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Differentiating High-Functioning Autism and Social Phobia

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Abstract

Both high-functioning autism (HFA) and social phobia (SP) involve profound social interaction deficits. Although these disorders share some similar symptoms, they are conceptualized as distinct. Because both HFA and SP are defined behaviorally, the degree of overlap between the two disorders may result in misinterpretation of symptoms. However, the deficits in each disorder differ, particularly in areas of social interaction, emotion recognition and expression, and communication. This paper reviews the literature that informs our current understanding of the behavioral overlaps and differences in HFA and SP. The review also addresses the implications of our current knowledge of these two disorders for differential diagnosis, treatment, and future research. Interdisciplinary, developmentally-oriented research may help extend current approaches to HFA and SP.

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References

  • Alfano, C. A., Beidel, D. C., & Turner, S. M. (2006). Cognitive correlates of social phobia among children and adolescents. Journal of Abnormal Child Psychology, 34, 189–201.

    Article  PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., Text revision). Washington, DC: APA.

  • Amir, N., Beard, C., Cobb, M., & Bomyea, J. (2009). Attention modification program in individuals with generalized anxiety disorder. Journal of Abnormal Psychology, 118, 28–33.

    Article  PubMed  Google Scholar 

  • Angold, A., Prendergast, M., Cox, A., Harrington, R., Simonoff, E., & Rutter, M. (1995). The child and adolescent psychiatric assessment (CAPA). Psychological Medicine, 25, 739–753.

    Article  PubMed  Google Scholar 

  • Banerjee, R., & Henderson, L. (2001). Social-cognitive factors in childhood social anxiety: A preliminary investigation. Social Development, 10, 558–572.

    Article  Google Scholar 

  • Baron-Cohen, S., Wheelwright, S., Skinner, R., Martin, J., & Clubley, E. (2001). The autism-spectrum quotient (AQ): Evidence from Asperger syndrome/high-functioning autism, males and females, scientists and mathematicians. Journal of Autism and Developmental Disorders, 31, 5–17.

    Article  PubMed  Google Scholar 

  • Bartz, J. A., & Hollander, E. (2006). The neuroscience of affiliation: Forging links between basic and clinical research on neuropeptides and social behavior. Hormones and Behavior, 50, 518–528.

    Article  PubMed  Google Scholar 

  • Battaglia, M., Ogliari, A., Zanoni, A., Citterio, A., Pozzoli, U., Giorda, R., et al. (2005). Influence of the serotonin transporter promoter gene and shyness on children’s cerebral responses to facial expressions. Archives of General Psychiatry, 62, 85–94.

    Article  PubMed  Google Scholar 

  • Battaglia, M., Ogliari, A., Zanoni, A., Villa, F., Citterio, A., Binaghi, F., et al. (2003). Children’s discrimination of expressions of emotions: Relationship with indices of social anxiety and shyness. Journal of the Academy of Child and Adolescent Psychiatry, 43, 358–365.

    Article  Google Scholar 

  • Bauminger, N., Solomon, M., Aviezer, A., Heung, K., Brown, J., & Rogers, S. J. (2008). Friendship in high-functioning children with autism spectrum disorder: Mixed and non-mixed dyads. Journal of Autism and Developmental Disabilities, 38, 1211–1229.

    Article  Google Scholar 

  • 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, 483–524.

    Article  PubMed  Google Scholar 

  • Beidel, D. C., Rao, P. A., Scharfstein, L., Wong, N., & Alfano, C. A. (2010). Social skills and social phobia: An investigation of DSM-IV subtypes. Behaviour Research and Therapy, 48, 992–1001.

    Article  PubMed  Google Scholar 

  • Beidel, D. C., & Turner, S. M. (2007). Shy children, phobic adults: Nature and treatment of social anxiety disorders (2nd ed.). Washington, DC: American Psychological Association.

  • Beidel, D. C., Turner, S. M., Young, B. J., Ammerman, R. T., Sallee, F. R., & Crosby, L. (2007). Psychopathology of adolescent social phobia. Journal of Psychopathology and Behavioral Assessment, 29, 47–54.

    Article  Google Scholar 

  • Bellini, S. (2004). Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus on Autism & Other Developmental Disabilities, 19, 78–86.

