Social Competence Predicts Anxiety Symptoms in Girls but Not Boys with ASD

Background: Children and adolescents with ASD have an estimated 39.6% prevalence rate of anxiety disorders (van Steensel, Bogels, & Perrin, 2011), much higher than the general population. Poor social functioning is related to increased anxiety in youth with and without ASD (Kerns et al., 2015; Settipani & Kendall, 2013). Recently, Johnston and Iarocci (2017) found that more internalizing symptoms (i.e., depression and generalized anxiety) were related to lower social competence in youth with and without ASD; however, gender differences were not possible to examine. Girls are more socially competent and have higher anxiety than boys (Crocetti et al., 2015; Dunsmore et al., 2008). Gender differences in social competence and anxiety in ASD may be especially helpful in understanding the difference in symptom profile between boys and girls with ASD

Objectives: The objective of the current study was to examine the relations between anxiety symptoms and social competence in girls, as compared to boys, with and without ASD.

Methods: Four hundred and eighty-four youth (ages 6-14), all with IQ>80, and their parents were included in this study. Parents completed the Behaviour Assessment System for Children (BASC-2; Kamphaus & Reynolds, 2004) and the Multidimensional Social Competence Scale (MSCS; Yager & Iarocci, 2013). The BASC provides an anxiety T-score and the MSCS provides an overall rating of social competence. Four groups were established using gender and diagnostic status: TD girls (n=108, mean age=9.41, mean IQ=113.07), ASD girls (n=42, mean age=9.87, mean IQ=108.45), TD boys (n=153, mean age=9.31, mean IQ=109.4), and ASD boys (n=181, mean age=9.91, mean IQ=104.9).

Results: Separate hierarchical multiple regressions were conducted for ASD and TD groups for each gender, with IQ and age included in the first block, MSCS total score included in the second block, and the anxiety subscale T-score of the BASC-2 as the dependent variable. Significant positive correlations were found between IQ and MSCS scores in girls in both groups (TD: r=.23, p=.007; ASD: r=.381, p=.006), and between age and anxiety T-scores for TD boys (r= .141, p=.042). A significant negative correlation was found between anxiety T-scores and MSCS total scores in girls with ASD (r=-.496, p<.001). No significant prediction was found for IQ, age, or MSCS scores for TD girls, TD boys, or ASD boys. However, the MSCS had significant predictive value for anxiety among girls with ASD (∆R2=.294, p<.001).

Conclusions: The results are consistent with previous research indicating that poorer social competence predicts greater anxiety symptoms in youth with ASD; however, this effect was only found in girls with ASD. These results indicate that poorer social competence predicts greater anxiety symptoms in girls with ASD, but not boys with ASD or typically developing youth. This suggests there may be important differences between these groups, such that deficits in social competence may have a greater effect on the mental health of girls with ASD compared to their same-gender TD peers and boys with and without ASD. Implications for future research will be discussed.