Advanced search
Publication Cover
Expert Review of Neurotherapeutics Volume 15, 2015 - Issue 11
Submit an article Journal homepage
687
Views
19
CrossRef citations to date
0
Altmetric
Reviews

Anxiety in youth with autism spectrum disorders: implications for treatment

Carly JohncoDepartment of Pediatrics, University of South Florida, Tampa, FL, USACorrespondence[email protected]
&
Eric A. StorchDepartment of Pediatrics, University of South Florida, Tampa, FL, USA;Department of Psychology, University of South Florida, Tampa, FL, USA;Department of Psychiatry & Behavioral Neurosciences, University of South Florida, Tampa, FL, USA;Department of Health Policy and Management, University of South Florida, Tampa, FL, USA;Rogers Behavioral Health – Tampa Bay, Tampa, FL, USA;All Children’s Hospital – Johns Hopkins Medicine, St Petersburg, FL, USA
Pages 1343-1352 | Published online: 07 Nov 2015

References

  • Papers of special note have been highlighted as:
  • ** of considerable interest
  • CDC. Prevalence of autism spectrum disorder among children aged 8 years - Autism and Developmental Disabilities Monitoring Network, 11 sites, United States, MMWR 2014; 2010.
  • White SW, Oswald D, Ollendick T, et al. Anxiety in children and adolescents with autism spectrum disorders. Clin Psychol Rev. 2009;29(3):216–229.
  • Vasa R, Carroll L, Nozzolillo A, et al. A systematic review of treatments for anxiety in youth with autism spectrum disorders. J Autism Dev Disord. 2014;44(12):3215–3229.
  • de Bruin EI, Ferdinand RF, Meester S, et al. High rates of psychiatric co-morbidity in PDD-NOS. J Autism Dev Disord. 2007;37(5):877–886.
  • Simonoff E, Pickles A, Charman T, et al. Psychiatric disorders in children with autism spectrum disorders: prevalence, comorbidity, and associated factors in a population-derived sample. J Am Acad Child Adolesc Psychiatry. 2008;47(8):921–929.
  • van Steensel FA, Bögels S, Perrin S. Anxiety disorders in children and adolescents with autistic spectrum disorders: a meta-analysis. Clin Child Fam Psychol Rev. 2011;14(3):302–317.
  • American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington (VA): American Psychiatric Publishing; 2013.
  • Kerns CM, Kendall PC, Zickgraf H, et al. Not to be overshadowed or overlooked: functional impairments associated with comorbid anxiety disorders in youth with ASD. Behav Ther. 2015;46:29–39.
  • Rieske R, Matson J, May A, et al. Anxiety in children with high-functioning autism spectrum disorders: significant differences and the moderating effects of social impairments. J Dev Phys Disabil. 2012;24(2):167–180.
  • Ung D, Wood JJ, Ehrenreich-May J, et al. Clinical characteristics of high-functioning youth with autism spectrum disorder and anxiety.Neuropsychiatry.2013;3(2):147.
  • Cath DC, Ran N, Smit JH, et al. Symptom overlap between autism spectrum disorder, generalized social anxiety disorder and obsessive-compulsive disorder in adults: a preliminary case-controlled study. Psychopathology. 2008;41(2):101–110.
  • Farrugia S, Hudson J. Anxiety in adolescents with asperger syndrome: negative thoughts, behavioral problems, and life interference. Focus Autism Dev Disabl. 2006;21(1):25–35.
  • Zandt F, Prior M, Kyrios M. Repetitive behaviour in children with high functioning autism and obsessive compulsive disorder. J Autism Dev Disord. 2007;37(2):251–259.
  • Wood JJ, Gadow KD. Exploring the nature and function of anxiety in youth with autism spectrum disorders. Clin Psychol Sci Pract. 2010;17(4):281–292.
  • Kerns CM, Kendall PC. The presentation and classification of anxiety in autism spectrum disorder. Clin Psychol Sci Pract. 2012;19(4):323–347.