    Article  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Biederman, J., Hirshfeld-Becker, D. R., Rosenbaum, J. F., Hérot, C., Friedman, D., Snidman, N., et al. (2001). Further evidence of association between behavioral inhibition and social anxiety in children. American Journal of Psychiatry, 158, 1673–1679.

    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 

  • Blair, K., Geraci, M., Devido, J., McCaffrey, D., Chen, G., Vythilingam, M., et al. (2008). Neural response to self- and other referential praise and criticism in generalized social phobia. Archives of General Psychiatry, 65, 1176–1184.

    Article  PubMed  Google Scholar 

  • Bögels, S. M., Alden, L., Beidel, D. C., Clark, L., Pine, D. S., Stein, M. B., et al. (2010). Social anxiety disorder: Questions and answers for the DSM-V. Depression and Anxiety, 27, 168–189.

    Article  PubMed  Google Scholar 

  • Bookheimer, S. Y., Wang, A. T., Scott, A., Sigman, M., & Dapretto, M. (2008). Frontal contributions to face processing differences in autism: Evidence from fMRI inverted face processing. Journal of the International Neuropsychological Society, 14, 922–932.

    Article  PubMed  Google Scholar 

  • Brune, C. W., Kim, S.-J., Salt, J., Leventhal, B. L., Lord, C., & Cook, E. H. (2006). 5-HTTLPR Genotype-specific phenotype in children and adolescents with autism. American Journal of Psychiatry, 163, 2148–2156.

    Article  PubMed  Google Scholar 

  • Cath, D. C., Ran, N., Smit, J. H., van Balkom, A. J. L. M., & Comijs, H. C. (2008). Symptom overlap between autism spectrum disorder, generalized Social Anxiety Disorder and obsessive-compulsive disorder in adults: A preliminary case-controlled study. Psychopathology, 41, 101–110.

    Article  PubMed  Google Scholar 

  • Centers for Disease Control, Prevention. (2009). Autism and developmental disabilities monitoring network surveillance year 2006. Morbidity and Mortality Weekly Report, 58, 1–20.

    Google Scholar 

  • Clark, D. M., & Wells, A. (1995). A cognitive model of social phobia. In R. G. Heimberg, M. Liebowitz, D. A. Hope, & F. R. Schneier (Eds.), Social phobia: Diagnosis, assessment, and treatment (pp. 69–93). New York: Guilford Press.

    Google Scholar 

  • Compton, S. N., Walkup, J. T., Albano, A., Piacentini, J. C., Birmaher, B., Sherrill, J. T., et al. (2010). Child/adolescent anxiety multimodal study (CAMS): Rationale, design, and methods. Child and Adolescent Psychiatry and Mental Health, 4, Article 1.

  • Constantino, J. N., Davis, S. A., Todd, R. D., Schindler, M. K., Gross, M. M., Brophy, S. L., et al. (2003). Validation of a brief quantitative measure of autistic traits: Comparison of the social responsiveness scale with the autism diagnostic interview-revised. Journal of Autism and Developmental Disorders, 33, 427–433.

    Article  PubMed  Google Scholar 

  • Coplan, R. J., Arbeau, K. A., & Armer, M. (2008). Don’t fret, be supportive! Maternal characteristics linking child shyness to psychosocial and school adjustment in kindergarten. Journal of Abnormal Child Psychology, 36, 359–371.

    Article  PubMed  Google Scholar 

  • Critchley, H. D., Daly, E. M., Bullmore, E. T., Williams, S. C. R., Van Amelsvoort, T., Robertson, D. M., et al. (2000). The functional neuroanatomy of social behaviour: Changes in cerebral blood flow when people with autistic disorder process facial expressions. Brain, 123, 2203–2212.

    Article  PubMed  Google Scholar 

  • Davis, E., Saeed, S. A., & Antonacci, D. J. (2008). Anxiety disorders in persons with developmental disabilities: Empirically informed diagnosis and treatment. Psychiatry Quarterly, 79, 249–263.

    Article  Google Scholar 

  • De Bruin, E. I., Ferdinand, R. F., Meester, S., de Nijs, P. F. A., & Verheij, F. (2007). High rates of psychiatric co-morbidity in PDD-NOS. Journal of Autism and Developmental Disorders, 37, 877–886.

