Researchers at King’s College London have recently published data on how cognitive, emotional and sensory factors are associated with social anxiety in adolescents with autism. Hannah Pickard and colleagues studied 61 autistic adolescents and 62 neurotypical adolescents who had similarly high levels of anxiety. They collected information on mental health symptoms and several cognitive, emotional and sensory factors using child-reported and parent-reported questionnaires. They also gathered experimental data about interoceptive accuracy – the ability to identify one’s own internal body states – using a heartbeat tracking task.
Pickard et al. found that in both autistic and neurotypical adolescents, elevated social anxiety was associated with increased intolerance of uncertainty (IU), alexithymia, maladaptive emotion regulation strategies, sensory hypersensitivity and interoceptive sensibility (but not accuracy). They also found that in all adolescents, IU, alexithymia and sensory hypersensitivity mediated the relationship between autistic traits and social anxiety symptoms.
“With regards to the clinical implications, our findings suggest that interventions that focus on targeting specific mechanisms, for example intolerance of uncertainty or sensory difficulties, may be beneficial for alleviating social anxiety in autistic adolescents”, explains Pickard. “Furthermore, given that few differences emerged in the correlates associated with social anxiety in both groups, we suggest that adapting existing effective interventions used in neurotypical adolescents might be fruitful for alleviating social anxiety symptoms in autistic adolescents”.
Further research is now needed to better understand the causal mechanisms that contribute towards social anxiety in autism — an area of research that to date, has unfortunately been neglected.
Pickard, H., Hirsch, C., Simonoff, E. & Happé, F. (2020), Exploring the cognitive, emotional and sensory correlates of social anxiety in autistic and neurotypical adolescents. J. Child Psychol. Psychiatr. doi: 10.111/jcpp.13214.
Alexithymia: difficulty identifying and describing one’s own emotions.
Interoceptive sensibility: subjective awareness of one’s own internal body states.
Intolerance of uncertainty (IU): negative perception, interpretation, or experience of uncertainty.