Exploring the relationship between anxiety and social functioning in youth with autism spectrum disorder

Recent systematic reviews and meta-analyses reveal that psychiatric comorbidities are highly prevalent in youth with Autism Spectrum Disorder (ASD), particularly anxiety disorders. Given the high prevalence of anxiety among this population, recent research has focused on investigating potential mechanisms underpinning anxiety. The purpose of the current study was to examine the relationship between anxiety and social functioning in youth with ASD as well as the moderating influence of sex, age, and IQ. The current study involved secondary data analysis, using data from the Simons Simplex Collection (SSC) dataset of the Simons Foundation for Autism Research Initiative (SFARI). The sample included 2,856 individuals aged 4 to 18. Overall, anxiety rates were around 38% in this population and similar across parent and teacher reports. Based on both parent and teacher data, social functioning accounted for a substantial portion of the variance in anxiety, controlling for age, sex, and IQ (17% for parent report and 15% for teacher report). The addition of social functioning domains (social awareness, social cognition, social communication, social motivation, and restricted interests and repetitive behaviours) to the hierarchical regression models accounted for more of the variance in anxiety, controlling for age, sex, and IQ (24% for parent report and 27% for teacher report). All five social functioning domains were significant predictors of anxiety. For parent data, IQ was found to moderate the relationship between anxiety and social functioning, suggesting that when social functioning is low, youth without Intellectual Disability (ID) show higher anxiety than youth with ID. Limitations and future directions for the research are discussed. It is hoped that these results will assist in identifying at-risk youth and developing preventive therapeutic and school- based interventions.