    Article  PubMed  Google Scholar 

  • Devlin, B., Cook, E. H., Coon, H., Dawson, G., Gigorenko, E. L., McMahon, W., et al. (2005). Autism and the serotonin transporter: The long and short of it. Molecular Psychiatry, 10, 1110–1116.

    Article  PubMed  Google Scholar 

  • Farrugia, S., & Hudson, J. (2006). Anxiety in adolescents with Asperger syndrome: Negative thoughts, behavioral problems, and life interference. Focus on Autism and Other Developmental Disabilities, 21, 25–35.

    Article  Google Scholar 

  • Foxx, R. M. (2008). Applied behavior analysis treatment of autism: The state of the art. Child and Adolescent Psychiatric Clinics of North America, 17, 821–834.

    Article  PubMed  Google Scholar 

  • Gamliel, I., & Yirmiya, N. (2009). Assessment of social behavior in autism spectrum disorders. In S. Goldstein, J. A. Naglieri, & S. Ozonoff (Eds.), Assessment of autism spectrum disorders (pp. 138–170). New York: The Guilford Press.

    Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Goddard, L., Howlin, P., Dritschel, B., & Patel, T. (2007). Autobiographical memory and social problem-solving in Asperger syndrome. Journal of Autism and Developmental Disorders, 37, 291–300.

    Article  PubMed  Google Scholar 

  • 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, 693–705.

    Article  PubMed  Google Scholar 

  • Greene, D. J., Colich, N., Iacoboni, M., Zaidel, E., Bookheimer, S. Y., & Dapretto, M. (2011). Atypical neural networks for social orienting in autism spectrum disorders. NeuroImage, 56, 354–362.

    Article  PubMed  Google Scholar 

  • Guyer, A. E., Lau, J. Y. F., McClure-Tone, E. B., Parrish, J., Shiffrin, N. D., Reynolds, R. C., et al. (2008). Amygdala and ventrolateral prefrontal cortex function during anticipated peer evaluation in pediatric social anxiety. Archives of General Psychiatry, 65, 1303–1312.

    Article  PubMed  Google Scholar 

  • Hadjikhani, N., Joseph, R. M., Snyder, J., & Tager-Flusberg, H. (2007). Abnormal activation of the social brain during face perception in autism. Human Brain Mapping, 28, 441–449.

    Article  PubMed  Google Scholar 

  • Happé, F., & Frith, U. (2006). The weak coherence account: Detail-focused cognitive style in autism spectrum disorders. Journal of Autism and Developmental Disorders, 36, 5–25.

    Article  PubMed  Google Scholar 

  • Harms, M., Martin, A., & Wallace, G. (2010). Facial emotion recognition in autism spectrum disorders: A review of behavioral and neuroimaging studies. Neuropsychology Review, 20, 290–322.

    Article  PubMed  Google Scholar 

  • Helt, M. S., Eigsti, I., Snyder, P. J., & Fein, D. A. (2010). Contagious yawning in autistic and typical development. Child Development, 81, 1620–1631.

    Article  PubMed  Google Scholar 

  • Hobson, R. P. (1986). The autistic child’s appraisal of expressions of emotion. Journal of Child Psychology and Psychiatry and Allied Disciplines, 27, 321–342.

    Article  Google Scholar 

  • Hofmann, S. G. (2007). Cognitive factors that maintain social anxiety disorder: A comprehensive model and its treatment implications. Cognitive Behaviour Therapy, 36, 193–209.

    Article  PubMed  Google Scholar 

  • Hofmann, S. G., Asnaani, A., & Hinton, D. E. (2010). Cultural aspects in social anxiety and social anxiety disorder. Depression and Anxiety, 27, 1117–1127.

    Article  PubMed  Google Scholar 

  • Hoge, E. A., Pollack, M. H., Kaufman, R. E., Zak, P. J., & Simon, N. M. (2008). Oxytocin levels in social anxiety disorder. CNS Neuroscience & Therapeutics, 24, 165–170.

    Article  Google Scholar 

  • Hollander, E., Novotny, S., Hanratty, M., Yaffe, R., DeCaria, C. M., Aronowitz, B. R., et al. (2003). Oxytocin infusion reduces repetitive behaviors in adults with autistic and Asperger’s disorders. Neuropsychopharmacology, 28, 193–198.

    Article  PubMed  Google Scholar 

  • Hunter, L., Buckner, J. D., & Schmidt, N. B. (2009). Interpreting facial expressions: The influence of social anxiety, emotional valence, and race. Journal of Anxiety Disorders, 23, 482–488.