**Discusses the presentation of anxiety in youth with ASD and the potential independence and crossover of symptoms.

  • Bellini S. Social skill deficits and anxiety in high-functioning adolescents with autism spectrum disorders. Focus Autism Dev Disabl. 2004;19(2):78–86.
  • Bellini S. The development of social anxiety in adolescents with autism spectrum disorders. Focus Autism Dev Disabl. 2006;21(3):138–145.
  • Tantam D. Psychological disorder in adolescents and adults with asperger syndrome. Autism. 2000;4(1):47–62.
  • Muris P, Steerneman P, Merckelbach H, et al. Comorbid anxiety symptoms in children with pervasive developmental disorders. J Anxiety Disord. 1998;12(4):387–393.
  • Lewin A, Wood J, Gunderson S, et al. Phenomenology of comorbid autism spectrum and obsessive-compulsive disorders among children. J Dev Phys Disabil. 2011;23(6):543–553.
  • Ruta L, Mugno D, D’Arrigo VG, et al. Obsessive-compulsive traits in children and adolescents with Asperger syndrome. Eur Adolesc Psychiatry. 2010;19(1):17–24.
  • Rodgers J, Glod M, Connolly B, et al. The relationship between anxiety and repetitive behaviours in autism spectrum disorder. J Autism Dev Disord. 2012;42(11):2404–2409.
  • Green S, Ben-Sasson A. Anxiety disorders and sensory over-responsivity in children with autism spectrum disorders: is there a causal relationship? J Autism Dev Disord. 2010;40(12):1495–1504.
  • Whiteley P, Rodgers J, Shattock P. Feeding patterns in autism. Autism. 2000;4(2):207–211.
  • Matson JL, Fodstad JC. The treatment of food selectivity and other feeding problems in children with autism spectrum disorders. Res Autism Spectr Disord. 2009;3(2):455–461.
  • Walkup JT, Albano AM, Piacentini J, et al. Cognitive behavioral therapy, sertraline, or a combination in childhood anxiety. New Engl J Med. 2008;359(26):2753–2766.
  • Ipser JC, Stein DJ, Hawkridge S, et al. Pharmacotherapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2009;(3):CD005170.
  • Vasa RA, Mazurek MO. An update on anxiety in youth with autism spectrum disorders. Curr Opin Psychiatry. 2015;28(2):83–90.
  • Namerow L, Thomas P, Bostic JQ, et al. Use of citalopram in pervasive developmental disorders. J Dev Behav Pediatrics. 2003;24(2):104–108.
  • Couturier JL, Nicolson R. A retrospective assessment of citalopram in children and adolescents with pervasive developmental disorders. J Child Adolesc Psychopharmacol. 2002;12(3):243–248.
  • King BH, Hollander E, Sikich L, et al. Lack of efficacy of citalopram in children with autism spectrum disorders and high levels of repetitive behavior: citalopram ineffective in children with autism. Arch Gen Psychiatry. 2009;66(6):583–590.
  • Martin A, Koenig K, Anderson GM, et al. Low-dose fluvoxamine treatment of children and adolescents with pervasive developmental disorders: a prospective, open-label study. J Autism Dev Disord. 2003;33(1):77–85.
  • Hollander E, Phillips A, Chaplin W, et al. A placebo controlled crossover trial of liquid fluoxetine on repetitive behaviors in childhood and adolescent autism. Neuropsychopharmacology. 2005;30(3):582–589.
  • Williams K, Wheeler DM, Silove N, et al. Selective serotonin reuptake inhibitors (SSRIs) for autism spectrum disorders (ASD). Cochrane Database Syst Rev. 2010;(8):CD004677.
  • McCormick LH. Treatment with buspirone in a patient with autism. Arch Fam Med. 1997;6(4):368–370.
  • Buitelaar JK, van der Gaag RJ, van der Hoeven J. Buspirone in the management of anxiety and irritability in children with pervasive developmental disorders: results of an open-label study. J Clin Psychiatry. 1998;59(2):56–59.
  • Joshi G. An open-label trial of buspirone for the treatment of anxiety in youth with autism spectrum disorders. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine; 2000. [cited 2015 Sep 14]. Available from: https://clinicaltrials.gov/ct2/show/NCT01850355.
  • Reynolds S, Wilson C, Austin J, et al. Effects of psychotherapy for anxiety in children and adolescents: a meta-analytic review. Clin Psychol Rev. 2012;32(4):251–262.

**This systematic review and meta-analysis is one of the two most recent review papers that summarizes the current evidence base for cognitive behavioral therapy (CBT) for anxiety in children with autism spectrum disorder (ASD).

