, M., Connor, S., & Daniels, M. L. (2005). Reduced cardiac parasympathetic activity in children with autism. Brain and Development, 27, 509–516. doi:10.1016/j.braindev.2005.01.003.

    Article  PubMed  Google Scholar 

  • Mondelli, V., Dazzan, P., Hepgul, N., Di Forti, M., Aas, M., D’Albenzio, A., et al. (2010). Abnormal cortisol levels during the day and cortisol awakening response in first-episode psychosis: The role of stress and of antipsychotic treatment. Schizophrenia Research, 116, 234–242. doi:10.1016/j.schres.2009.08.013.

    Article  PubMed  Google Scholar 

  • Muthén, L., & Muthén, B. (2012). Mplus user’s guide (5th ed.). Los Angeles: Author.

    Google Scholar 

  • Ozsivadjian, A., Hibberd, C., & Hollocks, M. J. (2014). Brief report: The use of self-report measures in young people with autism spectrum disorder to access symptoms of anxiety, depression and negative thoughts. Journal of Autism and Developmental Disorders, 44, 969–974. doi:10.1007/s10803-013-1937-1.

    Article  PubMed  Google Scholar 

  • Ozsivadjian, A., Knott, F., & Magiati, I. (2012). Parent and child perspectives on the nature of anxiety in children and young people with autism spectrum disorders: A focus group study. Autism: The International Journal of Research and Practice, 16, 107–121. doi:10.1177/1362361311431703.

    Article  Google Scholar 

  • Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 35(8), 741–756. doi:10.1016/S0005-7967(97)00022-3.

    Article  PubMed  Google Scholar 

  • Rutter, M., Bailey, A., & Lord, C. (2003). The social communication questionnaire. Los Angeles: Western Psychological Services.

    Google Scholar 

  • Salazar, F., Baird, G., Chandler, S., Tseng, E., O’sullivan, T., Howlin, P., et al. (2015). Co-occurring psychiatric disorders in preschool and elementary school-aged children with autism spectrum disorder. Journal of Autism and Developmental Disorders. doi:10.1007/s10803-015-2361-5.

    PubMed  Google Scholar 

  • Salum, G. A., Mogg, K., Bradley, B. P., Gadelha, A., Pan, P., Tamanaha, A. C., et al. (2013). Threat bias in attention orienting: Evidence of specificity in a large community-based study. Psychological Medicine, 43(4), 733–745. doi:10.1017/S0033291712001651.

    Article  PubMed  Google Scholar 

  • Schmitz, J., Krämer, M., Tuschen-Caffier, B., Heinrichs, N., & Blechert, J. (2011). Restricted autonomic flexibility in children with social phobia. Journal of Child Psychology and Psychiatry and Allied Disciplines, 52, 1203–1211. doi:10.1111/j.1469-7610.2011.02417.x.

    Article  Google Scholar 

  • See, J., MacLeod, C., & Bridle, R. (2009). The reduction of anxiety vulnerability through the modification of attentional bias: A real-world study using a home-based cognitive bias modification procedure. Journal of Abnormal Psychology, 118(1), 65–75. doi:10.1037/a0014377.

    Article  PubMed  Google Scholar 

  • Simon, D. M., & Corbett, B. A. (2013). Examining associations between anxiety and cortisol in high functioning male children with autism. Journal of Neurodevelopmental Disorders, 5, 32. doi:10.1186/1866-1955-5-32.

    Article  PubMed  PubMed Central  Google Scholar 

  • Simonoff, E., Pickles, A., Charman, T., Chandler, S., Loucas, T., & Baird, G. (2008). Psychiatric disorders in children with autism spectrum disorders: Prevalence, comorbidity, and associated factors in a population-derived sample. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 921–929. doi:10.1097/CHI.0b013e318179964f.

    Article  PubMed  Google Scholar 

  • Spence, S. H. (1998). A measure of anxiety symptoms among children. Behaviour Research and Therapy, 36, 545–566.

    Article  PubMed  Google Scholar 

  • StataCorp., & 13. (2013). Stata: Release 13. College Station, TX: StataCorp LP.

  • Sukhodolsky, D. G., Bloch, M. H., Panza, K. E., & Reichow, B. (2013). Cognitive-behavioral therapy for anxiety in children with high-functioning autism: A meta-analysis. Pediatrics, 132, e1341–e1350. doi:10.1542/peds.2013-1193.

    Article  PubMed  PubMed Central  Google Scholar 

  • Sumter, S. R., Bokhorst, C. L., Miers, A. C., Van Pelt, J., & Westenberg, P. M. (2010). Age and puberty differences in stress responses during a public speaking task: Do adolescents grow more sensitive to social evaluation? Psychoneuroendocrinology, 35(10), 1510–1516. doi:10.1016/j.psyneuen.2010.05.004.

    Article  PubMed  Google Scholar 

  • Taghavi, M. R., Neshat-Doost, H. T., Moradi, A. R., Yule, W., & Dalgleish, T. (1999). Biases in visual attention in children and adolescents with clinical anxiety and mixed anxiety-depression. Journal of Abnormal Child Psychology, 27, 215–223. doi:10.1023/A:1021952407074.

    Article  PubMed  Google Scholar 

  • Tottenham, N., Tanaka, J. W., Leon, A. C., McCarry, T., Nurse, M., Hare, T. A., et al. (2009). The NimStim set of facial expressions: Judgments from untrained research participants. Psychiatry Research, 168, 242–249. doi:10.1016/j.psychres.2008.05.006.