    Article  PubMed  Google Scholar 

  • Jackson, J. S., Torres, M., Caldwell, C. H., Neighbors, H. W., Nesse, R. M., Taylor, R. J., et al. (2004). The national survey of American life: A study of racial, ethnic and cultural influences on mental disorders and mental health. International Journal of Methods in Psychiatric Research, 13, 196–207.

    Article  PubMed  Google Scholar 

  • Jobe, L. E., & White, S. W. (2007). Loneliness, social relationships, and a broader autism phenotype in college students. Personality and Individual Differences, 42, 1479–1489.

    Article  Google Scholar 

  • Juranek, J., Filipek, P. A., Berenji, G. R., Modahl, C., & Osann, K. (2005). Association between amygdala volume and anxiety level: Magnetic resonance imaging (MRI) study in autistic children. Journal of Child Neurology, 21, 1051–1068.

    Article  Google Scholar 

  • Kagan, J., Reznick, J. S., & Snidman, N. (1988). Biological bases of childhood shyness. Science, 240, 167–171.

    Article  PubMed  Google Scholar 

  • Karg, K., Burmeister, M., Shedden, K., & Sen, S. (2011). The serotonin transporter promoter variant (5-HTTLPR), stress, and depression meta-analysis revisited: Evidence of genetic moderation. Archives of General Psychiatry, 68, 444–454.

    Article  PubMed  Google Scholar 

  • Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., et al. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.

    Article  PubMed  Google Scholar 

  • Kessler, R. C., Chiu, W. T., Demler, O., & Walters, E. E. (2005). Prevalence, severity, and co-morbidity of 12-month DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 617–627.

    Article  PubMed  Google Scholar 

  • Kim, J. A., Szatmari, P., Bryson, 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, 117–132.

    Article  Google Scholar 

  • Kirsch, P., Esslinger, C., Chen, Q., Mier, D., Lis, S., Siddhanti, S., et al. (2005). Oxytocin modulates neural circuitry for social cognition and fear in humans. The Journal of Neuroscience, 25, 11489–11493.

    Article  PubMed  Google Scholar 

  • Kloosterman, P. H., Keefer, K. V., Kelley, E. A., Summerfeldt, L. J., & Parker, J. D. A. (2011). Evaluation of the factor structure of the Autism-Spectrum Quotient. Personality and Individual Differences, 50, 310–314.

    Article  Google Scholar 

  • Kristensen, H., & Torgersen, S. (2008). Is social anxiety disorder in childhood associated with developmental deficit/delay? European Child and Adolescent Psychiatry, 17, 99–107.

    Article  PubMed  Google Scholar 

  • Kuusikko, S., Haapsamo, H., Jansson-Verkasalo, E., Hurtig, T., Mattila, M., Ebeling, H., et al. (2009). Emotion recognition in children and adolescents with autism spectrum disorders. Journal of Autism and Developmental Disorders, 39, 938–945.

    Article  PubMed  Google Scholar 

  • Kuusikko, S., Pollock-Wurman, R., Jussila, K., Carter, A. S., Mattila, M. L., Ebeling, H., et al. (2008). Social anxiety in high-functioning children and adolescents with autism and Asperger syndrome. Journal of Autism and Developmental Disorders, 38, 1697–1709.

    Article  PubMed  Google Scholar 

  • Kylliäinen, A., & Hietanen, J. K. (2006). Skin conductance responses to another person’s gaze in children with autism. Journal of Autism and Developmental Disorders, 36, 517–525.

    Article  PubMed  Google Scholar 

  • Leber, S., Heidenreich, T., Stangier, U., & Hofmann, S. G. (2009). Processing of facial affect under social threat in socially anxious adults: Mood matters. Depression and Anxiety, 26, 196–206.

    Article  PubMed  Google Scholar 

  • Leyfer, T. O., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). Comorbid psychiatric disorders in children with autism: Interview development and rates of disorders. Journal of Autism and Developmental Disorders, 36, 849–861.

    Article  PubMed  Google Scholar 

  • Lindner, J. L., & Rosen, L. A. (2006). Decoding of emotion through facial expression, prosody and verbal content in children and adolescents with Asperger’s syndrome. Journal of Autism and Developmental Disorders, 36, 769–777.