  • Ung D, Selles R, Small BJ, et al. A systematic review and meta-analysis of cognitive-behavioral therapy for anxiety in youth with high-functioning autism spectrum disorders. Child Psychiatry Hum Dev. 2015;46(4):533–547.
  • Kreslins A, Robertson AE, Melville C. The effectiveness of psychosocial interventions for anxiety in children and adolescents with autism spectrum disorder: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health. 2015;9(1):1.

**This systematic review and meta-analysis is one of the two most recent review papers that summarizes the current evidence base for CBT for anxiety in children with ASD.

  • Rotheram-Fuller E, MacMullen L. Cognitive-behavioral therapy for children with autism spectrum disorders. Psychol Sch. 2011;48(3):263–271.
  • Lang R, Regester A, Lauderdale S, et al. Treatment of anxiety in autism spectrum disorders using cognitive behaviour therapy: a systematic review. Dev Neurorehabil. 2010;13(1):53–63.
  • James AC, James G, Cowdrey FA, et al. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2015;2.
  • James AC, James G, Cowdrey FA, et al. Cognitive behavioural therapy for anxiety disorders in children and adolescents. Cochrane Database Syst Rev. 2013;(6):CD004690.

**This Cochrane review provides a comprehensive discussion of the literature examining CBT for anxiety in children and adolescents with ASD.

  • Sukhodolsky DG, Bloch MH, Panza KE, et al. Cognitive-behavioral therapy for anxiety in children with high-functioning autism: a meta-analysis. Pediatrics. 2013;132(5):e1341–1350.
  • Chalfant A, Rapee R, Carroll L. Treating anxiety disorders in children with high functioning autism spectrum disorders: a controlled trial. J Autism Dev Disord. 2007;37(10):1842–1857.
  • Ehrenreich-May J, Storch EA, Queen AH, et al. An open trial of cognitive-behavioral therapy for anxiety disorders in adolescents with autism spectrum disorders. Focus Autism Dev Disabil. 2014;29(3):145.
  • Fujii C, Renno P, McLeod B, et al. Intensive cognitive behavioral therapy for anxiety disorders in school-aged children with autism: a preliminary comparison with treatment-as-usual. School Ment Health. 2013;5(1):25–37.
  • Reaven J, Blakeley-Smith A, Culhane-Shelburne K, et al. Group cognitive behavior therapy for children with high-functioning autism spectrum disorders and anxiety: a randomized trial. J Psychol Psychiatry. 2012;53(4):410–419.
  • Wood JJ, Ehrenreich-May J, Alessandri M, et al. Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety: a randomized, controlled trial. Behav Ther. 2015;46:7–19.
  • McNally Keehn RH, Lincoln AJ, Brown MZ, et al. The coping cat program for children with anxiety and autism spectrum disorder: a pilot randomized controlled trial. J Autism Dev Disord. 2013;43(1):57–67.
  • Sofronoff K, Attwood T, Hinton S. A randomised controlled trial of a CBT intervention for anxiety in children with Asperger syndrome. J Psychol Psychiatry. 2005;46(11):1152–1160.
  • McConachie H, McLaughlin E, Grahame V, et al. Group therapy for anxiety in children with autism spectrum disorder. Autism Int J Res Pract. 2014;18(6):723.
  • White S, Ollendick T, Albano A, et al. Randomized controlled trial: multimodal anxiety and social skill intervention for adolescents with autism spectrum disorder. J Autism Dev Disord. 2013;43(2):382–394.
  • Ooi YP, Lam CM, Sung M, et al. Effects of cognitive-behavioural therapy on anxiety for children with high-functioning autistic spectrum disorders. Singapore Med J. 2008;49(3):215–220.
  • Ishikawa S-I, Okajima I, Matsuoka H, et al. Cognitive behavioural therapy for anxiety disorders in children and adolescents: a meta-analysis. Child Adolesc Ment Health. 2007;12(4):164–172.
  • Storch EA, Ehrenreich May J, Wood JJ, et al. Multiple informant agreement on the anxiety disorders interview schedule in youth with autism spectrum disorders. J Child Adolesc Psychopharmacol. 2012;22(4):292–299.
  • Grills AE, Ollendick TH. Multiple informant agreement and the anxiety disorders interview schedule for parents and children. J Am Acad Child Adolesc Psychiatry. 2003;42(1):30–40.
  • Lickel A, MacLean WE Jr., Blakeley-Smith A, et al. Assessment of the prerequisite skills for cognitive behavioral therapy in children with and without autism spectrum disorders. J Autism Dev Disord. 2012;42(6):992–1000.
  • Reaven J. The treatment of anxiety symptoms in youth with high-functioning autism spectrum disorders: developmental considerations for parents. Brain Res. 2011;1380:255–263.