    Article  PubMed  PubMed Central  Google Scholar 

  • Ulrich-Lai, Y. M., & Herman, J. P. (2009). Neural regulation of endocrine and autonomic stress responses. Nature Reviews Neuroscience, 10, 397–409. doi:10.1038/nrn2647.

    Article  PubMed  PubMed Central  Google Scholar 

  • Van Hecke, A. V., Lebow, J., Bal, E., Lamb, D., Harden, E., Kramer, A., et al. (2009). Electroencephalogram and heart rate regulation to familiar and unfamiliar people in children with autism spectrum disorders. Child Development, 80, 1118–1133.

    Article  Google Scholar 

  • van Steensel, F. J. A., Bögels, S. M., & Perrin, S. (2011). Anxiety disorders in children and adolescents with autistic spectrum disorders: A meta-analysis. Clinical Child and Family Psychology Review, 14, 302–317. doi:10.1007/s10567-011-0097-0.

    Article  PubMed  PubMed Central  Google Scholar 

  • van West, D., Claes, S., Sulon, J., & Deboutte, D. (2008). Hypothalamic–pituitary–adrenal reactivity in prepubertal children with social phobia. Journal of Affective Disorders, 111, 281–290. doi:10.1016/j.jad.2008.03.006.

    Article  PubMed  Google Scholar 

  • Walkup, J. T., Albano, A. M., Piacentini, J., Birmaher, B., Compton, S. N., Sherrill, J. T., et al. (2008). Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. The New England Journal of Medicine, 359, 2753–2766. doi:10.1056/NEJMoa0804633.

    Article  PubMed  PubMed Central  Google Scholar 

  • Waters, A. M., Craske, M. G., Bergman, R. L., & Treanor, M. (2008). Threat interpretation bias as a vulnerability factor in childhood anxiety disorders. Behaviour Research and Therapy, 46, 39–47. doi:10.1016/j.brat.2007.10.002.

    Article  PubMed  Google Scholar 

  • Waters, A. M., Henry, J., Mogg, K., Bradley, B. P., & Pine, D. S. (2010). Attentional bias towards angry faces in childhood anxiety disorders. Journal of Behavior Therapy and Experimental Psychiatry, 41, 158–164. doi:10.1016/j.jbtep.2009.12.001.

    Article  PubMed  Google Scholar 

  • Wechsler, D. (1999). Wechsler Abbreviated Scale of Intelligence (WASI). London: The Psychological Corporation.

    Google Scholar 

  • Wechsler, D. (2005). Wechsler Individual Achievement Test (2nd (WIAT II) ed.). London: The Psychological Corp.

  • White, S. W., Lerner, M. D., McLeod, B. D., Wood, J. J., Ginsburg, G. S., Kerns, C., et al. (2014). Anxiety in youth with and without autism spectrum disorder: Examination of factorial equivalence. Behavior Therapy. doi:10.1016/j.beth.2014.05.005.

    PubMed Central  Google Scholar 

  • Wilson, E. J., MacLeod, C., Mathews, A., & Rutherford, E. M. (2006). The causal role of interpretive bias in anxiety reactivity. Journal of Abnormal Psychology, 115, 103–111. doi:10.1037/0021-843X.115.1.103.

    Article  PubMed  Google Scholar 

  • Wood, J. J., Drahota, A., Sze, K., Har, K., Chiu, A., & Langer, D. A. (2009). Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: A randomized, controlled trial. Journal of Child Psychology and Psychiatry and Allied Disciplines, 50, 224–234. doi:10.1111/j.1469-7610.2008.01948.x.

    Article  Google Scholar 

  • Wood, J. J., & Gadow, K. D. (2010). Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clinical Psychology: Science and Practice, 17, 281–292. doi:10.1111/j.1468-2850.2010.01220.x.

    Google Scholar 

Download references

Acknowledgments

We would like to thank all the children and their families who took part in this research.

Author Contributions

MH, PH & ES conceived of the study, participated in its design and coordination. The data was collected by MH and all authors were involved in the analysis and interpretation of the data, the drafting of the manuscript and its critical revision. All authors read and approved the final manuscript.

Funding

This project was funded by the NIHR Biomedical Research Centre (BRC) in Mental Health (Grant Code: PCCKASA) and the South London and Maudsley Charitable Funds. This article presents independent research funded by the National Institute for Health Research (NIHR). The views expressed are those of the authors and not necessarily those of the National Health Service, the NIHR or the Department of Health.

Author information

Author notes

  1. Matthew J. Hollocks

    Present address: Department of Clinical Psychology, Norwich Medical School, University of East Anglia, Norwich, NR4 7TJ, UK

Authors and Affiliations

  1. Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Matthew J. Hollocks

  2. Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Andrew Pickles

  3. Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Patricia Howlin

  4. Department of Child and Adolescent Psychiatry and Biomedical Research Centre for Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Emily Simonoff

  5. Neurology Unit, R3, Department of Clinical Neurosciences, University of Cambridge, Box 83, Cambridge Biomedical Campus, Cambridge, CB2 0QQ, UK

    Matthew J. Hollocks

Authors
  1. Matthew J. Hollocks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Andrew Pickles
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Patricia Howlin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emily Simonoff
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Matthew J. Hollocks.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hollocks, M.J., Pickles, A., Howlin, P. et al. Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders. J Autism Dev Disord 46, 3295–3307 (2016). https://doi.org/10.1007/s10803-016-2878-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-016-2878-2

Keywords

Search

Navigation