22546
Threat Interpretation and Anxiety in Autistic Children and Their Mothers
Anxiety has been shown to be associated with cognitive biases such as negative interpretations of ambiguous situations in non-autistic individuals. Children on the autism spectrum often experience high levels of anxiety but well validated self-report measures of anxiety-related cognitions in this population are lacking.
Objectives:
We investigated for the first time the validity of an ambiguous scenarios interview, widely used in studies of anxiety in non-autistic children (Barrett et al., 1996; Creswell et al., 2014; Waite et al., 2015), with a group of autistic children. We also examined the relationship children’s interpretations had with their own and their mothers’ levels of anxiety.
Methods:
Twenty-six cognitively able children with autism, aged between 6 and 14 years, were presented with a series of 12 ambiguous scenarios such as: “You see the school principal walking around the playground and s/he has been asking other children where you are”. Children were asked how upset they would be in the situation (on a scale of 1-10) and offered a choice between a non-threatening and threatening interpretation of what was happening (coded 0 or 1). Eighteen mothers completed the same questions in regards to their autistic child. Typically developing children completed the same questions for comparison.
Children and mothers completed the Spence Children’s Anxiety Scale (SCAS). Mothers completed the Beck Anxiety Inventory.
Results:
Autistic children’s reports of how upset they perceived they would be in response to the 12 scenarios showed good internal consistency (α = .87) as did their threat interpretations (α = .80). Autistic children’s reports of how upset they perceived they would be in response to the scenarios showed a significant, positive association with their self-reported anxiety (r = .56, p =.01); but their threat interpretations did not (r = .21, p = .27). Mothers reported that autistic children would be significantly more upset (t (17) = 3.13, p =.01), and would perceive significantly more threat (t (17) = 2.53, p = .02) in the scenarios than autistic children self-reported. While maternal and self-reported child threat interpretations correlated significantly (r = .48, p = .046); reports of how upset children would be did not (r = .22, p = .38). In a multiple regression analysis, only mothers’ own anxiety (β = .86, p =.01), and not mothers’ reports of their children’s anxiety (β = -.05, p =.85), significantly predicted mothers’ reports of how upset children would be in the scenarios. There was a trend for children with autism to perceive greater levels of threat (M = 4.15; SD = 3.06) than a smaller group (N = 15) of typical children (M = 2.67; SD = 2.23; t (39) = 1.65, p = .11) across the 12 situations.
Conclusions:
The ambiguous scenarios interview is a viable tool for assessing threat-related cognitions in autistic children. Given evidence which suggests maternal expectations of children’s distress can promote the development of anxious cognitions in non-autistic children over time (Creswell et al., 2006), maternal cognitions, in addition to children’s cognitions, may prove useful targets for intervention.