    Article  PubMed  Google Scholar 

  • Lord, C., Rutter, M., DiLavore, P. C., & Risi, S. (2002). Autism diagnostic observation schedule. Los Angeles: Western Psychological Services.

    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.

    Article  PubMed  Google Scholar 

  • Matson, J. L., Worley, J. A., Fodstad, J. C., Chung, K., Suh, D., Jhin, H., et al. (2011). A multinational study examining the cross cultural differences in reported symptoms of autism spectrum disorders: Israel, South Korea, the United Kingdom, and the United States of America. Research in Autism Spectrum Disorders, 5, 1598–1604.

    Article  Google Scholar 

  • Mazurek, M. O., & Kanne, S. M. (2010). Friendship and internalizing symptoms among children and adolescents with ASD. Journal of Autism and Developmental Disorders, 40, 1512–1520.

    Article  PubMed  Google Scholar 

  • McIntosh, D. N., Reichmann-Decker, A., Winkielman, P., & Wilbarger, J. L. (2006). When the social mirror breaks: Deficits in automatic, but not voluntary mimicry of emotional facial expressions in autism. Developmental Science, 9, 295–302.

    Article  PubMed  Google Scholar 

  • Melfsen, S., Osterlow, J., & Florin, I. (2000). Deliberate emotional expressions of socially anxious children and their mothers. Journal of Anxiety Disorders, 14, 249–261.

    Article  PubMed  Google Scholar 

  • Monti, P. M., Kolko, D. J., Fingeret, A. L., & Zwick, W. R. (1984). Three levels of measurement of social skill and social anxiety. Journal of Nonverbal Behavior, 8, 187–194.

    Article  Google Scholar 

  • Moscovitch, D. A., & Hofmann, S. G. (2006). When ambiguity hurts: Social standards moderate self-appraisals in generalized social phobia. Behaviour Research and Therapy, 45, 1039–1052.

    Article  PubMed  Google Scholar 

  • Mostofsky, S., Dubey, P., Jerath, V., Jansiewicz, E., Goldberg, M., & Denckla, M. (2006). Developmental dyspraxia is not limited to imitation in children with autism spectrum disorders. Journal of the International Neuropsychological Society, 12, 314–326.

    Article  PubMed  Google Scholar 

  • Moukheiber, A., Rautureau, G., Perez-Diaz, F., Soussignan, R., Dubal, S., Jouvent, R., et al. (2010). Gaze avoidance in social phobia: Objective measure and correlates. Behaviour Research and Therapy, 48, 147–151.

    Article  PubMed  Google Scholar 

  • Muhlberger, A., Wieser, M., & Pauli, P. (2007). Visual attention during virtual social situations depends on social anxiety. Cyberpsychology and Behavior, 11, 425–430.

    Article  Google Scholar 

  • Muris, P., & Field, A. P. (2008). Distorted cognition and pathological anxiety in children and adolescents. Cognition and Emotion, 22, 395–421.

    Article  Google Scholar 

  • Myers, S., & Johnson, C. (2007). Management of children with autism spectrum disorders. Pediatrics, 120, 1162–1182.

    Article  PubMed  Google Scholar 

  • Nacewicz, B. M., Dalton, K. M., Johnstone, T., Long, M. T., McAuliff, E. M., Oakes, T. R., et al. (2006). Amygdala volume and nonverbal social impairment in adolescent and adult males with autism. Archives of General Psychiatry, 63, 1417–1428.

    Article  PubMed  Google Scholar 

  • Ollendick, T. H., & Hirshfeld-Becker, D. R. (2002). The developmental psychopathology of social anxiety disorder. Biological Psychiatry, 51, 44–58.

    Article  PubMed  Google Scholar 

  • Orsmond, G. I., Krauss, M. W., & Seltzer, M. M. (2004). Peer relationships and social and recreational activities. Journal of Autism and Developmental Disorders, 34, 245–256.

    Article  PubMed  Google Scholar 

  • Osterling, J., & Dawson, G. (1994). Early recognition of children with autism: A study of first birthday home video tapes. Journal of Autism and Developmental Disorders, 24, 247–257.

    Article  PubMed  Google Scholar 

  • Ozonoff, S., South, M., & Provencal, S. (2005). Executive functions. In F. R. Volkmar, R. Paul, A. Klin, & D. Cohen (Eds.), Handbook of autism and pervasive developmental disorders (3rd ed., pp. 606–627). Hoboken, NJ: Wiley.

