Skip to main content

Advertisement

SpringerLink
Log in

Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome

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

Abstract

We examined social anxiety and internalizing symptoms using the Social Phobia and Anxiety Inventory for Children (SPAI-C), the Social Anxiety Scale for Children -Revised (SASC-R), and the Child Behavior Checklist (CBCL) in a sample of fifty-four high-functioning subjects with autism or Asperger syndrome (HFA/AS) (M = 11.2 ± 1.7 years) and 305 community subjects (M = 12.2 ± 2.2 years). Children and adolescents completed the SPAI-C and SASC-R, and their parents completed the CBCL Internalizing scale. Adolescents with HFA/AS scored higher than the community sample on all measures. Behavioural avoidance and evaluative social anxiety increased by age within the HFA/AS group, whereas behavioural avoidance decreased by age in control participants. Data support that HFA/AS in adolescents may be associated with clinically relevant social anxiety symptoms.

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
Fig. 2

Similar content being viewed by others

References

  • Achenbach, T. M., & Eldelbrock, C. S. (1983). Manual for the child behavior checklist and revised child behavior profile. University of Vermont Department of Psychiatry, Burlington, VT.

    Google Scholar 

  • Albano, A. M., Dibartolo, P. M., Heimberg, R. G., & Barlow, D. H. (1995). Children and adolescents: Assessment and treatment. In: R. G. Heimberg, M. R. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment and treatment (pp 387–425). New York: The Guilford Press.

    Google Scholar 

  • American Psychiatric Association (APA). (2000). Diagnostic and statistical manual of mental disorders—fourth edition, text revision. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Attwood, T. (1998). Asperger’s syndrome: A guide for parents and professionals. London: Jessica Kingsley.

    Google Scholar 

  • Baird, G., Simonoff, E., Pickles, A., Chandler, S., Loucas, T., Meldrum, D., & Charman, T. (2006) Prevalence of disorders of the autism spectrum in a population cohort of children in south themes: The special needs and autism project (SNAP). The Lancet, 368(9531), 210–215.

    Article  Google Scholar 

  • Beidel, D. C. (1991). Social Phobia and overanxious disorder in school-age children. Journal of the American Academy of Child and Adolescent Psychiatry, 30, 545–552.

    Article  PubMed  Google Scholar 

  • Beidel, D. C., Turner, S. M., & Fink, C. M. (1996). Assessment of childhood social phobia: Construct, convergent, and discriminative validity of the social phobia and anxiety inventory for children (SPAI-C). Psychological Assessment, 8, 235–240.

    Article  Google Scholar 

  • Beidel, D. C., Turner, S. M., & Morris, T. L. (1998). Social phobia and anxiety inventory for children (SPAI-C). User´'s manual. North Tonawanda, NY: Multi-Health Systems Inc.

    Google Scholar 

  • Beidel, D. C., Turner, S., & Morris, T. (1999). Psychopathology of childhood social phobia. Journal of American Academy of Child and Adolescent Psychiatry, 38, 643–650.

    Article  Google Scholar 

  • Bennett, M. (1989). Children’s self attribution of embarrassment. British Journal of Developmental Psychology, 7, 207–217.

    Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • Berument, S. K., Rutter, M., Lord, C., Picles, A., & Bailey, A. (1999). Autism screening questionnaire: Diagnostic validity. British Journal of Psychiatry, 175, 444–451.

    Article  PubMed  Google Scholar 

  • Bishop, D. V. (1998). Development of the children’s communication checklist (CCC): A method for assessing qualitative aspects of communicative impairment in children. Journal of Child Psychology and Psychiatry, 39, 879–891.

    Article  PubMed  Google Scholar 

  • Boyle, M. H., Offord, D. R., Racine, Y., Fleming, J. E., Szatmari, P., & Sanford, M. (1993). Evaluation of the revised Ontario child health study scales. Journal of Child Psychology and Psychiatry, 34(2), 189–213.

    Google Scholar 

  • Centers for Disease Control and Prevention. www.cdc.gov/od/oc/media/pressrel/2007/r070208.htm. Accessed September 2007.

  • Chacrabarti, S., & Fombonne, E. (2001). Pervasive developmental disorders in preschool children. Journal of the American Medical Association, 285(24), 3093–3099.

    Article  Google Scholar 

  • Chalfant, A. M., Rapee, R., & Carrol, L. (2007). Treating anxiety disorders in children with high functioning autism spectrum disorders: A controlled trial. Journal of Autism and Developmental Disorders, 37, 1842–1857.

    Article  PubMed  Google Scholar 

  • Constantino, J., Przybeck, T., Friesen, D., & Todd, R. D. (2000). Reciprocal social behavior in children with and without pervasive developmental disorders. Journal of Developmental Behavioral Pediatrics, 21, 2–11.