**Discusses treatment adaptations and considerations for treatment anxiety in children with ASD.

  • Kendall PC, Hedtke KA. Cognitive-behavioral therapy for anxious children: therapist manual. Ardmore (PA): Workbook Publishing; 2006.
  • Rapee RM, Lyneham HJ, Schniering CA, et al. Cool kids child and adolescent anxiety program therapist manual. Sydney (Australia): Centre for Emotional Health, Macquarie University; 2006.
  • White SW, Albano AM, Johnson CR, et al. Development of a cognitive-behavioral intervention program to treat anxiety and social deficits in teens with high-functioning autism. Clin Child Fam Psychol Rev. 2010;13(1):77–90.
  • Reaven J, Blakeley-Smith A, Nichols S, et al. Facing your fears. Baltimore (MD): Paul H. Brookes Publishing Co.; 2011.
  • Wood JJ, Drahota A, Sze K, et al. Cognitive behavioral therapy for anxiety in children with autism spectrum disorders: a randomized, controlled trial. J Psychol Psychiatry. 2009;50(3):224–234.
  • Storch EA, Wood JJ, Kendall PC. Psychotherapy for anxiety in children with autism spectrum disorder. In: ClinicalTrials.gov [Internet]. Bethesda (MD): U.S. National Library of Medicine; 2000. [cited 2015 Sep 14]. Available from: https://ClinicalTrials.gov/show/NCT02028247
  • Reaven JA. Children with high-functioning autism spectrum disorders and co-occurring anxiety symptoms: implications for assessment and treatment. J Specialists Pediatr Nurs. 2009;14(3):192–199.
  • Reaven J, Hepburn S, Nichols S, et al. Coping group: fighting worry and facing fears: an unpublished treatment manual for children with ASD and anxiety disorder. Unpublished manuscript, University of Colorado at Denver and Health Sciences Center, 2005.
  • Moree BN, Davis Iii TE. Cognitive-behavioral therapy for anxiety in children diagnosed with autism spectrum disorders: modification trends. Res Autism Spectr Disord. 2010;4(3):346–354.