    Google Scholar 

  • Pelphrey, K. A., Sasson, N. J., Reznick, J. S., Paul, G., Goldman, B. D., & Piven, J. (2002). Visual scanning of faces in autism. Journal of Autism and Developmental Disorders, 32, 249–261.

    Article  PubMed  Google Scholar 

  • Pierce, K., Müller, R.-A., Ambrose, J., Allen, G., & Courchesne, E. (2001). Face processing occurs outside the fusiform ‘face area’ in autism: Evidence from functional MRI. Brain, 124, 2059–2073.

    Article  PubMed  Google Scholar 

  • Pine, D. S. (2001). Affective neuroscience and the development of social anxiety disorder. Psychiatric Clinics of North America, 24, 689–705.

    Article  PubMed  Google Scholar 

  • Pine, D. S., Guyer, A. E., Goldwin, M., Towbin, K. A., & Leibenluft, E. (2008). Autism spectrum disorder scale scores in pediatric mood and anxiety disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 652–661.

    Article  PubMed  Google Scholar 

  • Rapee, R. M., & Heimberg, R. G. (1997). A cognitive-behavioral model of anxiety in social phobia. Behaviour Research and Therapy, 38, 741–756.

    Article  Google Scholar 

  • Rapee, R. M., & Spence, S. H. (2004). The etiology of social phobia: Empirical evidence and an initial model. Clinical Psychology Review, 24, 737–767.

    Article  PubMed  Google Scholar 

  • Reaven, J. A. (2009). Children with high-functioning autism spectrum disorders and co-occurring anxiety symptoms: Implications for assessment and treatment. Journal for Specialists in Pediatric Nursing, 14, 192–199.

    Article  PubMed  Google Scholar 

  • Rodebaugh, T. L. (2009). Social phobia and perceived friendship quality. Journal of Anxiety Disorders, 23, 872–878.

    Article  PubMed  Google Scholar 

  • Ruscio, A., Brown, T., Chiu, W., Sareen, J., Stein, M., & Kessler, R. (2008). Social fears and social phobia in the USA: Results from the National Comorbidity Survey Replication. Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences, 38, 15–28.

    Article  Google Scholar 

  • Schlenker, B. R., & Leary, M. R. (1985). Social anxiety and communication about the self. Journal of Language and Social Psychology, 4, 171–192.

    Article  Google Scholar 

  • Schneider, B. (2009). An observational study of the interactions of socially withdrawn/anxious early adolescents and their friends. Journal of Child Psychology and Psychiatry, 50, 799–806.

    Article  PubMed  Google Scholar 

  • Schneider, B. H., & Tessier, N. G. (2007). Close friendship as understood by socially withdrawn, anxious early adolescents. Child Psychiatry and Human Development, 38, 339–351.

    Article  PubMed  Google Scholar 

  • Schneier, F. R. (2005). Neurobiological mechanisms of social anxiety disorder. CNS Spectrums, 10, 8–9.

    Google Scholar 

  • Senju, A., & Johnson, M. H. (2009). Atypical eye contact in autism: Models, mechanisms and development. Neuroscience and Biobehavioral Reviews, 33, 1204–1214.

    Article  PubMed  Google Scholar 

  • Silverman, W. K., Saavedra, L. M., & Pina, A. P. (2001). Test-retest reliability of anxiety symptoms and diagnoses. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 937–944.

    Article  PubMed  Google Scholar 

  • Simonian, S. J., Beidel, D. C., Turner, S. M., Berkes, J. L., & Long, J. H. (2001). Recognition of facial affect by children and adolescents diagnosed with social phobia. Child Psychiatry and Human Development, 32, 137–145.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Sofronoff, K., Attwood, T., & Hinton, S. (2005). A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. Journal of Child Psychology and Psychiatry, 46, 1152–1160.

    Article  PubMed  Google Scholar 

  • Spokas, M., Luterek, J. A., & Heimberg, R. G. (2009). Social anxiety and emotional suppression: The mediating role of beliefs. Journal of Behavior Therapy and Experimental Psychiatry, 40, 283–291.

