Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis.
Social functioning and the presentation of anxiety in children on the autism spectrum: A multimethod, multiinformant analysis.
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DOI：
10.1037/abn0000724
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发表时间：
2022-03
期刊：
影响因子：
--
通讯作者：
Kerns, Connor M
中科院分区：
文献类型：
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作者：
Hunsche, Michelle C;Cervin, Matti;Storch, Eric A;Kendall, Philip C;Wood, Jeffrey J;Kerns, Connor M
自闭症谱系儿童中同时发生的焦虑与更大的社会挑战有关，包括较差的社交技能和关系，这可能会影响焦虑症状的严重程度和表现，特别是社交焦虑。目前的研究使用贝叶斯网络分析和多方法方法来检查（1）社会功能的不同方面如何相互关联以及与焦虑严重程度和合并症的关系;（2）哪些方面最有影响力，因此可能代表干预的最佳目标;以及（3）在一个大规模的寻求治疗的患有焦虑症的自闭症儿童的样本中，社会功能与社会恐惧的表现有何关系（n = 191，7-13岁）。结果表明，社会能力的衡量标准之间存在很强的关联（即，心理理论[ToM]、社会动机、友谊获得）和社会融合的测量（即，欺凌、人际和同伴困难），只有欺凌与焦虑有显着联系。心理理论是网络中相互联系最紧密的变量，社会动机与其他变量，特别是与社会能力的其他方面，表现出最强的个人联系。心理理论受损的社会焦虑儿童不太可能表达对负面评价的恐惧，从而导致社会恐惧的独特诊断表现。研究结果表明，社会动机和心理理论可能是自闭症儿童共同发生的焦虑干预的重要目标。此外，与自闭症相关的社会认知困难，例如ToM，可能在这些青少年的焦虑的不同表现中发挥了作用。患有焦虑症的自闭症儿童往往在社交技能方面遇到重大困难（例如，观点采择、社会交流）和人际关系（例如，友谊，欺凌），这些社会困难可能反过来影响焦虑，特别是社交焦虑，在这些青年中表达。这项研究表明，在社会福祉的一个领域有困难的自闭症儿童很可能有困难，在许多其他相关领域的社会福祉;特别是，儿童的观点采择能力更有限和/或较少的兴趣，在社会交往可能有更少的互惠友谊和更大的困难与社会沟通。研究结果还表明，观点采择能力的差异可能解释了自闭症患者社交焦虑的独特表现，即社交焦虑的儿童更难以理解他人的想法，感受和意图，可能会因为社交情境中的困惑和不确定性而变得焦虑，而不是害怕被评判（社交焦虑障碍诊断的关键标准）。
Co-occurring anxiety in children on the autism spectrum is associated with greater social challenges, including poorer social skills and relationships, which may influence the severity and presentation of anxiety symptoms, particularly social anxiety. The current study used Bayesian network analytics and a multi-method approach to examine (1) how different facets of social functioning relate to one another and to anxiety severity and comorbidity; (2) which facet(s) are most influential and thus may represent optimal targets for intervention; and (3) how social functioning relates to the presentation of social fears in a large treatment-seeking sample of autistic children with anxiety disorders (n = 191, 7-13 years). Results indicated strong associations among measures of social ability (i.e., theory of mind [ToM], social motivation, friendship attainment) and among measures of social integration (i.e., bullying, interpersonal and peer difficulties), with only bullying demonstrating a significant association with anxiety. ToM was the most interconnected variable in the network, and social motivation demonstrated the strongest individual connections with other variables, particularly with other facets of social ability. Socially anxious children with impaired ToM were less likely to express fears of negative evaluation, resulting in a distinct diagnostic presentation of social fears. Findings suggest that social motivation and ToM may represent important targets for intervention for autistic children with co-occurring anxiety. Further, social-cognitive difficulties associated with autism, like ToM, may play a role in distinct manifestations of anxiety in these youth. Autistic children with co-occurring anxiety disorders tend to experience significant difficulties with social skills (e.g., perspective-taking, social communication) and interpersonal relationships (e.g., friendships, bullying), and those social difficulties may in turn influence how anxiety, particularly social anxiety, is expressed in these youth. This study demonstrates that autistic children with difficulties in one area of social well-being are likely to have difficulties across many other, related areas of social well-being; in particular, children with more limited perspective-taking ability and/or less interest in social interaction are likely to have fewer reciprocal friendships and greater difficulty with social communication. Findings also suggest that differences in perspective-taking ability might explain a unique presentation of social anxiety in autistic individuals, whereby socially anxious children who have more difficulty understanding the thoughts, feelings and intentions of others might become anxious due to confusion and uncertainty in social situations rather than fear of being judged (the key criteria for a diagnosis of Social Anxiety Disorder).