Anxiety in Individuals with ASD: Prevalence, Phenomenology, Etiology, Assessment, and Interventions

Individuals with autism spectrum disorder (ASD) experience high levels of anxiety symptomatology with an estimated prevalence rate of anxiety disorders as high as 40 %. It is likely that anxiety is prominent in individuals with ASD throughout the life-span and that factors such as age, IQ, and ASD symptoms may influence the rates, symptoms, or anxiety subtypes. The high comorbidity rate of anxiety in ASD is likely to be explained by ASD deficits that make the individual more prone to develop anxiety disorders; however, diagnostic overlap may also partly explain the high rates of anxiety. In addition, there is some limited evidence that the same risk factors identified in the development and maintenance of anxiety disorders in typically developing children may also play a role in youth with ASD. Self-reports as well as other informant reports, physiological measures, and direct observations are likely to be useful in assessing anxiety in ASD. To date, cognitive-behavioral therapy appears to hold the most evidence in treating anxiety in individuals with ASD. Other psychosocial interventions (including mindfulness-based and social-recreational interventions) may also be considered, although evidence has only recently began to emerge and more work is needed to understand which ASD-specific modifications or adaptations are likely to be most helpful