Mediators Between Autistic Traits and Anxiety Symptoms in Young Adults: ARE There Specific Mediators for Different Anxiety Subtypes?

Background:  The positive association between anxiety and Autistic Spectrum Disorders (ASD), as well as autistic traits, has been well documented. However, less is known about whether - and which- social, communication or behavioral factors mediate this relationship. In addition, it is not known whether there may be specific mediators between autistic traits and certain anxiety subtypes or symptoms (i.e. social, generalized or obsessive-compulsive anxiety symptoms). 

Objectives:  This study extended earlier work by Rosbrook and Whittingham (2010) and attempted to validate parts of the theoretical model of anxiety in ASD proposed by Wood and Gadow (2010). Specifically, the role of five potential mediators (social problem-solving, teasing experiences, social competence, prevention from/punishment for preferred repetitive behaviors, and frequent aversive sensory experiences in daily life) in the relationship between autistic traits and anxiety symptoms was investigated in an undergraduate Singaporean student sample. Furthermore, this study explored whether some of these mediators were specific to certain types of anxiety symptoms only (i.e. social, generalized or obsessive-compulsive). 

Methods:  Taking a dimensional approach to understanding autistic traits, 252 undergraduate university students aged 18-29 years old (88 males) studying in Singapore completed twelve questionnaires that measured autistic traits, anxiety and depressive symptoms and the five examined mediators. Multiple mediation analyses were conducted using the bootstrapping method. 

Results:  A significant positive relationship was found between autistic traits and anxiety. Most of the examined mediators were significant for the total anxiety and depressive symptoms mediation models. Aversive sensory experiences were the strongest mediator across all anxiety and depressive symptom mediation models. Some mediators were specific to particular types of anxiety:only prevention from/punishment for preferred repetitive behaviors and frequent aversive sensory experiences mediated the relationship between autistic traits and generalized anxiety or obsessive-compulsive symptoms. Social competence had the largest mediation effect in social anxiety, but was not a significant mediator of total anxiety symptoms, generalized anxiety or OCD symptoms. Teasing experiences mediated the relationship between autistic traits and total or social anxiety as well as depression, but not generalized anxiety or OCD symptoms.

Conclusions:  Our findings are consistent with Rosbrook and Whittingham (2010) and provide some evidence for Wood and Gadow’s (2010) conceptualization of anxiety in ASD, although clearly these findings also need to be replicated with clinical samples. Supporting individuals with high autistic traits in managing aversive sensory experiences may lead to decreases in many anxiety symptoms. Our results also suggest that interventions for anxious and depressive symptomatology in individuals with high autistic traits may be more effective if they target relevant autism-related stressors alongside core anxiety symptoms (i.e. social competence and decreasing or preventing teasing in socially anxious individuals with high autistic traits; managing repetitive behaviors in those with high autistic traits and generalized anxiety or obsessive compulsive symptoms). Possible implications for understanding and managing anxiety in clinically diagnosed individuals with ASD as well as in those with diagnosed anxiety disorders without ASD are discussed.