    Google Scholar 

  • Crozier, W. R., & Burnham, M. (1990). Age-related differences in children understanding of shyness. British Journal of Developmental Psychology, 8, 179–185.

    Google Scholar 

  • Ehlers, S., & Gillberg, C. (1996). Aspergerin syndrooma––yleiskatsaus. 1.painos. Helsinki: Suomen Autismiyhdistys, Yliopistopaino.

    Google Scholar 

  • Francis, G., Last, C. G., & Strauss, C. C. (1992). Avoidant disorder and social phobia in children and adolescents. Journal of American Academy of Child and Adolescent Psychiatry, 31, 1086–1089.

    Google Scholar 

  • Fyer, A. J., Mannuzza, S., & Chapman, T. F. (1993). A direct interview family study of social phobia. Archives of General Psychiatry, 50, 286–293.

    Google Scholar 

  • Gadow, K. D., & Sprafkin, J. (1998). Adolescent symptom inventory-4 norms manual. Stony Brook, New York: Checkmate Plus.

    Google Scholar 

  • Gadow, K. D., & Sprafkin, J. (2002). Child symptom inventory-4 screening and norms manual. Stony Brook, New York: Checkmate Plus.

    Google Scholar 

  • Gillott, A., Furniss, F., & Walter, A. (2001). Anxiety in high-functioning children with autism. Autism, 5(3), 277–286.

    Article  PubMed  Google Scholar 

  • Green, J., Gilrichrist, A., Burton, D., & Cox, A. (2000). Social and psychiatric functioning in adolescents with Asperger syndrome compared with conduct disorders. Journal of Autism and Developmental Disorders, 30(4), 279–293.

    Article  PubMed  Google Scholar 

  • Hayward, C., Killen J. D., Kraemer, H. C., & Taylor, C. B. (1998). Linking self-reported childhood behavioural inhibition to adolescent social phobia. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 1308–1316.

    Google Scholar 

  • Ivanova, M.Y, Dobrean, A., Dopfner, M., Erol, N., Fombonne, E., Fonseca, A. C., et al. (2007). Testing the 8-syndrome structure of the child behavior checklist in 30 societies. Journal of Clinical Child Adolescent Psychology, 36(3), 405–417.

    Google Scholar 

  • Kielinen, M., Linna S. L., & Moilanen, I. (2000). Autism in Northern Finland. European Child & Adolescent Psychiatry, 9, 162–167.

    Article  Google Scholar 

  • Kim, J.A, Szatmari, P., Byrson, S. E., Streiner, D. L., & Wilson, F. J. (2000). The prevalence of anxiety and mood problems among children with autism and Asperger syndrome. Autism, 4(2), 117–132.

    Article  Google Scholar 

  • Kuusikko, S., Pollock-Wurman, R., Ebeling, H., Hurtig, T., Joskitt, L., Mattila, M.-L., Jussila, K., & Moilanen, I. Psychometric evaluation of social phobia and anxiety inventory for children (SPAI-C) and social anxiety scale for children-revised (SASC-R). Submitted in European Child & Adolescent Psychiatry.

  • La Greca, A. M., & Stone, W. L. (1993). Social anxiety scale for children-revised: factor structure and concurrent validity. Journal of Clinical Child Psychology, 1, 17–27.

    Google Scholar 

  • Leyfer, O.T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., Tager-Flushberg, H., & Lainhart, J. E. (2006). Comorbid psychiatric disorders in children with autism: interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36(7), 849–861.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., & Risin, S. (2003). Autism diagnostic observation schedule. Manual (3rd edn.). Los Angeles: Western psychological services.

    Google Scholar 

  • Lord, C., Rutter, M., & LeCouter, A. (1995). Autism diagnostic interview -revised (3rd edn.). Los Angeles: Western psychological services.

    Google Scholar 

  • Mannuzza, S., Fyer, A. J., Liebowitz, M. R., & Klein, D. F. (1990). Delineating the boundaries of social phobia: its relationship to panic disorder and agoraphobia. Journal of Anxiety Disorders, 4(1), 41–59.

    Google Scholar 

  • Mattila, M. L., Kielinen, M., Jussila, K., Linna, S. L., Bloigu, R., Ebeling, & H., Moilanen, I. (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.

    Google Scholar 

  • Melfsen, S., Florin, I., & Warnke, A. (2001). Das Sozialphobie und -angsinventar für Kinder (SPAIK). Göttingen: Hogrefe.

    Google Scholar 

  • Melfsen, S., Walitza, S., & Warnke, A. (2006). The extent of social anxiety in combination with mental disorders. European Child & Adolescent Psychiatry, 15(2), 111–117.

    Article  Google Scholar 

  • Piven, J., & Palmer, P. (1999). Psychiatric disorder and the broad autism phenotype: evidence from a family study of multiple-indicence autism families. American Journal of Psychiatry, 156, 557–563.