**Discusses treatment adaptations and modification trends for CBT treatment for anxiety in children with ASD.

  • Jackson HJ. Current trends in the treatment of phobias in autistic and mentally retarded persons. Aust N Z J Dev Disabil. 1983;9(4):191–208.
  • Reaven JA, Blakeley-Smith A, Nichols S, et al. Cognitive-behavioral group treatment for anxiety symptoms in children with high-functioning autism spectrum disorders: a pilot study. Focus Autism Dev Disabil. 2009;24(1):27.
  • Chalfant A, Lyneham H, Rapee R, et al. Cool kids child anxiety program: autism spectrum disorder adaptation. Sydney (Australia): Center for Emotional Health, Macquarie University; 2011.
  • Creed TA, Kendall PC. Therapist alliance-building behavior within a cognitive-behavioral treatment for anxiety in youth. J Consult Clin Psychol. 2005;73(3):498–505.
  • Beidas RS, Benjamin CL, Puleo CM, et al. Flexible applications of the coping cat program for anxious youth. Cogn Behav Pract. 2010;17(2):142–153.
  • Kendall PC, Gosch E, Furr JM, et al. Flexibility within fidelity. J Am Acad Child Adolesc Psychiatry. 2008;47(9):987–993.
  • Rao P, Beidel D, Murray M. Social skills interventions for children with asperger’s syndrome or high-functioning autism: a review and recommendations. J Autism Dev Disord. 2008;38(2):353–361.
  • Jasmin E, Couture M, McKinley P, et al. Sensori-motor and daily living skills of preschool children with autism spectrum disorders. J Autism Dev Disord. 2009;39(2):231–241.
  • Liss M, Harel B, Fein D, et al. Predictors and correlates of adaptive functioning in children with developmental disorders. J Autism Dev Disord. 2001;31(2):219–230.
  • Carter A, Volkmar F, Sparrow S, et al. The vineland adaptive behavior scales: supplementary norms for individuals with autism. J Autism Dev Disord. 1998;28(4):287–302.
  • Kanne S, Gerber A, Quirmbach L, et al. The role of adaptive behavior in autism spectrum disorders: implications for functional outcome. J Autism Dev Disord. 2011;41(8):1007–1018.
  • Szatmari P, Archer L, Fisman S, et al. Asperger’s syndrome and autism: differences in behavior, cognition, and adaptive functioning. J Am Acad Child Adolesc Psychiatry. 1995;34(12):1662–1671.
  • Smith LE, Maenner MJ, Seltzer MM. Developmental trajectories in adolescents and adults with autism: the case of daily living skills. J Am Acad Child Adolesc Psychiatry. 2012;51(6):622–631.
  • Gillham JE, Carter AS, Volkmar FR, et al. Toward a developmental operational definition of autism. J Autism Dev Disord. 2000;30(4):269–278.
  • Drahota A, Wood JJ, Sze KM, et al. Effects of cognitive behavioral therapy on daily living skills in children with high-functioning autism and concurrent anxiety disorders. J Autism Dev Disord. 2011;41(3):257–265.
  • Thulin U, Svirsky L, Serlachius E, et al. The effect of parent involvement in the treatment of anxiety disorders in children: a meta-analysis. Cogn Behav Ther. 2014;43(3):185–200.
  • Manassis K, Lee TC, Bennett K, et al. Types of parental involvement in CBT with anxious youth: a preliminary meta-analysis. J Consult Clin Psychol. 2014;82(6):1163–1172.
  • Barrett PM, Dadds MR, Rapee RM. Family treatment of childhood anxiety: a controlled trial. J Consult Clin Psychol. 1996;64(2):333–342.
  • Greenberg JS, Seltzer MM, Hong J, et al. Bidirectional effects of expressed emotion and behavior problems and symptoms in adolescents and adults with autism. Am J Ment Retard. 2006;111(4):229–249.
  • Reaven J, Hepburn S. The parent’s role in the treatment of anxiety symptoms in children with high-functioning autism spectrum disorders. Ment Health Asp Dev Disabil. 2006;9:73–80.
  • Kannis L, Chambers R. Safety seeking behaviours: A review and reflection from a specialist anxiety treatment centre. Acparian. 2013;(5):7–10.
  • Schmidt NB, Woolaway-Bickel K, Trakowski J, et al. Dismantling cognitive–behavioral treatment for panic disorder: questioning the utility of breathing retraining. J Consult Clin Psychol. 2000;68(3):417–424.
  • Salkovskis PM. The importance of behaviour in the maintenance of anxiety and panic: a cognitive account. Behav Cogn Psychother. 1991;19(01):6–19.
  • Konstantareas MM, Stewart K. Affect regulation and temperament in children with autism spectrum disorder. J Autism Dev Disord. 2006;36(2):143–154.
  • Johnco C, Wuthrich VM, Rapee RM. The role of cognitive flexibility in cognitive restructuring skill acquisition among older adults. J Anxiety Disord. 2013;27(6):576–584.
  • Johnco C, Wuthrich VM, Rapee RM. The impact of late-life anxiety and depression on cognitive flexibility and cognitive restructuring skill acquisition. Depress Anxiety. 2015;32(10):754–762.
  • Hollocks MJ, Jones CRG, Pickles A, et al. The association between social cognition and executive functioning and symptoms of anxiety and depression in adolescents with autism spectrum disorders. Autism Res Off J Int Soc Autism Res. 2014;7(2):216.
  • Guillon Q, Hadjikhani N, Baduel S, et al. Visual social attention in autism spectrum disorder: insights from eye tracking studies. Neurosci Biobehav Rev. 2014;42:279–297.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Order Reprints Request Corporate Permissions

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

Request Academic Permissions

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.

Related research

People also read lists articles that other readers of this article have read.

Recommended articles lists articles that we recommend and is powered by our AI driven recommendation engine.

Cited by lists all citing articles based on Crossref citations.
Articles with the Crossref icon will open in a new tab.