    Article  PubMed  Google Scholar 

  • Stein, M. B., Chavira, D. A., & Jang, K. L. (2001). Bringing up bashful baby: Developmental pathways to social phobia. The Psychiatric Clinics of North America, 24, 661–675.

    Article  PubMed  Google Scholar 

  • Stein, M. B., & Stein, D. J. (2008). Social anxiety disorder. Lancet, 371, 1115–1125.

    Article  PubMed  Google Scholar 

  • Stel, M., van den Heuvel, C., & Smeets, R. C. (2008). Facial feedback mechanisms in autistic spectrum disorders. Journal of Autism and Developmental Disorders, 38, 1250–1258.

    Article  PubMed  Google Scholar 

  • Strahan, E., & Conger, A. J. (1998). Social anxiety and its effects on performance and perception. Journal of Anxiety Disorders, 12, 293–305.

    Article  PubMed  Google Scholar 

  • Strand, P. S., Cerna, S., & Downs, A. (2008). Shyness and emotion-processing skills in preschoolers: A 6-month longitudinal study. Infant and Child Development, 17, 109–120.

    Article  Google Scholar 

  • Sutton, S. K., Burnette, C. P., Mundy, P. C., Meyer, J., Vaughan, A., Sanders, C., et al. (2005). Resting cortical brain activity and social behavior in higher functioning children with autism. Journal of Child Psychology and Psychiatry, 46, 211–222.

    Article  PubMed  Google Scholar 

  • Tantam, D., Monaghan, L., Nicholson, H., & Stirling, J. (1989). Autistic children’s ability to interpret faces-a research note. Journal of Child Psychology and Psychiatry and Allied Disciplines, 30, 623–630.

    Article  Google Scholar 

  • Thompson, S., & Rapee, R. M. (2002). The effect of situational structure on the social performance of socially anxious and non-anxious participants. Journal of Behavior Therapy and Experimental Psychiatry, 33, 91–102.

    Article  PubMed  Google Scholar 

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

    Article  PubMed  Google Scholar 

  • Turner, R. A., Altemus, M., Enos, T., Cooper, B., & McGuinness, T. (1999). Preliminary research on plasma oxytocin in normal cycling women: Investigating emotion and interpersonal distress. Psychiatry: Interpersonal and Biological Processes, 62, 97–113.

    Google Scholar 

  • Vrijsen, J. N., Lange, W., Becker, E. S., & Rinck, M. (2010). Socially anxious individuals lack unintentional mimicry. Behaviour Research and Therapy, 48, 561–564.

    Article  PubMed  Google Scholar 

  • Weisbrot, D. M., Gadow, K. D., DeVincent, C. J., & Pomeroy, J. (2005). The presentation of anxiety in children with pervasive developmental disorders. Journal of Child and Adolescent Psychopharmacology, 15, 477–496.

    Article  PubMed  Google Scholar 

  • White, S., Hill, E., Happé, F., & Frith, U. (2009a). Revisiting the strange stories: Revealing mentalizing impairments in autism. Child Development, 80, 1097–1117.

    Article  PubMed  Google Scholar 

  • White, S. W., Oswald, D., Ollendick, T., & Scahill, L. (2009b). Anxiety in children and adolescents with autism spectrum disorders. Clinical Psychology Review, 29, 216–229.

    Article  PubMed  Google Scholar 

  • Wichman, C., Coplan, R. J., & Daniels, T. (2004). The social cognitions of socially withdrawn children. Social Development, 13, 377–392.

    Article  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. The Journal of Child Psychology and Psychiatry, 50, 224–234.

    Article  Google Scholar 

  • Yoon, K., & Zinbarg, R. E. (2008). Interpreting neutral faces as threatening is a default mode for socially anxious individuals. Journal of Abnormal Psychology, 117, 680–685.

    Article  PubMed  Google Scholar 

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Acknowledgments

We thank Marianne Barton and Kim Treadwell for assistance with revisions to the manuscript. We thank Marianne Barton, Deborah Fein, Inge-Marie Eigsti, Lauren Herlihy, Kelley Knoch, and Eva Troyb for their ideas and suggestions for an early version of the paper.

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Correspondence to Katherine E. Tyson.

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Tyson, K.E., Cruess, D.G. Differentiating High-Functioning Autism and Social Phobia. J Autism Dev Disord 42, 1477–1490 (2012). https://doi.org/10.1007/s10803-011-1386-7

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