    PubMed  Google Scholar 

  • Russell, E., & Sofronoff, K. (2005). Anxiety and social worries in children with Asperger syndrome. Australian and New Zealand Journal of Psychiatry, 39(7), 633–638.

    Article  PubMed  Google Scholar 

  • Rutter, M., Lecouter, A., Lord, C., MacDonald, H., Rios, P., & Folstein, S. (1988). Diagnosis and subsclassification of autism: Concepts and instrument development. In: E. Shcopler & C. B Mesibov (Eds.), Diagnosis and assessment in autism (pp. 239–259). New York: Plenum Press.

    Google Scholar 

  • Schneier, F. R., Spitzer, R. L., Gibbon, M., Fyer, A. J., Liebowitz, M. R., & Weisman, M. M. (1992). Social phobia. Comorbidity in an epidemiological sample. Archive of General Psychiatry, 49, 282–288.

    Google Scholar 

  • Stein, M. B., Walker, J. R., & Forde, D. R. (1994). Setting diagnostic thresholds for social phobia: Considerations from a community survey of social anxiety. American Journal of Psychiatry, 151, 408–412.

    PubMed  Google Scholar 

  • Sukhodolsky, D. G., Scahill, L., Gadow, K. D., Arnold, L. E., Aman, M. G., McDougle, C. J., McCracken, J. T., Tierney, E., Williams White, S., Lecavalier, L., & Vitiello, B. (2007). Parent-rated anxiety symptoms in children with pervasive developmental disorders: Frequency and association with core autism symptoms and cognitive functioning. Journal of Abnormal Child Psychology (Epub ahead of print).

  • Tantam, D. (2000). Psychological disorder in adolescents and adults with Asperger syndrome. Autism, 4(1), 47–62.

    Article  Google Scholar 

  • Towbin, K. E., Pradella, A., Gorrindo, T., Pine, D., & Leibenluft, E. (2005). Autism Spectrum traits in children with mood and axiety disorders. Journal of Child and Adolescence Psychopharmacology, 15(3), 452–464.

    Article  Google Scholar 

  • Watson, D., & Friend, R. (1969). Measurement of social-evaluative anxiety. Journal of Consulting and Clinical Psychology, 33, 448–457.

    Article  PubMed  Google Scholar 

  • Wechsler, D. (1991). Wechsler Intelligence Scale for Children, WISC-III (3rd edn.). New York: Psychological Corporation.

    Google Scholar 

  • Wittchen, H. U., & Beloch, E. (1996). The impact of social phobia on quality of life. International Clinical Psychopharmacology, 11(3), 15–23.

    Article  PubMed  Google Scholar 

  • 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.

    Article  PubMed  Google Scholar 

  • World Health Organization (WHO). (1993). Tenth revision of the international classification of disease. Geneva: World Health Organization.

    Google Scholar 

Download references

Acknowledgments

The research was supported by The Alma and K. A. Snellman Foundation, Oulu, Finland (PI: S. Kuusikko); Child Psychiatric Research Foundation, Finland (PI: S. Kuusikko); Northern Ostrobothnia Hospital District Area, Finland (PI: S. Kuusikko); Emil Aaltonen Foundation, Finland (PI: H. Ebeling); the Rinnekoti Research Foundation, Espoo, Finland (PI: M-L. Mattila); National Alliance for Autism Research (NAAR, PI: D. Pauls); Thule Institute, University of Oulu (PI: I. Moilanen); and Juselius Foundation (PI: I. Moilanen). We want to thank the participants of the study and Ms Leena Joskitt for her help in statistical analyses.

Author information

Authors and Affiliations

  1. Clinic of Child Psychiatric, University and University Hospital of Oulu, Oulu, Finland

    Sanna Kuusikko, Katja Jussila, Marja-Leena Mattila, Hanna Ebeling & Irma Moilanen

  2. Child Psychiatric Clinic, University Hospital of Oulu, P.O. Box 26, 90029 OYS, Oulu, Finland

    Sanna Kuusikko

  3. Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

    Rachel Pollock-Wurman & David L. Pauls

  4. University of Massachusetts Boston, Boston, MA, USA

    Alice S. Carter

Authors
  1. Sanna Kuusikko
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rachel Pollock-Wurman
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Katja Jussila
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Alice S. Carter
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marja-Leena Mattila
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Hanna Ebeling
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. David L. Pauls
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Irma Moilanen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Sanna Kuusikko.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Kuusikko, S., Pollock-Wurman, R., Jussila, K. et al. Social Anxiety in High-functioning Children and Adolescents with Autism and Asperger Syndrome. J Autism Dev Disord 38, 1697–1709 (2008). https://doi.org/10.1007/s10803-008-0555-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10803-008-0555-9

Keywords

Search

Navigation