Fears of Humiliation and Rejection Predict Aggressive Behavior In Children with HFASD

Background: The co-occurrence of social anxiety and aggression has been documented in HFASD (Farrugia & Hudson, 2006) but the nature of this relationship has not been empirically investigated. Many individuals with HFASD desire more peer interaction, but are more likely than their typically developing peers to be rejected (Sebastian et al., 2009), which may contribute to the development of fears of social humiliation and rejection (H/R fears).

Objectives: The objective was to examine the predictive value of H/R fears on aggressive behavior in children with HFASD compared to children with social anxiety disorder (SAD) without HFASD. Because social anxiety is inversely related to aggression in some individuals but positively related in others (Kashdan et al., 2009), and because we propose this pattern may be especially evident in HFASD, curvilinear relations between constructs were examined in both groups.

Methods: Participants were children and their parent(s) evaluated in a university-affiliated clinic. The HFASD sample (n = 20; 2 females) and the SAD sample (n = 20; 5 females) were comprised of children aged 7 to 15 without co-occurring intellectual disability. Self-reported H/R fears were measured with the Multidimensional Anxiety Scales for Children and mother-reported aggression was measured using the Child Behavior Checklist for Children.

Results: There were no significant differences in H/R fears between the groups; however, children with HFASD were significantly more aggressive. For the HFASD group, there was a significant curvilinear effect of H/R fears on aggression (b = .05, p < .05; F(3,15) = 4.39, p < .05), explaining 47% of the variance. For the SAD group, there was only a linear effect on aggression (b = -.24, p < .05), explaining 19% of the variance (F(2,17) = 3.77, p < .05).

Conclusions: Results suggest that clinically referred children with HFASD exhibit similar levels of H/R fears to children with SAD, but significantly more aggression. A moderate level of H/R fears predicted lower aggression in children with HFASD, whereas both relatively low and relatively high levels (borderline clinical) of such fears were associated with higher levels of aggressive behavior in these children. This may indicate an optimal level of concern about how one is viewed by peers in youth with HFASD; too little or too much social-evaluative anxiety may lead to problems with aggression This pattern is different from the inverse relationship between H/R fears and aggression in the SAD group.

References

Farrugia, S., & Hudson, J. (2006). Anxiety in adolescents with asperger syndrome:Negative thoughts, behavioral problems, and life interference. Focus on Autism and Other Developmental Disabilities, 21, 25-35.

Kashdan, T. B., McKnight, P. E., Richey, J. A., & Hofmann, S. G. (2009). When social anxiety disorder co-exists with risk-prone, approach behavior: Investigating a neglected, meaningful subset of people in the National Comorbidity Survey-Replication. Behaviour Research and Therapy, 47, 559–568.

Sebastian, C., Blakemore, S., & Charman, T. (2009). Reactions to ostracism in adolescents with autism spectrum conditions. Journal of Autism and Developmental Disorders, 39, 1122–1130.